Zeitschriftenartikel zum Thema „Empathy. English literature“

This paper investigates a novel study of Dickens’ Oliver Twist, used as a platform through which to discuss empathy and to promote deeper understanding with 18 grade eleven students in an English Language Arts classroom. Students’ experiences, perceptions, emotions, and relationships as they read, discuss, and write about the novel were explored through the use of narrative inquiry. The data, gathered through interviews, classroom writing samples, and field notes, provided rich examples of empathetic responses and insightful thinking by students.

The aim of this study is to identify the role of empathy in learning process and to make students get involved in it and obtain fruitful outcomes in this direction. The qualitative method was used in this study to find out due data for explaining the positive effects of empathy for better learning. This study emphasizes the importance of empathy and its influence for making the English learning process fruitful through comparing the explanations and views of different researches. This paper describes some of the key findings from profound studies of this matter, which examined the role of empathy in teacher–student relationships and its relevance to moral modelling. The project collected data through interviews and classroom observations and used grounded methodology theory for the analysis. The literature considers the latest research in neuroscience and the significance of emotions in moral decision making alongside older psychological research on affect and empathy in learning. Empathy has long been an intrinsic part of the education system, if schools are involved in intellectual development, they are inherently involved in emotional development. The results explain that the teachers should approach the students like mother and father while teaching. Thus, this approach will make students learn easily and also make the students motivation high and better towards learning.

Higher level thought involves both critical and creative thinking skills. Although the psychological literature is rich with research on teaching critical thinking, relatively little published work addresses ways of promoting creative thinking. In this article we describe the use of poetry writing in an abnormal psychology class to encourage creative exploration and informed empathy. Content analyses suggested that the majority of students' poems communicated both accurate information and empathy. Furthermore, most students described the poetry assignment as a positive learning experience. Two examples demonstrate creative ways students' poems can distill and communicate information.

Introduction: Patient experience with emergency department (ED) care is an expanding area of focus, and recent literature has demonstrated strong correlation between patient experience and meeting several ED and hospital goals. The objective of this study was to perform a systematic review of existing literature to identify specific factors most commonly identified as influencing ED patient experience. Methods: A literature search was performed, and articles were included if published in peer-reviewed journals, primarily focused on ED patient experience, employed observational or interventional methodology, and were available in English. After a structured screening process, 107 publications were included for data extraction. Result: Of the 107 included publications, 51 were published before 2011, 57% were conducted by American investigators, and 12% were published in nursing journals. The most commonly identified themes included staff-patient communication, ED wait times, and staff empathy and compassion. Conclusion: The most commonly identified drivers of ED patient experience include communication, wait times, and staff empathy; however, existing literature is limited. Additional investigation is necessary to further characterize ED patient experience themes and identify interventions that effectively improve these domains.

This article reports on perceptions and practices in relation to integrating culture into EFL teaching and how course material was designed within the Thai curriculum framework. Thai teachers’ understanding of what constitutes culture, the role it plays in language learning and how such understanding is being translated into pedagogical practices are under investigation. The practice demonstrated an attempt to adapt the Byram’s model to fit local circumstances, policies and needs. The knowledge of everyday cultures of native speakers was promoted, whilst cultures in the prior curriculum merely constituted high cultures such as literature. Potential materials, including newspapers and magazine articles, nonfiction, TV programmes and films were suggested to encourage an ethnographic frame of mind in students. The discussion of a few practical ways in which these materials can be used to promote cultural awareness and how they could be used to facilitate opportunities for language skills practice were provided. Feedback from students include the novelty of the experience, changing perspectives, facilitating better communication, practical and useful knowledge, fun, autonomous learning, critical thinking and empathy towards other cultures.

Abstract In this paper, we investigate the attention given to and the impact of interpersonal, people-oriented and transactional, problem-oriented stance in English complaint refusals in business correspondence. The analysis is based on a sample analysis of English e-mail sequences from a Belgian multinational as well as experimental research that probes into the effect of interpersonal strategies on customer outcomes. The sample analysis shows a sharp contrast between theory and practice: while the need for supportive language and interpersonal attention are standard items in textbook instructions, the data show little alignment with the customer through expressions of regret, gratitude, or empathy. The experiment, in its turn, shows a positive impact of interactional stance on interactional justice but little to no impact on satisfaction, perceived professionalism, and loyalty. This raises a number of questions regarding best practice and best practice models.

Burnout is a growing epidemic among professional healthcare students. Unaddressed burnout has been shown to have psychological and performance related detriments. The purpose of this scoping literature review was to investigate the prevalence of burnout and its effects on the psychological, professional, empathetic ability, and academic acuity of graduate healthcare students. Inclusion criteria included English language papers published within the last 10 years and subjects in graduate healthcare professional programs. This search encompassed 8,214 articles. After title and abstract screening, 127 articles remained and were sorted into five domains of interest: etiology, professionalism, mental health, empathy, and academic performance. After duplicates were removed, 27 articles remained for the scoping review. Graduate level healthcare students had higher levels of burnout than age matched peers and the general population. The high prevalence of burnout within graduate healthcare students can have an effect on their mental health, empathy, and professional conduct. Understanding the occurrence and effects of burnout within graduate healthcare programs allows faculty and administration to plan curriculum, and provide information to students to understand, recognize, and create opportunities to decrease burnout in order to create long lasting quality clinicians.

There are large number of students from around the world who are planning to continue their education in the U.S. universities. They have different nationalities, cultural backgrounds, social beliefs, and so on. Moreover, the educators who are from different countries have the special cultures. This is their task to manage the culturally diverse classrooms to obtain the best results for the educational purposes. In this study, the focus was on three main issues: (a) teaching in multicultural higher education, (b) students’ attitudes toward the different cultures (especially their classmates), and (c) the strategies the educators apply in the multicultural classroom to establish peace. Five Iranian faculties who were teaching English language literature subject, in California State universities, were selected and interviewed via Skype. The results showed that they had a very positive attitude toward teaching in multicultural classrooms. The educators claimed that they apply the emotional empathy, empathy training, culturally proportional curriculum, and the structured rules for the multicultural classroom. One of them argued that holding conferences regarding the diversity is very useful, and the other one proposed that holding involuntary service, sport, and community programs for both the immigrant and the local students is considerable to make the students closer and establish the sense of peace among them.

ABSTRACT Background The use of fine art in medical education has a long history. Numerous studies have investigated the potential benefits of incorporating art in medical education; however, there are gaps in knowledge regarding the efficacy, methodology, and clinical significance of these studies. Objective This scoping review of the literature aims to describe the available literature on the incorporation of art education in medical school and residency. Methods PubMed, Google Scholar, and MedEDPortal were queried from their inception dates through December 2019. English-language studies providing a detailed methodology and detailed analysis were included. A total of 37 studies were identified. Upon further screening of the studies' methodologies and results, 16 studies describing art education implemented with medical students and 12 studies describing art education implemented with residents were included for final review. Results Various methods of art education exist, including Visual Thinking Strategies (VTS), rigorous curricula, and unstructured roundtable discussions with art curators or artistically minded clinicians. Studies range in duration, art media, and type of analysis. Conclusions There has been an increasing effort to incorporate fine art education into medical training, primarily to enhance visual perception skills and empathy. Although there is limited research on its efficacy, and wide variations in study methodologies exist, results consistently indicate that participants find the incorporation of art into curricula beneficial. Further research analyzing which methodologies are most likely to yield statistically and clinically significant improvements in visual perception and empathy may lead to increased utilization of this teaching method.

Objective: to analyze the use of elements of effective nurse-patient communication in the light of the Transcultural Interprofessional Practice model. Methods: an integrative literature review was carried out in the CINAHL, LILACS, MEDLINE, SCOPUS, and Web of Science databases, without a time limit. Results: 12 studies were analyzed, most of them published in the English language, in 2017. Two categories were elaborated: effective verbal and non-verbal communication between nurses and patients. The elements of effective verbal communication were presented as speech and language; non-verbal ones presented as signals, distance, eye contact, time, touch, listening, empathy, and patience. Technology-assisted communication was part of both. Less frequently, the verbal communication process was hindered by language and non-verbal communication due to a lack of time availability. Conclusion: effective communication favors the establishment of trust, interaction, and the nurse-patient relationship.

A strong evidence base is critical for deepening our understanding of how drama therapy works, how practice might be improved and how to best support the growth of the profession. Building on a previous investigation, the authors reviewed available peer-reviewed, English language, empirical drama therapy research from 1945–2018 to answer the question: what are the prominent themes in drama therapy effectiveness research? Within an effectiveness context, the following themes emerged from this analysis: emotional and behavioural symptoms, social skills and social interactions, self-confidence and self-esteem, sense of self and identity, self-expression, well-being, emotional regulation, empathy, academic performance, language and linguistic performance, stigma, bodily awareness, empowerment and spontaneity. Emergent trends in the literature are discussed and a summation of findings is presented. In reference to the findings, the authors advance a rationale for increasing drama therapy quantitative research with validated and reliable measures.

On the 21st century scent of educational development, ‘dialogism’ hogs the limelight of leading ‎‎academics, mapping ergo a stiff stronghold for active learning pedagogies. ‎Regarding the field of literature more sensibly considered in English as Foreign Language (EFL) ‎‎context, the plea for embracing interactive talks reverberates discernably in the air, yet, engaging ‎‎practices are still an overlooked real-world praxis. Given this reality, the current paper ‎endeavours ‎to endorse the implementation of a new dialogic model that extrapolates its foundation-‎stone ‎techniques from both of Bakhtin’s (1983) discursive dialogues and Socratic argumentations. The ‎pertinent ‎problematics in this study is to investigate the effect of this model on enhancing ‎learners’ higher-order critical thinking skills (HOTSs). To fulfil this target, the researcher has ‎embarked on an ‎Experimental Study based on a pre/post-testing, carried on painstakingly with ‎second-year EFL students ‎at Oran2 University, Algeria. Substantially, after appraising the ‎treatment results through SPSS, the ‎study reveals that adopting such a dialogic model is a robust ‎sinew for “Bloometizing” EFL ‎literature classroom, namely by stimulating and revitalizing the ‎learners’ cognitive reasoning potentials at ‎a very high complexity. Besides, in-class interactions ‎help the students build empathy with ‎literary texts and strengthen their analytical strategies. ‎From this vantage point, the paper, finally, hopes that teachers adopt this dialogic model as a ‎fitting instructional capstone to bringing literature ‎back to life before the learners’ eyes and to add ‎the ‘wow’ factor inside literature classrooms.‎

ENGLISH ABSTRACT Culture is an integral part of language study, but the field has yet to put forward a coherent theoretical argument for how culture can or should be incorporated in language education. In an effort to remedy this situation, this paper reviews literature on the teaching of culture, drawing on Larzén’s (2005) identification of three pedagogies used to teach about culture within the language classroom: through a pedagogy of information, a pedagogy of preparation, and a pedagogy of encounter. The pedagogy of information takes a cognitive orientation, framing culture as factual knowledge, with a focus on the teacher as the transmitter of knowledge. The pedagogy of preparation portrays culture as skills, and aims to help students develop the sociocultural, pragmatic, and strategic competence necessary for interactions with native speakers. The pedagogy of encounter takes an intercultural approach, with an affective orientation, and aims to help students develop tolerance, empathy, and an awareness of their own and others’ perspectives, and the emergent nature of culture. Using these three pedagogies as a conceptual framework, this paper reviews scholarship in support and critique of each type of cultural teaching. Because each of these three pedagogies continues to be used in various contexts worldwide, a clear understanding of the beliefs systems underpinning the belief systems of teachers and learners is essential. Keywords: Culture; Language Teaching; Methodologies. INDONESIAN ABSTRACTBudaya merupakan bagian integral dari studi bahasa, namun khalayak belum mengemukakan argumen teoritis yang koheren untuk bagaimana budaya dapat atau harus digabungkan dalam pendidikan bahasa. Dalam upaya memperbaiki situasi ini, makalah ini mengulas literatur tentang ajaran budaya, dengan mengacu pada identifikasi tiga pedagogi Larzén (2005) yang digunakan untuk mengajarkan tentang budaya di dalam kelas bahasa: melalui pedagogi informasi, pedagogi persiapan, dan pedagogi perjumpaan Pedagogi informasi mengambil orientasi kognitif, membingkai budaya sebagai pengetahuan faktual, dengan fokus pada guru sebagai pemancar pengetahuan. Pedagogi persiapan menggambarkan budaya sebagai keterampilan, dan bertujuan untuk membantu siswa mengembangkan kompetensi sosiokultural, pragmatis, dan strategis yang diperlukan untuk interaksi dengan penutur asli. Pedagogi pertemuan mengambil pendekatan antar budaya, dengan orientasi afektif, dan bertujuan untuk membantu siswa mengembangkan toleransi, empati, dan kesadaran akan perspektif mereka sendiri dan orang lain, dan sifat budaya yang muncul. Dengan menggunakan ketiga pedagogi ini sebagai kerangka konseptual, makalah ini mengulas pustaka untuk mendukung dan mengkritik setiap jenis pengajaran budaya. Karena masing-masing dari ketiga pedagogi ini terus digunakan dalam berbagai konteks di seluruh dunia, pemahaman yang jelas tentang sistem kepercayaan yang mendasari sistem kepercayaan guru dan pelajar sangat penting.Kata kunci: Budaya; Pengajaran Bahasa; Metodologi.

Abstract The futility of decades of government efforts to disseminate Chinese literature has triggered discussions among Chinese scholars on how to translate and who should be entrusted with this task. Some blame the failure on traditional concepts of translation that overemphasize faithfulness to the original to the point of disregarding target cultural conditions, but others insist that China should have control over its cultural export and that Sino-English should be used to internationalize English. Findings show that traditional concepts should not be blamed, as aggressively source-oriented strategies have been used in outbound translation only in recent years, and that this shift in translation norms in government-initiated outbound translation has spread to non-literary text types, and also to Hong Kong and Taiwan. The same kind of aggressiveness has recently been displayed in other forms of cultural export, triggering resistance in other cultures. All these changes may be attributable to a heightening of cultural self-image. What is needed to address the issue is cultural self-reflection, which will lead to the awareness that economic growth does not immediately bring cultural prestige, and that source-initiated cultural export efforts may make little difference in central cultures. Cultural awareness at a higher level can be achieved only through empathy.

