Individual Journeys Research Articles

A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course.

Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the "ADHD Care Cascade". We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the "ADHD Care Cascade". By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course.

Sacred Circle: Symbol of Wholeness in Traditional Persian Art and Architecture.

Jung wrote extensively about the archetypal mandala symbol as an expression in many cultures of the centrality and nature of the interplay between human consciousness and divine consciousness. This article investigates-how in Persia, for millennia-the archetypal symbol of the mandala has been widespread in many expressions of the sacred arts. My research outlines the importance of the archetypal mandala symbol in Persian religio-aesthetic history from the first unearthed stone carvings of Persia's ancient foundations until the more recent, breathtakingly marvellous ceilings of traditional Persian architecture today. From the artistic expressions of first religious beliefs of ancient Persia-Mithraism-and through the development of the Zoroastrian faith until the subsequent rise of Christianity and then Islam, Persian sacred art illustrates the Jungian idea that wholeness sought in the journey of individuation is often expressed through archetypal symbols of circles that articulate basic truths about the divine interplay with humanity.

A diarized journey: an interpretative phenomenological analysis of the older person’s lived experience of a hip or knee replacement within a fast-track programme

BackgroundFor the older person living with end-stage hip or knee osteoarthritis, a hip or knee replacement can be a traumatic event, influencing the physical, physiological, psychological, social and economic facets of daily living. This interpretative phenomenological study aimed to reveal and interpret the daily lived experiences of the older person before, during and after a primary total hip or knee replacement surgery in a fast-track programme in South Africa.MethodsA qualitative interpretive phenomenological study, collecting data through solicited diaries and reflexive member validation interviews from seven participants aged 65–75 years, who underwent a primary elective hip or knee replacement surgery. The surgical fast-track process and data collection process happened simultaneously. Data collection from the solicited diary started before surgery, continued during the surgery process and finished six weeks after surgery and this was followed with reflexive member validation interviews. Interpretative phenomenological analysis was used throughout the three phases of the fast-track programme.ResultsThree superordinate themes developed during the three phases of surgery: “The holistic impact of pain on daily quality of life”, “Finding ways to cope”, and “Transition between independence and dependence and back”. Although former research confirms the physical impact of osteoarthritis on the older person and the success of fast-track programmes for subsequent hip and knee replacements, this study contributes to the holistic impact of the surgery on participants’ daily lives. The diarized journey of individuals through the psychological, psychosocial, physical, professional, and spiritual experience are described and interpreted in this study.ConclusionsAcross the solicited diaries, it was clear that pain as catalyst impacted the daily activities of the individual physically, psychologically, and psychosocially. Pain was subjectively present at different intensities during all the phases of the replacement surgery, impairing mobilization and triggering roller-coaster emotions. In order to cope with physical and emotional difficulties while preparing and adjusting to the environment, participants reflected on social support, physical and professional support, and spirituality. Throughout the preparation, hospitalization and the recovery process, the transition between independence, dependence, and back to independence was significant, reinforcing the individual’s determination to recover.

An investigation of mental health care pathways for patients with psychosis who engage in antisocial behaviours

ABSTRACT Secure mental health services aim to assess and treat mentally disordered offenders, where a patients care pathway involves their movement from service to service on an individual journey towards recovery. Research has attempted to understand the relationship between psychosis and violence for mentally disordered offenders. From this empirical evidence base a tripartite typology has emerged. Three subgroups have been categorised as (i) schizophrenia preceded by conduct disorder (SZ+CD), (ii) offenders with schizophrenia who begin offending at illness onset (SZ+AS), and (iii) offenders with schizophrenia (SZ). This study aimed to examine differences in care pathways between subgroups. The sample consisted of 77 male patients admitted to low- and medium-secure care. The subgroup of patients was determined from data collected from health records. The analysis examined the differences in patient care pathways. The results demonstrated differences in subgroup pathways to, within and from secure services. The SZ+CD subgroup had a higher number of placements used, were more likely to transition between the same level of security, and had an increased use of the private sector. The SZ+AS subgroup was significantly more likely to use intensive care and less likely to use high secure services. Examining care pathways of mentally disordered offenders will ensure a more evidence-based approach to the configuration and operationalisation of services, help guide policymakers and hopefully improve patient care.

