[Relationships. Art-affined physicians, gifted artist patients and the debate on art from a psychiatric context after 1945]. / Beziehungsgeschichten. Kunstaffine Ärzt:innen, begabte Künstlerpatient:innen und die Debatte um Kunst aus psychiatrischem Kontext nach 1945.

BACKGROUND: In 1945 the artist and art collector J. Dubuffet coined the term Art brut for original works by psychiatric inmates that had been created outside of traditions and art movements. In the following decades these works were at the center of negotiation processes in which not only psychiatrists but also exhibition organizers, gallery owners etc. increasingly became involved. OBJECTIVE: Based on the evaluation of four exemplary pairs of psychiatrists and artist patients (H. Müller-Suur-P. Goesch; M. in der Beeck-E. Spießbach; J. Porret-Forel-A. Corbaz; L. Navratil-R. Limberger), this study explores the field of tension between art and psychiatry after 1945. MATERIAL AND METHODS: The results of the subproject "Normal#Crazy Art. Works from a Psychiatric Context between Diagnostics and Aesthetics after 1945" of the German Research Foundation (DFG) research group "Normal#Crazy" (FOR 3031) are based on the evaluation of archival material, estates, interviews with contemporary witnesses and contemporary media. RESULTS: It is shown that different attitudes of the psychiatrists towards "their" artist patients strongly influenced their entry into the art world. In this context, impulses from beyond psychiatry were important in order to expand purely diagnostic views of the works with other approaches. DISCUSSION: The renewed interest in the individual creativity of patients after 1945 can be understood as a reaction to their dehumanization under fascism and National Socialism; however, the focus on the pathologized personality of artist patients could obscure alternative perspectives on their art, just as the disposal of their works by psychiatrists could hinder their dissemination.

The outsider phenomenon and the need to belong.

The outsider phenomenon is an existential pathology interrelated with the need to belong. It is a group related experience that has developmental foundations. W. R. D. Fairbairn (1952), was one of the first psychoanalysts who systematically challenged Freudian theory, and located the human experience within social relationships. Fairbairn (1935) suggested that the family is the first social group, leading to affiliations with important groups external to the family. This paper extrapolates from Fairbairn's ideas about schizoid character, which is an interpersonal experience, to group experiences in a family and with identity groups. Fairbairn's notions about the unavoidable activation of schizoid processes may help us understand what makes the outsider experience so pervasive.

'You Are Kind of Like One of Us': Exploring Researcher Positioning in Studying Community-Based Health Promotion Interventions Among Social Housing Residents of Danish, Turkish and Pakistani Origin.

The practice of qualitative research demands reflexivity throughout the entire research process, with special attention directed towards researcher positioning. In this article, I explore how aspects and characteristics of my social situation positioned me contrary to my expectations regarding researcher positioning. I draw on individual interviews, focus group discussions and field notes about community-based health promotion interventions among residents of Danish, Turkish and Pakistani origin in a deprived social housing area in Denmark. Rather than insider-outsider positioning, the concept represented by the term 'halfie' unfolds the complexity of my researcher positioning: less minority ethnic than the residents of Turkish and Pakistani origin and less Danish than the residents of Danish origin, but similar to both, being a descendant of Sri Lankan Tamil origin brought up in a Danish social housing area. Finally, I present methodological and ethical implications of being a halfie in the context of qualitative health research.

A Reflexive Lens on Preparing and Conducting Semi-structured Interviews with Academic Colleagues.

In qualitative research, researchers often conduct semi-structured interviews with people familiar to them, but there are limited guidelines for researchers who conduct interviews to obtain curriculum-related information with academic colleagues who work in the same area of practice but at different higher education institutions. Using a pragmatic constructivist stance, we address the practicalities of conducting semi-structured interviews with fellow educators who work in the same area of professional practice, where the researcher has to address the dual roles of "insider" and "outsider" as well as that of researcher and participant. Interviewing academic colleagues offers a unique opportunity for rich data collection, but researchers should adopt a flexible conversational style during interviewing within research parameters and be acutely aware of their positionality and fluidity of roles. This article contributes to existing knowledge by drawing on the work of previous scholars in various areas of research and research methodology thereby offering a practical and theoretical perspective on conducting qualitative research interviewing in higher education institutions where the role of researcher and participant can become blurred. These guidelines and insights will also benefit researchers who conduct research with peers who work together in the same area of expertise, in similar contexts and with whom there are varying levels of working relationships.

