Narrative Case Research Articles

Interreligious Respect Manifested in Chautauqua

This narrative case study report will focus on an intentional community (Lakeside, Ohio) that seeks to promote interreligious respect. It is posited that this interreligious respect is both directly expressed via community programming and indirectly expressed via normative community structures. This kind of community can serve as a model for other types of settings. The thesis statement for this report stresses that the Lakeside Chautauqua promotes interreligious respect through its defined community and programming. A fundamental premise is that in a diverse society such as we have in the United States, it is imperative that we have foundations for our varied religious perspectives to peacefully co-exist and, ideally, appreciate each other

School Violence Conflicts and Restorative Circles Narrative Therapy Case Study

본 연구는 학교폭력 갈등조정을 위한 회복적 서클(Restorative Circle) 이야기치료 사례연구이다. 본 연구대상은 참여자(피해학생, 가해학생)의 진술을 분석하여 자신에 대한 인식과 현재의 감정, 타인에 대한이해,갈등에 대한 재인식, 변화 등의 4가지 유형의 경험에 대한 내용이다. 본 연구는 학교폭력 사건 이후에 갈등조정과정에서 이야기를 중심으로 갈등해결을 위한 종합적 이해 및 대응체계의 문제를 파악하고 이해당사자들의역할과 책임을 탐색하도록 돕는 것이 목적이다. 이는 학교폭력 사건 이후 피해자와 가해자가 갈등의 해결과정에서 겪는 경험을 살펴보았다. 특히 갈등의 전개 양상 및 주요 요인, 갈등의 근본적 해결을 위한 욕구에 대해정확하고 관계자들을 돕기 위함이다. 본 연구문제는 다음과 같다. 첫째, 학교폭력 갈등조정을 위한 회복적서클의 경험은 무엇인가? 둘째, 학교폭력 갈등 및 회복은 어떻게 접근하는가? 셋째, 이야기치료 과정에서 학교폭력의 갈등조정 경험은 무엇인가? 따라서 이야기치료를 통해 학교폭력 피해자 및 가해자들은 갈등을 인식하고참여와 소통으로 문제를 해결하는 기회를 갖게 된다. 즉 회복적 서클경험과 이야기치료 과정은 학교폭력 피해자와가해자로 하여금 피해보상을 넘어 회복이라는 근원적인 갈등해결의 가능성을 발견하는 기회가 될 것이다.

Lessons related to Heavy Metal Pollution through Minamata Case Narrative Study

This study aims to provide an overview or description of learning related to heavy metal pollution through a narrative study of the Minamata case. The research method used in this study is an experimental method, this method is intended to find the relationship of certain variables to other variables under tightly controlled conditions. The characteristics contained in this study include: manipulation, control or control, and observation. The data analysis technique uses the Wilcoxon marked level method to test differences, this method is used to analyze the impact caused by a treatment or stimulus as well as to test the difference in the values ??of two populations represented by two sample groups. This study concludes that the learning method through narrative studies is proven to be able to make students more mastery of materials related to heavy metal pollution. This conclusion is based on several series of hypothesis testing that have been carried out where the alternative hypothesis states that the posttest score of students in the experimental group is greater than the posttest score of students in the control class.

Depicting the narratives of escape, drift, compromise, and return: New Chinese youth paradigms in narratives of social mobility

ABSTRACT Including the next generation of migrant workers, the young generation with the new mobility can be appropriately considered as an urban-based floating population because they are not rooted in rural areas, unlike the previous generation. Those of the previous generation had a unilateral mobility trajectory from rural to urban areas, whereas the new generation’s life is based on particular regions and combines mobility trends in a more diverse direction with their own life themes. For explaining the social mobility, we applied descriptive-narrative methodology composing of narrative case study and semi-structured interviews. In this paper, the authors examine the endless variability and temporality that Chinese youths acquire from their migration experiences as well as their empirical emotions of uncertainty, particularly the internal narratives that support them amid such variability. Our conclusion suggests that the diversity of the narratives that supports mobility practices and the possibility of realizing personalized narratives are directly linked to the sustainability of Chinese society. Therefore, future Chinese urban population policies may appropriately be made by considering the narratives.