There is a growing body of literature that addresses the relationships between film and television programmes and tourism. However, we argue in this paper that much of this research has not considered the critical issue of genre and how this may be a key factor in shaping tourist demand, expectation, experience and behaviour. In particular, we suggest that the distinctive characteristics of TV soap operas have been neglected, with much of the literature focused on English language, ‘blockbuster’ Hollywood produced film releases. In this paper, we address TV soap operas as genre in relation to audience consumption and their possible links with tourism. We discuss the defining features of soap operas including their serialisation, the level of audience exposure and emotional engagement along with their connections with personal and domestic everyday life. We note their being a platform for interpersonal, intercultural and inter-textual discourse. We argue in the context of film tourism, that viewing soap operas may promote identification, empathy, emotional connection and parasocial interactions, and that these may motivate some audience members to visit soap opera locations, and also contextualise their anticipation concerning what they might expect to experience.

The article is an analysis of the description of the garden in Bruno Schulz’s The Cinnamon Shops (Sklepy cynamonowe) and its two translations into Chinese. Wei-Yun Lin-Górecka has translated Schulz’s prose from the original Polish, while Lu Yuan’s translation is primarily based on English versions of his work. The analysis employs methods drawn from cognitive poetics and some elements of cognitive theory of translation, especially Elżbieta Tabakowska’s ideas on imagery and translation equivalence. The study helped characterize a complex conceptual blend found in the description and trace structural changes caused by the translators’ specific decisions. The translations are characterized by a relatively high level of equivalence. The conceptual blends they comprise differ from the one created by Bruno Schulz mostly in terms of the described elements’ positions on the empathy scale, which are mainly dependent upon the translators’ manner of using the devices of animation and anthropomorphism.

Abstract Objective This review examines studies that have identified both social and “cold” cognition in moderating emotional functioning as an outcome in individuals post-traumatic brain injury (TBI). Data Selection A systematic search of the literature was conducted using the keywords: social cognition, hot cognition, cognitive processes, emotions, emotional functioning, TBI, ABI, brain injury. The search included five databases: (1) EBSCOhost, (2) Google Scholar, (3) ScienceDaily, (4) PubMed, (5) World Health Organization. Inclusion criteria consisted of peer-reviewed articles published in English between 2013–2019 that utilized measures examining aspects of “cold cognition,” measures that investigated social cognition, and, outcome measures of emotional functioning in individuals who sustained a TBI. Data Synthesis A total number of 27 studies were identified through database searching with 16 papers selected. Three studies explained the function and implication of social cognition in individuals post-TBI. Additionally, 4 articles integrated statistical and demographic analyzes on individuals who suffered a TBI, and 9 studies exposed the relationship between “hot” and “cold” cognitions after sustaining a TBI. Conclusions Our results suggest that individuals with a TBI often exhibit difficulties in social cognition that is linked to changes in emotional functioning. Several studies pointed to the limbic system as an area influenced by both social and “cold” cognition regarding emotional output and experiences. Conversely, this system is often impacted in TBI. Other studies emphasized the relationship between attention and perception regarding one’s ability to adequately engage in empathy, emotional resonance, and sensitivity. Additionally, these studies outlined how impaired executive functioning influences empathy, attention, decision-making, and Theory of Mind.

Purpose – The objective of this article is to evaluate the quality of tourism services in the city of Cartagena de Indias, Colombia, from the perspective of foreign tourists arriving there, and to identify the elements that have the greatest influence on satisfaction and future behaviour, the latter expressed in the desire to return to enjoy the destination and/or recommend the city to third parties. Design – The paper proposes a Formative Type Model, where observable variables affect latent or structural variables. Five factors have been considered in this valuation: Tangibility, Reliability, Responsiveness, Security and Empathy. Methodology – The multivariate Partial Least Squares Regression technique is used, belonging to the set of methods of Structural Equation Systems. 390 surveys were applied to Spanish, English, and Italian-speaking international tourists, with a confidence level of 95% and a margin of error of 5%, assuming an infinite population. Findings – The results show that international tourists intend to return to the destination and overall satisfaction was positive. Originality – The results of this study contribute to the scientific literature on new methods for evaluating the quality of tourism services, using analysis techniques that place the customer at the center of decision-making.

Objetivo: Nuestro objetivo es identificar en la literatura el conocimiento y las prácticas de los Agentes de Salud de la Comunidad (ACS) sobre promoción de la salud.Método: Esta es una revisión integradora realizada en las bases de datos MEDLINE / PUBMED, LILACS y BDENF, de artículos completos en inglés, portugués o español. Utilizamos el método de análisis temático con el uso de tablas para una mejor sistematización.Resultados / Discusión: Fue posible analizar que los procesos de trabajo de ACS están fuertemente asociados con la capacitación técnica. Se observan las brechas en la producción de conocimiento sobre promoción de la salud, como práctica diaria, acciones preventivas y distribución de insumos / medicamentos, recolección de información sociodemográfica y la situación de salud de la población, perdiendo así el espacio para la producción de atención basada en promoción de la salud.Conclusión: La creación de lazos y la bienvenida como una herramienta inseparable para el trabajo de la ACS se vuelve pulsante en las discusiones. Objective: We aim to identify in the literature the knowledge and practices of Community Health Workers (CHWs) on health promotion.Method: This is an integrative literature review carried out in the MEDLINE/PUBMED, LILACS and BDENF databases, with full text articles in English, Portuguese or Spanish. We used the Thematic Analysis method, using tables for better systematization.Results / Discussion: It was possible to analyze that the CHW work processes are strongly associated with technical training. There are gaps in the production of knowledge about health promotion as a daily practice, with the presence of preventive actions and distribution of commodities/medications and collection of socio-demographic information and of the health situation of the population, leaving the production of care based on health promotion on the background.Conclusion: The discussions highlight the creation of bonds and empathy, as inseparable tools in the work of the CHW.

Purpose Based on a literature and practice review, the purpose of this paper is to examine the theoretical and clinical basis for using wordless books with patients who have intellectual disabilities (ID) and/or autism. Design/methodology/approach A literature review identified seminal peer-reviewed English language articles relating to the neuroscience of information and emotion processing for adults with ID and/or autism. In addition to published examples, illustrative case examples were contributed by clinicians regularly using wordless books. Findings Many people, including those with ID, selectively attend to visual information. Minimising the cognitive load by using wordless pictorial narrative reduces anxiety, and empowers the patient. Clinicians using such resources describe positive clinical outcomes. Only the Beyond Words wordless books have been identified in published clinical trials. Research limitations/implications Although existing evidence suggests a strong positive impact, further research into the use of wordless books for people with ID is needed. Practical implications Wordless books are reported to help develop staff skills and empathy for supporting adults with ID. The books facilitate some legally required reasonable adjustments to increase service access. Staff training is needed for effective use of wordless books. Originality/value Wordless books specifically designed with and for adults with word processing difficulties, ID and/or autism to enhance health literacy and explore their own narratives and emotional responses around health experiences and personal traumas are a unique approach. This paper may also offer the first exploration of their neuropsychological underpinnings.

Purpose The purpose of this paper is to contribute to understanding social entrepreneurship via a systematic literature review (SLR) of the construct’s varied definitions to assess the means by and the context in which the phenomenon is studied. Design/methodology/approach The SLR follows a deliberative, replicable, methodical and transparent process, including a quality assessment tool of definitional sources. SLR results are organized around Gartner’s (1985) framework of new value creation, thus additionally analysing the dimensionality with which social entrepreneurship has been studied. Finally, a qualitative analysis of the definitions reviews commonalities of themes within definitions to assess trends. Findings Significant research has been dedicated to defining social entrepreneurship. However, many efforts do not explore the full dimensionality of the concept, as findings reveal that no definition explored the four dimensions of entrepreneurship posited by Gartner (1985). Further, a time-series review of definitions demonstrates limited advancement in definitional development. Geographic location of definition authors and key word analysis challenge previous research on the activation of social entrepreneurship in literature. Research limitations/implications Although the SLR was conducted in a controlled manner, this study is time-bound and only reviews English-language publications. While results are analysed using a recognized framework (i.e. Gartner, 1985), other conceptual models are available. Although two researchers independently categorized and analysed definitions, assessment of quality was limited. The results offer an insight into how the conceptualization of social entrepreneurship may be advanced as well as the important role of practitioners in the development of the construct’s theory and practice. Practical implications The detailed appraisal of definitions may guide practitioners as they strive to define their own organizational efforts. The multi-dimensional conversation of social entrepreneurship in this study enables the leaders of different organizational types to ensure their social entrepreneurship activities consider all dimensions (i.e. environment, individual, organization and process). The SLR allows the practitioner to further engage in deep discussion on the future of the field by cataloguing their influence on the multi-dimensionality of the social entrepreneurship construct. Organizational leaders may also use the findings to generate more discussion around what is missing from the definitions (i.e. empathy, responsibility, resourcefulness and transparency). Originality/value The findings synthesize social entrepreneurship definitions across multi-disciplinary fields and contexts and within a multi-dimensional framework utilizing an infrequently used literature review method within social sciences.

The concept of evil is foregrounded in most of the poems of Khan. This paper focuses on the theme of evil in its variant shapes that are foregrounded in Khan’s poetry. For this purpose, both the collections of Khan, “Velvet of Loss” and “Pale Leaf (Three Voices)” are used for the data under study. Only those poems are selected that bear the foregrounded theme of evil. The poems that foreground the evil are Octopus, I Won’t Talk, The Dawn, The City, In a Café, Labyrinth, Nostalgia, Nemesis, Eclipsed Moon, Space-Scape, and Inertia. The presence of evil that negatively shapes the human condition is indirectly projected for making the reader taking interest which, in turn, compels them to become conscious of their plight in the present and terrifying dangers in the future. This consciousness, ultimately, leads to the reformation of society. In this regard, Khan can be taken as a great reformer of the society who carries a sense of sympathy and empathy through his terse and stenographic style. Lastly, this paper will guide local researchers for furthering research in the area of Pakistani Literature in English. In this regard, local voices will be analyzed for local issues and problems.

Objective Patient–physician interaction is continually examined in an era prioritizing patient-centered approaches, yet elaboration beyond aspects of communication and empathy is lacking. Major chronic conditions would benefit tremendously from understanding interpersonal aspects of patient–physician encounters. This review intends to provide a concise introduction to the interpersonal model of attachment theory and how it informs both the patient–physician interaction and medical outcomes in chronic care. Methods A narrative review of the theoretical, neurobiological, epidemiological, investigational, and clinical literature on attachment theory and its impact on medical outcomes was conducted, utilizing a variety of key words as searched on PubMed database. Studies and reviews included were of a variety of sources, including textbooks and peer-reviewed journals. Reports in languages other than English were excluded. Results Measurable, discrete attachment styles and behavioral patterns correlate with poor medical outcomes, including nonadherence in insecure dismissing attachment and care overutilization in insecure preoccupied attachment. Furthermore, insecure dismissing attachment is associated with significant mortality. These variables can be easily assessed, and their effects are reversible, as evidenced by collaborative care outcome data. Discussion Attachment theory is useful a model with application in clinical and investigational aspects of chronic illness care. Implications and guidelines are explored.

Objective: Healthcare organizations are increasingly engaging the voice of patients and families through storytelling initiatives in hopes that this will yield compassionate and humanistic outcomes. To date, very little research is available that directly guides and justifies storytelling initiatives as a mechanism for promoting humanistic culture shifts in healthcare. This review aimed to uncover diverse research and evidence on how storytelling can be utilized to promote humanistic shifts in healthcare organizations.Methods: A meta-narrative review and analysis was undertaken including qualitative, quantitative, theoretical, and conceptual papers. Searches were restricted to English Language journals, and no time frame restrictions were made. A literature assessment form was created to guide the review using a consistent taxonomy to appraise each paper. Analysis was done in two-stages: firstly, identifying emergent themes within each research discipline; secondly, comparing and contrasting themes from the different disciplines.Results: A total of 115 papers were identified for review resulting from the literature review protocol. Eighty-three papers were included in the final review: 48 papers from Healthcare/Medicine combined, 28 from Business, 14 from Education, 5 from Organizational Development and 19 from Humanities (inclusive of Psychology and Communications). There were three key findings: 1) Storytelling promotes sense-making while also perpetuating bias; 2) Stories are uniquely primed to elicit empathy and compassion; 3) Story listening and how stories are interacted with by the listener are key considerations for organizations aiming to shift culture.Conclusions: This review solidifies storytelling as a mechanism suited to furthering humanistic practices in healthcare while contributing new knowledge in support of developing policies, strategies and research initiatives that account for how stories are understood and the processes that encourage reflection and interaction by listeners.

