Uncomfortable Topics Research Articles

Who handles the tough talk? Supervisor sense of power and confronting difficult issues

AbstractAddressing difficult, controversial, or sensitive issues with employees is a critical component of effective leadership, but discussing uncomfortable topics with subordinates can be daunting, even for those with structural power. Distinguishing between the structural power that supervisors hold, and their situationally felt personal sense of power, we consider here how a supervisor's personal sense of power relates to his or her inclination to confront, or to avoid, difficult conversations, as well as to offer social support in such contexts. Integrating a social role theory perspective, we further consider the role of gender. Across an initial study (N = 588), and a follow‐up replication study (N = 567), we show that personal sense of power predicts supervisor's inclination to confront (and not to avoid) difficult issues in the workplace, as well as to offer social support to the target of conversation. We also consider whether such effects vary across male and female supervisors, finding inconsistent results across studies. In Study 1a, we found that power had less of an effect on the avoidance and support intentions of women than men, such that women (but not men) were more likely to constructively confront the difficult issue head on as well as to offer support, even when they felt low in personal power. These effects did not emerge in Study 1b. However, in both studies, we find a main effect of gender on social support such that women were more likely to provide social support when confronting difficult issues. We speculate about reasons for this inconsistency, and further theorize about the role of personal sense of power and gender in explaining supervisor's engagement in difficult conversations.

Accounting and silence: The unspeakable, the unsaid, and the inaudible

AbstractThis paper studies accounting and silence. Building on studies of accounting talk and introducing theories of “silencing,” we highlight the role of accounting silences in the production of engaging organizational conversations. Through a qualitative case study, we identify three forms of silence—the unspeakable, the unsaid, and the inaudible—and their links to accounting. Silences create motivations to engage in further accounting talk, but they also deny certain groups a voice in those conversations. An impression of participation, openness, and transparency emerges despite unequal access and the silencing of certain groups. Accounting itself can be silenced to avoid uncomfortable topics, potential problems, and anxiety‐inducing uncertainties. This silencing may serve to preserve a useful ignorance, avoid being in the know, and build alluring narratives and engaging conversations. Accounting silences sustain such conversations by protecting them from alternative voices, unsettling knowledge, and narratives that are incompatible with the organization's preferred story.

Dark Humor in the Poetry of Sherman Alexie and Ahmed Matar: A Comparative Study

Dark humor is a form of comedy that explores taboo topics such as death, disease, and tragedy. While it is often controversial and can be offensive to some, it is also a means of coping with difficult or uncomfortable topics and offering a fresh perspective on societal norms. Just as stated by Merriam-Webster’s Encyclopedia of Literature, dark humor or black humor is a kind of humor that is marked by the use of morbid, ironic, or grotesquely comic episodes that ridicule human folly. However, this paper examines the concept of dark humor by tackling some of the significant poems of the English poet “Sherman Alexie” and the Iraqi poet “Ahmed Matar.” Those two poets discuss subjects and problems of real-life experiences. The purpose of this research is to shed light on Native Americans' daily lives on reservations and demonstrate their pain as well as the poet’s personal experience there, which is discussed by Sherman Alexie in his poems, “Futures”, “Traveling”, “Translated from the American”, “Giving Blood”, “War all the time”, “Reservation cap driver”, “The mice war”. While the Iraqi poet tended to criticize Arab rules, the lack of freedom they force, their use of torture, the government, and their persuasion of authority at all costs. Here are some of his notable poems that this research are going to explain and make critique in details. “They put a watchdog on my mouth", "وَضَعوا فوقَ فمي كلبَ حِراسه", “My awful silence”, "صمتي الرهيب", “The lost Caravan”, "قافلة تائهة". Ultimately, this paper aims to offer a fair viewpoint on the usage of dark humor and to stimulate additional investigation into its psychological and social significance. It can be hypothesized that Dark humor has been used heavenly by Ahmed Matar and Sherman Alexie in their poetry, and the researcher is going to show the importance of using humor is to attack the capitalist system, as in Sherman Alexie country, and the ruthless hegemonic government as in Ahmed Matar' country. It is used to show vulgarity of governments and to amuse the audience to certain extent.