Management and Prevention of Surgical Site Infections in Spine Surgery in a Resource Poor Setting: The Irrua Protocol

Background and Aim: Surgical site infections (SSIs) in spine surgeries represent one of the most common hospital-acquired infections. SSI (refers to surgical wound infection within 30 days of surgery or 1 year after implant) portends a huge disease burden with devastating consequences for the patient and the hospital facilities with physical and psychological trauma to the patient and it is associated with an increased rate of morbidity and mortality. Despite improvements in the surgical protocol for asepsis and the role of prophylactic antibiotics in clean spine surgeries, a substantial increase still exists in the rate of SSIs. It is essential to review and identify factors predisposing patients with spinal problems to SSIs and its goal is to formulate a local protocol that helps to curtail SSIs and can be replicated in any setting in the world, considering the limitations of our setting. This study aims to review the risk factors for SSI following spine surgeries considering a 54-year-old woman with obesity who had SSI and highlights prevention ways. Methods and Materials/Patients: This study includes the search of the literature using several platforms, such as Google Scholar, Hinari, PubMed, Academia, and other search engines with related keywords to surgical site infections in spine surgery. The retrieved articles were reviewed and in some parts, the narrative case of the 54-year-old obese woman was discussed in the literature. Results: A total of 37 articles were found that matched the search words and satisfied the objective of the study. These articles were reviewed and used in writing this manuscript. Conclusion: SSIs are on the increase, and identifying risk factors on a patient basis is key to prevention. Protocol on preventive measures should be strictly followed to avoid catastrophes associated with SSIs.

Maintenance chemotherapy in advanced and metastatic pancreatic cancer, a narrative review and case series.

Limited data exist on the management of patients with locally advanced (aPC) or metastatic pancreatic (mPC) cancer who achieve stable disease/response after first-line chemotherapy. In this setting, maintenance therapy is important to minimize toxicity while preserving survival benefits. The aim of this study is to conduct a narrative review of the evidence available on the topic and present the results of a retrospective case series of patients with aPC or mPC who received maintenance therapy following a good response to induction chemotherapy. Olaparib is the only drug approved for maintenance therapy in patients with metastatic pancreatic cancer and germline Breast Cancer gene mutation. Data from several trials, including the phase II PANOPTIMOX-PRODIGE35 trial, showed clinical benefit from the use of 5-fluorouracil (5-FU) as maintenance. We also conducted a case series including 12 patients who received FOLFIRINOX as induction chemotherapy for aPC or mPC followed by fluorouracil (5-FU) or FOLFIRI maintenance therapy. Median progression-free survival is 22.13 months which is higher than that reported in the literature, which ranges between 5 and 10.6 months. Although further conclusions cannot be drawn because of the small sample size, the results are promising and encourage further exploration of this topic in larger prospective trials.

A Longitudinal Study of EFL Teacher Agency and Sustainable Identity Development: A Positioning Theory Perspective

This study reports on a longitudinal narrative case study of Lin, a tertiary level EFL teacher in China, exploring how she exercised her agency and achieved sustainable professional identity development in different phases of her career. Based on narrative data primarily from three rounds of semi-structured interviews and other sources of data, and drawing on the positioning theory, this research was designed to uncover the complex relationships between agency and professional identity transformation in an English teacher’s sustainable professional development trajectory. The analysis of Lin’s narratives was organised into three stages: the initial stage of negotiating exploited and marginalised teacher identities, then becoming a student again, and, finally, reconstructing professional teacher and researcher identities. The findings suggest the significant role of consistent individual agency in an EFL teacher’s negotiation and reconstruction of professional identities. The results also support the existing literature in revealing that identity is not a static or fixed notion, but rather a dynamic and ongoing process that is affected by a range of internal and external factors. The research also shows the vital role of teachers’ emotions and emotion regulation in the agency enactment and identity development. This study has important implications for language teacher agency and identity research. In particular, it may shed light on language teachers’ sustainable professional development, which is crucial in ensuring the pursuit of sustainable development in education and many other sustainable development goals.

