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1.
Cell ; 181(4): 749-753, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32413294

RESUMO

In 1991, Buck and Axel published a landmark study in Cell for work that was awarded the 2004 Nobel Prize. The identification of the olfactory receptors as the largest family of GPCRs catapulted olfaction into mainstream neurobiology. This BenchMark revisits Buck's experimental innovation and its surprising success at the time.


Assuntos
Receptores Odorantes/metabolismo , Olfato/fisiologia , Distinções e Prêmios , História do Século XX , Humanos , Neurobiologia , Prêmio Nobel , Neurônios Receptores Olfatórios , Receptores Acoplados a Proteínas G/metabolismo
2.
Neuroimage ; 292: 120613, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38631616

RESUMO

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.


Assuntos
Drama , Imageamento por Ressonância Magnética , Princípios Morais , Punição , Humanos , Feminino , Punição/psicologia , Adulto , Adulto Jovem , Sincronização Cortical/fisiologia , Empatia/fisiologia , Córtex Cerebral/fisiologia , Córtex Cerebral/diagnóstico por imagem , Narração
3.
Hippocampus ; 34(8): 438-451, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39016331

RESUMO

Studies of the impact of brain injury on memory processes often focus on the quantity and episodic richness of those recollections. Here, we argue that the organization of one's recollections offers critical insights into the impact of brain injury on functional memory. It is well-established in studies of word list memory that free recall of unrelated words exhibits a clear temporal organization. This temporal contiguity effect refers to the fact that the order in which word lists are recalled reflects the original presentation order. Little is known, however, about the organization of recall for semantically rich materials, nor how recall organization is impacted by hippocampal damage and memory impairment. The present research is the first study, to our knowledge, of temporal organization in semantically rich narratives in three groups: (1) Adults with bilateral hippocampal damage and severe declarative memory impairment, (2) adults with bilateral ventromedial prefrontal cortex (vmPFC) damage and no memory impairment, and (3) demographically matched non-brain-injured comparison participants. We find that although the narrative recall of adults with bilateral hippocampal damage reflected the temporal order in which those narratives were experienced above chance levels, their temporal contiguity effect was significantly attenuated relative to comparison groups. In contrast, individuals with vmPFC damage did not differ from non-brain-injured comparison participants in temporal contiguity. This pattern of group differences yields insights into the cognitive and neural systems that support the use of temporal organization in recall. These data provide evidence that the retrieval of temporal context in narrative recall is hippocampal-dependent, whereas damage to the vmPFC does not impair the temporal organization of narrative recall. This evidence of limited but demonstrable organization of memory in participants with hippocampal damage and amnesia speaks to the power of narrative structures in supporting meaningfully organized recall despite memory impairment.


Assuntos
Amnésia , Hipocampo , Rememoração Mental , Humanos , Hipocampo/patologia , Hipocampo/diagnóstico por imagem , Hipocampo/fisiopatologia , Rememoração Mental/fisiologia , Masculino , Feminino , Pessoa de Meia-Idade , Amnésia/fisiopatologia , Amnésia/patologia , Amnésia/psicologia , Adulto , Narração , Idoso , Testes Neuropsicológicos , Fatores de Tempo , Córtex Pré-Frontal/patologia , Córtex Pré-Frontal/fisiopatologia , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/lesões
4.
Cancer Control ; 31: 10732748241237328, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38454302

RESUMO

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.


Assuntos
Sobreviventes de Câncer , Neoplasias , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Masculino , Adolescente , Criança , Humanos , Projetos Piloto , Vacinas contra Papillomavirus/uso terapêutico , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Intenção , Neoplasias/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde
5.
Psychophysiology ; : e14642, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38961524

RESUMO

Narratives are effective tools for evoking emotions, and physiological measurements provide a means of objectively assessing emotional reactions - making them a potentially powerful pair of tools for studying emotional processes. However, extent research combining emotional narratives and physiological measurement varies widely in design and application, making it challenging to identify previous work, consolidate findings, and design effective experiments. Our scoping review explores the use of auditory emotional narratives and physiological measures in research, examining paradigms, study populations, and represented emotions. Following the PRISMA-ScR Checklist, we searched five databases for peer-reviewed experimental studies that used spoken narratives to induce emotion and reported autonomic physiological measures. Among 3466 titles screened and 653 articles reviewed, 110 studies were included. Our exploration revealed a variety of applications and experimental paradigms; emotional narratives paired with physiological measures have been used to study diverse topics and populations, including neurotypical and clinical groups. Although incomparable designs and sometimes contradictory results precluded general recommendations as regards which physiological measures to use when designing new studies, as a whole, the body of work suggests that these tools can be valuable to study emotions. Our review offers an overview of research employing narratives and physiological measures for emotion study, and highlights weaknesses in reporting practices and gaps in our knowledge concerning the robustness and specificity of physiological measures as indices of emotion. We discuss study design considerations and transparent reporting, to facilitate future using emotional narratives and physiological measures in studying emotions.