Introductionlong acting injectable formulations of antipsychotics are a valuable option for patients with schizophrenia, offering continuous medication delivery and stable dosage levels. Aripiprazole once-monthly is the first dopamine partial agonist available in long acting formulation approved in Europe for Schizophrenia with excellent results so far.Aimsto conduct a current review of articles related to the use and efficacy of Aripiprazole once monthly in patients with Schizophrenia.Methodssystematic review of the literature in English using the following keywords: “aripiprazole once-monthly”, “aripiprazole long acting formulation”, “schizophrenia”. PubMed database.ResultsAripiprazole once-monthly (AOM) formulation efficacy has been proven in many studies. The importance of maintaining an oral overlap during 14 days is highlighted in all studies that have been reviewed in order to reach therapeutic level; therefore, it can be used in patients with acute decompensations. Recent studies comparing AOM versus Paliperidone Palmitate once monthly (PP) have shown that patients with AOM had greater clinical improvement and, even though both drugs were well tolerated, when Quality of Life Style Scale was analyzed an important improvement in empathy, sense of purpose, emotional interaction and curiosity in the AOM group was observed.Conclusionslong acting injectable antipsychotics increase long-term adherence treatment and reduce risk of relapse. Because of its unique mechanism of action, Aripiprazole once-monthly improves positive and negative symptoms, giving the patient an opportunity to have a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Negli ultimi trent’anni anche nell’ambito della Storia della medicina si è accentuato un approccio narrativo, soprattutto nei Paesi anglosassoni. L’attenzione viene centrata sull’essere umano, sulle relazioni interpersonali, sulla storia individuale piuttosto che su quella collettiva. Tale prospettiva si avvale del contributo privilegiato della scrittura (il romanzo, la poesia, il teatro, le favole, i diari, gli epistolari) e di quello evocativo dell’arte. In primo piano l’esperienza di vita di medici e malati, ma anche di familiari, colta attraverso il processo empatico che l’opera suscita nel lettore/osservatore. La malattia è quindi vista come condizione esistenziale. Lo storico Roy Porter definisce questa prospettiva “the history from below” e ritiene possa essere utile nel ricostruire gli aspetti antropologici della malattia “from the patients’ point of view”. Lo studente di medicina “immergendosi” nelle storie di medici e malati del passato acquisisce la capacità di capire non solo la malattia ma di sentire l’esperienza del malato (empatia). Le storie aiutano a focalizzare ciò che manca o è andato perduto nella pratica medica, stimolano l’introspezione personale perché spingono a riflettere non sulle abilità pratiche (competenza tecnica) ma su se stessi, sulle proprie emozioni. Il linguaggio denotativo non esaurisce tutta la realtà umana perché «la medicina è contemporaneamente scienza naturale e scienza umanistica. Il chiarire e il comprendere sono necessari allo stesso modo» (D. Von Engelhardt). ---------- In the last thirty years a narrative approach has become more noticeable even in the field of the History of Medicine, above all in English speaking countries. Attention is concentrated on the human being, on interpersonal relations, on the history of the individual rather than on the collective body. This narrative approach privileges the individual as a person, rather than the group, a methodology that uses the contributions of literature (the novel, poetry, theatre, fables, diaries, letters) as well as the evocative approach of the arts. In the foreground are the life experiences of doctors and patients, also of close relatives, evinced by the empathic process that a work of art fuels in the reader or observer. Sickness is viewed as an existential condition. The historian, Roy Porter, defines this perspective as ‘the history from below’ and maintains that it can be useful in reconstructing the anthropological aspects of sickness from the patient’s point of view. By emerging himself in the stories of doctors and patients of the past, the medical student acquires the ability to understand not only the sickness but to feel the experience of the patient (empathy). Medical stories help to focalize what is missing or has been lost in medical practice, stimulating personal introspection, because these stories urge reflection not on technical competence but on themselves and on their own emotions. The denotative language does not diminish all human reality because «medicine is contemporaneously natural and humanistic science. Clarifying and understanding are both necessary in the same way» (D. Von Engelhardt).

One of the major concerns of management in today’s competitive business world,is to deliver superior customer service leading to satisfaction, loyalty, and positive word of mouth (+WOM). This study explores perceived service quality and identifies most significant predictors of +WOM at rural banks. Taking a cue from extant service quality literature, five dimensional performance-only SERVPERF scale was developed in English and later translated into vernacular Hindi employing back translation method. Structured research instrument was administered on 480 customers, who were contacted at the premises of designated rural branches of public sector banks located in the most populous province of Uttar Pradesh in India. To extract relevant factors, statistical tools such as Exploratory Factor Analysis (EFA), t-Test, and linear regression were employed. Reliability, predictive validity, and dimensionality of the scale has also been explored. To detect multi-collinearity and data structure, Variance Inflation Factor (VIF) and box-plot technique have been used. Study reports high levels of perceived service quality across all five dimensions while results of regression analysis show that reliability and empathy are potent contributors in explaining +WOM. Original 22-item SERVPERF scale was not found to be universally applicable and thus the study proposes a refined and shorter 13-item SERVPERF scale for assessing service quality at rural banks in India. Findings can be of vital importance to banking industry in re-structuring and prioritizing service quality dimensions and also developing appropriate promotional strategies by highlighting relevant aspects of service quality for generating desired +WOM.

Daniel Defoe is an enchanted incinerator of English literature sprung during the initial years of eighteenth century. His applauded Moll Flanders (1722) is professed as picaresque in literary vegetation. He has emotionally painted the commotion of a solitary, imprudent and prevalent female distinct against an inimical and droopy humanity. As a matter of datum, the female chief strolls into the alleyway of assorted catastrophes. She has borne the humanity either in an orthodox or warped mundane. All these archetypes of women have shed light in the fiction even before the initiation of feminist movements athwart the realm. These movements have engrossed the intellect of community and sedated as operational. At regular intervals, these have performed more elegant and redundant than being operative.Moll Flanders is not a typical incarnation of feminist thoughts. It has never strained to sketch an itinerary for the relegated female personality to outshine her eccentricity. Yet, it is indubitably pro-woman and reconnoiters a female character with the reputation of protagonist. The farsighted image of woman with grander tenets of empathy and sympathy is blossomed. In the contemporary habitat, the novel may not seem like far-reaching as it pushes the female lead to imitate and regret with ceaseless kinks and contraventions. But the novelist is ahead of his epoch in aiding his female protagonist to gallop and endure the probabilities amidst dejection and misfortunes. Hence, the research ornate has through an endeavour to enchant the inner quandary of woman in a masculine captivated sophistication with reference to Daniel Defoe’s Moll Flanders.

Objectives: A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. Methods: The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Results: Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. Conclusion: The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.

Background: The concept ‘encounter’ occurs in caring literature as a synonym for dialogue and relation describing deeper levels of interaction between patient and nurse. In nursing and caring research, the concept ‘caring encounter’ is often used without further reflection on the meaning of the concept. Encounters are, however, continuously taking place in the world of caring, which calls for a clarification of the concept. Objectives: This study is an analysis of the concept of caring encounter in nursing from the patients’ and nurses’ point of view. Method: Rodgers’ evolutionary view guided the concept analysis within the theoretical perspective of caritative caring. Data sources: Peer-reviewed articles in English published between 1990 and 2014 were retrieved from the databases: CINAHL, PubMed, Web of Science, ScienceDirect (Elsevier), Springer Link, Primo Central (Ex Libris) and Academic Search Premier (EBSCO) using different combinations of encounter, caring and nursing as keywords. In all, 28 articles related to caring encounters were included in the analysis after applying inclusion and exclusion criteria. Ethical considerations: This study was conducted according to good scientific practice. Results: Four antecedents to the caring encounter are found in the nurse’s way of being: a reflective way of being; openness, sensitivity, empathy and ability to communicate; confidence, courage and professionalism; and showing respect and supporting dignity. The attributes are as follows: being there, uniqueness and mutuality. As a consequence, the caring encounter influences both patient and nurse. Discussion and conclusion: The caring encounter is an encounter between two equal persons where one is nurse and the other is patient. They encounter in mutuality, in true presence, and both have allowed themselves to be the person they are. The results clarify the conceptual differences between relationship and caring communion as the mutuality in the caring encounter differs from the dependence on the other pronounced in the relationship.

Introduction. The article presents the results of researching the samples of English-speaking literary heritage, which reveals psycholinguistic features of dialogical communication and peculiarities of communicants' perception of interactions meanings in dialogic speech. The technique of detecting the frequency of using different dialogues that differ in number of replicas is described. Objective. The purpose of the article is to characterize the psycholinguistic features of dialogical communication, to study units of the dialogue as means of forming a culture of communication of those who get aeducation. Methods. The methods of analysis of domestic and foreign works of art, analysis of dictionary definitions, methods of contextual and logical-semantic analyzes, elements of statistical analysis are used in the article. Results. It is substantiated that dialogue as a form of a communicative act is the most used form of verbal activity in which the text categories of communicants are implemented, their interpersonal relations are displayed, speech communication strategies appear, etc. Dialogue speech is characterized as a situational and thematic community of communicative motives in verbal statements consistently generated by two or more interlocutors in the direct act of communication. The frequency of the use of dialogues consisting of different amounts of dialogical unities is revealed. It is defined average number of dialogues consisting of dialogical unities; the frequency of dialogue with a different number of dialogical unities. It is considered the definitions of dialogue, dialogism, dialogical learning, dialogical speech, dialogical communication; it is characterized of the developed system of exercises and tasks for forming a culture of dialogical communication. Conclusions. It is concluded that for the formation of a culture of dialogical communication of the educational recipients, it is of great importance to turn to highly artistic samples of literature for the purpose of emotional perception of them; creating situations of empathy with the characters of the work by «impersonation» in these images; work on dialogical situations; the use of dialogues as a means of socialization.

BackgroundSchwartz Center Rounds®(Rounds) were introduced into the UK in 2009 to support health-care staff to deliver compassionate care, something the Francis report (Francis R.Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office; 2013) identified as lacking. Rounds are organisation-wide forums that prompt reflection and discussion of the emotional, social and ethical challenges of health-care work, with the aim of improving staff well-being and patient care.ObjectivesHow, in which contexts and for whom Rounds participation affects staff well-being at work, increases social support for staff and improves patient care.Design(1) A scoping review of Rounds literature and comparison with alternative interventions; (2) mapping Rounds providers via a survey, telephone interviews and secondary data; (3) a two-wave survey of (i) new attenders/non-attenders in 10 sites to determine the impact on staff engagement and well-being; and (ii) interviews with Rounds attenders, non-attenders, facilitators, clinical leads, steering group members, board members and observations in nine case study sites to (4) describe experiences and (5) test candidate programme theories by which Rounds ‘work’ (realist evaluation).Setting(1) International literature (English); (2) all Rounds providers (acute/community NHS trusts and hospices) at 1 September 2014 (survey/interview) and 15 July 2015 (secondary data); (3) 10 survey sites; and (4 and 5) nine organisational case study sites (six of which also took part in the survey).Participants(1) Ten papers were reviewed for Rounds and 146 were reviewed for alternative interventions. (2) Surveys were received from 41 out of 76 (54%) providers and interviews were conducted with 45 out of 76 (59%) providers. (3) Surveys were received from 1140 out of 3815 (30%) individuals at baseline and from 500 out of 1140 (44%) individuals at follow-up. (4 and 5) A total of 177 interviews were conducted, as were observations of 42 Rounds, 29 panel preparations and 28 steering group meetings.Results(1) The evidence base is limited; compared with 11 alternative interventions, Rounds offer a unique organisation-wide ‘all staff’ forum in which disclosure/contribution is not essential. (2) Implementation rapidly increased between 2013 and 2015; Rounds were implemented variably; challenges included ward staff attendance and the workload and resources required to sustain Rounds; and costs were widely variable. (3) There was no change in engagement, but poor psychological well-being (12-item General Health Questionnaire) reduced significantly (p < 0.05) in Rounds attenders (25% to 12%) compared with non-attenders (37% to 34%). (4 and 5) Rounds were described as interesting, engaging and supportive; four contextual layers explained the variation in Rounds implementation. We identified four stages of Rounds, ‘core’ and ‘adaptable’ components of Rounds fidelity, and nine context–mechanism–outcome configurations: (i) trust, emotional safety and containment and (ii) group interaction were prerequisites for creating (iii) a countercultural space in Rounds where staff could (iv) tell stories, (v) self-disclose their experiences to peers and (vi) role model vulnerability; (vii) provide important context for staff and patient behaviour; (viii) shining a spotlight on hidden staff and patient stories reduced isolation and enhanced support/teamwork; and (ix) staff learned through reflection resulting in ripple effects and outcomes. Reported outcomes included increased empathy and compassion for colleagues and patients, support for staff and reported changes in practice. The impact of Rounds is cumulative and we have identified the necessary conditions for Rounds to work.LimitationsRounds outcomes relied on self-report, fewer regular attenders were recruited than desired, and it was not possible to observe staff post Rounds.ConclusionRounds offer unique support for staff and positively influence staff well-being, empathy and compassion for patients and colleagues.Future workThe adaptation of Rounds to new contexts and to increase reach needs evaluation.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

The English socio-cultural context was crucial to the dissemination of the work of George Seferis in Europe. Early translations appeared in both French and English, but it was the English versions that propelled Seferis toward international recognition and the Nobel Prize, and gave rise to translations into more peripheral literatures such as Spanish. The wide social circle Seferis enjoyed in the English-speaking world was a key factor in his early success in the United Kingdom. Other determinants were British intellectuals’ empathy for the Greeks during the Colonels’ dictatorship and their liking for modern poetry similar to that of T. S. Eliot.

Background:Nurse-led care has been shown to be clinically effective and cost effective in rheumatoid arthritis (RA) but the role of the nurse in early RA is not well defined. Evidence for processes of care in RA is limited and it is not known how well rheumatology nurse-led clinics meet care needs of people with early RA.Objectives:The aim of this study was to develop an understanding of rheumatology nurse-led care from the perspective of people with early RA.Methods:A qualitative systematic review was conducted. The review protocol is published in the International prospective register of systematic reviews.In March 2019, the following databases were searched: MEDLINE, EMBASE, CINAHL, PsycINFO and OpenGrey. Due to lack of studies in early RA this review included adults with early and established inflammatory arthritis, qualitative studies with data on patients’ perspectives of nurse-led care, published in peer-reviewed journals in English between 2010 and 2019. Two reviewers screened titles, abstracts and full texts. Data were extracted and managed in tables. Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment of the included studies. A thematic synthesis was undertaken using the framework of Thomas and Harden.1Results:The search identified 1034 records. After screening and assessing for eligibility, 8 qualitative studies were included in the review (133 patients), 2 studies included people with early RA. Three main themes were identified (Figure 1).Figure 1.Themes of nurse-led care from the perspective of people with RAProviding knowledge and skill. This theme delineated rheumatology nursing as providing professional expertise in the planning and delivery of care. The rheumatology nurse-led service included easy access via telephone helpline, consultations with the clinical nurse specialist for assessment of disease activity and care needs, planning of care, disease information and education, supporting self-management, and referral to rheumatologist and the multi-disciplinary team. People with RA highly valued the nurse expertise and specialist knowledge provided at nurse-led clinics.‘She was very good at informing me, so I have only praise for this ... because I have never had it like this before’. (Person with early RA).Using a person-centred approach.This theme showed nurse-led care using a person-centred approach combined with empathy and good communication skills, which created a good therapeutic environment. People with RA appreciated the person-centeredness, empathy and involvement of the nurse. ‘She is very sensitive. She can see if I am feeling bad and comes straight to me and asks: “How are you today?” ...You are treated and taken seriously’. (Person with early RA).Meeting patients‘ care needs. This theme presented nurse-led care as creating a sense of being empowered and psychologically supported in the management of RA and its impact. Nurse-led care made people with RA feel cared for, secure and confident. It added value to rheumatology care and made care complete.‘The thought of sticking a needle into my own stomach... it felt a bit like I would never manage to do that. However, they have been absolutely wonderful here ... and now I can do it myself’. (Person with early RA).Conclusion:Nurse-led care for people with RA is characterised by provision of rheumatology expertise using a person-centred approach, and patients‘ holistic care needs are being met. This study found a dearth of literature on perceptions of nurse-led care in people with early RA, which highlights the need for further research in this population.References:[1]Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews.BMC Med Res Methodol2008; 8: 45.Disclosure of Interests:Anne-Marie Tetsche Sweeney: None declared, Candy McCabe: None declared, Caroline Flurey: None declared, Joanna Robson: None declared, Alice Berry: None declared, Pamela Richards: None declared, Mwidimi Ndosi Grant/research support from: Bristol Myers Squibb, Consultant of: Janssen, Pfizer

