Lay People Research Articles

Assessing trust with injected health information in Poland’s healthcare system: Lay people versus healthcare workers

Health information can influence patient trust and is vital to the healthcare system of a country. This study comparatively assesses trust levels within Poland’s healthcare system from two perspectives: non-healthcare workers (i.e. lay people) and healthcare workers. Four trust indicators, i.e. the payer, visiting or consulting with a physician, the medical profession, and hospitals are used to test trust volatility. The methodology combined a participant three-stage experiment by measuring level of trust, randomly separating participants into two groups – i.e. control and experimental – and testing whether observational changes were long-lasting. Results indicate that the level of trust of non-healthcare workers to the payer, a physician, and hospitals was susceptible to the information provided, while trust to the medical profession did not show sensitivity and almost did not change. Statistical analysis showed the non-healthcare workers trust level in all tested objects, apart from the medical profession, tended to return to their start values. Healthcare workers, on the other hand, had an overall higher level of trust in a physician, the medical profession, and hospitals. Overall, it can be concluded that the impact from the intervention in terms of hospitals was lower for the healthcare workers.

How Do Lay People Identify Knee Swelling and What Would They Do About It: Survey Results in the Context of an Event on the Topic of Knee Osteoarthritis

Objective: Besides pain, joint stiffness and muscle weakness, swelling is a common symptom of knee osteoarthritis. According to the literature, there are clinical tests such as the bulge sign or circumference measurement as part of the clinical examination to identify knee swelling. Pharmacological interventions, knee bandages, temporary sports bans and physical interventions are effective decongestant measures. In the conservative treatment of knee osteoarthritis, the promotion of self-management principles is crucial. However, the general population´s level of knowledge regarding the identification and treatment of knee swelling is unknown. To get directly in contact with lay people, a crowdsourcing approach is appropriate. Consequentially, the aim of our crowdsourcing-based study is to get an inside of how lay people identify knee swelling and which measures they would adopt. Methods: Under the assumption that crowdsourcing-based methods can further develop conservative osteoarthritis treatment- in our case especially in the context of knee swelling-, a cross-sectional survey on knee swelling in osteoarthritis was carried out as part of a lecture including a workshop organised in a rural Austrian community. The 26 participants answered two open questions about characteristics and decongestant measures of knee swelling. A content structuring qualitative content analysis with a combined deductive and inductive approach followed by a frequency analysis was used to evaluate the data. Results: The participants determine knee swelling primarily based on at least one of the cardinal symptoms of inflammation (f=26), as well as an undefined optical increase in circumference (f=9). Physical (f=24), pharmacological (f=14) and complementary interventions (f=16) with partly unclear evidence are mentioned as decongestant measures. Conclusion: Identifying knee swelling and applying appropriate decongestant measures challenges lay people. Due to the deficits found, the chosen research method considering a continuous participation of lay people has the potential to further dev

The “Sense of the Faith” in History: Its Sources, Reception, and Theology by John J. Burkhard