6.
Conserv Biol ; 38(3): e14285, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38686632

RESUMO

Most protected area impact research that uses counterfactuals draws heavily on quantitative methods, data, and knowledge types, making it valuable in producing generalizations but limited in temporal scope, historical detail, and habitat diversity and coverage of ecosystem services. We devised a methodological pluralistic approach, which supports social science qualitative methods, narratives, mixed methods, and interdisciplinarity, to fully unlock the potential of counterfactuals in ensuring a place-based and detailed understanding of the socioecological context and impacts of protected areas. We applied this approach to derive possible counterfactual conditions for the impact of a montane protected area on 40 years of vegetation change in the Cape Floristic Region-a global biodiversity hotspot and UNESCO World Heritage Site in South Africa. We incorporated diverse methods, knowledge, and information sources, drawing on before-after protected area comparisons for inside and outside the protected area. A significant increase in shrubland vegetation (17-30%) was observed and attributed primarily to a decline in frequent burning for grazing. This also occurred outside the protected area and was driven by socioeconomic drivers and not by concerns over biodiversity conservation or land degradation. Had the protected area not been established the area would have seen intensification of cultivation and increased road networks, buildings, and water storage in dams. Our approach increased historical temporal coverage of socioecological change and contextualized assumptions around causality. Protected area impact evaluation should reengage in place-based research that fully incorporates pluralism in methodologies for constructing counterfactuals in a way that builds regional and global understanding from the local level upward. We devised 10 key principles for deriving counterfactuals grounded in methodological pluralism, covering aspects of collaboration, cocreation, inter- and transdisciplinarity, diverse values and lived experiences, multiple knowledge types, multiple possible causal mechanisms, social science qualitative methods, perceptions, perspectives, and narratives.


Importancia del pluralismo metodológico en la derivación de situaciones contrafactuales para la conservación basada en evidencias Resumen La mayoría de las investigaciones sobre el impacto de las áreas protegidas que usan situaciones contrafactuales se basan en gran medida en métodos cuantitativos, datos y tipos de conocimiento, por lo que son muy valiosas para producir generalizaciones, pero limitadas en el enfoque temporal, el detalle histórico y la diversidad de hábitats y cobertura de los servicios ambientales. Diseñamos una estrategia metodológica pluralista, la cual apoya los métodos cualitativos de las ciencias sociales, narrativas, métodos mixtos e interdisciplinarios para utilizar por completo el potencial de las situaciones contrafactuales para asegurar un conocimiento detallado y basado en el lugar del contexto socio ecológico y el impacto de las áreas protegidas. Aplicamos esta estrategia para derivar las posibles condiciones contrafactuales del impacto de un área protegida montañosa sobre 40 años de cambio de vegetación en el reino florístico del Cabo ­ un punto caliente de biodiversidad y Sitio de Patrimonio Mundial de la UNESCO en Sudáfrica. Incorporamos varios métodos, conocimientos y fuentes de información a partir de las comparaciones antes­después dentro y fuera del área protegida. Observamos un incremento significativo en la vegetación del matorral (17­30%), el cual atribuimos principalmente en la disminución de la quema frecuente para el pastoreo. Esto también ocurrió fuera del área protegida y fue causado por factores socioeconómicos y no por preocupación por la conservación de la biodiversidad o por la degradación del suelo. De no haberse establecido el área protegida, la zona habría sufrido una intensificación de cultivos y un incremento de carreteras, edificios y almacenamiento de agua en presas. Nuestra estrategia incrementó la cobertura histórica temporal del cambio socio­ecológico y contextualizó las suposiciones sobre la causalidad. La evaluación del impacto del área protegida debe volver a la investigación basada en el lugar que incorpora de lleno el pluralismo en la metodología para construir situaciones contrafactuales de una forma que genere conocimiento regional y global a partir del nivel local y hacia arriba. Diseñamos diez principios clave para derivar las situaciones contrafactuales basados en el pluralismo metodológico, la cobertura de los aspectos de colaboración, creación conjunta, inter­ y transdisciplinariedad, valores diversos y experiencias vividas, varios tipos de conocimiento, diferentes mecanismos causales posibles, métodos cualitativos de las ciencias sociales, percepciones, perspectivas, historias y narrativas.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Conservação dos Recursos Naturais/métodos , África do Sul , Ecossistema
7.
Cereb Cortex ; 33(11): 7001-7014, 2023 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-36752641