Po co komu Kapitol? Stronniczość przekazów medialnych w Polsce, Rosji i Niemczech

The article concerns media bias using examples of public media in three countries: Poland, Russia, and Germany. The study aims to compare the degree of bias between television news outlets when covering the events of Capitol Hill on January 6, 2021. The main research method used was the content analysis of news programming by public media outlets. 73 journalistic materials were coded, and the categorisation key contained 85 research categories. Quantitative methods were used to calculate the statistical significance of differences between broadcasters. Findings supported the hypothesis that bias exists in various forms and different intensities, as well as across many media, especially in Europe. In addition, biased silence, i.e., the avoidance of uncomfortable topics, may misrepresent the image of reality reported by the media. As a result, the recipient receives a distorted picture of the world, oriented towards ideas with which the editors sympathise, although it is extremely difficult to determine the direction of this sympathy.

Communication: A Basic Skill of Medical Practice

The doctor-patient relationship is central to the practice of medicine and is essential for the delivery of high-quality healthcare in the diagnosis and treatment of disease. There is utmost need for effective communication in medical practice. Communication is the key that unlocks a number of benefits. It leads to increased patient satisfaction, better understanding of the treatment, improved compliance, and overall better health. Therefore, clearer communication better understanding, and thus, better outcomes in the patients’ and attendants’ satisfaction. The need for communication with patients should be emphasized as it helps patients feel at ease, reduces their anxiety and builds their confidence, makes patients/clients feel valued, and reduces the chances of medical errors. Some of the key barriers to effective communication are such as personal barriers: negative attitude by doctors towards communication and giving it a low priority due to their concern primarily to treat illness rather than focus on patients’ other needs which may be psychological or related to social wellbeing. Human failings, such as tiredness and stress: A lack of inclination to communicate with patients. This can be due to lack of time, uncomfortable topics, lack of confidence and concerns relating to confidentiality. Inconsistency in providing information and giving conflicting information by different healthcare providers. Organizational barriers, lack of time, pressure of work being subjected to interruptions. If the complains are justified it is important that you apologize and ask the relatives what they would like to be done about it. Any problem that the family feels or experience should be actively identified and appropriate action should be taken to resolve them. If their demanding behavior continues, set the limit and you can tell them that you cannot do better than what is being done. If the relatives insist on continuing to disagree about the patient’s management, it may be necessary to call some senior doctor to try to explain and convince them. Imparting bad news is an emotional experience for the doctor as well as the patient and requires additional targeted strategies. When you speak to the patient they get the chance to clarify their doubts. Medical schools/ Colleges must be encouraged to provide the best possible communication skills training as part of the core undergraduate curriculum. This training should have set objectives and clear methods of assessment. More communication skills training programs should be developed at post graduate level. Doctors should use the appraisal process as a vehicle for discussing the success of communication skills training. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 178

Middle fossa triangles - A step-by-step dissection.

The anatomy and surgical approach to the cavernous sinus and the middle fossa can constitute a considerable challenge, specially for young surgeons. Although their surgical explorations have gone through a popular phase in the past, to this date, they remain an uncomfortable subject for many neurosurgeons. The aim of this paper is to systematically review its anatomy and multiple corridors through a step-by-step dissection of the middle fossa triangles, providing a roadmap for surgeons. A step-by-step dissection of the cavernous sinus was performed in two fresh-frozen cadavers aiming to describe the anatomy of ten different middle fossa triangles, demonstrating the feasibility of the use of their spaces while surgically approaching this area. The intradural opening of the roof of the cavernous sinus was obtained by dissection of clinoidal, carotid-oculomotor, supratrochlear, optic-carotideal, and oculomotor triangles, allowing an expanded superior view. On the counterpart, the extradural exploration of the lateral wall through the middle fossa floor peeling exposed the infratrochlear, anteromedial, and anterolateral triangles. The middle fossa floor itself was the door to approaching posterior fossa through anterior petrosectomy. The dissection of each individual triangle can be amplified exponentially with exploration of its adjacents, providing broader surgical corridors. The cavernous sinus still remains far from an "every man's land," but its systematic study based on direct approaches can ease the challenges of its surgical exploration, allowing surgeons to feel more comfortable with its navigation, with consequently benefit in the treatment of patients.