Insider vs. outsider CEO and firm performance: Evidence from the Covid-19 pandemic.

We examine the connection between firm performance and a CEO's previous position (inside or outside the firm), using Covid-19 as an exogenous shock. Firms led by insider CEOs outperformed those led by outsider CEOs in terms of return on assets during the Covid-19 crisis period in 2020, but there was no performance differential in the period before the crisis. Additional tests indicate that outperformance under insider CEOs is observed in firms holding more cash and firms with a higher proportion of internally promoted non-CEO executives. These findings have important implications for boards of directors making CEO appointments.

Outsider Witness Groups as a Means of Professional Growth in Family Therapy Training: An Exploratory Qualitative Study.

This exploratory qualitative study examines the experiences and meanings associated with family therapy trainees' participation in the narrative practice of Outsider Witness Groups (OWG). At the Barcai Institute in Tel Aviv, we incorporate OWGs into our live clinical supervision courses. In some sessions, we offer the families undergoing therapy the opportunity to listen to the reflections of the group of trainees regarding what they witnessed during the session. Twenty-nine family therapy trainees participated in the study in five focus group interviews. Analysis of the interviews yielded four core themes regarding the trainees' experiences: (i) Exploring the stance of the therapist; (ii) The art of listening; (iii) Reflection on hierarchy and boundary setting; and (iv) Negotiating self-disclosure. The findings indicate that family therapy trainees stand to benefit significantly in their professional journey, development, and growth from integrating OWG practices into their training. OWG fosters the development of critical reflectivity in trainees, including the deconstruction of common and taken-for-granted assumptions. It also fosters practices related to family therapy, and perhaps also to therapy in general. The findings also suggest that taking part in OWGs during training may contribute to family therapy trainees' development of critical reflectivity as a means of introducing a more critical and political approach to therapy and developing their own preferred stories as therapists.

Este estudio exploratorio cualitativo analiza las experiencias y los significados asociados con la participación de practicantes de terapia familiar en la práctica narrativa con grupos de testigos externos (OWG; White, 2007). En el Barcai Institute de Tel Aviv, incorporamos grupos de testigos externos en nuestros cursos de supervisión clínica en vivo. En algunas sesiones, ofrecemos a las familias que están en terapia la oportunidad de escuchar las reflexiones del grupo de practicantes con respecto a lo que observaron durante la sesión. Veintinueve practicantes de terapia familiar participaron en el estudio en cinco entrevistas de grupos focales. Los análisis de las entrevistas arrojaron cuatro temas principales relativos a las experiencias de los practicantes: (a) el análisis de la postura del terapeuta; (b) el arte de escuchar; (c) la reflexión sobre la jerarquía y la fijación de límites; y (d) la negociación de la autorrevelación. Los resultados indican que los practicantes de terapia familiar salen ganando considerablemente en su recorrido, desarrollo y crecimiento profesional como consecuencia de la integración de las prácticas de grupos de testigos externos en su formación. Los grupos de testigos externos fomentan el desarrollo de la reflexividad crítica en los practicantes, incluida la deconstrucción de los supuestos comunes y dados por sentado. También promueven las prácticas relacionadas con la terapia familiar, y quizá también con la terapia en general. Los resultados también sugieren que formar parte de los grupos de testigos externos durante la formación puede contribuir al desarrollo de la reflexividad crítica de los practicantes de terapia familiar como forma de incorporar un enfoque más crítico y político de la terapia y desarrollar sus propias historias preferidas como terapeutas.

Behind the (Virtual) Mirror: Online Live Supervision in Couple and Family Therapy.

