Stretching the Vitruvian Man: Investigating Affective and Representational Arts-based Methodologies Towards Theorizing a More Humanistic Model of Medicine

Westernized medicine can be said to illustrate its history and structure, as well as its current understanding of the capacity and appearance of the human through its visual representations of the body. Scientific images, this paper argues, become a site for interrogating the tangle of idealism, truth, objectivity and knowledge in how knowledge is actively used, replicated, paralleled and otherwise functions. First, asking how depictions of the medicalized body inform the epistemological foundations of medicine, and to what end, this work opens up the question of methodology, arguing that the integration of the modes of arts-based practices can bring medicine toward a much more realistic picture of the world. A parallel argument is a similarly concentrated interrogation of the affective quality of arts-based methodology, which is commonly understood to be the nucleus of work on the political dimensions of non-representational theory. I complicate the dominant scholarly preference for an ontologically rooted affect theory, finding it theoretically non-viable for art and humanistic medicine by thinking through subjectivity, autobiographical accounts of illness and epistemological flexibility. I see a path forward using a biologically and evolutionarily rooted affect theory, noting the ethical implications of its differences for a humanistic approach to medicine

Time out : organizational training for improvisation in lifesaving critial teams

textExemplified by fire crews, SWAT teams, and emergency surgical units, critical teams are a subset of action teams whose work is marked by finality, pressure, and potentially fatal outcomes (Ishak & Ballard, 2012). Using communicative and temporal lenses, this study investigates how organizations prime and prepare their embedded critical teams to deal with improvisation. This study explicates how organizations both encourage and discourage improvisation for their embedded critical teams. Throughout the training process, organizations implement a structured yet flexible “roadmap”-type approach to critical team work, an approach that is encapsulated through three training goals. The first goal is to make events routine to members. The second goal is to help members deal with non-routine events. The third goal is to help members understand how to differentiate between what is routine and non-routine. The grounded theory analysis in this study also surfaced three tools that are used within the parameters of the roadmap approach: experience, communicative decision making, and sensemaking. Using Dewey’s (1939, 1958) theory of experience, I introduce a middle-range adapted theory of critical team experience. In this theory, experience and sensemaking are synthesized through communicative decision making to produce decisions, actions, and outcomes in time-limited, specialized, stressful environments. Critical teams have unique temporal patterns that must be considered in any study of their work. Partially based on the nested phase model (Ishak & Ballard, 2012), I also identify three phases of critical team process as critical-interactive, meaning that they are specific to action/critical teams, and they are engaged in by critical teams for the expressed purpose of interaction. These phases are simulation, adaptation, and debriefing. These tools and phases are then placed in the Critical-Action-Response Training Outcomes Grid (CARTOG) to create nine interactions that are useful in implementing a structured yet flexible approach to improvisation in the work of critical teams. Data collection consisted of field observations, semi-structured interviews, and impromptu interviews at work sites. In total, I engaged in 55 hours of field observations at 10 sites. I conducted 31 semi-structured interviews with members of wildland and urban fire crews; emergency medical teams; and tactical teams, including SWAT teams and a bomb squad. I also offer practical implications and future directions for research on the temporal and communicative aspects of critical teams, their parent organizations, and considerations of improvisation in their work.Communication Studie

What Literature Knows

This volume sheds light on the nexus between knowledge and literature. Arranged historically, contributions address both popular and canonical English and US-American writing from the early modern period to the present. They focus on how historically specific texts engage with epistemological questions in relation to material and social forms as well as representation. The authors discuss literature as a culturally embedded form of knowledge production in its own right, which deploys narrative and poetic means of exploration to establish an independent and sometimes dissident archive. The worlds that imaginary texts project are shown to open up alternative perspectives to be reckoned with in the academic articulation and public discussion of issues in economics and the sciences, identity formation and wellbeing, legal rationale and political decision-making