Shakespeare in Shang-Chi

Trevor Slattery, played by Ben Kingsley, holds an uncomfortable subject position within the Marvel Cinematic Universe. He was introduced as the Mandarin in Iron Man 3 (2013), and this appearance occasioned significant criticism for its racist tropes. Slattery was recently re-introduced in Shang-Chi and the Legend of the Ten Rings (2021), accompanied by the short film All Hail the King (2021). The racist elements within Slattery’s characterization have been justified in two specific ways: his role as an actor and his portrayal as a clown. With his most recent appearances, both of those covers have been deliberately intertwined with Shakespeare. Long before Harold Bloom asserted Shakespeare as Author-God, the Bard was used as a tool of colonialization around the world; the assumption was that his words and poetry would solidify English as a lingua franca and have a “civilizing,” “gentling” effect on the masses. As Ruben Espinosa states: “Shakespeare is, and always has been, invariably connected to discourses about oppressive structures” (Espinosa 2021, 159). And yet what is especially curious about the Marvel Cinematic Universe’s most recent use of Shakespeare is the seeming willful ignorance of this complex history.

Parents' Discussions of the COVID-19 Pandemic and Death With Young Children.

Death and loss are often uncomfortable topics for adults to discuss with young children. Disruptions caused by the COVID-19 pandemic, however, made the avoidance of these topics nearly impossible. The current study explored how 20 parents engaged with their young children (ages 3-6) in discussions about death, dying, and loss as they jointly experienced this global crisis. Interviews were conducted both prepandemic (Summer/Fall 2019) and a year later, at the early stage of the COVID-19 pandemic, before vaccines were approved (Summer 2020). Results suggest parents largely sought to balance sheltering children from stress and socializing them with socioemotional competencies. The pandemic context, however, brought parents a sense of urgency to scaffold their children's ability to remain resilient after experiencing losses. Practical implications are discussed regarding how family nurses and other practitioners can provide support to families of young children during the COVID-19 pandemic and potential future global crises.

Cultivating patient-centered care skills through engagement in difficult conversations

Background and purposeAppropriately engaging with patients around sensitive, challenging, or uncomfortable topics, often termed “difficult conversations,” is a facet of patient-centered care. Development of such skills prior to practice often occurs in the hidden curriculum. Instructors implemented and evaluated a longitudinal simulation-based module aimed at advancing students' understanding and abilities to use patient-centered care skills to navigate difficult conversations within the formal curriculum. Educational activity and settingThe module was embedded within the third professional year of a skills-based laboratory course. Four simulated patient encounters were revised to increase opportunities to practice patient-centered skills during difficult conversations. Preparatory discussions and pre-simulation assignments delivered foundational knowledge, and post-simulation debriefing allowed for feedback and reflection. Students completed pre- and post-simulation surveys to measure understanding of patient-centered care, empathy, and perceived ability. Instructors assessed student performance in eight skill areas using the Patient-Centered Communication Tools. FindingsOf 137 students, 129 completed both surveys. Students' definitions of patient-centered care grew in accuracy and detail following module completion. Eight of the 15 empathy items were significantly changed from pre- to post-module, signifying enhanced empathy. Student perception of ability to perform patient-centered care skills significantly improved from baseline to post-module. Across the semester, student performance on simulations significantly improved on six out of eight patient-centered care skills. SummaryStudents deepened their understanding of patient-centered care, grew in aspects of empathy, and improved actual and perceived ability to deliver care that is patient-centered during challenging encounters.

Patient- and community-centered approaches as the cornerstone of health services evaluation in the 21st century.

This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Restrictions on contraceptive services for unmarried youth: a qualitative study of providers’ beliefs and attitudes in India

Sexual and reproductive health (SRH) of unmarried youth is an important issue, particularly in Indian society, where premarital sex is socially restricted. It is an uncomfortable subject for most people, including healthcare providers, who are responsible for catering to the reproductive health needs of youth. This is because of the prevailing social norms, where sex outside marriage is discouraged and stigmatised. These social norms give importance to virginity, and children outside marriage are not welcome. The present qualitative study was conducted in public health facilities (primary and secondary) to explore the attitudes of healthcare providers in providing contraceptive services to unmarried youth. In-depth interviews were conducted with family planning (FP) service providers (frontline healthcare workers [ASHAs] nurses and FP counsellors) between October 2017 and September 2018. Almost a quarter of the providers were either hesitant or against providing contraceptives to unmarried youth. Providers stated that they preferred emergency contraceptive pills for unmarried girls if they had already engaged in unprotected sex. Providers expressed strong personal views against premarital sex because they believed it was against existing social norms. Some providers were concerned about the possible negative reactions of the community if they recommended any contraceptive to unmarried youth. A few providers even considered it illegal to provide contraceptives to unmarried youth, though there is no such law in the country. Findings further indicated that though the country had launched programmes for improving adolescents and youth SRH, service providers were still conflicted between medical eligibility and social beliefs.