RESUMO

Although we must experience our lives chronologically, storytellers often manipulate the order in which they relay events. How the brain processes temporal information while encoding a nonlinear narrative remains unclear. Here, we use functional magnetic resonance imaging during movie watching to investigate which brain regions are sensitive to information about time in a narrative and test whether the representation of temporal context across a narrative is more influenced by the order in which events are presented or their underlying chronological sequence. Results indicate that medial parietal regions are sensitive to cued jumps through time over and above other changes in context (i.e., location). Moreover, when processing non-chronological narrative information, the precuneus and posterior cingulate engage in on-the-fly temporal unscrambling to represent information chronologically. Specifically, days that are closer together in chronological time are represented more similarly regardless of when they are presented in the movie, and this representation is consistent across participants. Additional analyses reveal a strong spatial signature associated with higher magnitude jumps through time. These findings are consistent with prior theorizing on medial parietal regions as central to maintaining and updating narrative situation models, and suggest the priority of chronological information when encoding narrative events.


Assuntos
Mapeamento Encefálico , Encéfalo , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Lobo Parietal/diagnóstico por imagem , Sinais (Psicologia)
8.
Can J Psychiatry ; 69(5): 358-368, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38174363

RESUMO

OBJECTIVE: Responsible media reporting is an accepted strategy for preventing suicide. In 2015, suicide prevention experts launched a media engagement initiative aimed at improving suicide-related reporting in Canada; its impact on media reporting quality and suicide deaths is unknown. METHOD: This pre-post observational study examined changes in reporting characteristics in a random sample of suicide-related articles from major publications in the Greater Toronto Area (GTA) media market. Articles (n = 900) included 450 from the 6-year periods prior to and after the initiative began. We also examined changes in suicide counts in the GTA between these epochs. We used chi-square tests to analyse changes in reporting characteristics and time-series analyses to identify changes in suicide counts. Secondary outcomes focused on guidelines developed by media professionals in Canada and how they may have influenced media reporting quality as well as on the overarching narrative of media articles during the most recent years of available data. RESULTS: Across-the-board improvement was observed in suicide-related reporting with substantial reductions in many elements of putatively harmful content and substantial increases in all aspects of putatively protective content. However, overarching article narratives remained potentially harmful with 55.2% of articles telling the story of someone's death and 20.8% presenting an other negative message. Only 3.6% of articles told a story of survival. After controlling for potential confounders, a nonsignificant numeric decrease in suicide counts was identified after initiative implementation (ω = -5.41, SE = 3.43, t = 1.58, p = 0.12). CONCLUSIONS: We found evidence that a strategy to engage media in Canada changed the content of reporting, but there was only a nonsignificant trend towards fewer suicides. A more fundamental change in media narratives to focus on survival rather than death appears warranted.


Assuntos
Suicídio , Humanos , Canadá , Projetos de Pesquisa , Prevenção do Suicídio
9.
Artigo em Inglês | MEDLINE | ID: mdl-38740649

RESUMO

The present understanding of professional identity formation is problematic since it underrepresents minority physicians and potentially excludes their professional identity formation experiences. Rural physicians are expected to have similar underrepresented aspects as minority physicians because of their specific sociocultural contexts and consequent private-professional intersection, which lead to ethical complexities. Therefore, to bridge this research gap, we interviewed 12 early- to mid-career Japanese physicians working in rural areas and explored their experiences. Through a narrative analysis guided by Figured Worlds theory, we analysed the data by focusing on the vocabulary, expressions, and metaphors participants used to describe their experiences. A central theme emerged concerning how the rural physicians configurated their personal versus professional participation in their local communities. Further, their identity narratives varied regarding how they constructed their identities, rural communities, and relationships as well as their identity formation ideals and strategies to achieve them. Informed by 'Big Questions' concerning worldview framework, we delineated four identity narratives as prototypes to describe how they participated in their communities. These identity narratives provide a preliminary understanding of how diverse identity formation is for rural physicians. In addition, our findings exposed the current professional identity formation framework as potentially biased towards single forms of participation in monolithic communities, overlooking complicated forms of participation in multiple communities. We argue that applying frameworks and concepts to capture these multiple forms of participation as well as revisiting the 'discourse of integration' are necessary steps to overcome the limitation of the current understanding of professional identity formation.