191 Penthrox Is Effective but Is It Patient Approved?

Abstract Aim Penthrox is a handheld inhaler that administers methoxyflurane. It’s use is approved for analgesia in moderate-to-severe trauma-related pain in adults in emergency department (ED). The literature currently lacks methodologically robust qualitative data on individual patient experience. Using a structured qualitative study, we set out to address this shortcoming. Method Focus group Five patients were selected to identify key themes they felt important to explore and these were included in the questionnaire design. Study Design We retrospectively identified all uses of Penthrox in ED from June to August 2021. Qualitative data was gathered using the Trickett short interview method and responses grouped into positive and negative descriptors. In addition, quantitative data concerning their experience using 5-point Lickert scales were also gathered. Results Questionnaires 101 responded to the questionnaire. Penthrox® was utilised mainly for the manipulation of fractures, most commonly for that of the Ankle and Wrist. 90% reported an overall satisfaction of ‘≥ Good’. 97% reported ease-of-use ‘≥ Good’. Its analgesic effectiveness was rated as ‘Excellent’ by 52%, and ‘≥Good’ by 89%. The most reported side-effects were drowsiness (13%) and nausea (7%). The majority reported no side-effects (74%). 94% would take it again if required. A NVIVO word cloud was created visually confirming an overall positive experience amongst the patients. Conslusions This study shows that Penthrox is a well-tolerated and user-friendly means of alleviating trauma-related pain in ED. It highlights the importance of taking into consideration the individual patient journey alongside robust evidence-based data on safety and efficacy for the development of a holistic treatment.

Diana Scully: A Feminist Mentor and Torch Bearer.

In this piece, two former students and colleagues of Diana Scully reflect on her influence on their academic, professional, and personal lives. The authors provide a general overview of Scully's contributions to gender equity in terms of scholarship and curricular development, as well as her commitment to mentoring students and junior colleagues. They share their individual journeys developing expertise and working in the field of violence against women, as well as their collaborations as teachers, researchers, advocates, and service providers that were influenced, guided, and promoted by Scully.

SP9.2 Penthrox Is Effective but Is It Patient Approved?

Abstract Aim Penthrox is a handheld inhaler that administers methoxyflurane. Its use is approved for analgesia in moderate-to-severe trauma-related pain in adults in emergency department (ED). The literature currently lacks methodologically robust qualitative data on individual patient experience. Using a structured qualitative study, we set out to address this shortcoming. Methods Focus group: Five patients were selected to identify key themes they felt important to explore and these were included in the questionnaire design. Study Design We retrospectively identified all uses of Penthrox in ED from June to August 2021. Qualitative data was gathered using the Trickett short interview method and responses grouped into positive and negative descriptors. In addition, quantitative data concerning their experience using 5-point Lickert scales were also gathered. Results Questionnaires: 101 responded to the questionnaire. Penthrox® was utilised mainly for the manipulation of fractures, most commonly for that of the Ankle and Wrist. 90% reported an overall satisfaction of ‘≥ Good’. 97% reported ease-of-use ‘≥ Good’. Its analgesic effectiveness was rated as ‘Excellent’ by 52%, and ‘≥ Good’ by 89%. The most reported side-effects were drowsiness (13%) and nausea (7%). The majority reported no side-effects (74%). 94% would take it again if required. A NVIVO word cloud was created visually confirming an overall positive experience amongst the patients. Conclusions This study shows that Penthrox is a well-tolerated and user-friendly means of alleviating trauma-related pain in ED. It highlights the importance of taking into consideration the individual patient journey alongside robust evidence-based data on safety and efficacy for the development of a holistic treatment.

Exploring the impact of a ‘Clients-as-Tutors Program on speech-language pathology students’ and graduates understanding of client-centred practice

Purpose This study explored the impact of an Australian regional university’s Clients-as-Tutors Program (CTP) on speech-language pathology students’ perception and understanding of client-centred practice. Method Two focus group interviews comprising three final-year students and four newly graduated speech-language pathologists who had completed the CTP. An inductive thematic analysis was undertaken to identify salient themes. Result Three themes were identified: (a) learning from theory, (b) learning from others, and (c) learning from yourself. These themes represented all participants’ experiences in the CTP, yet there were unique, individual journeys that each participant experienced. Conclusion Findings from this study have the capacity to affect change in how client-centred practice is taught at universities across speech-language pathology and other health courses, to disrupt the traditional power structure between client and clinician, and to provide an evidence base for the role of experiential learning in this area.

