Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Common Sense and the Natural Light in George Berkeley’s Philosophy

Philosophia - It is argued that George Berkeley’s term ‘common sense’ does not indicate shared conviction, but the shared capacity of reasonable judgement, and is therefore to be...     

Nonsuicidal Self-injury,Suicide Planning,and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization

Research on Child and Adolescent Psychopathology - The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90 days...     

Human Self-Domestication and the Evolution of Pragmatics

As proposed for the emergence of modern languages, we argue that modern uses of languages (pragmatics) also evolved gradually in our species under the effects of human self-domestication, with three key aspects involved in a complex feedback loop: (a) a reduction in reactive aggression, (b) the sophistication of language structure (with emerging grammars initially facilitating the transition from physical aggression to verbal aggression); and (c) the potentiation of pragmatic principles governing conversation, including, but not limited to, turn-taking and inferential abilities. Our core hypothesis is that the reduction in reactive aggression, one of the key factors in self-domestication processes, enabled us to fully exploit our cognitive and interactional potential as applied to linguistic exchanges, and ultimately to evolve a specific form of communication governed by persuasive reciprocity—a trait of human conversation characterized by both competition and cooperation. In turn, both early crude forms of language, well suited for verbal aggression/insult, and later more sophisticated forms of language, well suited for persuasive reciprocity, significantly contributed to the resolution and reduction of (physical) aggression, thus having a return effect on the self-domestication processes. Supporting evidence for our proposal, as well as grounds for further testing, comes mainly from the consideration of cognitive disorders, which typically simultaneously present abnormal features of self-domestication (including aggressive behavior) and problems with pragmatics and social functioning. While various approaches to language evolution typically reduce it to a single factor, our approach considers language evolution as a multifactorial process, with each player acting upon the other, engaging in an intense mutually reinforcing feedback loop. Moreover, we see language evolution as a gradual process, continuous with the pre-linguistic cognitive abilities, which were engaged in a positive feedback loop with linguistic innovations, and where gene-culture co-evolution and cultural niche construction were the main driving forces.     

Injustice impairs self-regulation and affects food choice

Overweight and obesity are risk factors for a range of chronic diseases, many of them caused by excessive consumption of unhealthy foods and insufficient consumption of healthy foods. The present study aims to experimentally test the effect of being exposed to injustice on the intention to consume healthy and unhealthy foods, through self-regulation. We predicted that injustice decreases self-regulation which in turn increases the intention to consume unhealthy foods and decreases the intention to consume healthy foods. Undergraduate students (N = 175; 89% women; M_age = 24.28, SD = 7.36) were randomly exposed to a scenario describing an unjust or a just academic situation. In a subsequent allegedly unrelated task, participants were asked to indicate their intention to consume each of 26 food items (half depicting unhealthy foods and half healthy foods, random order) during the subsequent week. As expected, injustice decreased self-regulation which in turn increased the intention to consume unhealthy foods and decreased the intention to consume healthy foods. These results highlight the central importance of justice perceptions in the study of consumption and contribute to frame it in the study of the consequences of economic inequalities for nutrition.