Reviewed by: The “Sense of the Faith” in History: Its Sources, Reception, and Theology by John J. Burkhard Jared Wicks S.J. The “Sense of the Faith” in History: Its Sources, Reception, and Theology. By John J. Burkhard, OFM Conv. (Collegeville, MN: Liturgical Press Academic. 2022. Pp. xiv, 442. $59.95. ISBN: 9780814666890). John Burkhard taught ecclesiology at the Washington Theological Union from the 1990s until the Union’s closure in 2015, with service as its President in 2006 and 2008–09. Theologians will know Burkhard’s ample bibliographies of post-Vatican Council II studies of the sensus fidei published in Heythrop Journal in 1993, 2005, and 2006. The volume reviewed here is also extensive bibliographically, offering a chronological list of nearly 400 studies of the sensus from 1940 to 2000. The importance of Burkhard’s work rests on the centrality of the sensus fidei in Vatican II’s teaching, as brought out recently in several passages of Ormond Rush’s theological summa of the Council, The Vision of Vatican II (Liturgical Press, 2019). For the sensus fidei is a key dimension of a basic theological principle of the Council, namely, faith’s graced adherence to God’s saving revelation. The sensus is the capacity, sometimes called an “instinct,” given by the Holy Spirit’s “anointing” (1 John 2: 20.27), to enable the believer and the believing community to lay hold of God’s word in its true meaning while dismissing inauthentic versions. It is at the heart of living faith in personal adherence, penetration of revealed meaning, and the application of God’s word to life in the Lord (so, Lumen gentium 12, also 35, with Dei verbum 8, and Gaudium et spes 44 and 62). In ten substantial chapters, Burkhard presents the history of treatments of the sensus fidei in Catholic teaching, both by theologians and the magisterium, beginning with scattered references to doctrines held by an unexplained “sense of the church” both before Trent and in that council’s decrees. Learned accounts treated the sensus in nineteenth-century works by Johann Adam Möhler, Giovanni Perrone, and John Henry Newman, with its importance being sealed by Pope Pius IX’s consultation of the Catholic people’s consensus in adhering in faith to Mary’s Immaculate Conception, as a step toward the dogmatic definition of 1854. In the twentieth century, two Dominicans treated the sensus, first as a major factor in doctrinal development (Francisco Marin-Sola) and then as the instinctive wisdom of the believer’s graced sensibility (Mannes D. Koster). After the dogmatic definition of Mary’s Assumption in 1950, the Alsatian Redemptorist Clément Dillenschneider promoted attention to the sensus fidei while relating it to the Church’s lex orandi, while Yves Congar’s Lay People in the Church (originally 1953) situated the [End Page 168] sensus in God’s spiritual endowment of the whole Church to enable it to carry out its share in Christ’s prophetic office. Burkhard relates the iter of the sensus fidei through the labors of Vatican Council II, beginning textually with a later chapter of the 1962 schema De ecclesia, which contrasted public opinion in the Church with the grace-effect that enables the believing people to respond obediently to proposed teaching and understand its meaning. In early 1963 a transformed ecclesiology schema located the sensus in a new second chapter on the whole people of God, who are indefectible in believing, taught and anointed as they are by God (Jn. 6:45; 1 Jn. 2:20.27), for carrying out in the world Christ’s offices of priest, prophet, and royal servant. The aula discussion of 1963 led to several refinements now in Lumen gentium 12, which distinguishes sharply the one sensus of all believers from the great variety of charisms for special callings, with the former leading believers to adhere to what is truly the word of God (1 Thes. 2:13), both grasping its depths and applying it more completely in life. Burkhard treats the reception of Vatican II’s doctrine of the sensus fidei in several venues, as in ecumenical dialogue documents, in the new codes of Catholic canon law, in papal teaching, especially by...

Audio Describing Sound – What Sounds are Described and How?

Given that the aural meaning-making channels are the main channels that people with sight loss have access to when processing audiovisual products, it is striking that hardly any research has been done on how dialogues, music, and sound effects are integrated in audio description (AD). A possible explanation is the lack of conceptual, theoretical, and methodological frameworks to systematically analyse sound. In the present article we study whether insights from film studies, multimodality research and audionarratology can be used to study sound in AD. After an overview of the state of the art, we present a case study that was carried out within the context of two master’s dissertations and for which an analytical framework for sound descriptions was designed and tested on different scenes from the Flemish film Loft (Van Looy, 2008). In addition to testing the validity of the framework, we wanted to obtain some concrete insights into what types of sounds were described and what narrative position and functions they occupied. On the one hand, the analysis shows AD usually renders the sounds that are the most prominent and most easily recognized. On the other hand, the analysis also shows that although the framework for the analysis clearly has its merits and can provide valuable insights, determining the narrative functions of sounds remains difficult. Therefore, the article ends with various new research questions and a clear plea for more research in this uncharted territory. Lay Summary When people with sight loss listen to an audiovisual product like a film or series, they mainly follow the story based on the sounds, such as dialogues, music, sound effects and the audio description track. It is, therefore, surprising that researchers have not paid a lot of attention to understanding how sounds complement the audio description in telling the story. One reason may be that researchers lack the necessary methods and theory to study sounds scientifically. In this paper, we try to develop this knowledge, by combining insights from different disciplines, such as film studies, multimodality research and audionarratology to create a framework for sound analysis in AD. Together with two Master students, we applied the framework to a case study, namely the analysis of the Flemish film Loft, directed by Erik Van Looy in 2008. The aim of this project was to test the methods we propose for this analysis. But we also wanted to find out what types of sounds are usually audio described and what their narrative contribution is - how they help build the story that is told in the film. Our analysis shows that AD usually renders the sounds that are the most prominent and most easily recognized. The analysis also shows that it is difficult to understand the narrative contribution of sounds, though, with the current scientific frameworks that we have. Therefore, the article ends with various new research questions and a clear plea for more research in this domain.