Abstrak Mata kuliah drama jurusan sastra inggris Sekolah Tinggi Ilmu Bahasa Asing Persada Bunda hanya menitikberatkan pada analisis teks dan dialog. Sementara bermain drama juga dapat meningkatkan empat kemampuan yang harus dimiliki oleh mahasiswa sastra Inggris yaitu speaking skill, listening skill, reading skill, dan writing skill. Melalui speaking skill mahasiswa telah melakukan kegiatan berbicara. Sementara listening skill mahasiswa telah melakukan kegiatan menyimak. Pada saat membacakan penggalan dialog dalam naskah drama, mahasiswa melakukan kegiatan membaca dan tentu saja dibutuhkan reading skill yang mumpuni. Sementara pada writing skill mahasiswa diharapkan dapat menulis naskah teks drama yang ingin dipentaskan. Berdasarkan masalah ini, penulis tertarik untuk melakukan penelitian dengan judul “Model Pembelajaran Role Play dalam Meningkatkan Kemampuan Bermain Drama Mahasiswa Jurusan Sastra Inggris Sekolah Tinggi Ilmu Bahasa Asing (STIBA) Persada Bunda”. Tujuan dilakukannya penelitian ini untuk melihat bagaimana model pembelajaran Role Play dapat meningkatkan kemampuan bermain drama. Berdasarkan data yang diperoleh, Penerapan model pembelajaran Role Play membantu meningkatkan kemampuan bermain drama mahasiswa jurusan sastra inggris Sekolah Tinggi Ilmu Bahasa Asing Persada Bunda dengan peningkatan Persentase Penilaian Hasil sebesar 29,20%. Kata Kunci : Role Play, Peningkatan Bermain Drama Abstract Drama course of English Literature of Foreign Language School Persada Bunda focuses on text analysis and dialogue. Playing the drama can also increase the four skills that must be possessed by students of English literature that is speaking skills, listening skills, reading skills, and writing skills. Through the speaking skills, students have been doing the talking activity. While listening skills, the student has been doing a listening activity. When reading a snippet of dialogue in a drama script, students do reading and of course, required a qualified reading skill. While the writing skill students are expected to write a drama text script to be staged. Based on this problem, the authors are interested in conducting research under the title "Role Play Learning Model in Enhancing the Ability to play Drama Students of English Literature of Foreign Language School of Foreign Studies (STIBA) Persada Bunda". The purpose of this research is to see how the Role Play learning model can improve the ability to play drama. Based on the data obtained, Implementation of Role Play learning model helps to improve the ability to play drama majoring in English Literature of Foreign Language School Persada Bunda with an increase of the percentage of Result Assessment of 29.20%. Key Words: Role Play, Improved Drama Play

Nursing is an applied profession which requires the combination of theoretical content and practical skills in a meaningful way. Nursing education must help students internalize information, skills, attitudes, professional values and ethical standards concerning the discipline and make them a part of their behavior. Nursing education necessitates an education system which covers all cognitive, affective and psychomotor areas of learning at a level of adequacy that could get students to assume the specified roles. As well as technical skills, such skills as providing a holistic and empathic health care and communication and team cooperation must be included by this system. The main objective of nursing education is to train nurses who can combine theory and practice, think critically in the learning process and have acquired effective problem solving skills. In the educational settings of our day, different teaching technologies are employed at each stage of instruction. Many instructional methods and strategies are tried out for the improvement of information and skills in nursing education. A great majority of educational methods and strategies consists of computer aided education, simulation and distance education approaches. One of the methods employed in order for students to improve their competence in health care management and to gain perfection. It is not always possible for students to gain appropriate clinical experience because they spend less time in the clinic due to such reasons as the limited areas of clinical practice in the complex structure of health care system, shorter stays of patients in hospitals and problems concerning the education system. However, despite all these negative factors, nurses are expected to possess the ability to perform nursing skills perfectly when encountered challenging situations. Considering such restrictions, simulation based learning plays a pivotal role for nursing students studying in the constantly changing health care system to get properly prepared.Simulation practices are considered as a significant step towards offering safe care to patients in health care services by providing a learning environment in which environmental risks are minimized. In recent years, patient stimulators that have high fidelity have attracted gradually increasing interest as en educational tool in nursing education. This review was planned with the aim of examining the results of studies carried out on the use of high fidelity simulation in nursing education. Study population consisted of 53 published studies which were reached as a result of the review of the data bases, “Pubmed” and “Science Direct” using the keywords “simulation”, “nursing”, “education”, “students” and “high fidelity” in April-May 2017. In the review, articles which were published in English and had their full texts were chosen for examinations. 23 studies meeting the criteria of the present research comprised the study sample. More than half the studies (15) included in the review cover the comparison of high fidelity simulation with another learning method. High fidelity simulation is also seen to be compared with standardized patients, traditional learning methods and moderate and low fidelity simulation. In the examination of the results of these studies most methods showed no superiority to others, but it was found that knowledge, skills and performance scores increased in the education offered using high fidelity simulation. In conclusion, in the education carried out with high fidelity simulation, increases can be observed in students’ clinical thinking and decision making, confidence, motivation and motor skills. Therefore, the use of simulation in the education of nursing students is accepted as the golden standard.Extended English abstract is in the end of PDF (TURKISH) file.ÖzetHemşirelik, kuramsal içeriğin, pratik beceri ile anlamlı bir biçimde birleşmesini gerektiren uygulamalı bir meslektir. Hemşirelik eğitimi; öğrencilere belirtilen rolleri kazandıracak yeterlilikte bilişsel, duyusal ve psikomotor öğrenme alanlarını kapsayan bir eğitim sistemini gerektirmektedir. Bu sistemde teknik becerilerin yanı sıra; bütüncül ve empatik bakım verme, iletişim ve ekip işbirliği gibi beceriler de yer almalıdır. Hemşirelik eğitiminde temel amaç; teori ile uygulamayı birleştirebilen, öğrenme sürecinde eleştirel düşünebilen ve etkin problem çözme becerisi kazanmış hemşireler yetiştirmektir. Günümüzde eğitim ortamlarında, öğretim sürecinin her aşamasında farklı öğretim teknolojileri kullanılmaktadır. Eğitim yöntem ve stratejilerinin önemli bir grubunu, bilgisayar destekli eğitim, simülasyon ve uzaktan eğitim yaklaşımları oluşturmaktadır. Öğrencilerin hasta bakım yönetiminde yeterliliğini geliştirmesi ve yetkinlik kazanması için benimsenen yöntemlerinden birisi de simülasyondur. Sağlık bakım sisteminin karmaşık yapısı içinde klinik uygulama alanlarının sınırlı olması, hastaların hastanede kalış sürelerinin kısalması ve eğitim sistemi kaynaklı nedenlerle klinikte daha az zaman geçirmeleri sonucunda öğrencilerin uygun klinik deneyim kazanabilmeleri her zaman mümkün olamamaktadır. Ancak tüm bu olumsuz faktörlere rağmen hemşirelerden zor durumlar karşısında hemşirelik becerilerini eksiksiz sergileyebilecek yeteneğe sahip olmaları beklenmektedir. Söz konusu sınırlamalar göz önüne alındığında, simülasyon temelli öğrenme, sürekli değişen sağlık bakım sistemi içinde eğitim gören hemşirelik öğrencilerinin yeterli hazırlanmasında anahtar rol oynamaktadır.Son yıllarda gerçekliğe yakınlığı yüksek hasta simülatörleri hemşirelik eğitiminde bir eğitim aracı olarak giderek artan bir ilgiyle kullanılmaktadır. Bu derleme hemşirelik eğitiminde yüksek gerçeklikli simülasyon kullanımına yönelik yapılan çalışmaların sonuçlarını incelemek amacıyla planlanmıştır. Çalışmanın evrenini Nisan-Mayıs 2017 tarihlerinde “simülation”, “nursing”, “education”, “students”, “high fidelity” anahtar kelimeleriyle, “Pubmed” ve “Science Direct” veri tabanları taranarak yayınlanmış olan 53 çalışma oluşturmuştur. İncelemede, yayın dili İngilizce olan ve tam metni bulunan makaleler seçilmiştir. Araştırma kriterlerini karşılayan 23 çalışma derlemenin örneklemini oluşturmuştur. Derlemeye dahil edilen araştırmaların yarısından fazlası (15) yüksek gerçeklikli simülasyon ile bir diğer öğrenme yönteminin karşılatırılmasından oluşmaktadır. Yüksek gerçeklikli simülasyonun; standardize hasta, geleneksel öğrenme yöntemleri, orta ve düşük gerçeklikli simülasyon ile karşılaştırıldığı görülmektedir. Bu çalışmaların sonuçları incelendiğinde çoğunun birbirine karşı bir üstünlüğü bulunmamış fakat yüksek gerçeklikli simülasyon ile yapılan eğitimde bilgi, beceri ve performans puanlarında artma olduğu saptanmıştır. Sonuç olarak yüksek gerçeklikli simülasyon ile yapılan eğitimde; öğrencilerin klinik düşünme ve karar verme, özgüven, motivasyon ve motor becerilerinde artma görülmektedir. Bu nedenle, hemşirelik öğrencilerinin eğitiminde simülasyon kullanımı altın standart olarak kabul edilmektedir.

ABSTRACTThis study is aimed at investigating the rhetorical structure of Introduction chapters of English master theses written by Indonesian postgraduate students and identifying the frequency of communicative moves and their constituent steps as well as finding how the students justify their research projects reported in their Introduction chapters. The research design was mixed method research combining quantitative and qualitative method. Twenty Introduction chapters of English master theses were taken from two different fields; English language education and applied linguistics, and they were analyzed using checklists. The results: (1) three moves and fifteen steps are found in the introduction chapters of master theses and three newly identified steps other than those specified in Bunton’s are also found in the corpus of this study and (2) three moves are considered obligatory moves, seven steps are classified as obligatory, four Steps are conventional and seven Steps are optional. Further, the majority of Indonesian postgraduate students tend to rhetorically justify their research project based on the knowledge gap found in the literature. This study concludes that the move and step model suggested by Bunton (2002) and modified from Swales’ CARS is effective enough to capture the possible rhetorical structure of introduction chapter of master thesis written by Indonesian postgraduate students. ABSTRAKPenelitian ini bertujuan untuk menemukan pola retorika bab pendahuluan dalam thesis bahasa Inggris diantaranya mengidentifikasi bagian pendahuluan yang memiliki moves (tahapan), steps (langkah), dan menjustifikasi pentingnya penelitian dilakukan. Desain penelitian yang digunakan dalam penelitian ini adalah metode campuran (mixed method) yang menggabungkan kuantitatif dan kualitatif, dan instrumen utama yang digunakan dalam menganalisis data adalah instrumen ceklist. Data penelitian ini diambil dari dua bidang thesis yang berbeda; pengajaran bahasa Inggris dan fitur linguistik. Hasil dari penelitian ini: (1) tiga Moves (tahapan) dan limabelas Steps (langkah) ditemukan dalam bab Pendahuluan thesis pada penelitian ini. Selain itu, ditemukan juga tiga Steps (langkah) baru yang tidak ditemukan dalam pola Bunton (2002); (2) tiga Moves (tahapan) dikategorikan harus/wajib ada, tujuh Steps (langkah) diiklasifikasikan harus ada, empat Steps (langkah) boleh ada, dan tujuh Steps (langkah) boleh tidak ada. Selanjutnya, mayoritas mahasiswa pascasarjana Indonesia cenderung secara retoris menjustifikasi proyek penelitian mereka berdasarkan pada celah (gap) yang terdapat dalam penelitian-penelitian terkait terdahulu. Penelitian ini menyimpulkan bahwa pola tahapan (Move) dan langkah (Step) yang dikemukakan oleh Bunton (2002) dan dimodifikasi dari pola retorika Swales yakni Creating a Research Space (CARS) cukup efektif digunakan dalam menggambarkan struktur retorika bab pendahuluan pada thesis yang ditulis oleh mahasiswa pascasarjana Indonesia.How to Cite: Pujiyanti, I. A., Arsyad, S., Arono. (2018). Rhetorical Structure Analysis on Introduction Chapters of English Master Theses by Indonesian Postgraduate Students. IJEE (Indonesian Journal of English Education), 5(2), 143-162. doi:10.15408/ijee.v5i2.8423

ABSTRAKWanita berhak memilih penanganan premenopause namun penentuan keputusan menimbulkan masalah baru. Penelitian ini bertujuan untuk menelaah literature mengenai pengalaman penentuan keputusan dalam memilih penanganan gejala menopause dan peran petugas kesehatan terutama perawat untuk membantu proses penentuan keputusan. Sumber diambil dari database PubMed, ScienceDirect, dan SAGEPub. Enam kata kunci yang digunakan adalah fulltext, berbahasa Inggris, penelitian kualitatif berhubungan dengan penentuan keputusan dalam memilih penanganan gejala menopause. Total terdapat 42 artikel dari empat Negara yang berbeda dan setelah dilakukan pemilihan kriteria inklusi, empat artikel yang ditelaah. Dari empat artikel menemukan bahwa wanita mengungkapkan perasaan mereka tentang kurangnya informasi tentang menopause dan manajemen gejala menopause sehingga mereka menemukan kesulitan ketika memutuskan untuk terapi. Sebagian besar itu menunjukkan tentang kurangnya dukungan dari petugas kesehatan. Dari artikel juga menemukan mengenai faktor tentang pengambilan keputusan, dibagi menjadi empat kategori: (1) karakteristik individu (demografi, pengalaman menopause, gejala); (2) nilai-nilai, sikap, keyakinan, dan preferensi (sikap dan keyakinan tentang menopause dan perawatan, modalitas disukai, toleransi untuk risiko / efek samping); (3) fakta dan informasi tentang menopause dan manajemen gejala (jumlah, jenis, sumber, kredibilitas, ketersediaan); dan (4) konteks pelayanan kesehatan (perawatan kesehatan penyedia komunikasi, kepercayaan, ketersediaan / waktu, pengetahuan, hubungan). Sebuah model yang komprehensif pengambilan keputusan manajemen gejala menopause harus dibuat di Indonesia. Perawat sebagai penyedia layanan harus meningkatkan kemampuan komunikasi yang efektif untuk membantu perempuan dalam proses pengambilan keputusan misalnya dengan menggunakan intervensi Coacing Decision di acara bimbingan atau konsultasi.Kata kunci: penentuan keputusan wanita menopause, penetuan keputusan, peran perawatABSTRACTWomen have a right for choose the best premenopause treatment for her ownself, but decision making process sometime become new problem. Aim of this study was to review the literature regarding experience related to women’s menopausal symptoms management decision making and role of care provider especially nurse for helping client in decision making process. Reference lists collected from PubMed, ScienceDirect, and SAGEPub database. There are six keywords have been used for searching the article. Full- text, English language, qualitative study articles related to women’s menopausal symptom management decision making were reviewed. A total of 42 articles from four different countries and after considered inclusion criteria, four articles were reviewed. From four articles found that women expressed their feeling about a lack menopause information and its menopausal symptom management so they found difficulties when decided for the therapy. Most of it showed about a lack of support from care provider. From articles also found about factors about decision making, devided to four catagories: (1) individual characteristics (demographics, menopause experience, symptomatology); (2) values, attitudes, beliefs, and preferences (attitudes and beliefs about menopause and treatments, preferred modalities, tolerance for risks/side effects); (3) facts and information about menopause and symptom management (amount, type, source, credibility, availability); and (4) health care context (health care provider communication, trust, availability/time, knowledge, relationship). A comprehensive model of menopausal symptom management decision making should be made in Indonesia. Nurse as a care provider must increase an effective communication ability to help women in decision making process for example by using Decision Coacing Intervention at tutoring or consultation event. Keywords: woman’s menopause decision making, decision making, role of nurse DOWNLOAD FULL TEXT PDF >>