Internet sourcing and unsafe use of controlled drugs (opioids, sedatives and GABA drugs) in the UK: An in depth case study of consumer dynamics during COVID-19

The Internet offers increased availability and accessibility of medicinal pharmaceuticals including those containing opioids, sedatives and gamma-aminobutyric acid (GABA) drugs through both legal and illegal routes. Sourcing concerns have been further heightened due to the current severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic which reduced face-to-face access for non-COVID-19 related health conditions and to drug treatment services. This study is the second of a two stage study comprising interviews with three key stakeholders who were policy makers, health care professionals or police, and three individuals who sourced medicinal products online (ISOs). An in-depth case study approach was adopted. Thematic analysis of in-depth case narratives revealed the following key themes; Motivations, initiation, and making the move online; Process of sourcing online; Supply issues and COVID-19; Perception of control; Quality of medications; and Public health recommendations. Motivations for purchasing online are complex and methods to divert and control the supply of medicinal pharmaceuticals are equally complex and difficult to navigate. Novel routes to access now include Telegram, a cross-platform messaging service with enhance encryption and privacy. Whilst stakeholders and ISOs had similar views on the prevalence and ease of access to medication, there were also some substantial differences primarily in terms of perceptions of risk. This study highlights the need for enhanced pharmacovigilance of non-regulated online vendors and the imperatives of continued health messaging around the potential self-directed use of these controlled drugs and the dangers of using websites purporting to be regulated pharmacies.

Clearing Steatosis Prior to Liver Surgery for Colorectal Metastasis: A Narrative Review and Case Illustration.

Over recent years, non-alcoholic fatty liver disease (NAFLD) has become the most common liver disorder in the developed world, accounting for 20% to 46% of liver abnormalities. Steatosis is the hallmark of NAFLD and is recognized as an important risk factor for complication and death after general surgery, even more so after liver resection. Similarly, liver steatosis also impacts the safety of live liver donation and transplantation. We aim to review surgical outcomes after liver resection for colorectal metastases in patients with steatosis and discuss the most common pre-operative strategies to reduce steatosis. Finally, as illustration, we report the favorable effect of a low-caloric, hyper-protein diet during a two-stage liver resection for colorectal metastases in a patient with severe steatosis.

Presumed sympathetic ophthalmia following scleral buckling surgery: A case report and review of the literature.

To report a case of presumed sympathetic ophthalmia (SO) following scleral buckling (SB) surgery and to discuss the possible pathogenesis of this condition by reviewing the current evidence on this subject. Case report and narrative review of the literature; our case was imaged with spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA), fundus autofluorescence (FAF), fluorescein angiography (FFA) and indocyanine green angiography (ICGA). A 55-year-old man presented with a macula on rhegmatogenous retinal detachment which was treated with 360° SB surgery, subretinal fluid drain (SRFD), cryopexy and pneumoretinopexy. Due to failure of the primary surgery, a second procedure was performed the day after with the explant of the prior buckle and the implant of a wider circumferential element. At three months from surgery, the patient complained of severe bilateral vision loss. Multimodal imaging revealed bilateral, multi-focal exudative retinal detachments and choroidal swelling. A diagnosis of presumed SO was made and the patient was treated with a combination of steroid and immunosuppressive drugs. The clinical picture completely resolved at postoperative month 12. SO may be a rare complication of SB surgery. In our case, early recognition and prompt immunosuppressive treatment achieved good long-term clinical results.

Transition experiences of Middle Eastern midwives into Australian practice: A multiple case narrative study.

To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. This was a qualitative study using multiple case narrative approach underpinned by structuration theory. A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi-structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. Middle Eastern qualified midwives in Australia re-evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context-specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves.

Chest wall reconstruction in children and adolescents: recent personal experience from a case series and narrative review

Chest wall reconstruction in children and adolescents: recent personal experience from a case series and narrative review

Telling Stories with Data

The fidelity provided by rich, nuanced ethics consult narratives does not proscribe efforts to advance the profession by using data to assess performance and demonstrate value. While these two approaches have been described as in conflict with one another, the former sets the bar to which the latter should aim; to achieve this, consult data should, minimally, do two things: (1) tell the story of the case, as best as possible, in language easily accessible to both ethicists and non-ethicists alike; and (2) do so in a way that elements of interest can be aggregated, disambiguated, and analyzed. Here we present a three-component system designed with that in mind. First, the Armstrong Clinical Ethics Coding System (ACECS) produces a set of six codes that tell a simplified story of the case. These six codes form a meta narrative, which, like meta data, can be aggregated, disambiguated, and analyzed. Second, we use a data model to uncover the stories those data tell. The results allow us to understand relationships, recognize patterns, and reveal insights that are otherwise not discoverable when using narratives alone. Third, due to tremendous heterogeneity among cases, we represent findings visually using techniques borrowed from data storytelling, a powerful means to demonstrate the value of a consult service to administrators and others. The ability to derive meta narratives from an aggregate of case narratives allows us to describe, in detail, the work of our consult service in a manner directly comparable to other services that use the system while we preserve unprecedented case-level nuance. If adopted broadly, this functionality suggests a means to undergird the legitimacy of the ethics consult practice itself in an evidence-based manner similar to that which undergirds other domains of healthcare.