Knowledge on Hypertension and its Therapy in Lay People

Hypertension is one of the non-communicable diseases that is becoming a global problem. Hypertension is characterized by systolic blood pressure of 140 mmHg and diastolic 90 mmHg (according to JNC VIII). Uncontrolled hypertension can lead to complications such as stroke, ischemic heart disease, heart attack, heart failure, kidney failure, blindness, etc.
 According to Basic Health Research (Riskesdas 2018) the prevalence of hypertension for >18 years is 8.4%, and through measurements taken in health care facilities by 34.1%. Prevalence in the city was 34.4%, in the village was 33.7%, while according to gender 31.3% (male) and 36.9% (female).
 The purpose of the study was to find out the knowledge and awareness of laypeople on hypertension and its therapy. This was a cross-sectional online study with 11 questions. Respondents were recruited from social media groups. Results: five hundred respondents (62.8 % female, 37.2 % male). The most age range at the age 21-40 years (36.2 %), 41-55 years (38.2%) and 56-65 years old (18.4%). Seventy-two percent of respondents did not have hypertension, and 9% said they did not know. Fifty-three percent of respondents know about the value of high blood pressure, and 89% respondents said hypertension should be treated regularly. The most hypertension complications answered by respondents were stroke (40%), heart attack (26%) and heart failure (16%). Amlodipine was the most mentioned by respondents, the second was ACE-inhibitor. However, omeprazole and omega-3 also mentioned as anti-hypertension. Genetic and a diet high in salt were risk factors that many respondents chose. Conclusion: Respondents have a good understanding on hypertension. Information related to behaviour is needed, so that prevalence does not continue to increase.

Are Lay People Able to Estimate Breeding Bird Diversity?

Studies about biodiversity and well-being used different approaches to assess biodiversity, e.g., scientific counts and censuses or perceived biodiversity estimated by the respondents. Here, we assessed whether laypeople could estimate the breeding bird diversity or species richness at specific places. For comparison, we carried out bird censuses with standard methods of professional ornithologists and used citizen science data from the internet platform Ornitho (Germany). Lay people from the public (1184 respondents) were surveyed between May and July 2022 at 40 different places in southwest Germany between Rottenburg/Tübingen and Stuttgart following the catchment of the river Neckar (30 people surveyed per place). People were asked to estimate the bird species richness/diversity at this current place. Here, we show that the data from the citizen science platform does not correlate with the professional census counts nor with the perceived species richness of laypeople. Laypeople have a generally good assessment of the bird species richness, correlating with the data of professionals (r = 0.325, p = 0.041). On average, the number of species assessed by laypeople lies in between the values of the professional morning and afternoon census. People were most often surveyed in the afternoon; therefore, their assessment must be done on other factors than actual birds present. This result is valuable for future studies on the connection between biodiversity and well-being.

Role of ductular reaction and ductular–canalicular junctions in identifying severe primary biliary cholangitis