Patient journey of individuals tested for HCV in Spain: LiverTAI, a retrospective analysis of EHRs through natural language processing

Patient journey of individuals tested for HCV in Spain: LiverTAI, a retrospective analysis of EHRs through natural language processing

The Archetypal Analysis on Main Characters of Stephen King's Rita Hayworth and Shawshank Redemption

This research article explores the application of Jungian archetypal theory in analyzing Stephen King's novella, Rita Hayworth and Shawshank Redemption. The primary focus of this analysis is to uncover the archetypal identities embodied by the central characters, Andy Dufresne and Ellis "Red" Redding. Employing a close-reading method, the researcher examines the novella to gather relevant data for this study. By delving deep into their individual journeys and psychological transformations, the objective of this research is to unveil the underlying archetypal forces that shape their roles within the narrative. Drawing inspiration from Carl Jung's concept of archetypes and the collective unconscious, this analysis identifies Andy Dufresne as a manifestation of the "trickster" and "hero" archetypes, as evidenced by his portrayal in the story. On the other hand, Red embodies the "mentor" archetype, serving as a seasoned inmate and the narrator of the novella. In this way, the study sheds light on the archetypal dimensions present in the characters of the novella.

URM: Underrepresented or Underrecognized? A Case Study of Black Pediatric Critical Care Physicians.

This study explored Black physicians' experience via an antideficit lens to gain new ideas for advancing minoritized physicians in academic medicine more broadly. Increasingly, systemic racism in academic medicine is intentionally acknowledged and named. However, many solutions to tackle racism and the overall paucity of Black physicians use a deficit framing, painting Black physicians and trainees as lacking preparation, interest, or experience and qualifications. Such solutions aim to help Black people assimilate into the "White Space" of academic medicine, rather than focusing on Black people's strengths. This qualitative study included 15 Black physicians and trainees in pediatric critical care medicine (PCCM) from across the country who participated in semistructured interviews. Through an antideficit lens, the researchers examined the social, cultural, and structural contexts influencing the participants' individual experiences. They analyzed the data combining thematic and narrative qualitative analysis approaches, including restorying. The data help promote understanding of the landscape and context in which Black PCCM physicians become successful. Achievement took on different forms for the participants. Participants described enablers of achievement that supported them through their individual journeys spanning 3 general domains-intrinsic, interpersonal, and systemic. Three additional enablers were tied specifically to participants' Black identities-harnessing Blackness as a superpower, leaning in to lead, and successfully navigating the "unwritten rules." By using an antideficit framework, this study delineates and centers participants' ingenuity in cultivating repertoires of practice that enabled them to succeed, despite challenges rooted in systemic racism. Going forward, rather than focus solely on what is missing, academic medicine should try to shift systems and regularly recognize and value the knowledge, expertise, and merit Black that physicians bring. Perhaps an appropriate framing is not that Black physicians are underrepresented in medicine; maybe instead, it is that they are underrecognized.

Pait at Paet (Pain and Chisel): The Struggles and Victories of a Santo Maker

Religious arts and crafts are culturally and spiritually relevant for many, leading to an interest for deeper understanding. The emergence of religious carving industries is essential to exploring this field. However, there has been limited research on people who decided to pursue this line of work. This study then aimed to provide a thorough understanding of the experience of individuals who start their own religious carving business. Using a case study design, results of the study provided in-depth account of the journey of individuals who start their own religious carving business which also included their motivations, difficulties, approaches, and coping techniques. Individuals in this venture can work toward achieving both personal and professional well-being by understanding the complex relationship between familial and entrepreneurial roles, addressing the challenges encountered, and putting into practice effective marketing and coping mechanisms.

Leitmotivic Strategies in Nobuo Uematsu’s Final Fantasy Soundtracks

Abstract This article discusses Nobuo Uematsu’s leitmotivic soundtracks to the 16-bit Final Fantasy role-playing games. I identify five distinct techniques within these soundtracks whereby a game’s main theme is musically connected to a single character theme: eponymous omission, motivic networking, thematic hybridization, associative troping, and the double main theme. I argue that these different techniques demonstrate how a character’s individual journey reflects the story’s underlying literary theme, which is itself represented by the musical main theme. I conduct topical, motivic, formal, and semiotic analyses of the soundtracks to FFIV–VI and discuss how their character themes, though mostly non-transformative, engage in a larger leitmotivic network of inter-related thematic families that interact with their main themes in dramatically meaningful ways. This analysis demonstrates subtle ways in which leitmotivic scoring can heighten one’s narratological understanding of a story, and may be useful for those seeking to arrange video game soundtracks into programmatic music that tells or retells a game’s story.