Exploring the Experiences of d/Deaf and Hard of Hearing Children in a Mainstream School in Zimbabwe: A Narrative Analysis.

The experiences of d/Deaf and hard of hearing children enrolled in a mainstream school in Zimbabwe are explored. The study used a qualitative approach and a narrative case study design. A sample consisting of two boys and three girls whose ages ranged from 13 to 14 years was purposively selected. Face-to-face semistructured interviews were employed as a data collection tool. The narrative analysis revealed that although d/Deaf and hard of hearing children in the school communicated through sign language, they could develop friendships with hearing children. However, the d/Deaf and hard of hearing children experienced behavioral and mental health issues, including, among others, lack of support, discrimination, and labeling.

Embedding health literacy research and best practice within a socioeconomically and culturally diverse health service: A narrative case study and revised model of co-creation.

Health literacy interventions and research outcomes are not routinely or systematically implemented within healthcare systems. Co-creation with stakeholders is a potential vehicle through which to accelerate and scale up the implementation of innovation from research. This narrative case study describes an example of the application of a co-creation approach to improve health literacy in an Australian public health system that provides hospital and community health services to one million people from socioeconomically and culturally diverse backgrounds. We provide a detailed overview of the value co-creation stages and strategies used to build a practical and sustainable working relationship between a University-based academic research group and the local health district focussed on improving health literacy. Insights from our experience over a 5-year period informed the development of a revised model of co-creation. The model incorporates a practical focus on the structural enablers of co-creation, including the development of a Community of Practice, co-created strategic direction and shared management systems. The model also includes a spectrum of partnership modalities (spanning relationship-building, partnering and co-creating), acknowledging the evolving nature of research partnerships and reinforcing the flexibility and commitment required to achieve meaningful co-creation in research. Four key facilitators of health literacy co-creation are identified: (i) local champions, (ii) co-generated resources, (iii) evolving capability and understandingand (iv) increasing trust and partnership synergy. Our case study and co-creation model provide insights into mechanisms to create effective and collaborative ways of working in health literacy which may be transferable to other health fields in Australia and beyond. Our co-creation approach brought together a community of practice of consumers, healthcare professionals and researchers as equal partners.

“Coming here you should speak English”: performing creativity on a YouTube channel for teaching speaking

The present study aims to explore strategies in teaching speaking using YouTube as media as well as the advantages and disadvantages of this platform in teaching speaking. Nested in a narrative case study approach, data were garnered through interviews using WhatsApp and Google Forms. An EFL teacher who is also a YouTuber and six students in tenth grade of a senior high school in Purwokerto, Central Java, Indonesia volunteered to participate. Study findings demonstrate that the EFL teacher integrated technology, i.e., YouTube, as a learning medium, and she provided video learning videos according to the material needed by students. The teacher designed a learning video with herself as a role model. Before uploading it on YouTube, the teacher watched the video first and edited some errors. The study also reveals several advantages of using YouTube in teaching speaking. YouTube videos promoted the teacher’s creativity in employing technology as learning media. Students could learn anywhere and anytime through videos on YouTube and practiced from videos of native speakers. Conversely, adopting YouTube videos in a speaking class had disadvantages, such as the selection of YouTube videos relevant to learning materials, restricted opportunities to have feedback from their teachers, and poor internet connection.

Divestment as investment: “Kondo-ing” selves in the context of overaccumulation

The accumulation, display, and use of objects have long been recognized as a means through which individuals construct social position and the self. Consumption can thus be thought of as investment, with seemingly infinite payoff as more status items are consumed. However, in the context of overaccumulation, privileged individuals with “cluttered” homes are disposing of their still-valuable possessions. This article uses narrative and content analyses of a critical case, Tidying Up with Marie Kondo, a Netflix program designed to help families with cluttered homes sort through their things, to explore the meanings associated with accumulating “too much”: namely, uncontrolled, unactualized selves; class transgression; and failed gender and parental roles. Discarding items, regardless of their value, reduces the clutter, which eliminates the problems symbolized by having too much. Thus, divestment is framed as a means through which individuals can invest in the self, particularly in class position, gender and parental roles, and agency.

