Multidimensional Experience Research Articles

How do external environmental stimuli and internal psychological cultural identity affect tourists’ behavioral intentions in public cultural spaces?

The role of cities and regions is becoming increasingly crucial in the process of global localization. As vital carriers of urban activities, public spaces are receiving widespread attention; however, the substantial impact of multidimensional experiences of public cultural spaces on urban tourism and the role of cultural identity within these spaces have yet to be extensively studied. This study establishes a framework based on scenescape and stimulus-organism-response theories to explore how external stimuli influence tourists’ behavioral intentions. We developed and conducted a questionnaire survey targeting individuals who have visited the “Most Beautiful Public Cultural Spaces” in Nanjing, China. A total of 287 valid samples were collected for analysis. Four types of external environmental stimuli—physical, activity, mechanism, and virtual spaces—were found to have direct and indirect effects on tourists’ behavioral intentions with cultural identity playing an intermediary role. These new insights provide theoretical enlightenment and practical recommendations for enhancing tourism experiences in public cultural spaces.

Symptom Network and Clusters of the Multidimensional Symptom Experience in Patients With Atrial Fibrillation

Background The symptom network can provide a visual insight into the symptom mechanisms. However, few study authors have explored the multidimensional symptom network of patients with atrial fibrillation (AF). Objectives We aimed to identify the core symptom and symptom clusters of patients with AF by generating a symptom network. Furthermore, we wanted to identify multiple characteristics related to symptom clusters. Methods This is a cross-sectional study. A total of 384 patients with AF at Tianjin Medical University General Hospital were enrolled. The University of Toronto Atrial Fibrillation Severity Scale was used to assess AF symptoms. Network analysis was used to explore the core symptom and symptom cluster. Results Shortness of breath at rest (r s = 1.189, r c = 0.024), exercise intolerance (r s = 1.116), shortness of breath during physical activity (r s = 1.055, r c = 0.022), and fatigue at rest (r c = 0.020) have the top centrality for strength and closeness. The top 3 symptoms of bridge strength were shortness of breath at rest (r s = 0.264), dizziness (r s = 0.208), and palpitations (r s = 0.207). Atrial fibrillation symptoms could be clustered into the breathless cluster and the cardiac cluster. We have identified multiple factors such as mental health status, left ventricular ejection fraction, heart failure, sex, B-type natriuretic peptide, and chronic obstructive pulmonary disease as significant contributors within the breathless cluster, whereas sex, mental health status, and history of radiofrequency ablation were strongly associated with the cardiac cluster, holding promise in elucidating the underlying mechanisms of these symptoms. Conclusion Special attention should be given to shortness of breath at rest as its core and bridging role in patients' symptoms. Furthermore, both the breathless and cardiac clusters are common among patients. Network analysis reveals direct connections between symptoms, symptom clusters, and their influencing factors, providing a foundation for clinicians to effectively manage patients' symptoms.

Capturing mobile, situational, and multi-dimensional tourist experience: an integrated approach

ABSTRACT Inspired by the critical and mobility turns in tourism studies, this article provides a conceptualisation of understanding tourist experiences on the move, along with an integrated methodology for tracking mobile tourist experiences. It argues that tourist experience is mobile and situational. Multi-dimensional aspects of tourist experience evolve and interact during their journey. Based on recent theoretical and methodological advancements, this article proposes an integrated approach to capturing the geographic, sensory, social, and emotional aspects of tourist experiences at specific places and times throughout their journey. To offer a more comprehensive understanding of the intricate and evolving nature of tourist experiences in different geographical contexts, this approach integrates Global Positioning System (GPS) tracking, portable sound levels sensing, and wearable physiological sensing technologies, together with Ecological Momentary Assessment (EMA) survey, in-situ photos and videos, and photo – and video-elicited interviews. A study case of the mobile tourist experience on Mount Huangshan in China is used to illustrate the integrated approach. Finally, this article concludes by discussing theoretical contributions, methodological advancements, and practical implications, which lay foundations for understanding the dynamics and complexities of tourist experiences in future studies.