Ernesto’s Journey of Individuation: A Jungian Analysis of José María Arguedas’s Los ríos profundos

This paper explores the journey of individuation of Ernesto, the main character of Los ríos profundos (1958), written by José María Arguedas. By applying the Jungian literary theory, one can see the process of individuation in Ernesto as he progresses through the novel. As Ernesto begins his transition from the Andean world to the Western world, he also crisscrosses from his collective unconscious to his consciousness. His journey exhibits the painful but exciting journey between the two realms of the psyche. Arguedas presents the following five Jungian archetypes in many ways and on many levels in this novel: persona, ego, shadow, anima and self. The process of individuation is not only an inner journey for Ernesto, it is also a learning process, which allows his maturation. This essay explores Los ríos profundos, a “literature of migration,” as Antonio Cornejo Polar (1998) has denominated Arguedas’s work, and “literature of growth,” as Luis Harss (1983) and Ariel Dorfman (1980) discuss in their articles, while focusing on the journey of Ernesto and incorporating a Jungian literary perspective.

An optimal train journey with bounds on energy consumption during specified intermediate time intervals

In order to mitigate consumption of electrical energy during periods of peak demand it is common for electricity system operators to offer financial incentives that encourage large corporate consumers to reduce power usage at designated critical times. For train operators on large rail networks it may be more profitable to limit energy consumption during these times, for selected individual train journeys, rather than always implementing a true optimal strategy that minimizes overall energy consumption. In this paper we use classical methods of constrained optimization to find driving strategies for a single train that minimize energy consumption subject to constraints on energy usage within designated high-demand time intervals during the journey. We illustrate our results by considering a journey with realistic parameters and two different nominal sets of energy consumption constraints.

Recovery journey of people with a lived experience of schizophrenia: a qualitative study of experiences

BackgroundMental health recovery involves an integration of clinical and psychosocial frameworks. The recovery journey of individuals diagnosed with schizophrenia and the factors that influence it have been extensively studied. Because the recovery journey is culturally influenced, we examined the recovery process expriences of individuals diagnosed with schizophrenia in China, focusing on the influence of a Confucian-dominated collectivist and family-centred culture.MethodsAn Interpretive Phenomenological Analysis (IPA) study was conducted; data were gathered through in-depth interviews with 11 individuals with lived experience of schizophrenia.ResultsFour themes were identified in this study: traumatic illness experiences, influence of the family, motives for recovery, and posttraumatic growth, comprising ten subthemes. “For the family” and “relying on oneself” are the main drivers of recovery for individuals with a Chinese cultural background. Some people believe that taking care of themselves is an important way to ease the burden on their families and treat them well. There is a link between ‘for the family’ and ‘relying on oneself.ConclusionsIndividuals living with schizophrenia in China have undergone significant traumatic experiences and have profound interactions with their families. Post-traumatic growth reflects an increase in the individual’s connection to others and individual agency. It also suggests that the individual is not receiving enough support outside of the family. The impact of individual agency and family relationships should be considered in services that promote recovery, and clinic staff should enhance support outside the home to the individuals.

Nursing, midwifery, and allied health professions research capacities and cultures: a survey of staff within a university and acute healthcare organisation

BackgroundThere is an increasing focus on the development of research capacity and culture in Nursing, Midwifery and Allied Health Professions (NMAHP). However, better understanding of the existing research success and skills, motivators, barriers, and development needs of NMAHP professionals is required to inform this development. This study sought to identify such factors within a university and an acute healthcare organisation.MethodsAn online survey, incorporating the Research Capacity and Culture tool, was administered to NMAHP professionals and students at a university and an acute healthcare organisation in the United Kingdom. Ratings of success/skill levels of teams and individuals were compared between professional groups using Mann–Whitney U tests. Motivators, barriers, and development needs were reported using descriptive statistics. Descriptive thematic analysis was used for open-ended text responses.ResultsA total of 416 responses were received (N&M n = 223, AHP n = 133, Other n = 60). N&M respondents were more positive than their AHP counterparts about the success/skill levels of their teams. There were no significant differences between N&M and AHP in their ratings of individual successes/skills. Finding and critically reviewing relevant literature were identified as specific individual strengths; with weaknesses in securing research funding, submitting ethics applications, writing for publication, and advising less experienced researchers. The main motivators for research were to develop skills, increased job satisfaction, and career advancement; whilst barriers included lack of time for research and other work roles taking priority. Key support needs identified included mentorship (for teams and individuals) and in-service training. Open-ended questions generated main themes of ‘Employment & staffing’, ‘Professional services support’, ‘Clinical & academic management’, ‘Training & development’, ‘Partnerships’ and ‘Operating principles’. Two cross-cutting themes described issues common to multiple main themes: ‘Adequate working time for research’ and ‘Participating in research as an individual learning journey’.ConclusionsRich information was generated to inform the development of strategies to enhance research capacity and culture in NMAHP. Much of this can be generic but some nuances may be required to address some specific differences between professional groups, particularly related to perceived team success/skills and priorities identified for support and development.