10.
BMC Public Health ; 24(1): 1506, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38840086

RESUMO

BACKGROUND: Human papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol. METHODS: The study uses a two by three factorial design. A total of 1200 young adults in Texas, age 18-26 years, who have not been previously fully vaccinated against HPV will be randomly assigned to one of six conditions to receive: (1) standard CDC information about HPV vaccination (control); (2) video narratives about HPV vaccination; (3) written narratives about HPV vaccination; or (4-6) enhanced access to HPV vaccine combined with (4) standard CDC information, (5) video narratives, or (6) written narratives. The two primary outcomes are the rate of HPV vaccination initiation by 3-month follow-up and rate of HPV vaccination completion by 9-month follow-ups. We will determine the impact of the individual level intervention (i.e., persuasive narratives through video or written format), the systemic level intervention (i.e., enhanced access to HPV vaccines), and the combination of both levels, on HPV vaccination initiation and completion. We will also use purposive sampling to select participants to take part in semi-structured interviews/focus groups to better understand the mechanisms of the intervention. DISCUSSION: Recruitment and data collection began in March 2022. We expect to complete data collection by March 2026. We expect that narratives, enhanced access, and the combination of both will improve HPV vaccination initiation and completion rates among young adults. If proven successful, these individual- and system-level interventions can be easily disseminated in regions with low HPV vaccination rates to improve HPV vaccination, and ultimately decrease HPV-related cancer burden. TRIAL REGISTRATION: NCT05057312.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Texas , Adulto Jovem , Vacinas contra Papillomavirus/administração & dosagem , Infecções por Papillomavirus/prevenção & controle , Adolescente , Adulto , Feminino , Masculino , Promoção da Saúde/métodos , Vacinação/estatística & dados numéricos
11.
Proc Natl Acad Sci U S A ; 118(22)2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34031240

RESUMO

Storytelling is a distinctive human characteristic that may have played a fundamental role in humans' ability to bond and navigate challenging social settings throughout our evolution. However, the potential impact of storytelling on regulating physiological and psychological functions has received little attention. We investigated whether listening to narratives from a storyteller can provide beneficial effects for children admitted to intensive care units. Biomarkers (oxytocin and cortisol), pain scores, and psycholinguistic associations were collected immediately before and after storytelling and an active control intervention (solving riddles that also involved social interaction but lacked the immersive narrative aspect). Compared with the control group, children in the storytelling group showed a marked increase in oxytocin combined with a decrease in cortisol in saliva after the 30-min intervention. They also reported less pain and used more positive lexical markers when describing their time in hospital. Our findings provide a psychophysiological basis for the short-term benefits of storytelling and suggest that a simple and inexpensive intervention may help alleviate the physical and psychological pain of hospitalized children on the day of the intervention.


Assuntos
Comunicação , Hidrocortisona/metabolismo , Ocitocina/metabolismo , Dor/metabolismo , Saliva/metabolismo , Atenção , Biomarcadores/metabolismo , Criança , Pré-Escolar , Emoções , Feminino , Humanos , Masculino , Manejo da Dor
12.
Sociol Health Illn ; 46(3): 437-456, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37786367

RESUMO

Obstetric fistula is a life transforming event resulting in embodied biographical disruption. Survivors suffer myriad long-term physical and emotional consequences. This paper is an account of a narrative inquiry, conducted with 15 fistula survivors in North-central, Nigeria, who described how their identities had been transformed by their condition. A narrative therapeutic approach, using Frank's 'chaos, restitution and quest' typology, was used to map their recovery narratives. 'Chaos', described by Frank as the opposite of restitution, dominated, with women losing hope of recovery. Women's shift towards 'restitution' began with treatment, but inadequate health-care access often delayed this process. In their quest narratives, women's life and identify changes enabled them to derive meaning from their experience of obstetric fistula within the context of their own lives. The findings highlight socio-structural factors raising the risk of obstetric fistula, which in turn causes biographical disruption and hampers sufferers' treatment and recovery. Rehabilitation should include income-generating skills to bring succour to survivors, particularly those whose incontinence persists after repairs.