Background & AimsPrimary biliary cholangitis (PBC) is a chronic cholangiopathy characterised by immuno-mediated injury of interlobular bile ducts leading to intrahepatic cholestasis and progressive liver fibrosis. PBC histology is characterised by portal inflammation, progressive fibrosis, ductopenia, and the appearance of the so-called ductular reaction. The aim of the present study was to investigate the pathogenetic relevance of ductular reaction in PBC. MethodsLiver biopsies were collected from naïve people with PBC (N = 87). Clinical–serological parameters were obtained at diagnosis and after 1 year of ursodeoxycholic acid (UDCA) treatment. Histological staging was performed on all slides according to multiple scoring systems and criteria for PBC. Liver samples were obtained from Mdr2−/− mice treated with or without UDCA. Samples were processed for histology, immunohistochemistry, and immunofluorescence. ResultsDuctular reaction in people with PBC correlated with the disease stage and liver fibrosis, but not with disease activity; an extensive ductular reaction correlated with serum alkaline phosphatase levels at diagnosis, response to UDCA, and individuals’ estimated survival, independently from other histological parameters, including disease stage. In people with PBC, reactive ductules were associated with the establishment of junctions with bile canaliculi and with fibrogenetic cell activation. Consistently, in a mouse model of intrahepatic cholestasis, UDCA treatment was effective in reducing ductular reaction and fibrosis and increasing ductular–canalicular junctions. ConclusionsExtensive ductular reaction outlines a severe histologic phenotype in PBC and is associated with an inadequate therapy response and a worse estimated prognosis. Lay summaryIn people affected by primary biliary cholangitis (PBC), the histological appearance of extensive ductular reaction identifies individuals at risk of progressive fibrosis. Ductular reaction at diagnosis correlates with the lack of response to first-line therapy with ursodeoxycholic acid and serves to restore ductular–canalicular junctions in people with PBC. Assessing ductular reaction extension at diagnosis may add valuable information for clinicians.

Predatory trading: ethics judgments, legality judgments and investment intentions

PurposePredatory trading is a stock market trading technique in which certain market participants exploit information about other market participants' need to trade. Predatory trading often harms others. Hence, this paper examines the determinants and effects of financial practitioners' and lay people's judgments of predatory trading. Specifically, it investigates how the public availability and reliability of the exploited information affect their ethics and legality judgments and how the latter influence their behavioral intentions and regulation support.Design/methodology/approachThe authors conducted two scenario judgment studies. In the first study, participants were financial practitioners, and in the second – lay people.FindingsPractitioners often judge predatory trading to be ethical. Practitioners and lay people incorporate in their ethics and legality judgments the public availability of the exploited information but tend to discount the legal reliability criterion. Lay people justify their ethics judgments using harm, legal or profit maximization principles. Practitioners' intentions to engage in predatory trading and lay people's intentions to let predatory fund managers invest their money depend on their judgments, which influence their regulation support.Originality/valueThis paper is the first to explore people's judgments of predatory trading. It highlights that despite the harm that predatory trading involves, practitioners often judge it to be ethical. Although law tends to lag behind financial innovation, people base their judgments and hence also behavioral intentions on their interpretation of the regulation. Hence, it reveals a dark aspect of the relationship between ethics and legality judgments.

Does learning you are autistic at a younger age lead to better adult outcomes? A participatory exploration of the perspectives of autistic university students.

People learn they are autistic at different ages. We wanted to know if telling kids they are autistic earlier helps them feel better about their lives when they grow up. We are a team of autistic and non-autistic students and professors. Seventy-eight autistic university students did our online survey. They shared how they found out they were autistic and how they felt about being autistic. They also shared how they feel about their lives now. Around the same number of students learned they were autistic from doctors and parents. Students who learned they were autistic when they were younger felt happier about their lives than people who learned they were autistic when they were older. Students who learned they were autistic when they were older felt happier about being autistic when they first found out than people who did not have to wait as long. Our study shows that it is probably best to tell people they are autistic as soon as possible. The students who did our study did not think it was a good idea to wait until children are adults to tell them they are autistic. They said that parents should tell their children they are autistic in ways that help them understand and feel good about who they are.

Relationship between lay and expert perceptions of COVID-19 vaccine development timelines in Canada and USA.

ObjectivesCompare lay expectations of medical development to those of experts in the context of SARS-CoV-2 vaccine development.MethodsA short online survey of experts and lay people measuring when participants believe important vaccine milestones would occur and how likely potential setbacks were. Samples of US and Canadian lay people recruited through Qualtrics. The expert sample was created through a contact network in vaccine development and supplemented with corresponding authors of recent scholarly review articles on vaccine development.ResultsIn aggregate, lay people gave responses that were within 3 months of experts, tending to be later than experts for early milestones and earlier for later milestones. Median lay best estimates for when a vaccine would be available to the public were 08/2021 and 09/2021 for the US and Canadian samples, compared with 09-10/2021 for the experts. However, many individual lay responses showed more substantial disagreement with expert opinions, with 54% of lay best estimates of when a vaccine would be available to the public being before the median expert soonest estimate or after the median expert latest estimate. Lay people were much more pessimistic about vaccine development encountering setbacks than experts (median probability 59% of boxed warning compared with only 30% for experts). Misalignment between layperson and expert expectations was not explained by any demographic variables collected in our survey.ConclusionMedian lay expectations were generally similar to experts. At the individual level, however, lay people showed substantial variation with many believing milestones would occur much sooner than experts. Lay people were in general much more pessimistic about the prospect of setbacks than were experts.