Successful healthcare technology requires person-centred relationships and contexts: case narratives on medication-dispensing systems

Background: Providing person-centred care with a limited workforce is a major challenge in our ageing society. While care technologies such as electronic medication-dispensing systems are a means to help older persons with chronic conditions continue living independently, few studies have explored their implementation and use from a multiple stakeholder perspective. This prompted six Dutch care organisations and a university of applied sciences to collaborate in the Living Longer @ Home practice development project. Aim: To explore the influence of medication-dispensing systems on service user self-reliance and self-determination, as well as on professional and informal carer workload, in the community setting. Methods: A total of 14 case studies were used to understand the complexity and particularity of medication-dispensing systems in community care. Case narratives were constructed by (supervised) nursing students, then collated, and critically and creatively analysed by university- and practice-based researchers. Results: The case narratives reveal that while technology can increase self-reliance and self-determination for service users, it can also raise (new) concerns about medication safety and social isolation. Even after careful medication-dispensing systems indication, introduction and implementation, carer workloads may simply be changed rather than reduced. The dyadic and triadic relationships are affected as roles and responsibilities change, and trust may need to be rebuilt. Conclusions: Working with medication-dispensing systems entails more than implementing a piece of technology. While these systems can increase the duration of safe independent living, their effect on the lifeworld of those involved also needs to be considered and prepared for. A person-centred and relationship-oriented as opposed to task-orientated approach is advisable. Implications for practice: Before the introduction of care technology, nurses should discuss its impact on service users, informal carers, themselves and the dyadic/triadic relationship Practitioners, managers and technicians should collaboratively integrate care technology into community care services (Supervised) construction of case narratives enables workplace learning and practice development

A study of parental decision-making over the vaccination of girls, based on the protection motivation theory and the elaboration likelihood model.

This study proposed a new theoretical framework that combines the protection motivation theory and the elaboration likelihood model to examine how health information processing patterns influence parents' vaccination decision-making on behalf of their daughters. Based on survey data from 359 parents of girls aged 9-15, we tested the theoretical model by using structural equation model. The results showed that the central route, represented by information quality, affected the parents' perceptions of HPV severity and susceptibility; the peripheral route, represented by source credibility, influenced their perceptions of HPV severity, HPV susceptibility, vaccine response efficacy, and secondary risks. Also, Chinese parents' perceptions of HPV vaccines, not perceptions of HPV, affected their intention to vaccinate their daughters. The study suggests in addition to improving the quality of health information, the peripheral route, such as the release of vaccination photos, public immunization evaluations, and case narratives, should also be used to change parents' perceptions. Besides, reducing the traditional stigmatization of female sexuality and improving parents' understanding of the new generation's sexual attitudes will increase parents' intention to have their daughters vaccinated against HPV.

Attitudes and practices on induced abortion among Igembe Women in Meru County, Kenya

This study sought to investigate beliefs about induced abortion in the Igembe community, Meru County. Purposively sampled individuals provided data via case narratives, in-depth interviews, and focus group discussions. Transcripts were generated verbatim, and data was thematically analyzed in accordance with the objectives of the study. Inducing abortion was culturally acceptable and recognized in Igembe, particularly when an uncircumcised girl became pregnant or when an uncircumcised boy got a girl pregnant. Such abortions were obtained by men who had been specifically trained by elders for the purpose. Isolation of the pregnant girl/woman from family and peers, counselling in preparation for the abortion, cleansing of the girl and family after the procedure, use of herbs, rolling of banana stalks on the girl's/stomach, woman's and insertion of objects in the private parts were all practices used to induce abortion. According to the study, women were subjected to induced abortion in order to ensure adherence to social norms and reduce pre-marital sex. Women in Igembe continue to obtain abortions, and traditional approaches and legislation have been ineffective in eliminating the practice. Furthermore, religious beliefs, traditions, and socio-cultural norms continue to stigmatize and condemn abortion-seekers. Furthermore, the decision to have an abortion is motivated by both internal and external forces that are carefully considered by the concerned women.