The implementation of care pathways to improve children’s allergy services

National reviews demonstrate quality deficiencies in UK health services for allergic children. In response, the RCPCH developed care pathways to improve the organisation and delivery of allergy care. However, care pathway interventions have variable success. Consequently, a literature review and four ethnographic case studies were conducted to theorise care pathway implementation and inform practical recommendations for health service improvements. This process followed the four stages of MELD dialectic: First Moment (1M) of (non-)being, Second Edge (2E) of becoming, Third Level (3L) of integrated totality, and Fourth Dimension (4D) of agency. The 1M results define the mechanisms that cause allergy health service deficiencies and how to address them. Deficiencies were found to emerge from causal mechanisms interacting at physiological, inter-personal, and systemic levels. Care pathway interventions that address these mechanisms could improve the quality of children’s allergy services. However, healthcare improvements also depend on the implementation process and contextual influences. The 2E results describe the unfolding journeys of four teams improving their local health services for allergic children. The 3L results integrate the 1M theoretical understanding and 2E empirical experiences into an advanced understanding of allergy care pathway implementation. The improvement context totality captures contextual factors that manifest differently depending on geohistorical contingencies. This creates unique local challenges and opportunities. The child allergy intervention totality integrates care pathway interventions implemented across case studies. What intervention elements are implemented and to what degree is negotiated based on local challenges and opportunities. The improvement process totality captures the quality improvement methods used to develop interventions and overcome contextual challenges. Children’s allergy health service improvements emerge from the three totalities operating as a dynamic whole. The 4D results discuss the resolution of dialectical contradictions related to the improvement of children’s allergy services. They integrate contradictory theoretical insights identified across academic disciplines by grounding them in the 2L empirical case study experiences and relating them to the 3L structural understanding. These theoretical developments are subsequently translated into practical strategies to navigate and optimise local efforts to improve children’s allergy services. This study used MELD to make theoretical contributions in clinical allergy and improvement science with the aim to support the improvement of children’s allergy services in practice.Open Acces

The Therapeutic Church

This project aims to develop Nexus Point Church as a therapeutic environment. The Therapeutic Church environment is a supportive community, one member to another, ministering to each other empathetically, not service dependent or a dispenser of services. It is “Pew Neighbor” supportive and crisis intervention ready. The Therapeutic Church provides a therapeutic environment that heals interactively in spirit, mind, body, and relationship to improve the quality of life for the church member and those seeking help. This project identifies members as “Pew Neighbors” due to the proximity and continual closeness shared with those within the church community. Pew neighbors serve one another through love via the new commandment Jesus gave that identifies His disciples: “A new commandment I give to you, that you love one another, even as I have loved you, that you also love one another. By this all men will know that you are My disciples, if you have love for one another” (John 13:34–35, NASB). Through an insider’s perspective method, the results of a pre-survey/questionnaire, an 8 Session Course: Elements of a Therapeutic Church, and a post-survey/questionnaire measured the participants’ knowledge and understanding of a Therapeutic Church environment to determine the plausibility of developing a Therapeutic Church ministry emulating Jesus’ approach to preaching the gospel and integrative healing in spirit, mind, body, and relationship (Luke 4:14–21). Research results indicated a significant improvement in participants’ knowledge and understanding of a Therapeutic Church environment after completing the course, thus determining the favorable plausibility of developing Nexus Point as a Therapeutic Church

Tall, opaque words :diction and rhetoric in the works of Sir Thomas Browne

PhD ThesisThis thesis considers two aspects of the literary style of Sir Thomas Browne. The first four chapters examine the novelty and creativity of his diction, and chapters five to eight describe and interpret the rhetorical features inherent in his sentence-structures. A final chapter summarises the significance of my findings. Chapter one surveys the history of critical opinion and comment upon Browne's choice of words. Chapter two assesses the degree to which it is possible to define innovation in English vocabulary by reference to lexicographical techniques. Chapter three, in three parts, considers the historical background to innovative diction in the seventeenth century, especially as it is evident in learned and scientific writings. The fourth chapter is a detailed examination of the presence, function and impact of word-coinage in Religio Medici, Pseudodoxia Epidemica and The Garden of Cyrus. Chapter five provides a summary of the persuasive aspects of rhetoric in Browne's prose. Chapter six examines his use and omission of personal pronouns, as indicators of feeling and belief. Chapters seven and eight consider the processes of argument in Pseudodoxia Epidemical and both the direct and indirect means by which Browne registers the degrees of his convictions, beliefs and opinions. A brief concluding chapter asserts the value of Browne's style in discourses designed to persuade, as well as in those which provoke the imagination. A substantial appendix registers, alphabetically, those words for which there is evidence that Browne was their first literary user. Further appendices provide data relating to these coinages, and analyse their presence in both Browne's works and in those of other contemporary writers.The Department of Education and Science, Newcastle