Chronic Kidney Disease of Uncertain Etiology in Sri Lanka: Curing between Medicine and Traditional Culture

Chronic Kidney Disease of unknown origin (CKDu) has appeared across Sri Lanka’s North Central Province (NCP) since the 1990s as an epidemic, unexplained by conventional associated risk factors. During the past few decades, a large number of studies attempted to determine the unknown etiology of CKDu. Despite these investigations, no concrete conclusions were developed, though a number of contradictory hypotheses emerged. The present ethnographic study was carried out in two endemic areas, labelled as “CKDu hotspots”, and illuminates how curing takes place between biomedicine and traditional cultural practices. Our ethnographic study thoroughly scrutinized three decades of lived experience, lay-perceptions and local discourses on CKDu. We used a qualitative study design with a transcendental phenomenological approach and employed a mixture of ethnographic methods. Data collection techniques included participant observation, in-depth interviews, focus group discussions and key informant interviews. Data was analysed by using an interpretive thematic analysis model. Findings revealed that lay people have constructed a popular discourse on CKDu, and we explored their views on the origin, etiology and prevalence of CKDu in their locality over the past few decades. Patients’ narratives revealed that there were currently a number of gaps in service delivery. These were mainly due to distant relationships between healthcare providers and CKDu patients. Lay people in affected communities were marginalized throughout the investigation process to determine the unknown etiology, their involvement marginalized to merely acting as objects for scientific instigation. The affected communities strongly believed that CKDu was a recent phenomenon resulting from the mismanagement of the natural environment due to social and lifestyle changes. These findings highlight local dynamics of healthcare seeking behaviours which demand complementary medicine system, particularly given the number of limitations in the biomedical system. Empirical evidence generated from this study suggests a conceptual shift to an ethno-medical model to address CKDu. Improving cultural competency and communication skills among healthcare providers in public health are crucial in order to apply a “bio-psychosocial perspective” in healthcare delivery system and bridging the gap between hospital and the community.

Adapting to and Assessing Online Worship: Listening to Rural Church of England Lay People

ABSTRACT The aim of the present study was to analyse the comments made by 133 rural lay people who voiced their views on, and experience of, the move to online provision of worship services during the Covid-19 pandemic. Issues identified centred on the content and structure of such worship with virtual Holy Communion being the service most frequently mentioned as cause for concern. Overall, however, rural lay people were positive about their experience. In particular, the opportunities online worship provided for increasing communication among and across congregations, for growing church numbers and attracting previously hard-to-reach groups, and for the ways in which it was enriching worshipping life by increasing choice and access to a wider range of services. Going forward these rural lay people were optimistic that worship that continued to respect the importance of gathering in the church building could be combined with some level of online provision.

Lay people's beliefs about creativity: evidence for an insight bias.

Research finds that creative ideas are generated by two cognitive pathways: insight and persistence. However, emerging research suggests people's lay beliefs may not adequately reflect both routes. We propose that people exhibit an insight bias, such that they undervalue persistence and overvalue insight in the creative process.

Dichotomy of lay people and health professionals perception of physical activity is a challenge for activity education and promotion within primary health care - a qualitative study.