Online therapy and supervision, a rapidly rising practice in couple and family therapy, has been the subject of a growing body of literature. From its early days, family therapy training has included live supervision, which has typically been conducted by a supervisor and a team of trainees situated on the other side of a one-way mirror. With the outbreak of the COVID-19 global pandemic, we-the staff of supervisors at the Barcai Institute in Tel Aviv, Israel-were compelled to find solutions to continue meeting with clients and to provide supervision for family therapy trainees. To this end, we have shifted our live supervision courses ("practicums") to the virtual arena, adapting the popular application "Zoom" into what we call "PractiZoom." Based on over 100 PractiZoom sessions conducted between March and May 2020, involving 14 supervisors and 28 therapists-in-training and their clients, the article reflects on this pioneering online practicum for the online live supervision of therapists with geographically distributed participants. In this article, we outline our operational methods and adaptations for conducting live behind-the-mirror supervision online. Following a short theoretical background, we outline the process of online live supervision, discuss our reflections and those of our trainees on the challenges and possibilities it poses, and offer a number of preliminary conclusions and recommendations.

La terapia y la supervisión en línea, una práctica que está aumentando rápidamente en la terapia de pareja y familiar, ha sido tema de publicaciones crecientes. Desde sus primeros días, la capacitación en terapia familiar ha incluido la supervisión en vivo, que normalmente ha sido dirigida por un supervisor y un equipo de practicantes ubicados del otro lado de un vidrio de visión unilateral. En la medida de nuestro conocimiento, la bibliografía aún tiene que abordar la supervisión en línea en vivo que incluya una familia, un terapeuta, un supervisor y un equipo, todos en línea. Con el brote de la pandemia mundial de la COVID-19, nosotros─el personal de supervisores de Barcai Institute de Tel Aviv, Israel─nos vimos obligados a encontrar soluciones para continuar las reuniones con los pacientes y supervisar a los practicantes de terapia familiar. Con ese fin, hemos trasladado nuestros cursos de supervisión en vivo ("prácticas") al área virtual, adaptando la famosa aplicación "Zoom" a lo que nosotros llamamos "PractiZoom." Sobre la base de 100 sesiones en PractiZoom realizadas entre marzo y mayo de 2020, en las que participaron 14 supervisores y 28 terapeutas en prácticas y sus pacientes, el artículo reflexiona sobre esta práctica innovadora en línea para la supervisión en línea de terapeutas con participantes geográficamente dispersos. En este artículo, describimos nuestros métodos operativos y adaptaciones para llevar a cabo una supervisión en línea en vivo detrás del espejo. Después de un breve marco teórico, describimos el proceso de la supervisión en línea en vivo, debatimos nuestras reflexiones y las de nuestros practicantes sobre las dificultades y las posibilidades que plantea, y ofrecemos numerosas conclusiones y recomendaciones preliminares.

Authentication Protocol for Cloud Databases Using Blockchain Mechanism.

Cloud computing has made the software development process fast and flexible but on the other hand it has contributed to increasing security attacks. Employees who manage the data in cloud companies may face insider attack, affecting their reputation. They have the advantage of accessing the user data by interacting with the authentication mechanism. The primary aim of this research paper is to provide a novel secure authentication mechanism by using Blockchain technology for cloud databases. Blockchain makes it difficult to change user login credentials details in the user authentication process by an insider. The insider is not able to access the user authentication data due to the distributed ledger-based authentication scheme. Activity of insider can be traced and cannot be changed. Both insider and outsider user's are authenticated using individual IDs and signatures. Furthermore, the user access control on the cloud database is also authenticated. The algorithm and theorem of the proposed mechanism have been given to demonstrate the applicability and correctness.The proposed mechanism is tested on the Scyther formal system tool against denial of service, impersonation, offline guessing, and no replay attacks. Scyther results show that the proposed methodology is secure cum robust.

American Indian Researcher Perspectives on Qualitative Inquiry About and Within American Indian Communities.