The Dark Side of Projects: Uncovering Slavery, Corruption, Criminal Organizations, and Other Uncomfortable Topics

The Dark Side of Projects: Uncovering Slavery, Corruption, Criminal Organizations, and Other Uncomfortable Topics

Disrupted and Unsettled: An Introduction to Monuments, Memorials, and Italian Migrations

Disrupted and Unsettled: An Introduction to Monuments, Memorials, and Italian Migrations

Patient card games in palliative care: integrative review

BackgroundIn the context of palliative care, a new approach has been documented that allows for sensitive end-of-life conversations to be established through a game of cards.ObjectiveThis study aimed to identify...

“To be our best selves”: Critical dialogue with girls of color about their experiences in a social justice leadership program

This critical qualitative study explores the affordances of social justice-oriented education that centers youth of color and their desire to engage in complex and nuanced dialogue concerning social and political issues relevant to their lives. In doing so, this paper focuses on the experiences of six high school girls of color participating in a New York City based nonprofit program committed to social justice, activism, and leadership. Specifically, it investigates their participation in a course as they interrogated power, oppression, and privilege at the interpersonal and institutional levels. Guided by the theoretical underpinnings of Critical Race Feminism (CRF) and figured worlds, this study’s findings highlight the necessity of discussions about topics often seen as “taboo” in school spaces. The girls saw the dismissal and/or reluctance to engage with “uncomfortable topics” in schools as an attempt to cover up or shield students from histories and realities that may be harsh but necessary knowledge. The girls also stressed the value of opportunities to share and explore multiple aspects of their identity through the course content and activities. Lastly, the pedagogical practice of taking space and making space allowed girls of color to make sense of their individual and collective experiences.

COVID-19 lockdown: Online survey of psychosocial factors of adolescents

Background:The coronavirus pandemic has affected more than 14 million people in the world. Adults are somehow able to manage their stress created by the most fearful disease. However, it is the children and adolescents who are most affected by COVID-19 lockdown.Aim:This study aimed to assess the effect of COVID-19 lockdown on adolescent's psychosocial factors.Materials and Methods:Using the Google Form link, a questionnaire was developed and an online survey was conducted. This online questionnaire consisted of 40 items assessing personal, social, academic, and family domains related to adolescents.Results:A total of 223 responses were obtained. The results indicate that 6.5% of adolescents experience extreme level of anxiousness, 29.8% become little irritable and angry, affecting their personal/emotional domain. About 12.6% of the adolescents are uncomfortable with social distancing and 48.4% of them greatly miss their friends; 38.1% miss their school and 28.8% are unable to clear their doubts through online teaching. Mathematics was the most uncomfortable subject for them to deal with 49.8%. About 79% of adolescents suffer mildly from family distress, 43.3% (extremely) are eagerly waiting for the lockdown to end.Conclusion:Among all four domains, the family domain was the most affected due to COVID-19 lockdown, followed by social, academic, and personal domains.

ЭВФЕМИЗМЛАРНИНГ ТАЪРИФИ ВА ҚЎЛЛАНИЛИШИ

This article describes the definition of euphemisms and its application in speech. Itis common to use terms that are soft, vague, and often indirect to avoid expressions that are considered harsh, insulting, or inappropriate. There are some events in every society that are unpleasant to discuss, but it is inevitable to address sensitive issues from time to time. Because of this, many communication strategies have changed the way people engage in uncomfortable topics. Traditionally, this set of discursive methods is called euphemism