<strong>English</strong><br />Development concept explained in the mid of 20th century keeps improving. One of the concept improvements is application of “community-based development” concept. This concept criticizes the relatively unsuccessful rural development based on individuals and households. One of actual community-based development types is implemented in the Prima Tani Program planning. The Program planning consists of (i) the program is located at the rural areas as the smallest units, (ii) action plan was applied using participatory rural appraisal, (iii) encouraging self reliance, and (iv) uses of local institutional resources. The paper is a literature study based on the documents of Prima Tani Program planning and the writer’s involvement in filed activities of the Program planning in West Nusa Tenggara Province. The assessment shows that it is necessary to well measure communal degree of the community. This is the basis for overall program implementation.<br /><br /><br /><strong>Indonesian</strong><br />Konsep pembangunan yang dijelaskan pada pertengahan abad ke 20 terus mengalami perbaikan. Salah satu bentuk perbaikan konsep adalah diterapkannya konsep “pembangunan berbasiskan komunitas”. Konsep ini dapat dipandang sebagai kritik konsep pembangunan pedesaan selama ini yang berlandaskan kepada pendekatan individual dan rumah tangga yang dinilai kurang berhasil. Salah satu bentuk konkrit pembangunan berbasiskan komunitas diterapkan dalam rancangan program Prima Tani. Hal ini setidaknya terlihat dari empat aspek yaitu: penetapan lokasi program pada desa sebagai unit terkecil, penerapan PRA dalam penyusunan rencana aksi yang dilakukan secara partisipatif, upaya meningkatkan kemandirian, serta penggunaan sumberdaya kelembagaan setempat. Tulisan ini merupakan studi literatur yang didasarkan atas dokumen-dokumen rancangan Prima Tani serta keterlibatan penulis dalam melakukan kegiatan lapang Prima Tani di Provinsi Nusa Tenggara Barat. Hasil penelaahan membuktikan perlunya perhatian untuk mengukur derajat komunalitas warga secara baik. Hal ini merupakan titik tolak dalam pengimplementasian program secara keseluruhan.

A Rooted Man and a Sacred PoetBy Viggo MortensenA Review of A.M. Allchin: N.F.S. Grundtvig. An Introduction to his Life and Work. With an afterword by Nicholas Lossky. 338 pp. Writings published by the Grundtvig Society, Århus University Press, 1997.Canon Arthur Macdonald Allchin’s services to Grundtvig research are wellknown to the readers of Grundtvig Studier, so I shall not attempt to enumerate them. But he has now presented us and the world with a brilliant synthesis of his studies of Grundtvig, a comprehensive, thorough and fundamental introduction to Grundtvig, designed for the English-speaking world. Fortunately, the rest of us are free to read as well.It has always been a topic of discussion in Denmark whether Grundtvig can be translated, whether he can be understood by anyone except Danes who have imbibed him with their mother’s milk, so to speak. Allchin is an eloquent proof that it can be done. Grundtvig can be translated and he can be made comprehensible to people who do not belong in Danish culture only, and Allchin spells out a recipe for how it can be done. What is required is for one to enter Grundtvig’s universe, but to enter it as who one is, rooted in one’s own tradition. That is what makes Allchin’s book so exciting and innovative - that he poses questions to Grundtvig’s familiar work from the vantage point of the tradition he comes from, thus opening it up in new and surprising ways.The terms of the headline, »a rooted man« and »a sacred poet« are used about Grundtvig in the book, but they may in many ways be said to describe Allchin, too. He, too, is rooted in a tradition, the Anglican tradition, but also to a large extent the tradition taken over from the Church Fathers as it lives on in the Orthodox Church. Calling him a sacred poet may be going too far.Allchin does not write poetry, but he translates Grundtvig’s prose and poetry empathetically, even poetically, and writes a beautiful and easily understood English.Allchin combines the empathy with the distance necessary to make a renewed and renewing reading so rewarding: »Necessarily things are seen in a different perspective when they are seen from further away. It may be useful for those whose acquaintance with Grundtvig is much closer, to catch a glimpse of his figure as seen from a greater distance« (p. 5). Indeed, it is not only useful, it is inspiring and capable of opening our eyes to new aspects of Grundtvig.The book falls into three main sections. In the first section an overview of Grundtvig’s life and work is given. It does not claim to be complete which is why Allchin only speaks about »Glimpses of a Life«, the main emphasis being on the decisive moments of Grundtvig’s journey to himself. In five chapters, Grundtvig’s way from birth to death is depicted. The five chapters cover: Childhood to Ordination 1783-1811; Conflict and Vision 1811-29; New Directions, Inner and Outer 1829-39; Unexpected Fulfilment 1839-58; and Last Impressions 1858-72. As it will have appeared, Allchin does not follow the traditional division, centred around the familiar years. On the contrary, he is critical of the attempts to focus everything on such »matchless discoveries«; rather than that he tends to emphasize the continuity in the person’s life as well as in his writings. Thus, about Thaning’s attempt to make 1832 the absolute pivotal year it is said: »to see this change as an about turn is mistaken« (p. 61).In the second main section of the book Allchin identifies five main themes in Grundtvig’s work: Discovering the Church; The Historic Ministry; Trinity in Unity; The Earth made in God’s Image; A simple, cheerful, active Life on Earth. It does not quite do Allchin justice to say that he deals with such subjects as the Church, the Office, the Holy Trinity, and Creation theology.His own subtitles, mentioned above, are much more adequate indications of the content of the section, since they suggest the slight but significant differences of meaning that Allchin masters, and which are immensely enlightening.It also becomes clear that it is Grundtvig as a theologian that is the centre of interest, though this does not mean that his work as educator of the people, politician, (history) scholar, and poet is neglected. It adds a wholeness to the presentation which I find valuable.The third and longest section of the book, The Celebration of Faith, gives a comprehensive introduction to Grundtvig’s understanding of Christianity, as it finds expression in his sermons and hymns. The intention here is to let Grundtvig speak for himself. This is achieved through translations of many of his hymns and long extracts from his sermons. Allchin says himself that if there is anything original about his book, it depends on the extensive use of the sermons to illustrate Grundtvig’s understanding of Christianity. After an introduction, Eternity in Time, the exposition is arranged in the pattern of the church year: Advent, Christmas, Annunciation, Easter and Whitsun.In the section about the Annunciation there is a detailed description of the role played by the Virgin Mary and women as a whole in Grundtvig’s understanding of Christianity. He finishes the section by quoting exhaustively from the Catholic theologian Charles Moeller and his views on the Virgin Mary, bearing the impress of the Second Vatican Council, and he concludes that in all probability Grundtvig would not have found it necessary to disagree with such a Reformist Catholic view. Finally there are two sections about The Sign of the Cross and The Ministry of Angels. The book ends with an epilogue, where Allchin sums up in 7 points what modem features he sees in Gmndtvig.Against the fragmented individualism of modem times, he sets Gmndtvig’s sense of cooperation and interdependence. In a world plagued with nationalism, Gmndtvig is seen as an example of one who takes national identity seriously without lapsing into national chauvinism. As one who values differences, Grundtvig appeals to a time that cherishes special traditions.Furthermore Gmndtvig is one of the very greatest ecumenical prophets of the 19th century. In conclusion Allchin translates »Alle mine Kilder« (All my springs shall be in you), »Øjne I var lykkelige« (Eyes you were blessed indeed) and »Lyksaligt det Folk, som har Øre for Klang« (How blest are that people who have an ear for the sound). Thus, in a sense, these hymns become the conclusion of the Gmndtvig introduction. The point has been reached when they can be sung with understanding.While reading Allchin’s book it has been my experience that it is from his interpretation of the best known passages and poems that I have learned most. The familiar stanzas which one has sung hundreds of times are those which one is quite suddenly able to see new aspects in. When, for example, Allchin interprets »Langt højere Bjerge« (Far Higher Mountains), involving Biblical notions of the year of jubilee, it became a new and enlightening experience for me. But the Biblical reference is characteristic. A Biblical theologian is at work here.Or when he interprets »Et jævnt og muntert virksomt Liv paa Jord« (A Simple Cheerful Active Life on Earth), bringing Holger Kjær’s memorial article for Ingeborg Appel into the interpretation. In less than no time we are told indirectly that the most precise understanding of what a simple, cheerful, active life on earth is is to be found in Benedict of Nursia’s monastic mle.That, says Allchin, leads us to the question »where we are to place the Gmndtvigian movement in the whole spectmm of Christian movements of revival which are characteristic of Protestantism« (p. 172). Then - in a comparison with revival movements of a Pietistic and Evangelical nature – Allchin proceeds to give a description of a Grundtvigianism which is culturally open, but nevertheless has close affinities with a medieval, classical, Western monastic tradition: a theocentric humanism. »It is one particular way of knitting together the clashing archetypes of male and female, human and divine, in a renunciation of evil and an embracing of all which is good and on the side of life, a way of making real in the frailties and imperfections of flesh and blood a deeply theocentric humanism« (p. 173).Now, there is a magnificent English sentence. And there are many of them. Occasionally some of the English translations make the reader prick up his ears, such as when Danish »gudelige forsamlinger« becomes »meetings of the godly«. I learnt a few new words, too (»niggardliness« and »esemplastic«) the meaning of which I had to look up; but that is only to be expected from a man of learning like Allchin. But otherwise the book is written in an easily understood and beautiful English. This is also true of the large number of translations, about which Allchin himself says that he has been »tantalised and at times tormented« by the problems connected with translating Grundtvig, particularly, of course, his poetry. Naturally Allchin is fully aware that translation always involves interpretation. When for example he translates Danish »forklaret« into »transfigured«, that choice pulls Grundtvig theologically in the direction that Allchin himself inclines towards. This gives the reader occasion to reflect. It is Allchin’s hope that his work on translating Grundtvig will be followed up by others. »To translate Grundtvig in any adequate way would be the work of not one person but of many, not of one effort but of many. I hope that this preliminary study may set in train a process of Grundtvig assimilation and affirmation« (p. 310)Besides being an introduction to Grundtvig, the book also becomes an introduction to past and contemporary Danish theology and culture. But contemporary Danish art, golden age painting etc. are also brought in and interpreted.As a matter of course, Allchin draws on the whole of the great Anglo-Saxon tradition: Blake, Constable, Eliot, etc., indeed, there are even quite frequent references to Allchin’s own Welsh tradition. In his use of previous secondary literature, Allchin is very generous, quoting it frequently, often concurring with it, and sometimes bringing in half forgotten contributions to the literature on Grundtvig, such as Edvard Lehmann’s book from 1929. However, he may also be quite sharp at times. Martin Marty, for example, must endure being told that he has not understood Grundtvig’s use of the term folkelig.Towards the end of the book, Allchin discusses the reductionist tactics of the Reformers. Anything that is not absolutely necessary can be done away with. Thus, what remains is Faith alone, Grace alone, Christ alone. The result was a radical Christ monism, which ended up with undermining everything that it had originally been the intention to defend. But, says Allchin, Grundtvig goes the opposite way. He does not question justification by faith alone, but he interprets it inclusively. The world in all its plenitude is created in order that joy may grow. There is an extravagance and an exuberance in the divine activity. In a theology that wants to take this seriously, themes like wonder, growth and joy must be crucial.Thus, connections are also established back to the great church tradition. It is well-known how Grundtvig received decisive inspiration from the Fathers of the Eastern Church. Allchin’s contribution is to show that it grows out of a need by Grundtvig himself, and he demonstrates how it manifests itself concretely in Grundtvig’s writings. »Perhaps he had a deep personal need to draw on the wisdom and insight of earlier ages, on the qualities which he finds in the sacred poetry of the Anglo-Saxons, in the liturgical hymns of the Byzantine Church, in the monastic theology of the early medieval West. He needs these resources for his own life, and he is able to transpose them into his world of the nineteenth century, which if it is no longer our world is yet a world in which we can still feel at home. He can be for us a vital link, a point of connection with these older worlds whose riches he had deciphered and transcribed with such love and labour« (p. 60).Thus the book gives us a discussion - more detailed than seen before – of Grundtvig’s relationship to the Apostolic Succession, the sacramental character of the Church and Ordination, and the phenomenon transfiguration which is expounded, partly by bringing in Jakob Knudsen. On the background of the often observed emphasis laid by Grundtvig on the descent into Hell and the transfiguration, his closeness to the orthodox form of Christianity is established. Though Grundtvig does not directly use the word »theosis« or deification, the heart of the matter is there, the matter that has been given emphasis first and foremost in the bilateral talks between the Finnish Lutheran Church and the Russian Orthodox Church. But Grundtvig’s contribution is also seen in the context of other contemporaries and reforming efforts, Khomiakov in Russia, Johann Adam Möhler in Germany, and Keble, Pusey and Newman in England. It is one of Allchin’s major regrets that it did not come to an understanding between the leaders of the Oxford Movement and Grundtvig. If an actual meeting and a fruitful dialogue had materialized, it might have exerted some influence also on the ecumenical situation of today.Allchin shows how the question of the unity of the Church and its universality as God’s Church on earth acquired extreme importance to Grundtvig. »The question of rediscovering Christian unity became a matter of life and death« (p. 108). It is clear that in Allchin’s opinion there has been too little attention on this aspect of Grundtvig. Among other things he attributes it to a tendency in the Danish Church to cut itself off from the rest of the Christian world, because it thinks of itself as so special. And this in a sense is the case, says Allchin. »Where else, at the end of the twentieth century, is there a Church which is willing that a large part of its administration should be carried on by a government department? Where else is there a state which is still willing to take so much responsibility for the administration of the Church’s life?« (p. 68). As will be seen: Allchin is a highly sympathetic, but far from uncritical observer of Danish affairs.When Allchin sees Grundtvig as an ecumenical theologian, it is because he keeps crossing borders between Protestantism and Catholicism, between eastern and western Christianity. His view of Christianity is thus »highly unitive« (p. 310). Grundtvig did pioneer work to break through the stagnation brought on by the church schisms of the Reformation. »If we can see his efforts in that way, then the unfinished business of 1843 might still give rise to fruitful consequences one hundred and fifty years later. That would be a matter of some significance for the growth of the Christian faith into the twentyfirst century, and not only in England and Denmark« (p. 126).In Nicholas Lossky’s Afterword it is likewise Grundtvig’s effort as a bridge builder between the different church groupings that is emphasized. Grundtvig’s theology is seen as a »truly patristic approach to the Christian mystery« (p. 316). Thus Grundtvig becomes a true all-church, universal, »catholic« theologian, for »Catholicity is by definition unity in diversity or diversity in unity« (p. 317).With views like those presented here, Allchin has not only introduced Grundtvig and seen him in relation to present-day issues, but has also fruitfully challenged a Danish Grundtvig tradition and Grundtvigianism. It would be a pity if no one were to take up that challenge.