Constructing and Consuming the Periphery

In August 2021, Mahasweta Devi’s iconic short story “Draupadi” (1978), which brings alive the long tradition of adivasi/tribal resistance against systemic oppression and its brutal reprisal, was deleted from the English Honours syllabus of Delhi University on the grounds of “hurt” sentiments. Why would a story of tribal resistance ruffle postcolonial sentiments? Triggered by this excision, our essay attends to the context of “Draupadi” – the Naxalite movement (1967–1975), the armed uprising that contested the feudal-bourgeois hegemony of the postcolonial Indian state – and examines the representation of the restless periphery in contemporary fiction, Bengali and English, in terms of political and attendant aesthetic negotiations. The Naxalite movement inspired a specific genre of literature in Bengali, Naxal Sahitya, whose growth was contemporaneous with the movement itself. It explored the possibility of a new modernity and subjectivity, tangling with the inherited forms of narrative in both poetry and prose. Globally, which signifies still a western platform, the Naxal made an appearance in Jhumpa Lahiri’s The Lowland (2013) and Neel Mukherjee’s The Lives of Others (2014). In both, the questions raised by movement, of land and of the tiller, are imaginatively resolved by the diasporic journey of select individuals to the United States of America. Our essay offers an intertextual reading of these two anglophone, global novels by Lahiri and Mukherjee with the Bengali, local narratives of Samaresh Majumdar’s Kalbela/Dark Times (1983) and Mahasweta Devi’s Operation? Bashai Tudu (1978/2003). We address the ways in which imaginative literature embeds a movement that challenged the hierarchies of a decolonized nation, the possibilities of the novel’s – a form hegemonically associated with the individual rather than the collective – investment in the construction of the periphery, the hierarchy of the local and the global, and the territoriality of the marketable consumptions of stories.

Reflect, Reframe, and Re-Imagine Theory and Practice in Speech, Language, and Hearing Sciences: Introduction to the Forum.

Reflect, Reframe, and Re-Imagine Theory and Practice in Speech, Language, and Hearing Sciences: Introduction to the Forum.

From Surviving Cancer to Getting on With Life: Adult Testicular Germ Cell Tumor Survivors' Perspectives on Transition From Follow-Up Care to Long-Term Survivorship.

With an increasing incidence and a high cure rate, a growing number of testicular germ cell tumor (TGCT) survivors require specialized follow-up care. However, knowledge of these patients' needs is lacking, leaving TGCT survivors with unmet care needs at risk of symptom burden when transitioning to long-term survivorship. This grounded theory study aimed to understand the perspectives of TGCT survivors' transition from follow-up care to long-term survivorship. A total of 12 adult TGCT survivors in follow-up care or completion less than a year were in-depth semi-structured interviewed. Interviews were audiotaped and transcribed verbatim. Transcripts were analyzed by constant comparison, and the core category "Dealing with back-and-forth forces" emerged in the integrated concepts. Two comparative processes in dealing with those forces were identified: the process of Living beyond the sword of Damocles involved the transition from feeling threatened by cancer to overcoming those threats; the process of Getting on with one's life can be described as transitioning from a period where cancer overruled their lives to carrying on with everyday life. The processes toward long-term survivorship follow general characteristics; the transition itself is an individual journey that depends on (life) experiences. The constructed model can guide healthcare professionals and researchers involved in TGCT survivorship to understand TGCT survivors' individual and ensuing needs. When TGCT survivors receive individualized and tailored follow-up care, it can assist in preventing and reducing long-term and late effects on long-term survivorship.