To Be in Pain: Pain Multidimensional Questionnaire as Reliable Tool to Evaluate Multifaceted Aspects of Pain

Background/Objectives: Pain is a multidimensional experience influenced by sensory, emotional, and cognitive factors. Traditional pain assessments often fail to capture this complexity. This study aimed to develop and validate the Pain Multidimensional Questionnaire (Pa-M-QU), a new self-report tool designed to assess pain catastrophizing, sensitivity, and coping strategies. Methods: Two independent samples of Italian-speaking participants, aged 18 and above, were recruited online. The first sample (n = 392; mean age = 29.36) was used for exploratory factor analysis (EFA), and the second sample (n = 123; mean age = 28.0) for confirmatory factor analysis (CFA). Pearson’s correlations and convergent validity analyses were conducted. Results: From an initial pool of 59 items identified through focus group discussions, 35 items were removed based on reliability analysis. The final 24-item Pa-M-QU features a three-factor structure: catastrophizing, pain sensitivity, and coping with pain. Conclusions: The Pa-M-QU offers a rapid, non-invasive assessment that captures the multidimensional nature of pain. It is a starting point to develop tools for both clinical and research settings, aiding in evaluating pain in healthy individuals and predicting acute and chronic pain disorders. Future research should focus on refining the Pa-M-QU for broader clinical applications and exploring its potential to complement or replace traditional pain assessments, thereby advancing pain management and research.

Grief in Older Adults: A Concept Analysis

Objectives Grief is a human, universal, personal and multidimensional experience. Although studies have been conducted to describe grief, there is no consensus among scholars about its theoretical or empirical definition in older adults. This study aims to analyze the concept of grief in old age. Methods & Materials This is a review study that was conducted in eight steps using Walker and Avant’s concept analysis method. To find studies related to grief in the elderly, a search in online databases including ScienceDirect, Scopus, PsychInfo, PubMed, Web of Science, and EMBASE using keywords: Grief, mourn, bereavement, old, geriatric, aging, age, later life, seniors, nonagenarian, octogenarian and centenarian. Also, articles were examined without considering the time limit published until January 30, 2023. The search strategy, screening, and data reporting were done based the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Results Of 5963 articles, 34 were included. According to the findings, grief had five features, “a unique phenomenon”, “negative emotional experience”, “physiological irritation”, “experience of loneliness”, and “loss of previous meanings”. Three antecedents of grief included: Loss of loved ones, loss of pets, spouse divorce, and loss of health. Four consequences of grief included health consequences, social consequences, financial consequences, and resiliency. Conclusion The provided definition of grief in older adults can help the health team understand the concept better and carry out investigations, interventions, and evaluations to improve the health of the elderly.

Exploring athlete pain assessment experiences and priorities; a two-part qualitative series of athlete and physiotherapist interactions. Part Two. “Forging our future” - Athlete and physiotherapists' priorities for pain assessment and beyond

ObjectivesTo explore the priorities and directions of athlete upper and lower limb pain assessment by facilitating shared understandings of athletes and sport physiotherapists. DesignQualitative research using a hermeneutic phenomenological approach. MethodsWe carried out focus groups comprising a deliberate criterion sample using a constructivist perspective. At the end of each focus group, we used the nominal group technique method to generate a list of consensus-based priorities for future pain assessment. Our paper follows the consolidated criteria for reporting qualitative research (COREQ) guidelines. ResultsWe completed five focus groups, comprising twelve athletes (female, n = 5, male, n = 7) and four sport physiotherapists (male, n = 4). Two final themes (and six subthemes) were developed; I Enhanced Communication and Pain Descriptions (describing and representing pain, better communication, the role of technology, providing direction and setting the pace), and II Integrating Sport Specific and Multidimensional Assessments (broadening the pain assessment toolkit, the role of technology). We developed a set of thirteen practical priorities for pain assessment that span the subjective, objective, and general aspects of the athlete pain assessment. ConclusionsWe have presented stakeholder-generated perspectives, direction and priorities for athlete pain assessment. Athletes and physiotherapists must continue to work together to achieve a comprehensive sport-specific multidimensional pain assessment experience alongside their wider support networks to ensure optimal representation and communication. We have highlighted some available pain assessment tools and strategies and outlined how novel tools may address certain gaps. Researchers, clinicians, and athletes can consider the practical guidance we have provided to address these priorities.