Assuntos
Fístula , Narração , Gravidez , Humanos , Feminino , Nigéria , Pesquisa Qualitativa
13.
J Adolesc ; 96(1): 152-166, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37859549

RESUMO

INTRODUCTION: Whether adolescents' routine disclosure to parents is voluntary is assumed but rarely assessed. Researchers also have not examined whether disclosure and lying are premeditated, occurring before rather than after disclosure or lying, and whether adolescents use a single strategy consistently rather than applying multiple strategies when deciding whether to disclose or lie about their activities. This study investigated these significant gaps in the literature and tested whether voluntariness (for disclosure), timing, consistency, and parental psychological control are associated with lessons learned from disclosure and lying. METHODS: Narrative interviews were conducted in 2014-2015 with 131 primarily middle-class, mostly White US early and middle adolescents and college students (M's = 12.74, 15.81, 20.41 years). Narrated disclosure and lying interviews were reliably coded for voluntariness, timing, consistency, and lessons learned. Parental psychological control was assessed using an online survey. RESULTS: Disclosure was primarily strategic or voluntary and less often involuntary. Lying occurred more often before the narrated event, whereas disclosure occurred more often after. Youth typically reported using other strategies besides the elicited one. Disclosing after was associated with lessons learned. Voluntary disclosure was associated with psychological growth, and psychological control was associated with negative self-lessons. CONCLUSIONS: Disclosure and lying are complex and nuanced, varying in their timing, consistency, and voluntariness. These features contribute to adolescents' meaning-make from disclosure and lying. The findings have implications for future research on disclosure and secrecy.


Assuntos
Comportamento do Adolescente , Revelação , Humanos , Adolescente , Comportamento do Adolescente/psicologia , Pais/psicologia , Confidencialidade , Relações Pais-Filho
14.
BMC Med Educ ; 24(1): 292, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38491363

RESUMO

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.


Assuntos
Educação em Farmácia , Medicina Narrativa , Estudantes de Medicina , Humanos , Singapura , Estudantes de Medicina/psicologia , Empatia , Pessoal de Saúde
15.
BMC Med Educ ; 24(1): 259, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38459537

RESUMO

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.


Assuntos
COVID-19 , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Faculdades de Medicina , Pandemias , Profissionalismo/educação , Atitude , COVID-19/epidemiologia
16.
J Clin Nurs ; 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822476

RESUMO

AIM: To explore patient and family narratives about their recognition and response to clinical deterioration and their interactions with clinicians prior to and during Medical Emergency Team (MET) activations in hospital. BACKGROUND: Research on clinical deterioration has mostly focused on clinicians' roles. Although patients and families can identify subtle cues of early deterioration, little research has focused on their experience of recognising, speaking up and communicating with clinicians during this period of instability. DESIGN: A narrative inquiry. METHODS: Using narrative interviewing techniques, 33 adult patients and 14 family members of patients, who had received a MET call, in one private and one public academic teaching hospital in Melbourne, Australia were interviewed. Narrative analysis was conducted on the data. RESULTS: The core story of help seeking for recognition and response by clinicians to patient deterioration yielded four subplots: (1) identifying deterioration, recognition that something was not right and different from earlier; (2) voicing concerns to their nurse or by family members on their behalf; (3) being heard, desiring a response acknowledging the legitimacy of their concerns; and (4) once concerns were expressed, there was an expectation of and trust in clinicians to act on the concerns and manage the situation. CONCLUSION: Clinical deterioration results in an additional burden for hospitalised patients and families to speak up, seek help and resolve their concerns. Educating patients and families on what to be concerned about and when to notify staff requires a close partnership with clinicians. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Clinicians must create an environment that enables patients and families to speak up. They must be alert to both subjective and objective information, to acknowledge and to act on the information accordingly. REPORTING METHOD: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting. PATIENT OR PUBLIC CONTRIBUTION: The consumer researcher was involved in design, data analysis and publication preparation.