It is presumed that Indigenous researchers are optimally positioned to conduct research about or within their own or other Indigenous communities. However, these researchers may still experience challenges, barriers, and distressing events that are important to identify. Qualitative inquiry may be a particularly vulnerable context for Indigenous researchers given the nature of data collection methods and an emphasis on researcher-participant relationships. This paper details the personal reflections of two American Indian (AI) researchers who carried out qualitative research focused on AI issues and/or communities. The first project examined undergraduate students' opinions of the use of AI imagery in the form of a race-based university mascot. The second was a study of the mental health needs of AI youth and families in an urban community. Several themes characterized both of their experiences and might be generalizable to others working in these contexts: (a) coping with racism and microaggressions; (b) the role and impact of identity politics; (c) community insider/outsider tension; and (d) managing personal distress associated with the research topics and process. These themes are discussed to illuminate ways that Indigenous researchers, engaged in research on Indigenous topics and/or with Indigenous communities, are challenged and affected by their work.

The ecology of cooperative breeding behaviour.

Ecology is a fundamental driving force for the evolutionary transition from solitary living to breeding cooperatively in groups. However, the fact that both benign and harsh, as well as stable and fluctuating, environments can favour the evolution of cooperative breeding behaviour constitutes a paradox of environmental quality and sociality. Here, we propose a new model - the dual benefits framework - for resolving this paradox. Our framework distinguishes between two categories of grouping benefits - resource defence benefits that derive from group-defended critical resources and collective action benefits that result from social cooperation among group members - and uses insider-outsider conflict theory to simultaneously consider the interests of current group members (insiders) and potential joiners (outsiders) in determining optimal group size. We argue that the different grouping benefits realised from resource defence and collective action profoundly affect insider-outsider conflict resolution, resulting in predictable differences in the per capita productivity, stable group size, kin structure and stability of the social group. We also suggest that different types of environmental variation (spatial vs. temporal) select for societies that form because of the different grouping benefits, thus helping to resolve the paradox of why cooperative breeding evolves in such different types of environments.

Enter as an outsider: Teaching organizational humility.

The concept of cultural humility acknowledges the enormous task of becoming culturally competent by encouraging curiosity about the context within which others live. For physicians, this includes curiosity about the organizations in which they work as Outsiders in settings such as a new hospital or patients' homes. However, efforts to train healthcare professionals in cultural competence are often de-emphasized due to the pressure learners feel to acquire Medical Knowledge and clinical skills. Little time is devoted to address the significance of cultural humility for fully appreciating the experiences of others. Efforts to educate physicians-in-training about the cultural aspects of care require innovative approaches that help them recognize bias without provoking defensiveness. Enter as an Outsider is a highly focused activity which fosters a culturally humble approach to an often neglected problem, organizational bias. This article describes how cultural humility is explained to learners and small group activities are used to explore the thoughts and feelings of an organization's Insiders and Outsiders. This program relies on instructor self-disclosure to facilitate learning and on a video vignette from popular-culture media to illustrate being an Outsider in a healthcare setting. Participants in this training have improved their ability to recognize when they are Outsiders where they provide care. They have developed a better understanding that cultural humility in organizations is a gateway to providing quality care. They have begun the process of committing to respectfully learn from the organization's Insiders.

Inside-Out: Representational Ethics and Diverse Communities.

The purpose of this paper is to write about insights and special considerations for researchers who are, to some degree, "insiders" to the communities they study by expanding on the concept of representational ethics as applied to research in community psychology with diverse and marginalized groups. Representational ethics refers to the ways that researchers, artists, or corporations represent the identities of the people they portray in their communications. As community psychologists we generate and disseminate knowledge about the communities we work with, and in that process, create narratives about the people who participate in our studies. In preparing a report on psychological issues among Evangelical Christian refugees from the former Soviet Union, Dina Birman struggled with her portrayal of this group and her own status of being both an insider and an outsider to this community. When investigating academic aspirations and psychological distress among Muslim high school students, Ashmeet Oberoi was forced to acknowledge the one-sidedness of the discourse on autonomy and cultural socialization of Muslim adolescents. In her research with Cuban-educated doctors in Miami, Florida, Wendy Moore encountered similar issues as she considered how to represent gender dynamics among her participants.

Delivering culturally sensitive, sexual health education in western Kenya: a phenomenological case study.