Neural mechanisms underlying placebo and nocebo effects in tonic muscle pain

Pain is a highly subjective and multidimensional experience, significantly influenced by various psychological factors. Placebo analgesia and nocebo hyperalgesia exemplify this influence, where inert treatments result in pain relief or exacerbation, respectively. While extensive research has elucidated the psychological and neural mechanisms behind these effects, most studies have focused on transient pain stimuli. To explore these mechanisms in the context of tonic pain, we conducted a study using a 15-minute tonic muscle pain induction procedure, where hypertonic saline was infused into the left masseter of healthy participants. We collected real-time Visual Analogue Scale (VAS) scores and functional magnetic resonance imaging (fMRI) data during the induction of placebo analgesia and nocebo hyperalgesia via conditioned learning. Our findings revealed that placebo analgesia was more pronounced and lasted longer than nocebo hyperalgesia. Real-time pain ratings correlated significantly with neural activity in several brain regions. Notably, the putamen was implicated in both effects, while the caudate and other regions were differentially involved in placebo and nocebo effects. These findings confirm that the tonic muscle pain paradigm can be used to investigate the mechanisms of placebo and nocebo effects and indicate that placebo analgesia and nocebo hyperalgesia may have more distinct than common neural bases.

Walking the hidden city: the role of citywalk in shaping destination branding experience

ABSTRACT Citywalk, a burgeoning travelling phenomenon, significantly shapes destination branding experience (DBE) construction. Social media posts about citywalk have gained significant exposure on platforms like Xiaohongshu, one of the fastest-growing social media platforms in mainland China. Contemporary tourism research identifies six DBE dimensions: sensory, affective, behavioural, cognitive, spiritual, and relational. However, how these DBE dimensions are reflected in tourists’ citywalk experiences on social media remains unclear. Few studies have examined how young citywalkers reveal their DBE through Xiaohongshu posts. This study aims to investigate the citywalkers’ experiences by aligning them with six DBE dimensions. Utilising netnography and analyzing Xiaohongshu posts, this study highlights the multi-dimensional experience fostered by citywalks, surpassing the conventional focus on brand experience dimensions in marketing research. Except for cognitive experience, other dimensions of experience demonstrate potential interactions among themselves.

MDES and Movie Watching: Examining Thought Patterns During Movie Watching Task

Multi dimensional experience sampling (MDES) occurs when questions are asked to participants while they are completing a certain task, and to assess and examine various facets and thought processes of participant’s experience while encountering that particular activity (Wallace et al., 2024). For instance, examining a participant's emotional state. This sampling method was applied to a movie watching study completed over the duration of May to August 2024. The study included 15 participants, who each observed a total of 15 film clips, in person in the lab located in Kingston, Ontario. The clips each ranged from one to three minutes, and comprised of various film genres. Participants would then complete an MDES questionnaire after observing each film clip. Once the data was obtained, a Principal Component Analysis (PCA) was completed. It was discovered that four components of thought were found including intrusive distraction, sensory engagement, episodic knowledge, and narrative comprehension of the clips. Episodic knowledge highlights the participant’s attention fixating on past events and their emotions and focuses less on current deliberate thoughts, and narrative comprehension concentrates on the participant’s problem-solving skills to understand the content occurring in the clips. Whereas, participant’s sensory engagement features their focus to sounds and images in the clips, and intrusive distraction aids in displaying that their focus is poor while viewing the clips, but their intrusive thoughts are high. Using the data it can be assumed that various thought processes can occur while an individual observes movies. It also aided in identifying any factors that could help or hinder participants' ability to focus on the movie clip task. The data can be beneficial in furthering our understanding of an individual's attentional abilities when viewing various genres and pieces of media. Works Cited Wallace, R. S., Mckeown, B., Goodall-Halliwell, I., Chitiz, L., Forest, P., Karapanagiotidis, T., Mulholland, B., Turnbull, A. G., Vanderwal, T., Hardikar, S., Alam, T. G., Bernhardt, B., Wang, H.-T., Strawson, W., Milham, M., Xu, T., Margulies, D., Poerio, G. L., Jefferies, E., … Smallwood, J. (2024). Mapping Patterns of Thought onto Brain Activity during Movie-Watching, 1–38. https://doi.org/10.1101/2024.01.31.578244