Acute Myocardial Infarction (AMI) is also known as a heart attack, coronary occlusion, or just coronary, which is a life-threatening condition characterized by the formation of local necrotic areas within the myocardium. One that is very influential on the psychological state of patients with heart problems that will be able to change the coping patterns of patients in dealing with the disease and live their lives is the emergence of anxiety. This paper is a literature review / literature review from several data bases namely Google Schoolar, ScienceDirect, NCBI and PubMed. Search articles are limited from 2010 to 2020. The author uses the keywords "anxiety" and "Acute myocardial infarction / Myocardial infarction". The results of the research from four data bases obtained 102 articles 43 from Indonesian language articles and 59 English articles. Based on the facts that occur in the condition of patients with AMI, anxiety is one of the conditions that can cause changes in physical, or psychological. Anxiety that appears can have a negative effect on the success of treatment and treatment, it is necessary to have appropriate pharmacological and nonpharmacological therapy. Non-pharmacological therapy, namely psychological therapy and complementary therapy. Complementary therapy has been recognized and accepted as a form of nursing care. The results of the analysis of several studies showed that independent nursing interventions that were proven effective in reducing anxiety were by giving aromatherapy namely aromatherapy Geranium, Lemon, and Lavender. Aromatherapy is a method that uses essential oils to improve physical and emotional health. Aroma therapy has a positive effect because it is known that a fresh, fragrant aroma stimulates sensory, receptors and ultimately affects other organs so that it can have a powerful effect on emotions. The results of this study can be considered giving nursing interventions to reduce anxiety in AMI patients by giving aromatherapy Keywords: anxiety; acute myocardial infarction; aromatherapy ABSTRAK Acute Myocardial Infarction (AMI) juga di kenal sebagai serangan jantung, oklusi koroner, atau hanya koroner, yang merupakan kondisi mengancam jiwa yang ditandai dengan pembentukan area nekrotik lokal di dalam miokardium. Salah satu yang sangat berpengaruh pada keadaan psikologis pasien dengan gangguan jantung sehingga akan dapat merubah pola koping pasien dalam menghadapi penyakit maupun menjalani hidupnya adalah timbulnya kecemasan. Tulisan ini merupakan tinjauan literatur/literature review dari beberapa data base yaitu Google schoolar, ScienceDirect, NCBI dan PubMed. Penelusuran artikel dibatasi dari tahun 2010 sampai dengan tahun 2020. Penulis menggunakan kata kunci “kecemasan” dan “akut miokard infark/ miokard infark”. Hasil penelitian dari empat data base diperoleh 102 artikel 43 dari artikel bahasa Indonesi dan 59 artikel Bahasa Inggris. Berdasarkan fakta-fakta yang terjadi pada kondisi pasien dengan AMI, kecemasan merupakan salah satu keadaan yang dapat menimbulkan adanya perubahan keadaan fisik, maupun psikologis. Kecemasan yang muncul dapat memberikan efek negatif bagi keberhasilan perawatan dan pengobatan, maka diperlukan terapi farmakologi maupun non-farmakologi yang tepat. Terapi non farmakologi yaitu terapi psikologis dan terapi komplementer. Terapi komplementer telah diakui dan diterima sebagai bentuk asuhan keperawatan. Hasil analisis beberapa penelitian menunujukkan intervensi keperawatan mandiri yang terbukti efektif menurunkan kecemasan adalah dengan pemberian aromaterapi yaitu aromaterapi Geranium, Lemon, dan Lavender. Aromaterapi adalah metode yang menggunakan minyak atsiri untuk meningkatkan kesehatan fisik dan emosi. Aroma terapi mempunyai efek positif karena diketahui bahwa aroma yang segar, harum merangsang sensori, reseptor dan pada akhirnya mempengaruhi organ yang lainnya sehingga dapat menimbulkan efek kuat terhadap emosi. Hasil studi ini dapat dipertimbangkan pemberian intervensi keperawatan untuk menurunkan kecemasan pada pasien AMI dengan pemberian aromaterapi Kata kunci: kecemasan; akut miokard infark; aromaterapi

Marcus Wood; Slavery, Empathy, and Pornography (Lynn M. Festa)Michèle Praeger; The Imaginary Caribbean and Caribbean Imaginary (Celia Britton)Charles V. Carnegie; Postnationalism Prefigured: Caribbean Borderlands (John Collins)Mervyn C. Alleyne; The Construction and Representation of Race and Ethnicity in the Caribbean and the World (Charles V. Carnegy)Jerry Gershenhorn; Melville J. Herskovits and the Racial Politics of Knowledge (Richard Price)Sally Cooper Coole; Ruth Landes: A Life in Anthropology (Olivia Maria Gomes Da Cunha)Maureen Warner Lewis; Central Africa in the Caribbean: Transcending Time, Transforming Cultures (Robert W. Slenes)Gert Oostindie (ed.); Facing up to the Past: Perspectives on the Commemoration of Slavery from Africa, the Americas and Europe (Gad Heuman)Gert Oostindie, Inge Klinkers; Decolonising the Caribbean: Dutch Policies in a Comparative Perspective (Paul Sutton)Kirk Peter Meigho; Politics in a ‘Half-Made Society’: Trinidad and Tobago, 1925-2001 (Douglas Midgett)Linden Lewis (ed.); The Culture of Gender and Sexuality in the Caribbean (David A.B. Murray)Gertrude Aub-Buscher, Beverly Ormerod Noakes (eds.); The Francophone Caribbean Today: Literature, Language, Culture (Elizabeth Walcott-Hackshaw)Sally Lloyd-Evans, Robert B. Potter; Gender, Ethnicity and the Iinformal Sector in Trinidad (Katherine E. Browne)STeve Striffler, Mark Moberg (eds.); Banana Wars: Power, Production and History in the Americas (Peter Clegg)Johannes Postma, Victor Enthoven (eds.); Riches from Atlantic Commerce: Dutch Transatlantic Trade and Shipping, 1585-1817 (Gert J. Oostindie)Phil Davison; Volcano in Paradise: Death and Survival on the Caribbean Island of Montserrat (Bonham C. Richardson)Ernest Zebrowski jr; The Last Days of St. Pierre: The Volcanic Disaster that Claimed Thirty Thousand Lives (Bernard Moitt)Beverley A. Steele; Grenada: A History of Its People (Jay R. Mandle)Walter C. Soderlund (ed.); Mass Media and Foreign Policy: Post-Cold War Crises in the Caribbean (Jason Parker)Charlie Whitham; Bitter Rehearsal: British and American Planning for a Post-War West Indies (Jason Parker)Douglas V. Amstrong; Creole Transformation from Slavery to Freedom: Historical Archaeology of the East End Community, St. John, Virgin Islands (Karin Fog Olwig)H.U.E. Thoden van Velzen; Een koloniaal drama: De grote staking van de Marron vrachtvaarders, 1921 (Chris de Beet)Joseph F. Callo; Nelson in the Caribbean: The Hero Emerges, 1784-1787 (Carl E. Swanson)Jorge Duany; The Puerto Rican Nation on the Move: Identities on the Island and in the United States (Juan Flores)Raquel Z. Rivera; New York Ricans from the Hip Hop Zone (Halbert Barton)Alfonso J. García Osuna; The Cuban Filmography, 1897 through 2001 (Ann Marie Stock)Michael Aceto, Jeffrey P. Williams (eds.); Contact Englishes of the Eastern Caribbean (Geneviève Escure)In: New West Indian Guide / Nieuwe West-Indische Gids (NWIG) 79 (2005), no. 1 & 2

Marcus Wood; Slavery, Empathy, and Pornography (Lynn M. Festa)Michèle Praeger; The Imaginary Caribbean and Caribbean Imaginary (Celia Britton)Charles V. Carnegie; Postnationalism Prefigured: Caribbean Borderlands (John Collins)Mervyn C. Alleyne; The Construction and Representation of Race and Ethnicity in the Caribbean and the World (Charles V. Carnegy)Jerry Gershenhorn; Melville J. Herskovits and the Racial Politics of Knowledge (Richard Price)Sally Cooper Coole; Ruth Landes: A Life in Anthropology (Olivia Maria Gomes Da Cunha)Maureen Warner Lewis; Central Africa in the Caribbean: Transcending Time, Transforming Cultures (Robert W. Slenes)Gert Oostindie (ed.); Facing up to the Past: Perspectives on the Commemoration of Slavery from Africa, the Americas and Europe (Gad Heuman)Gert Oostindie, Inge Klinkers; Decolonising the Caribbean: Dutch Policies in a Comparative Perspective (Paul Sutton)Kirk Peter Meigho; Politics in a ‘Half-Made Society’: Trinidad and Tobago, 1925-2001 (Douglas Midgett)Linden Lewis (ed.); The Culture of Gender and Sexuality in the Caribbean (David A.B. Murray)Gertrude Aub-Buscher, Beverly Ormerod Noakes (eds.); The Francophone Caribbean Today: Literature, Language, Culture (Elizabeth Walcott-Hackshaw)Sally Lloyd-Evans, Robert B. Potter; Gender, Ethnicity and the Iinformal Sector in Trinidad (Katherine E. Browne)STeve Striffler, Mark Moberg (eds.); Banana Wars: Power, Production and History in the Americas (Peter Clegg)Johannes Postma, Victor Enthoven (eds.); Riches from Atlantic Commerce: Dutch Transatlantic Trade and Shipping, 1585-1817 (Gert J. Oostindie)Phil Davison; Volcano in Paradise: Death and Survival on the Caribbean Island of Montserrat (Bonham C. Richardson)Ernest Zebrowski jr; The Last Days of St. Pierre: The Volcanic Disaster that Claimed Thirty Thousand Lives (Bernard Moitt)Beverley A. Steele; Grenada: A History of Its People (Jay R. Mandle)Walter C. Soderlund (ed.); Mass Media and Foreign Policy: Post-Cold War Crises in the Caribbean (Jason Parker)Charlie Whitham; Bitter Rehearsal: British and American Planning for a Post-War West Indies (Jason Parker)Douglas V. Amstrong; Creole Transformation from Slavery to Freedom: Historical Archaeology of the East End Community, St. John, Virgin Islands (Karin Fog Olwig)H.U.E. Thoden van Velzen; Een koloniaal drama: De grote staking van de Marron vrachtvaarders, 1921 (Chris de Beet)Joseph F. Callo; Nelson in the Caribbean: The Hero Emerges, 1784-1787 (Carl E. Swanson)Jorge Duany; The Puerto Rican Nation on the Move: Identities on the Island and in the United States (Juan Flores)Raquel Z. Rivera; New York Ricans from the Hip Hop Zone (Halbert Barton)Alfonso J. García Osuna; The Cuban Filmography, 1897 through 2001 (Ann Marie Stock)Michael Aceto, Jeffrey P. Williams (eds.); Contact Englishes of the Eastern Caribbean (Geneviève Escure)In: New West Indian Guide / Nieuwe West-Indische Gids (NWIG) 79 (2005), no. 1 & 2