According to the WHO, healthy adults aged 18-64 should perform at least 150 min of moderate-intensity aerobic physical activity (PA), or at least 75 min of vigorous-intensity PA, throughout the week, or an equivalent combination of moderate and vigorous activity. These recommendations should be promoted and involved in primary health care (PHC) staff daily practice. Tailoring the education message depends on peoples' perspective on PA, but in Poland there is no research on the subject. The aim of the study was to explore and compare the perception of lay people (LP) and health professionals (HP) of PA to find similarities and differences in their perspective - as this may have an impact on PHC-based education on PA (favourable or unfavourable). Six mini FGIs were carried out. Research sample consisted of 16 LP from urban settings and 10 HP (doctors, nurses). LP and HP appreciated PA as important and considerably controllable health determinant. LP attributed the main gains of PA to psycho-social benefits, and HP strictly to diseases risk reduction. Both groups had difficulties in defining PA and doubts abounded about PA and exercise. Optimal dose (volume) of PA was generally unclear and the WHO recommendation were unknown. HP seemed to be more eager than LP to appreciate simple forms of PA, e.g. walking. Barriers to PA perceived by LP were described in terms of 'real life' factors (sportswear, access, job), and HP mostly by cognition (knowing, judging) and social status. LP preferred positive, rewarding motivation for PA, but HP one that was negative and fear-based. Referring to activity, LP and HP were like travellers in parallel universes. This created challenges in PHC-based education. Some suggestion for PA education were given. More qualitative and quantitative research are needed.

Aesthetic evaluation of lip position with respect to profile divergence: A silhouette based study.

Objective: To determine the mean attractiveness and score of lip position that is rated by orthodontists and lay persons in different levels of profile divergence as seen in silhouette images. Study Design: Cross-sectional survey. Setting: Punjab Dental Hospital/de’Montmorency College of Dentistry, Lahore. Period: January 2020 to July 2020. Material & Methods: Lay people were selected from the hospital and orthodontic postgraduate trainees were selected from the college. An ideal profile image was constructed and converted to silhouette. By changing position of subnasale and soft tissue pogonion horizontally in relation to true vertical line, divergence of profile was changed and 3 forms of straight/normal profile were created. Three sets of profiles were created (1 anterior divergent, 2 straight divergent, 3 posterior divergent) and each set consisted of 5 images with different degrees of lip protrusion. Results: There were 50% of both genders in orthodontists and 48% males and 52% females in lay person with mean ages 28.74±2.55 and 34.66±7.30 years respectively were part of the study. There was significant difference found between orthodontists and lay person for anterior divergent profile with normal position (4.54±0.61 and 4.68±0.47 with P<0.05). Conclusion: The normal lip position is viewed as the most ideal position; however the same does not have any significant bearing to the straight divergent profile, in which the assessments of various groups were uncertain.

What Makes a Terrorist? Muslims’ and non-Muslims’ Lay Perceptions of Risk Factors and Their Consequences for Counterterrorism Policy Support

ABSTRACT The question of why people become terrorists has preoccupied scholars and policy makers for decades. Yet, very little is known about how lay people perceive individuals at risk of becoming terrorists. In two studies conducted in the U.K., we aimed to fill this gap. Study 1 showed that Muslims and non-Muslims perceived a potential minority-group terrorist in terms of both structural (e.g., life-history, social) and individual risk factors (e.g., personality, psychopathology, ideology). In Study 2, Muslims and non-Muslims perceived a potential right-wing majority-group terrorist as having more individual predispositions to terrorism than a potential left-wing majority-group terrorist. Importantly, in both studies, individualist perceptions such as psychopathology were positively associated with support for stricter law enforcement, whereas structuralist perceptions such as adverse childhood experiences were positively associated with support for social interventions. Lay people seem to have multifactorial understandings of individuals at risk of becoming terrorists, which influence their counterterrorism policy support.

Assessing the Church of England’s Leadership Response to the Covid-19 Pandemic: Listening to the Voice of Rural Lay People

AbstractThe aim of the present study is to analyse the qualitative text written on the back page of a quantitative survey concerned with the Church of England’s response to the Covid-19 pandemic. Of the 1460 rural lay people in England who took part in the Coronavirus, Church & You survey, 501 wrote further (sometimes detailed) comments on the back page (34 per cent participation rate). This study analyses the comments made by a subsection of these 501 rural lay people, specifically the 52 participants who voiced their views on how the Church of England’s leadership responded during the first four months of the Covid-19 pandemic. Analysis identified a number of issues and concerns, including: a lack of quality leadership, comparing with other Churches, becoming irrelevant, centralizing action, closing rural churches, neglecting rural people, neglecting rural clergy, marginalizing rural communities, using the kitchen table, and looking to the future. Overall, rural lay people were disappointed with the response of church leadership to the first national lockdown. If these churchgoers are to be fruitfully reconnected with their churches after the pandemic, then leadership of the Church of England may need to hear and to take seriously their concerns.