Exploring Genre-Specific Thought Patterns Through Real-Time Experience Sampling of Movie Clips

Understanding cognition during media consumption is crucial to understanding how individuals process complex stimuli in everyday life. This study employed multi-dimensional Experience Sampling (mDES) to capture real-time thoughts as participants viewed 2-3 minute movie clips across various genres. By utilizing movie clips, this study bridges real-world scenarios with the control of a laboratory setting; revealing how different movie genres uniquely shape thought patterns. I conducted Principal Component Analysis to identify the underlying structure of participants' thoughts. The analysis revealed four distinct thought components, named based on their loading structure: (1) Narrative Comprehension, (2) Episodic Knowledge, (3) Intrusive Distraction, and (4) Sensory Engagement, replicating components found in earlier mDES movie-watching studies (Konu et al., 2021; Wallace et al., 2024). To examine how subjects’ thoughts differed based on the genre of the movie clip, I conducted a series of linear mixed models comparing component scores for each component across genres. The analysis indicated certain thought patterns differed by genre. In Intrusive Distraction, Comedy clips scored significantly lower than Drama clips (p <.001), Romantic Comedy clips (p = .007), and clips of an unspecified genre (other) (p = .010). In Episodic Knowledge, Thriller clips scored significantly lower than Action clips (p = .002), Comedy clips (p <.001), Drama clips (p <.001), Family clips (p <.001), and Romantic Comedy clips (p <.001). Altogether, this study replicates the component structure found in earlier movie watching mDES studies, showing consistency across samples. Additionally, this study makes a significant contribution to the field of ongoing thought research by being the first to empirically establish that individuals’ internal experiences systematically differ based on movie genre. These findings suggest researchers should consider genre-specific influences when designing future movie-based tasks in psychology and neuroimaging studies. However, the small sample size (N=15) warrants caution; larger studies are needed for improved reliability and validity.

A multi-modal evaluation of experimental pain and psychological function in women with carpometacarpal osteoarthritis

ObjectiveThumb carpometacarpal osteoarthritis (CMC1 OA) is a prevalent and debilitating condition that lacks effective treatments. Understanding the multidimensional pain experience across CMC1 OA disease stages is crucial to improving treatment outcomes. This study examined how radiographic CMC1 OA severity is associated with physical, psychological, and somatosensory function. MethodThirty-one women with early-stage (Eaton-Littler 1–2) or end-stage (Eaton-Littler 3–4) radiographic CMC1 OA completed validated questionnaires to assess pain, disability, and psychological function. Additionally, experimental pain was measured in each participant using quantitative sensory testing (QST) (mechanical, pressure, vibratory, thermal) at seven body sites (thenar, hypothenar, brachioradialis bi-laterally; quadriceps on affected side). Cohort differences (early-vs. end-stage) across all variables were analyzed using a multivariable modeling approach that included fixed effects and interactions; notably, age was controlled as a confounder. ResultsEnd-stage CMC1 OA participants had higher scores in the pain (p ​= ​0.01) and function (p ​= ​0.02) portions of the AUSCAN assessment, self-reported disability of the DASH questionnaire (p ​= ​0.04), and painDETECT scores (p ​= ​0.03), indicating greater pain and disability compared to early-stage participants. Additionally, end-stage CMC1 OA participants demonstrated reduced vibratory detection and heat pain thresholds at multiple body sites (p's ​< ​0.05), with significant interactions observed across the mechanical and cold stimuli. ConclusionFindings revealed women with end-stage CMC1 OA exhibited increased neuropathic pain characteristics and somatosensory loss compared to those with early-stage CMC1 OA. These results underscore the importance of addressing both peripheral and centralized pain mechanisms and the need for multimodal approaches in the treatment of CMC1 OA.