17.
Qual Health Res ; 34(1-2): 48-60, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37918375

RESUMO

There is a growing acceptance that ADHD is a multi-dimensional disorder in which not all symptoms are associated with deficits or functional impairments. This article contributes to research on the positive aspects of the diagnosis, specifically understanding the positive aspects of living with ADHD. The empirical data was based on individual interviews and self-narratives of 10 young adults with ADHD. Narrative analysis was implemented when investigating their stories. The findings showed that challenges with the diagnosis were not necessarily stably occupied, and for some, the diagnosis was thought of as a benefit and something they would not have been without. Four stories highlighted particularly the context of positive aspects: (1) insight and strategies, (2) targeted efforts, (3) balanced energy, and (4) social skills. These aspects were correlated to both the individual's strengths as well as the strengths and support that could be related to their societal and cultural environment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adulto Jovem , Humanos , Adolescente , Narração
18.
J Cancer Educ ; 39(1): 96-102, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37978102

RESUMO

Black breast cancer survivors (BCS) in comparison with White BCS are more likely to experience suboptimal quality of life (QoL). QoL is a multi-dimensional concept that focuses on different aspects of well-being (e.g., emotional well-being). There is limited evidence on the perspectives and experiences of QoL (e.g., the influence of breast cancer on QoL) and the QoL concerns (e.g., negative perceptions of body appearance) among Black BCS. The purpose of this study was to explore the QoL experiences and QoL concerns of Black BCS. Primary data was collected in semi-structured interviews and analyzed using a thematic analysis. A narrative approach (detailed stories or life experiences of a small group of people) was used to better understand the research topic among the target group. Ferrell's Conceptual Framework on QoL in Breast Cancer was used to guide the development of the interview questions, codes, and themes. There were 10 Black BCS, averaging 58 years of age. Two coders achieved a moderate level of agreement (i.e., Kappa) of 0.77. Five major themes were identified: defining QoL (what QoL means to them), behavioral changes (e.g., altering behaviors due to cancer), phases of cancer (e.g., breast cancer diagnosis), QoL experiences and factors affecting QoL, and impactful statements from cancer survivors (other meaningful information shared by the participants). The survivors reported multiple QoL concerns and body image issues. The study findings warrant cancer education interventions or programs to address the relevant survivorship issues of Black BCS.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Feminino , Humanos , População Negra , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Qualidade de Vida , Sobreviventes/psicologia , Pessoa de Meia-Idade
19.
J Clin Psychol ; 80(4): 836-854, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37566386

RESUMO

BACKGROUND: Complex PTSD is a recent addition to the ICD-11 diagnostic system. AIMS: This case study describes the delivery of Skills Training in Affective and Interpersonal Regulation and Narrative Therapy (SNT), a flexible, multi-component therapy that addresses the symptoms of complex posttraumatic stress disorder. SNT balances interventions that address current-day stressors with those that reappraise the meaning of traumatic past events. This paper outlines 16 sessions of SNT with a 55-year-old gay man. DISCUSSION: The case analysis describes the ways in which SNT is relevant and effective in addressing the client's mulitple concerns. The skills work helped the client effectively  manage ongoing minority stress, discrimination, and micro-aggressions related to his identity as a gay man. Review and re-appraisal of his traumatic memories, which focused on the sudden death of his partner from AIDS along with discussion of events from his childhood that shaped his reactions to this loss, allowed the client to create a more integrated sense of self as well as a more compassionate view of himself. Implications regarding the relevance of SNT for sexual and gender minority individuals are discussed.


Assuntos
Terapia Narrativa , Minorias Sexuais e de Gênero , Transtornos de Estresse Pós-Traumáticos , Masculino , Humanos , Criança , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Comportamento Sexual , Estudos Longitudinais
20.
J Child Lang ; 51(2): 385-410, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37439209

RESUMO

The present study explored developmental differences in preschoolers' use of reported speech and internal state language in personal narratives. Three-, four-, and five-year-olds attending a laboratory preschool shared 204 stories about 'a time when you were happy/sad'. Stories were audio-recorded, transcribed, and coded for reported speech (direct, indirect, narrativized) and internal state language (cognitive states, total emotion terms, unique emotion terms). Personal narratives told by five-year-olds included more cognitive states and more narrativized speech than those told by three- and four-year-olds, even when accounting for children's vocabulary skills, and that reported speech (narrativized, direct) were positively correlated with cognitive state talk. These findings highlight distinct shifts in children's use of cognitive state talk and reported speech in personal narratives told at age five. Associations between reported speech and internal state language are both informed by and support Vygotsky's (1978) fundamental claim that psychological processes are socially mediated by language.


Assuntos
Desenvolvimento da Linguagem , Fala , Criança , Pré-Escolar , Humanos , Emoções , Vocabulário , Narração
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