Symbiotic relations as the foundation of propaganda: Directions for future research

ContextPropaganda seems to be around us all the time, yet many people would find it difficult to provide a definition of propaganda. It becomes one of those words that are easy to use, but hard to define. Scholars have been writing on propaganda for centuries, yet the definition still remains illusive. Lay people simply call propaganda all communications they disagree with. Propaganda becomes brainwashing or, even worse, psychological warfare. ObjectivesThe article seeks to address this problem of identifying propaganda. MethodThe article develops a theoretical argument by bringing a psychological and psychoanalytic work of Fromm into the real of communication sciences. ResultsThe author argues that propaganda is more than just a profanity for communication activities we disagree with. In fact, this essay suggests that propaganda is best understood through a psychoanalytical research on sadism and masochism by Fromm. Fromm using a biological concept of symbiosis explained sadism and masochism as a way of building symbiotic relations making an individual bigger than just oneself. Applying this theory to a society makes propagandist and propagandee not that different from a sadist and masochist, both gaining meaning for their lives through propaganda and becoming parts of something bigger. Propaganda's symbiotic relations rely on groupthink and participatory rhetoric focusing on building group cohesion and establishing “us versus them” mentality. ConclusionThe article concludes that propaganda's symbiotic relations work through groupthink and participatory rhetoric focusing on building group cohesion and establishing “us versus them” mentality. Propaganda removes an individual, focusing instead on many; propaganda eradicates individual's desires focusing instead on needs of the group; and propaganda draws sharp boundaries where own group ends and the enemy territory begins. Propaganda becomes an aggressive symbiosis aimed at its own survival and protection from the others. The study, building on this explicating of propaganda through symbiotic relations, proposes several areas for future research on propaganda to better understand its connection to psychology and psychoanalysis.

Deficit Lay or Deficit Expert: How Do “Experts” in Environmental Projects Perceive Lay People and Lay Knowledge?

This research reveals expert perceptions of lay people and lay knowledge in environmental projects, such as information giving activities, research projects, and environmental planning projects. A semistructured interview method was employed with six researchers from a university in Sweden. Although the expert–lay relationship has traditionally been discussed within a “deficit model,” many experts in this research expressed a more positive view of lay people and lay knowledge; however, situations where lay knowledge was considered useful varied. The experts’ motivation for communication was analyzed within the four communication modes of education, responding, supplementing, and dialogue. Their recognition of the “deficit expert” was one of the remarkable findings: the experts acknowledged their knowledge and competence in understanding “reality” had its limitations and questioned the objectivity and universality of science in relation to environmental science.

Scenario modelling as planning evidence to improve access to emergency obstetric care in eastern Indonesia.

The rate of maternal deaths in remote areas in eastern Indonesia–where geographic conditions are difficult and the standard of infrastructure is poor–is high. Long travel times needed to reach emergency obstetric care (EMOC) is one cause of maternal death. District governments in eastern Indonesia need effective planning to improve access to EMOC. The aim of this study was to develop a scenario modelling tool to be used in planning to improve access to EMOC in eastern Indonesia. The scenario model was developed using the geographic information system tool in NetLogo. This model has two inputs: the location of the EMOC facility (PONED) and the travel cost of moving across geographical features in the rainy and dry seasons. We added a cost-benefit analysis to the model: cost is the budget for building the infrastructure; benefit is the number of people who can travel to the EMOC in less than 1 hour if the planned infrastructure is built. We introduced the tool to representative midwives from all districts of Nusa Tenggara Timur province and to staff of Kupang district planning agency. We found that the tool can model accessibility to EMOC based on weather conditions; compare alternative infrastructure planning scenarios based on cost-benefit analysis; enable users to identify and mark poor infrastructure; and model travel across the ocean. Lay people can easily use the tool through interactive scenario modelling: midwives can use it for evidence to support planning proposals to improve access to EMOC in their district; district planning agencies can use it to choose the best plan to improve access to EMOC. Scenario modelling has potential for use in evidence-based planning to improve access to EMOC in low-income and lower-middle-income countries with poor infrastructure, difficult geography conditions, limited budgets and lack of trained personnel.