Experiences and barriers in downward referral decision-making for palliative care patient caregivers under China's three-tiered linkage model: A qualitative study

ObjectiveThis study aimed to explore hospice caregivers’ downward referral decision-making experiences and barriers under the triadic linkage model in China and to analyze the deeper social dynamics of hospice referral choices. MethodsSemi-structured interviews were conducted with caregivers handling hospice referrals from two primary hospice agencies in Nanjing, China. The themes were analyzed and summarized using the Colaizzi 7-step analysis. ResultsFour themes and nine subthemes were extracted: multidimensional caregiver psychological experience (Dilemma and Guilt, Emotional Support and Psychological Adaptation), perceived disparities between referral organizations (convenience and affordability in the home community, perceived lack of primary health care resources), limitations of caregiver decision-making (cognitive comprehension bias, difficulty in information seeking, and passive acceptance of decision making), and limitations of health care referral support (lack of health care referral guidance, inadequate referral handoffs). ConclusionsFeedback from caregivers of hospice-referred patients reveals many barriers to hospice referral decision making and referral implementation. Overcoming these barriers entails efforts to change the cognitive misunderstandings regarding hospice referrals from patients' perspective, clarify the distribution of responsibilities among hospice agencies, and provide information support and decision-making assistance. These measures must be employed to improve the implementation of hospice referral, realize the multiple benefits of hierarchical diagnosis and treatment, boost patients’ satisfaction with the referrals, and ensure the rational and efficient distribution of hospice resources.

Unraveling the physiological and psychosocial signatures of pain by machine learning.

Pain is a complex subjective experience, strongly impacting health and quality of life. Despite many attempts to find effective solutions, present treatments are generic, often unsuccessful, and present significant side effects. Designing individualized therapies requires understanding of multidimensional pain experience, considering physical and emotional aspects. Current clinical pain assessments, relying on subjective one-dimensional numeric self-reports, fail to capture this complexity. To this aim, we exploited machine learning to disentangle physiological and psychosocial components shaping the pain experience. Clinical, psychosocial, and physiological data were collected from 118 chronic pain and healthy participants undergoing 40 pain trials (4,697 trials). To understand the objective response to nociception, we classified pain from the physiological signals (accuracy >0.87), extracting the most important biomarkers. Then, using multilevel mixed-effects models, we predicted the reported pain, quantifying the mismatch between subjective level and measured physiological response. From these models, we introduced two metrics: TIP (subjective index of pain) and Φ (physiological index). These represent possible added value in the clinical process, capturing psychosocial and physiological pain dimensions, respectively. Patients with high TIP are characterized by frequent sick leave from work and increased clinical depression and anxiety, factors associated with long-term disability and poor recovery, and are indicated for alternative treatments, such as psychological ones. By contrast, patients with high Φ show strong nociceptive pain components and could benefit more from pharmacotherapy. TIP and Φ, explaining the multidimensionality of pain, might provide a new tool potentially leading to targeted treatments, thereby reducing the costs of inefficient generic therapies. RESC-PainSense, SNSF-MOVE-IT197271.

Electroencephalografic Activity during the Reading of Erotic Texts with and without Aggression

Sexual arousal (SA) is a multidimensional experience that includes cognitive, emotional, motivational and physiological components. Texts with erotic content have been used to generate a state of SA. Erotic texts often include aggressive content that has not been evaluated in relation to SA. The aim of this work was to compare cortical functionality in women when reading a sexually explicit text (SET) and a sexually explicit text with aggression (SETA). Twenty-seven women participated. The EEG activity of the frontal, temporal and parietal locations was recorded during the reading of both texts. The participants found the SET to be more pleasant than the SETA. Both texts were identified as triggers of general and SA. While reading the SETA, there was an increase in absolute power in the frontal and parietal locations, a higher intrahemispheric correlation between the left frontal and temporal locations in fast frequency bands and a greater interhemispheric correlation between the frontal locations in the delta and alpha1 bands. These findings indicate that cortical functionality during SA in women differs based on the content and context of the erotic material being read, possibly associated with mechanisms that underlie the processing and incentive value assignment of stimuli with sexual and aggressive connotations.