M246. DIGITAL SELF-MONITORING AND EMBODIMENT IN FIRST EPISODE PSYCHOSIS: ETHICAL CONSIDERATIONS

BackgroundSmartphone technology has seen expanding interest across nearly all areas of medicine, including psychiatry, where app-based technologies frequently function as proxies for digitized behavioural phenotypes (Firth and Torous 2015). In the area first episode psychosis especially, there has been a rising interest in the use of digital platforms for patient self-management as well as for assessment of symptom domains (Ben-Zeev et al. 2014; Bell et al. 2018).MethodsThis paper discusses findings from a 3 year-long ethnographic study carried out within a first episode psychosis program in Toronto, Canada, in combination with a discourse analysis of the clinical and research literature relating to the use of self-monitoring technologies within first episode psychosis contexts. The qualitative data consists of formal and informal interviews with psychiatric service users, family members, and clinicians (n=45 interviews), in addition to observational field work within the clinical setting. Data were analyzed thematically within an interpretivist-constructivist frame, and triangulated through reflexive field notes, member-checking, and the authors’ clinical experience within the field. Themes were reviewed with senior clinicians in the first episode clinic setting as well as psychiatric service users for reliability and fidelity.ResultsSelf-monitoring technologies are increasingly used in both research and clinical care settings, most frequently related to the management of medication side effects and the tracking of the phenomenological aspects of psychotic and psychotic-like experiences. The uptake of these technologies by psychiatric service users in this setting was varied: at times, symptom and side effect tracking faciliated conversations about uncomfortable topics such as sexual side effects of antipsychotics, while in other instances the use of self-monitoring technologies was intrusive. Challenges with self-monitoring were likely to arise when issues relevant to understanding complex phenomena such as medication adherence were prematurely narrowed or when experiential narratives were foreclosed by the structure imposed by the technologies themselves. Resistance to self-monitoring arose in novel and interesting ways.DiscussionEngaging in self-monitoring, whether for side effect tracking or phenomenological analysis of moment-to-moment experiences have significant material effects on those engaged in such practices. When we consider the study findings through the lens of contemporary mental health ethics, we can appreciate how such technologies carry with them a potential for what has been termed “epistemic injustice” (Medina 2013; Fricker 2007), even at the same time as they offer potentially novel, meaningful forms of health care engagement. Grappling with this tension is of critical importance in light of the expansion of such platforms in both clinical and research environments

Communicating death with humor: Humor types and functions in death over dinner conversations

Using Death over Dinner conversations, we examined 83 family and/or friend groups comprising 424 participants to understand how humor is used when talking about death and dying. Thematic analysis revealed that family and friends used six types of humor in their conversations about death: entertainment humor, gallows humor, tension-relieving humor, confused/awkward laughter, group humor/narrative chaining, and self-deprecating humor. We discuss the benefits and drawbacks of the use of humor when discussing uncomfortable topics, practical applications related to humor and death, as well as possibilities for future research.

A critical investigation of Y7 students’ perceptions of Roman slavery as evidenced in the stories of theCambridge Latin Course

In an article,‘The Slaves were Happy’: High School Latin and the Horrors of Classical Studies,Erik Robinson, a Latin teacher from a public high school in Texas, criticises how, in his experience, Classics teaching tends to avoid in-depth discussions on issues such as the brutality of war, the treatment of women and the experience of slaves (Robinson, 2017). However, texts such as the article ‘Teaching Sensitive Topics in the Secondary Classics Classroom’ (Hunt, 2016), and the book ‘From abortion to pederasty: addressing difficult topics in the Classics classroom’ (Sorkin Rabinowitz & McHardy, 2014) strongly advocate for teachers to address these difficult and sensitive topics. They argue that the historical distance between us and Greco-Roman culture and history can allow students to engage and participate in discussions that may otherwise be difficult and can provide a valuable opportunity to address uncomfortable topics in the classroom. Thus, Robinson's assertion that Classics teaching avoids these sensitive topics may not be so definitive. Regardless, Robinson claims that honest confrontations in the classroom with the ‘legacy of horror and abuse’ from the ancient world can be significantly complicated by many introductory textbooks used in Latin classes, such as theCambridge Latin Course(CLC), one of the most widely used high school Latin textbooks in use in both America and the United Kingdom (Robinson, 2017). In particular, Robinson views the presentation of slavery within theCLCas ‘rather jocular and trivialising’ which can then hinder a reader's perspective on the realities of the violent and abusive nature of the Roman slave trade (Robinson, 2017). As far as he was concerned, the problem lay with the characterisation of theCLC's slave characters Grumio and Clemens, who, he argued, were presented there as happy beings and seemingly unfazed by their positions as slaves. There was never any hint in the book that Grumio or Clemens were unhappy with their lives or their positions as slaves, even though, as theCLCitself states in its English background section on Roman slavery, Roman law ‘did not regard slaves as human beings, but as things that could be bought or sold, treated well or badly, according to the whim of their master’ (CLCI, 1998, p. 78). One might argue, therefore, that there seems to be a disconnect between the English language information we learn about the brutality of the Roman slave trade provided in the background section of Stage 6, and what we can infer about Roman slavery from the Latin language stories involving our two ‘happy’ slaves.