Abstract—COVID-19 is a major emerging disease that affects any certain condition. However, a recent report suggests the occurrence of hyperglycemia without any present diabetes in COVID-19 patients. This study aimed to systematically review recent evidence on hyperglycemia in COVID-19 patients. Literature research was done using four search engines, consist of Google Scholar, PubMed, ScienceDirect, and ProQuest, and limited to English manuscript only and published from February 2020 to September 2020. SARS-CoV-2 could damage the pancreas by causing the destruction of the β-cell structure that leads to impairment of glucose metabolism and worsen pre-existing diabetes or determine the appearance of hyperglycemia in non-diabetes. Inflammation also plays a major important role in hyperglycemia related to COVID-19. Hyperglycemia increased the vulnerability of the lung, by promoting and facilitating the entry of the SARS-CoV-2 into the host cells, and decreasing lung function. Moreover, the mortality and morbidity rate conceivable increased due to hyperglycemia. The presence of high glucose levels is linked with the progression of COVID-19 severity. Thus, the glucose level should be concerned, either in a patient with present diabetes or without any presence of diabetes. Examination and monitoring of glucose levels might be a useful tool to prevent the seriousness of COVID-19 Keywords: diabetes mellitus, SARS-CoV-2, high glucose level, pulmonary infection Abstrak—COVID-19 adalah penyakit yang muncul yang mempengaruhi kondisi tertentu.Namun, sebuah laporan baru-baru ini menunjukkan terjadinya hiperglikemia tanpa adanya diabetes pada pasien COVID-19. Penelitian ini bertujuan untuk meninjau secara sistematis bukti terbaru tentang hiperglikemia pada pasien COVID-19. Penelitian literatur dilakukan dengan menggunakan empat mesin pencari, yaitu Google Scholar, PubMed, ScienceDirect, dan ProQuest, dan terbatas hanya pada manuskrip berbahasa Inggris dan diterbitkan dari Februari 2020 hingga September 2020. SARS-CoV-2 dapat merusak pankreas dengan menyebabkan kerusakan pada pankreas. struktur sel β yang menyebabkan gangguan metabolisme glukosa dan memperburuk diabetes yang sudah ada sebelumnya atau menentukan munculnya hiperglikemia pada kelompok non-diabetes. Peradangan juga memainkan peran penting utama dalam hiperglikemia terkait COVID-19. Hiperglikemia meningkatkan kerentanan paru-paru, dengan mendorong dan memfasilitasi masuknya SARS-CoV-2 ke dalam sel inang, dan menurunkan fungsi paru-paru. Selain itu, angka mortalitas dan morbiditas yang diperkirakan meningkat karena hiperglikemia. Adanya kadar glukosa yang tinggi dikaitkan dengan perkembangan keparahan COVID-19. Dengan demikian, kadar glukosa harus diperhatikan, baik pada pasien dengan diabetes saat ini atau tanpa adanya diabetes. Pemeriksaan dan pemantauan kadar glukosa mungkin menjadi alat yang berguna untuk mencegah derajat keparahan COVID-19. Kata kunci: diabetes mellitus, SARS-CoV-2, peningkatan kadar glukosa, infeksi paru