While generic programmes have been created to raise sexual health awareness, these cannot always be applied to communities whose cultures and circumstances make them especially vulnerable to infection. Taking a phenomenological approach, this paper examines the circumstances of the Gusii people of Kisii, Kenya, and examines the specific challenges of providing sexual health education to the community as experienced by an ethnic Gusii woman, Joyce Ombasa. Joyce's story reveals that the Gusii living in and around rural villages have several cultural characteristics that make them susceptible to HIV/AIDS and that render community health education problematic, especially if offered by a female educator of the same ethnicity. Women cannot teach men. Discussions of sex and condom use, and viewing the naked bodies of the opposite sex are taboo. Promiscuity is commonplace and there is a reluctance to use condoms and to undergo HIV testing. Female circumcision persists and there is a high rate of sexual violence, incest and intergenerational sexual intercourse. In addition, government policies and legislation threaten to exacerbate some of the sexually risky behaviours. Bringing HIV education and female empowerment to the rural Gusii requires a culturally sensitive approach, discarding sexual abstinence messages in favour of harm minimisation, including the promotion of condom use, regular HIV testing and the rejection of female circumcision and intergenerational sex. Trust needs to be built through tactics such as adopting a complex and fluid outsider identity and replacing formal sex education with training in income generating skills and casual discussions regarding condoms and sexual health.

'The Head Carver': Art Extraordinary and the small spaces of asylum.

This paper uses the unique collection of Scottish outsider art, labelled Art Extraordinary, as a window into the often neglected small spaces of asylum care in the early twentieth century. By drawing upon materials from the Art Extraordinary collection and its associated archives, this paper demonstrates the importance of incorporating small and everyday spaces of care - such as gardens, paths, studios and boats - into the broader historical narratives of psychiatric care in Scotland. Examples of experiential memorialization and counterpoints to asylum surveillance culture will be illuminated. The significance of using 'outsider' art collections as a valuable source in tracing geographical histories will be highlighted.

Being Met as marked - patients' experiences of being infected with community-acquired methicillin-resistant Staphylococcus aureus (MRSA).

BACKGROUND: It is known that patients who acquired methicillin-resistant Staphylococcus aureus (MRSA) in hospitals suffer and feel as plague. Moreover, the patient interaction with nurses and physicians is described as frightening. Little is known about patient experiences after having acquired CA-MRSA concerning care and everyday life. AIM: To reveal and interpret otherwise healthy patients' lived experiences of receiving care and their everyday life after having acquired community MRSA (CA-MRSA). METHODS: A phenomenological hermeneutic approach guided by Ricouer was conducted. Interviews with twelve patients were transcribed verbatim into a text. The text was analysed in three phases: naive understanding, structural analysis and comprehensive understanding to reveal a possible being in the world. In this study, this referred to what it means to be infected with CA-MRSA. RESULTS: The findings indicate that patients who acquired MRSA experience a changed body image. They suffer from ignorant and frightened behavior from healthcare workers, social contacts, and also of being bullied by colleagues. Despite this, patients assume great responsibility for protecting others. However, knowledgeable staff alleviate suffering and bring peace of mind to the patients. CONCLUSIONS: Preventing patient's feelings of being a pest, an outsider living with fear, requires urgent education and understanding about resistant bacteria and how to meet an infected patient. The results describing patients, affected with MRSA, may contribute and touch the readers to better understanding of patient's changed body image and suffering and how to mitigate these feelings.

Creating a Space for Acknowledgment and Generativity in Reflective Group Supervision.

Small group supervision is a powerful venue for generative conversations because of the multiplicity of perspectives available and the potential for an appreciative audience to a practitioner's work. At the same time, the well-intentioned reflections by a few practitioners in a room can inadvertently duplicate normative discourses that circulate in the wider culture and the profession. This article explores the use of narrative practices for benefiting from the advantages of group supervision while mindful of the vulnerability that comes with sharing one's work among colleagues. The reflective group supervision processes described were modified from the work of Tom Andersen and Michael White to provide a venue that encourages the creative multiplicity of group conversation while discouraging unhelpful discourses which constrain generative conversation.

Perils and pitfalls for clinicians embarking on qualitative research in physiotherapy.