The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury.

U.S. Service members and Veterans (SM/V) experience elevated rates of traumatic brain injury (TBI), chronic pain, and other non-pain symptoms. However, the role of non-pain factors on pain interference levels remains unclear among SM/Vs, particularly those with a history of TBI. The primary objective of this study was to identify factors that differentiate high/low pain interference, given equivalent pain intensity among U.S. SM/V participating in the ongoing Long-term Impact of Military-relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) national multi-center prospective longitudinal observational study. An explainable machine learning was used to identify key predictors of pain interference conditioned on equivalent pain intensity. The final sample consisted of n = 1,577 SM/Vs who were predominantly male (87%), and 83.6% had a history of mild TBI(s) (mTBI), while 16.4% were TBI negative controls. The sample was categorized according to pain interference level (Low: 19.9%, Moderate: 52.5%, and High: 27.6%). Both pain intensity scores and pain interference scores increased with the number of mTBIs (p < 0.001), and there was evidence of a dose response between the number of injuries and pain scores. Machine learning models identified fatigue and anxiety as the most important predictors of pain interference, whereas emotional control was protective. Partial dependence plots identified that marginal effects of fatigue and anxiety were associated with pain interference (p < 0.001), but the marginal effect of mTBI was not significant in models considering all variables (p > 0.05). Non-pain factors are associated with functional limitations and disability experience among SM/V with an mTBI history. The functional effects of pain may be mediated through multiple other factors. Pain is a multi-dimensional experience that may benefit most from holistic treatment approaches that target comorbidities and build supports that promote recovery.

Εμπειρίες συμπερίληψης μέσα από συναυλίες σύμπραξης του 4ου Δημοτικού Σχολείου Αλεξανδρούπολης με το Ε.Ε.Ε.Ε.Κ. και το ΕΝΕΕΓΥ-Λ Αλεξανδρούπολης. Η μελωδία της διαφορετικότητας ενώνει καρδιές και παιδιά!

Τhis work is the result of collaboration between the 4th Primary School of Alexandroupolis " Chronis Aidonidis" and the Laboratory of Special Vocational Education Training (EEEEK) and the Unified Special Vocational High School (ENEEGY-L) of Alexandroupolis. The collaboration occurred because artistic activities offer students multidimensional experiences (cognitive, emotional, psychomotor). The activities were designed and implemented based on the goals of co-education programs, the guidelines of the Detailed Curriculum of Studies of EEEEEK and Primary Education, the principles governing the inclusion process, and the use of special teaching principles in shaping the curriculum and apply special teaching techniques. Students were made aware that equal access to knowledge for all people based on their particular abilities is a constitutional imperative, and the democratic right to co-education of students is a universal good that ensures opportunities and learning possibilities.

증강현실 기술과 북 디자인 시각화에 관한 연구

With the advent of the era of integrated media, augmented reality(AR) has been applied in many fields, and has put forward innovative requirements for traditional design forms. The research goal of this paper is to integrate AR technology to realize the visualization of book design, provide new possibilities for new forms of book design, create emotional resonance for consumers, and have certain reference value for the development of book design and the sustainable development of cultural industry. First, this paper uses literature analysis, case analysis, empirical analysis, and questionnaire survey methods to give a relevant overview of AR technology and book design visualization, analyze its research status and application cases. Secondly, using the model hypothesis method, a research model of AR technology and book design visualization was constructed, and the feasibility of the model was analyzed. Finally, the results were evaluated and verified using the survey questionnaire and PSSUQ usability scale. The following conclusions were drawn through the study. First, AR technology can break through the limitations of book design, prompt consumers to change from passive reading to active interaction, broaden the reading perspective, attract more participants, and increase the reading rate. Second, establishing a book design visualization system model with AR technology will have important significance and role, and the model will provide reference value for designers' innovative design concepts. Bring consumers a rich and multi-dimensional interactive experience and adapt to new trends in future development.

South Asia's unprotected poor: A systematic review of why social protection programs fail to reach their potential.