Background and Objective: Suicide attempts are 10-20X more common than completed suicide and an important risk factor for death by suicide, yet most people who attempt suicide do not die by suicide. The process of recovering after a suicide attempt has not been well studied. The Reasons to go on Living (RTGOL) Project, a narrative web-based study, focuses on experiences of people who have attempted suicide and made the decision to go on living, a process not well studied. Narrative research is ideally suited to understanding personal experiences critical to recovery following a suicide attempt, including the transition to a state of hopefulness. Voices from people with lived experience can help us plan and conceptualize this work. This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. Material and Methods: A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery, a process which enabled participation from a large and diverse group of participants. The only direction given was “if you have made a suicide attempt or seriously considered suicide and now want to go on living, we want to hear from you.” The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Over 5 years, data analysis occurred in several phases over the course of the study, resulting in the identification of data that were inputted into an Excel file. This analysis used stories where participants described positive involvement with the mental health system (50 stories). Results: Several participants reflected on experiences many years previous, providing the privilege of learning how their life unfolded, what made a difference. Over a five-year period, 50 of 226 stories identified positive experiences with mental health care with sufficient details to allow analysis, and are the focus of this paper. There were a range of suicidal behaviours in these 50 stories, from suicidal ideation only to medically severe suicide attempts. Most described one or more suicide attempts. Three themes identified included: 1) trust and relationship with a health care professional, 2) the role of friends and family and friends, and 3) a wide range of services. Conclusion: Stories open a window into the experiences of the period after a suicide attempt. This study allowed for an understanding of how mental health professionals might help individuals who have attempted suicide write a different story, a life-affirming story. The stories that participants shared offer some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers, including immediately after a suicide attempt. Results of this study reinforce that just one caring professional can make a tremendous difference to a person who has survived a suicide attempt. Key Words: web-based; suicide; suicide attempt; mental health system; narrative research Word Count: 478 Introduction My Third (or fourth) Suicide AttemptI laid in the back of the ambulance, the snow of too many doses of ativan dissolving on my tongue.They hadn't even cared enough about meto put someone in the back with me,and so, frustrated,I'd swallowed all the pills I had with me— not enough to do what I wanted it to right then,but more than enough to knock me out for a good 14 hours.I remember very little after that;benzodiazepines like ativan commonly cause pre- and post-amnesia, says Google helpfullyI wake up in a locked rooma woman manically drawing on the windows with crayonsthe colors of light through the glassdiffused into rainbows of joy scattered about the roomas if she were coloring on us all,all of the tattered remnants of humanity in a psych wardmade into a brittle mosaic, a quilt of many hues, a Technicolor dreamcoatand I thoughtI am so glad to be able to see this. (Story 187)The nurse opening that door will have a lasting impact on how this story unfolds and on this person’s life. Each year, almost one million people die from suicide, approximately one death every 40 seconds. Suicide attempts are much more frequent, with up to an estimated 20 attempts for every death by suicide.1 Suicide-related behaviours range from suicidal ideation and self-injury to death by suicide. We are unable to directly study those who die by suicide, but effective intervention after a suicide attempt could reduce the risk of subsequent death by suicide. Near-fatal suicide attempts have been used to explore the boundary with completed suicides. Findings indicated that violent suicide attempters and serious attempters (seriousness of the medical consequences to define near-fatal attempts) were more likely to make repeated, and higher lethality suicide attempts.2 In a case-control study, the medically severe suicide attempts group (78 participants), epidemiologically very similar to those who complete suicide, had significantly higher communication difficulties; the risk for death by suicide multiplied if accompanied by feelings of isolation and alienation.3 Most research in suicidology has been quantitative, focusing almost exclusively on identifying factors that may be predictive of suicidal behaviours, and on explanation rather than understanding.4 Qualitative research, focusing on the lived experiences of individuals who have attempted suicide, may provide a better understanding of how to respond in empathic and helpful ways to prevent future attempts and death by suicide.4,5 Fitzpatrick6 advocates for narrative research as a valuable qualitative method in suicide research, enabling people to construct and make sense of the experiences and their world, and imbue it with meaning. A review of qualitative studies examining the experiences of recovering from or living with suicidal ideation identified 5 interconnected themes: suffering, struggle, connection, turning points, and coping.7 Several additional qualitative studies about attempted suicide have been reported in the literature. Participants have included patients hospitalized for attempting suicide8, and/or suicidal ideation,9 out-patients following a suicide attempt and their caregivers,10 veterans with serious mental illness and at least one hospitalization for a suicide attempt or imminent suicide plan.11 Relationships were a consistent theme in these studies. Interpersonal relationships and an empathic environment were perceived as therapeutic and protective, enabling the expression of thoughts and self-understanding.8 Given the connection to relationship issues, the authors suggested it may be helpful to provide support for the relatives of patients who have attempted suicide. A sheltered, friendly environment and support systems, which included caring by family and friends, and treatment by mental health professionals, helped the suicidal healing process.10 Receiving empathic care led to positive changes and an increased level of insight; just one caring professional could make a tremendous difference.11 Kraft and colleagues9 concluded with the importance of hearing directly from those who are suicidal in order to help them, that only when we understand, “why suicide”, can we help with an alternative, “why life?” In a grounded theory study about help-seeking for self-injury, Long and colleagues12 identified that self-injury was not the problem for their participants, but a panacea, even if temporary, to painful life experiences. Participant narratives reflected a complex journey for those who self-injured: their wish when help-seeking was identified by the theme “to be treated like a person”. There has also been a focus on the role and potential impact of psychiatric/mental health nursing. Through interviews with experienced in-patient nurses, Carlen and Bengtsson13 identified the need to see suicidal patients as subjective human beings with unique experiences. This mirrors research with patients, which concluded that the interaction with personnel who are devoted, hope-mediating and committed may be crucial to a patient’s desire to continue living.14 Interviews with individuals who received mental health care for a suicidal crisis following a serious attempt led to the development of a theory for psychiatric nurses with the central variable, reconnecting the person with humanity across 3 phases: reflecting an image of humanity, guiding the individual back to humanity, and learning to live.15 Other research has identified important roles for nurses working with patients who have attempted suicide by enabling the expression of thoughts and developing self-understanding8, helping to see things differently and reconnecting with others,10 assisting the person in finding meaning from their experience to turn their lives around, and maintain/and develop positive connections with others.16 However, one literature review identified that negative attitudes toward self-harm were common among nurses, with more positive attitudes among mental health nurses than general nurses. The authors concluded that education, both reflective and interactive, could have a positive impact.17 This paper is one part of a larger web-based narrative study, the Reasons to go on Living Project (RTGOL), that seeks to understand the transition from making a suicide attempt to choosing life. When invited to tell their stories anonymously online, what information would people share about their suicide attempts? This paper reports on a secondary research question of the larger study: what stories do participants tell of the positive role/impact of the mental health system. The focus on the positive impact reflects an appreciative inquiry approach which can promote better practice.18 Methods Design and Sample A website created for The RTGOL Project (www.thereasons.ca) enabled participants to anonymously submit a story about their suicide attempt and recovery. Participants were required to read and agree with a consent form before being able to submit their story through a text box or by uploading a file. No demographic information was requested. Text submissions were embedded into an email and sent to an account created for the Project without collecting information about the IP address or other identifying information. The content of the website was reviewed by legal counsel before posting, and the study was approved by the local Research Ethics Board. Stories were collected for 5 years (July 2008-June 2013). The RTGOL Project enabled participation by a large, diverse audience, at their own convenience of time and location, providing they had computer access. The unstructured narrative format allowed participants to describe their experiences in their own words, to include and emphasize what they considered important. Of the 226 submissions to the website, 112 described involvement at some level with the mental health system, and 50 provided sufficient detail about positive experiences with mental health care to permit analysis. There were a range of suicidal behaviours in these 50 stories: 8 described suicidal ideation only; 9 met the criteria of medically severe suicide attempts3; 33 described one or more suicide attempts. For most participants, the last attempt had been some years in the past, even decades, prior to writing. Results Stories of positive experiences with mental health care described the idea of a door opening, a turning point, or helping the person to see their situation differently. Themes identified were: (1) relationship and trust with a Health Care Professional (HCP), (2) the role of family and friends (limited to in-hospital experiences), and (3) the opportunity to access a range of services. The many reflective submissions of experiences told many years after the suicide attempt(s) speaks to the lasting impact of the experience for that individual. Trust and Relationship with a Health Care Professional A trusting relationship with a health professional helped participants to see things in a different way, a more hopeful way and over time. “In that time of crisis, she never talked down to me, kept her promises, didn't panic, didn't give up, and she kept believing in me. I guess I essentially borrowed the hope that she had for me until I found hope for myself.” (Story# 35) My doctor has worked extensively with me. I now realize that this is what will keep me alive. To be able to feel in my heart that my doctor does care about me and truly wants to see me get better.” (Story 34). The writer in Story 150 was a nurse, an honours graduate. The 20 years following graduation included depression, hospitalizations and many suicide attempts. “One day after supper I took an entire bottle of prescription pills, then rode away on my bike. They found me late that night unconscious in a downtown park. My heart threatened to stop in the ICU.” Then later, “I finally found a person who was able to connect with me and help me climb out of the pit I was in. I asked her if anyone as sick as me could get better, and she said, “Yes”, she had seen it happen. Those were the words I had been waiting to hear! I quickly became very motivated to get better. I felt heard and like I had just found a big sister, a guide to help me figure out how to live in the world. This person was a nurse who worked as a trauma therapist.” At the time when the story was submitted, the writer was applying to a graduate program. Role of Family and Friends Several participants described being affected by their family’s response to their suicide attempt. Realizing the impact on their family and friends was, for some, a turning point. The writer in Story 20 told of experiences more than 30 years prior to the writing. She described her family of origin as “truly dysfunctional,” and she suffered from episodes of depression and hospitalization during her teen years. Following the birth of her second child, and many family difficulties, “It was at this point that I became suicidal.” She made a decision to kill herself by jumping off the balcony (6 stories). “At the very last second as I hung onto the railing of the balcony. I did not want to die but it was too late. I landed on the parking lot pavement.” She wrote that the pain was indescribable, due to many broken bones. “The physical pain can be unbearable. Then you get to see the pain and horror in the eyes of someone you love and who loves you. Many people suggested to my husband that he should leave me in the hospital, go on with life and forget about me. During the process of recovery in the hospital, my husband was with me every day…With the help of psychiatrists and a later hospitalization, I was actually diagnosed as bipolar…Since 1983, I have been taking lithium and have never had a recurrence of suicidal thoughts or for that matter any kind of depression.” The writer in Story 62 suffered childhood sexual abuse. When she came forward with it, she felt she was not heard. Self-harm on a regular basis was followed by “numerous overdoses trying to end my life.” Overdoses led to psychiatric hospitalizations that were unhelpful because she was unable to trust staff. “My way of thinking was that ending my life was the only answer. There had been numerous attempts, too many to count. My thoughts were that if I wasn’t alive I wouldn’t have to deal with my problems.” In her final attempt, she plunged over the side of a mountain, dropping 80 feet, resulting in several serious injuries. “I was so angry that I was still alive.” However, “During my hospitalization I began to realize that my family and friends were there by my side continuously, I began to realize that I wasn't only hurting myself. I was hurting all the important people in my life. It was then that I told myself I am going to do whatever it takes.” A turning point is not to say that the difficulties did not continue. The writer of Story 171 tells of a suicide attempt 7 years previous, and the ongoing anguish. She had been depressed for years and had thoughts of suicide on a daily basis. After a serious overdose, she woke up the next day in a hospital bed, her husband and 2 daughters at her bed. “Honestly, I was disappointed to wake up. But, then I saw how scared and hurt they were. Then I was sorry for what I had done to them. Since then I have thought of suicide but know that it is tragic for the family and is a hurt that can never be undone. Today I live with the thought that I am here for a reason and when it is God's time to take me then I will go. I do believe living is harder than dying. I do believe I was born for a purpose and when that is accomplished I will be released. …Until then I try to remind myself of how I am blessed and try to appreciate the wonders of the world and the people in it.” Range of Services The important role of mental health and recovery services was frequently mentioned, including dialectical behavioural therapy (DBT)/cognitive-behavioural therapy (CBT), recovery group, group therapy, Alcoholics Anonymous, accurate diagnosis, and medications. The writer in Story 30 was 83 years old when she submitted her story, reflecting on a life with both good and bad times. She first attempted suicide at age 10 or 12. A serious post-partum depression followed the birth of her second child, and over the years, she experienced periods of suicidal intent: “Consequently, a few years passed and I got to feeling suicidal again. I had pills in one pocket and a clipping for “The Recovery Group” in the other pocket. As I rode on the bus trying to make up my mind, I decided to go to the Recovery Group first. I could always take the pills later. I found the Recovery Group and yoga helpful; going to meetings sometimes twice a day until I got thinking more clearly and learned how to deal with my problems.” Several participants described the value of CBT or DBT in learning to challenge perceptions. “I have tools now to differentiate myself from the illness. I learned I'm not a bad person but bad things did happen to me and I survived.”(Story 3) “The fact is that we have thoughts that are helpful and thoughts that are destructive….. I knew it was up to me if I was to get better once and for all.” (Story 32): “In the hospital I was introduced to DBT. I saw a nurse (Tanya) every day and attended a group session twice a week, learning the techniques. I worked with the people who wanted to work with me this time. Tanya said the same thing my counselor did “there is no study that can prove whether or not suicide solves problems” and I felt as though I understood it then. If I am dead, then all the people that I kept pushing away and refusing their help would be devastated. If I killed myself with my own hand, my family would be so upset. DBT taught me how to ‘ride my emotional wave’. ……….. DBT has changed my life…….. My life is getting back in order now, thanks to DBT, and I have lots of reasons to go on living.”(Story 19) The writer of Story 67 described the importance of group therapy. “Group therapy was the most helpful for me. It gave me something besides myself to focus on. Empathy is such a powerful emotion and a pathway to love. And it was a huge relief to hear others felt the same and had developed tools of their own that I could try for myself! I think I needed to learn to communicate and recognize when I was piling everything up to build my despair. I don’t think I have found the best ways yet, but I am lifetimes away from that teenage girl.” (Story 67) The author of story 212 reflected on suicidal ideation beginning over 20 years earlier, at age 13. Her first attempt was at 28. “I thought everyone would be better off without me, especially my children, I felt like the worst mum ever, I felt like a burden to my family and I felt like I was a failure at life in general.” She had more suicide attempts, experienced the death of her father by suicide, and then finally found her doctor. “Now I’m on meds for a mood disorder and depression, my family watch me closely, and I see my doctor regularly. For the first time in 20 years, I love being a mum, a sister, a daughter, a friend, a cousin etc.” Discussion The 50 stories that describe positive experiences in the health care system constitute a larger group than most other similar studies, and most participants had made one or more suicide attempts. Several writers reflected back many years, telling stories of long ago, as with the 83-year old participant (Story 30) whose story provided the privilege of learning how the author’s life unfolded. In clinical practice, we often do not know – how did the story turn out? The stories that describe receiving health care speak to the impact of the experience, and the importance of the issues identified in the mental health system. We identified 3 themes, but it was often the combination that participants described in their stories that was powerful, as demonstrated in Story 20, the young new mother who had fallen from a balcony 30 years earlier. Voices from people with lived experience can help us plan and conceptualize our clinical work. Results are consistent with, and add to, the previous work on the importance of therapeutic relationships.8,10,11,14–16 It is from the stories in this study that we come to understand the powerful experience of seeing a family members’ reaction following a participant’s suicide attempt, and how that can be a potent turning point as identified by Lakeman and Fitzgerald.7 Ghio and colleagues8 and Lakeman16 identified the important role for staff/nurses in supporting families due to the connection to relationship issues. This research also calls for support for families to recognize the important role they have in helping the person understand how much they mean to them, and to promote the potential impact of a turning point. The importance of the range of services reflect Lakeman and Fitzgerald’s7 theme of coping, associating positive change by increasing the repertoire of coping strategies. These findings have implications for practice, research and education. Working with individuals who are suicidal can help them develop and tell a different story, help them move from a death-oriented to life-oriented position,15 from “why suicide” to “why life.”9 Hospitalization provides a person with the opportunity to reflect, to take time away from “the real world” to consider oneself, the suicide attempt, connections with family and friends and life goals, and to recover physically and emotionally. Hospitalization is also an opening to involve the family in the recovery process. The intensity of the immediate period following a suicide attempt provides a unique opportunity for nurses to support and coach families, to help both patients and family begin to see things differently and begin to create that different story. In this way, family and friends can be both a support to the person who has attempted suicide, and receive help in their own struggles with this experience. It is also important to recognize that this short period of opportunity is not specific to the nurses in psychiatric units, as the nurses caring for a person after a medically severe suicide attempt will frequently be the nurses in the ICU or Emergency departments. Education, both reflective and interactive, could have a positive impact.17 Helping staff develop the attitudes, skills and approach necessary to be helpful to a person post-suicide attempt is beginning to be reported in the literature.21 Further implications relate to nursing curriculum. Given the extent of suicidal ideation, suicide attempts and deaths by suicide, this merits an important focus. This could include specific scenarios, readings by people affected by suicide, both patients themselves and their families or survivors, and discussions with individuals who have made an attempt(s) and made a decision to go on living. All of this is, of course, not specific to nursing. All members of the interprofessional health care team can support the transition to recovery of a person after a suicide attempt using the strategies suggested in this paper, in addition to other evidence-based interventions and treatments. Findings from this study need to be considered in light of some specific limitations. First, the focus was on those who have made a decision to go on living, and we have only the information the participants included in their stories. No follow-up questions were possible. The nature of the research design meant that participants required access to a computer with Internet and the ability to communicate in English. This study does not provide a comprehensive view of in-patient care. However, it offers important inputs to enhance other aspects of care, such as assessing safety as a critical foundation to care. We consider these limitations were more than balanced by the richness of the many stories that a totally anonymous process allowed. Conclusion Stories open a window into the experiences of a person during the period after a suicide attempt. The RTGOL Project allowed for an understanding of how we might help suicidal individuals change the script, write a different story. The stories that participants shared give us some understanding of “how” to provide support at a most-needed critical juncture for people as they interact with health care providers immediately after a suicide attempt. While we cannot know the experiences of those who did not survive a suicide attempt, results of this study reinforce that just one caring professional can make a crucial difference to a person who has survived a suicide attempt. We end with where we began. Who will open the door? References 1. World Health Organization. Suicide prevention and special programmes. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/index.html Geneva: Author; 2013.2. Giner L, Jaussent I, Olie E, et al. Violent and serious suicide attempters: One step closer to suicide? J Clin Psychiatry 2014:73(3):3191–197.3. Levi-Belz Y, Gvion Y, Horesh N, et al. Mental pain, communication difficulties, and medically serious suicide attempts: A case-control study. Arch Suicide Res 2014:18:74–87.4. Hjelmeland H and Knizek BL. Why we need qualitative research in suicidology? Suicide Life Threat Behav 2010:40(1):74–80.5. Gunnell D. A population health perspective on suicide research and prevention: What we know, what we need to know, and policy priorities. Crisis 2015:36(3):155–60.6. Fitzpatrick S. Looking beyond the qualitative and quantitative divide: Narrative, ethics and representation in suicidology. Suicidol Online 2011:2:29–37.7. Lakeman R and FitzGerald M. How people live with or get over being suicidal: A review of qualitative studies. J Adv Nurs 2008:64(2):114–26.8. Ghio L, Zanelli E, Gotelli S, et al. Involving patients who attempt suicide in suicide prevention: A focus group study. J Psychiatr Ment Health Nurs 2011:18:510–18.9. Kraft TL, Jobes DA, Lineberry TW., Conrad, A., & Kung, S. Brief report: Why suicide? Perceptions of suicidal inpatients and reflections of clinical researchers. Arch Suicide Res 2010:14(4):375-382.10. Sun F, Long A, Tsao L, et al. The healing process following a suicide attempt: Context and intervening conditions. Arch Psychiatr Nurs 2014:28:66–61.11. Montross Thomas L, Palinkas L, et al. Yearning to be heard: What veterans teach us about suicide risk and effective interventions. Crisis 2014:35(3):161–67.12. Long M, Manktelow R, and Tracey A. The healing journey: Help seeking for self-injury among a community population. Qual Health Res 2015:25(7):932–44.13. Carlen P and Bengtsson A. Suicidal patients as experienced by psychiatric nurses in inpatient care. Int J Ment Health Nurs 2007:16:257–65.14. Samuelsson M, Wiklander M, Asberg M, et al. Psychiatric care as seen by the attempted suicide patient. J Adv Nurs 2000:32(3):635–43.15. Cutcliffe JR, Stevenson C, Jackson S, et al. A modified grounded theory study of how psychiatric nurses work with suicidal people. Int J Nurs Studies 2006:43(7):791–802.16. Lakeman, R. What can qualitative research tell us about helping a person who is suicidal? Nurs Times 2010:106(33):23–26.17. Karman P, Kool N, Poslawsky I, et al. Nurses’ attitudes toward self-harm: a literature review. J Psychiatr Ment Health Nurs 2015:22:65–75.18. Carter B. ‘One expertise among many’ – working appreciatively to make miracles instead of finding problems: Using appreciative inquiry as a way of reframing research. J Res Nurs 2006:11(1): 48–63.19. Lieblich A, Tuval-Mashiach R, Zilber T. Narrative research: Reading, analysis, and interpretation. Sage Publications; 1998.20. Braun V and Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006:3(2):77–101.21. Kishi Y, Otsuka K, Akiyama K, et al. Effects of a training workshop on suicide prevention among emergency room nurses. 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Objetivo: Buscar evidências disponíveis na literatura sobre abordagem da empatia/habilidade empática em estudantes de Enfermagem. Método: Revisão integrativa da literatura nas bases de dados PubMed, LILACS e SciELO, resultando em 11 artigos. Resultados: Os estudos foram publicados entre 2013 e 2019, com três artigos em revistas com Qualis Capes, sendo três em revistas internacionais. O país com maior número de estudos na temática foi o Brasil, com sete, seguido de Portugal, México, Colômbia e Cuba com um estudo cada. A maior parte dos autores eram doutores (seis). O delineamento dos estudos, eram tanto qualitativos, quanto quantitativos (cinco) e a maior parte tinha nível de evidência IV. A análise de conteúdo identificou as categorias temáticas: Percepção do estudante de Enfermagem acerca do cuidado e empatia; Reflexão sobre empatia e a Enfermagem; e Habilidade empática e suas competências. Conclusão: A empatia é vista como capacidade essencial na formação de estudantes de Enfermagem e está diretamente relacionada ao cuidado humanizado e pessoal por parte da equipe de saúde. Esta habilidade deve fazer parte da matriz curricular em todos os cursos da saúde para fortalecer a afetividade durante o processo de cuidar.Descritores: Empatia; Educação em Enfermagem; Cuidados de Enfermagem; Estudantes; Estudantes de Enfermagem. EMPATHIC SKILL AND ITS LEARNING IN NURSING STUDENTSObjective: To search for available evidence in the literature on how empathy / empathic ability in nursing students is approached. Method: Integrative literature review, for selection, three PubMed, LILACS and SciELO databases resulted of 11 articles. Results: Most studies were published in 2013 and 2019, with 27.3% in journals with classification in Brazil on Qualis Capes B1 and 18.2% in A1, 3 was in international journals, and 45.5% in both English and Portuguese. The country with the largest number of studies on the subject was Brazil, with seven (64%), followed by Portugal, Mexico, Colombia and Cuba with one (9%) study each. Most of the authors were doctors (55.3%). The approuches of the studies were both quali and quantitative (45.4%) and most had level of evidence IV. The content analysis identified the thematic categories: (1) the nursing student's perception of care and empathy; (2) reflection on empathy and nursing; and (3) empathic ability and competencies. Conclusion: Empathy is seen as an essential capacity in the training of nursing students and is directly related to humanized and more personal care by the health team. This skill must be part of the teaching grid in all areas of health and all they benefit from their learning.Descriptors: Empathy; Education, Nursing; Nursing Care; Students; Students, Nursing. HABILIDAD EMPÁTICA Y SU APRENDIZAJE EN ESTUDIANTES DE ENFERMERÍAObjectivo: Buscar evidencia disponible en la literatura sobre cómo se aborda la empatía/habilidad empática en estudiantes de enfermería. Método: Revisión bibliográfica integral em las bases de datos PubMed, LILACS y SciELO resultando en 11 artículos. Resultados: La mayoría de los estudios se publicaron en 2013 y 2019, con un 27,3% en revistas con classificação en Brasil Qualis Capes B1 y un 18,2% en A1, 3 en revistas internacionales y un 45,5% en inglés y portugués. El país con el mayor número de estudios sobre el tema fue Brasil, con siete (64%), seguido de Portugal, México, Colombia y Cuba con un (9%) estudio cada uno. La mayoría de los autores eran médicos (55,3%). Los diseños de los estudios fueron tanto cualitativos como cuantitativos (45,4%) y la mayoría tenía un nivel de evidencia IV. El análisis de contenido identificó las categorías temáticas: (1) la percepción de atención y empatía del estudiante de enfermería; (2) reflexión sobre empatía y enfermería; y (3) capacidad y competencias empáticas. Conclusion: La empatía es vista como una capacidad esencial en la formación de estudiantes de enfermería y está directamente relacionada con la atención humanizada y más personal del equipo de salud. Esta habilidad debe ser parte de la red de enseñanza en todas las áreas de la salud y todos se benefician de su aprendizaje.Descriptores: Empatía; Educación en Enfermería; Atención de Enfermeira; Estudiantes; Estudiantes de Enfermeira.

Abstract Background Empathy is an important characteristic to possess for healthcare professionals. It has been found to improve communication between professionals and patients and to improve clinical health outcomes. The Jefferson Scale of Empathy (JSE) was developed to measure this quality and has been used extensively, and psychometrically appraised, with a variety of cohorts and in different cultural environments. However, no study has been undertaken to systematically examine the methodological quality of studies which have assessed psychometric factors of the JSE. This systematic review will examine the quality of published papers that have reported on psychometric factors of the JSE. Methods A systematic review of studies which report on the psychometric properties of the JSE will be conducted. We will use a predefined search strategy to identify studies meeting the following eligibility criteria: original data is reported on for at least one of the psychometric measurement properties described in the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist, examines the JSE in a healthcare cohort (using the student, physician or health profession versions of the JSE), and is published from January 2001 and in the English language. Conference abstracts, editorials and grey literature will be excluded. Six electronic databases (Medline, EMBASE, PsychInfo, PubMed, Web of Science and CINAHL) will be systematically searched for articles meeting these criteria and studies will be assessed for eligibility by two review authors. The methodological quality of included papers will be examined using the COSMIN Risk of Bias checklist. Discussion A narrative description of the findings will be presented along with summary tables. Recommendations for use of the JSE with various cohorts and circumstances will be offered which may inform future research in this field. Systematic review registration PROSPERO CRD42018111412