AIM: To consider the pros and cons of focus groups versus interviews for studies interested in examining patient experiences of clinical interventions. The paper looks at the hazards of being a clinician when collecting qualitative data and shares these experiences to provide useful learning for other clinicians embarking on qualitative approaches. BACKGROUND: Sub-acromial decompression surgery (SAD) is the accepted, surgical intervention for shoulder impingement syndrome. Evidence suggests that outcomes from SAD are no more superior to conservative management. This raises questions as to whether alternative explanations such as patient experience are at play when considering patient outcomes. DATA SOURCES: A study looking at patients' experiences of subacromial decompression surgery six months after the operation. REVIEW METHODS: One small focus group and one individual interview took place to explore patient experience following sub-acromial decompression shoulder surgery. DISCUSSION: Focus groups risk producing competitive and comparative discussions, and clinical researchers require sufficient training and mentoring to recognise and assist group dynamics. The study exposed ways in which clinicians involved in collecting data may be injured to aspects of patients' experiences, and accordingly may not explore in depth aspects important to patients. CONCLUSION: This paper highlights the importance of novice researchers thinking carefully about the capacity for 'practitioner eyes' to influence analytical decisions about study design and the direction of data collection. Focus group interactions are complex and risk being underestimated by inexperienced clinical researchers. IMPLICATIONS FOR RESEARCH/PRACTICE: Novice researchers are advised to be open to the possibility that unpredictable situations are likely to occur and expose assumptions about the study design. Preparation and guidance is required to avoid some of the challenges and manage group dynamics effectively in the first instance.

The Contribution of Bullying Involvement and Alexithymia to Somatic Complaints in Preadolescents.

Somatic complaints during preadolescence are connected to individual and contextual factors, and extant research highlights the relevance of alexithymia and bullying involvement. In this cross-sectional study, we explored the joint and unique influence of bullying involvement-as perpetrators, victims, or outsiders-and alexithymia on somatic complaints in a sample of 179 Italian middle-school students (aged 11-15). Findings revealed an indirect association between bullying perpetration and victimization complaints through alexithymia. We also found a significant direct association between victimization and somatic complaints. No significant association between outsider behavior and somatization was found. Our results revealed that bullying perpetration and victimization could increase youths' risk for somatic complaints and clarify one of the processes underlying this association. The current findings further emphasize the relevance of emotional awareness for youths' well-being and propose that implementing social-emotional skills might prevent some of the adverse consequences of being involved in bullying episodes.

Effects of outsider witness practice on a support group for parents of children with autism spectrum disorder.

PURPOSE: Providing effective support to parents of children with autism spectrum disorder (ASD) is an important part of clinical work. This study used outsider witnesses in group counselling for parents of children with ASD and explored the mechanism through which the therapeutic effects occurred. METHOD: Parents of children diagnosed with ASD participated in an eight-session group activity. Two outsider witnesses were introduced into some of the sessions. The participants were interviewed to collect their experiences of and reflections on the outsider-witness practice. Texts were analysed using the categorical content approach. RESULTS: The intervention was effective because the participants shifted their subjective experiences to an objective position, leading them to reflect on their previous limited perspectives, thus resulting in self-redefinition. These therapeutic effects may arise due to physical displacement, experience resonance, and externalization of subjective experiences. The results of this study have important implications for parents and practitioners.

The economics of early inequality.

We examine three recent frameworks that attempt to explain early inequality. One explanation involves the emergence of dense and predictable resource patches in the Holocene, together with differential asset accumulation and inheritance by individuals or households. In this view, agriculture and pastoralism led to greater inequality because farmland and animal herds were readily inherited. Another explanation involves the distinction between ideal free and ideal despotic population distributions, together with factors that could trigger a transition from the former to the latter. We offer a third framework based on economic concepts. In our view, inequality initially arose across locations (insider-outsider inequality) and reflected geographical differences in resource endowments at those locations. As population densities increased, the barriers to individual migration across locations included fewer kinship linkages and the use of force by insiders to exclude outsiders. These barriers became important with the transition from mobile to sedentary foraging and predate agriculture. Insider-outsider inequality was followed by stratification within settlements (elite-commoner inequality), which arose at still higher population densities. We see these three theoretical approaches as distinct but complementary. While they overlap, each emphasizes some phenomena and processes ignored by the other two. This article is part of the theme issue 'Evolutionary ecology of inequality'.