The incongruity between South Asia's economic growth and extreme poverty has led to a growing interest in social protection and subsequent implementation of anti-poverty initiatives. However, many programs have consistently fallen short of their full potential in reaching the poor. We reviewed the literature to understand the factors behind this failure. A search of EconLit, Global Health Database, MEDLINE and SocINDEX, supplemented by an external search, yielded 42 papers evaluating 23 programs. Inclusion criteria included social and political determinants of program outcomes. Articles were assessed for quality using the GRADE and GRADE CERQual criteria and analyzed using Thomas & Harding's thematic synthesis approach. We identified five themes: (1) structurally flawed program theories overlook the complexities of poverty and are rooted in simplistic cause-and-effect approaches; (2) elite capture through appropriation of benefits, powerful positioning in program implementation, and gatekeeping through relationships of patronage; (3) insufficient targeting strategies to reach the poorest; (4) neglect of gendered restrictions, hidden costs, lack of legal documentation, and physical and social exclusion; (5) active self-exclusion from social protection to maintain dignity, a perception that programs are substandard, and a lack of resources required. The review highlights the well-documented disconnect between South Asian social protection program designs and the ground realities of their 'ideal' beneficiaries. This stems from a dominance of Western-led poverty discourse that disregards the influence of caste, the challenge of effective engagement with a group whose identity remains unclear, and fast-paced funding calls that do not lend themselves to meaningful identification and collaboration with the invisible poor. We suggest this disconnect is intentional and reflects a broader power dynamic rooted in geopolitical interests and national priorities. Study limitations reflect the shortcomings of the existing literature, which largely uses quantitative research methods that fail to capture the multidimensional experiences of the poor.

A grounded theory on acceptance of diagnosis as a pathway to recovery in bipolar disorder

The recovery process in bipolar disorder is a subjective and multidimensional experience that seeks to develop new meanings and purposes for living a satisfying life despite the limitations imposed by the disorder. Thus, this qualitative study aimed to explore the perceptions of recovery and the meanings attributed by individuals undergoing treatment for bipolar disorder to the elements considered relevant in this process. Semi-structured interviews with open-ended questions were conducted to explore the experiences and perspectives of recovery in individuals undergoing treatment for bipolar disorder. Grounded Theory was used as the method for qualitative analysis. The study included 26 participants aged between 18 and 65 years. Based on the analysis of participant reports, we identified two main themes: living with the illness and what it means to be in recovery. The perception of recovery is an individual process and can differ from the medical model. Participants suggest that accepting the diagnosis of bipolar disorder and finding meaning in life are essential to their recovery. They also describe how mental health professionals can facilitate or hinder this process. Understanding patients’ perceptions can facilitate access to healthcare services and treatment adherence.

Gender differences in the quantitative and qualitative assessment of chronic pain among older people.

Pain, regardless of its causes, is a subjective and multidimensional experience that consists of sensory, emotional and cognitive factors that cannot be adequately captured by a single number on a pain scale. The aim of the study was to understand gender differences in the assessment of quantitative and qualitative chronic pain among older people. The study used a questionnaire that included questions about demographic and social characteristics as well as the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Depression Scale (GDS-15), McGill Pain Questionnaire (MPQ). The pain rating index based on rank values of adjectives was higher among women than men (18.36 ± 7.81 vs. 17.17 ± 9.69, p = 0.04). The analysis of the frequency of selection of individual adjectives describing the sensory aspects of pain showed that men described the pain as "stabbing" more often than women (26.1% vs. 14.3%, p < 0.05). Women chose adjectives from the emotional category more often than men (59.8% vs. 75.4%, p < 0.05), describing the pain as "disgusting" (8.9% vs. 1.4%, p < 0.05), "unbearable" (19.6 vs. 4.3, p < 0.05). In the subjective category, there was a difference between women and men in terms of describing pain as "terrible" (23.2% vs. 7.2%, p < 0.05) and as "unpleasant" (11.6% vs. 23.3%, p < 0 0.05). When referring to pain, women tend to employ more detailed and factual language, indicative of heightened emotional sensitivity. Men tend to use fewer words and focus on the sensory aspects of pain. Subjective aspects of pain were demonstrated by both women and men.