Schizophrenia and the progression of emotional expression in relation to others

Gaining an improved understanding of people diagnosed with schizophrenia has the potential to influence priorities for therapy. Psychosis is commonly understood through the perspective of the medical model. However, the experience of social context surrounding psychosis is not well understood. In this research project we used a phenomenological methodology with a longitudinal design to interview 7 participants across a 12-month period to understand the social experiences surrounding psychosis. Eleven themes were explicated and divided into two phases of the illness experience: (a) transition into emotional shutdown included the experiences of not being acknowledged, relational confusion, not being expressive, detachment, reliving the past, and having no sense of direction; and (b) recovery from emotional shutdown included the experiences of being acknowledged, expression, resolution, independence, and a sense of direction. The experiential themes provide clinicians with new insights to better assess vulnerability, and have the potential to inform goals for therapy

A hepatoid carcinoma of the pancreatic head

Hepatoid carcinoma (HC) is an extremely rare form of neoplasm. Its cellular structure resembles that of a hepatocellular carcinoma (HCC). To date, only 26 cases of hepatoid carcinoma of the pancreas have been reported in the literature. We report the diagnosis of a hepatoid carcinoma of the pancreatic head in a 78-year-old male patient. The tumor was detected incidentally during routine abdominal ultrasound scanning. Laboratory tests did not show any abnormalities except for a monoclonal gammopathy of undetermined significance. After CT, MRI, and laparoscopic biopsy that failed to obtain the diagnosis, the patient underwent a Whipple procedure. The final pathology report described a hepatoid carcinoma of the pancreatic head (pathological T3, N0 (0/10), L0, V0, R0, M0). After the patient recovered, no further therapy was recommended by the tumor board and he was discharged. Regular follow-up was suggested; however, the patient suddenly died of acute coronary artery disease 2 months after surgery

A video life-world approach to consultation practice: The relevance of a socio-phenomenological approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes

A critical perspective on second-order empathy in understanding psychopathology: phenomenology and ethics

The centenary of Karl Jaspers’ General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work (edited by Stanghellini and Fuchs). Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: (1) Is second-order empathy (phenomenologically) possible? (2) Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices

Feminist phenomenology and the woman in the running body

Modern phenomenology, with its roots in Husserlian philosophy, has been taken up and utilised in a myriad of ways within different disciplines, but until recently has remained relatively under-used within sports studies. A corpus of sociological-phenomenological work is now beginning to develop in this domain, alongside a longer standing literature in feminist phenomenology. These specific social-phenomenological forms explore the situatedness of lived-body experience within a particular social structure. After providing a brief overview of key strands of phenomenology, this article considers some of the ways in which sociological, and particularly feminist phenomenology, might be used to analyse female sporting embodiment. For illustrative purposes, data from an autophenomenographic project on female distance running are also included, in order briefly to demonstrate the application of phenomenology within sociology, as both theoretical framework and methodological approach

The ambivalence of losing weight after bariatric surgery

This study is grounded in a phenomenological lifeworld perspective. It aims at providing rich descriptions of lived experience of the process of losing weight after obesity surgery. Two women participated in in-depth interviews four times each during the first postoperative year. Based on the women's experiences, a meaning structure—the ambivalence of losing weight after obesity surgery—was identified across the women's processes of change. This consisted of five core themes: movement and activity—freedom but new demands and old restraints; eating habits and digestion—the complexity of change; appearance—smaller, but looser; social relations—stability and change; and being oneself—vulnerability and self-assurance. These core themes changed over time in terms of dominance. The experience of ambivalence is discussed according to a phenomenological perspective of the body as lived experience

Repercussões da COVID-19 no cuidado ao idoso: percepções de enfermeiros da Atenção Primária à Saúde

Objective: to understand the perceptions of Primary Health Care (PHC) nurses about the repercussions of COVID-19 on the care and daily life of the elderly. Method: exploratory, descriptive study with a qualitative approach. Ten nurses from the PHC of Santa Catarina were integrated. Data collection took place through a semi-structured interview, between July and September 2021, with an application video call due to the pandemic. Content analysis was used to organize and assess the information. Results: two categories emerged: Repercussions of COVID-19 in the care of the elderly in PHC; COVID-19 and the transformations in the daily lives of the elderly regarding health care. Conclusion: the pandemic generated social and affective restrictions and reduced face-to-face activities carried out in PHC, culminating in changes in health. Therefore, the reflection and planning of actions regarding the care of the elderly in PHC are fundamental, especially regarding mental health, affected in the pandemic context.Objetivo: comprender las percepciones de los enfermeros de la Atención Primaria de Salud (APS) sobre las repercusiones de la COVID-19 en el cuidado y el cotidiano de los ancianos. Método: estudio exploratorio, descriptivo con abordaje cualitativo. Se integraron 10 enfermeros de la APS de Santa Catarina. La recolección de datos se realizó a través de una entrevista semi-estructurada, entre julio y septiembre de 2021, con una aplicación de video llamada debido a la pandemia. Para la organización y evaluación de la información se utilizó el análisis de contenido. Resultados: surgieron dos categorías: Repercusiones de la COVID-19 en el cuidado del anciano en la APS; COVID-19 y las transformaciones en el cotidiano de los ancianos para el cuidado de la salud. Conclusión: la pandemia generó restricciones sociales y afectivas, además de la reducción de las actividades presenciales realizadas en la APS, culminando en cambios en la salud. Por lo tanto, son fundamentales la reflexión y la planificación de acciones para el cuidado de los ancianos en la APS, especialmente en lo que respecta a la salud mental, afectada en la situación de pandemia.Objetivo: compreender as percepções de enfermeiros da Atenção Primária à Saúde (APS) sobre as repercussões da COVID-19 no cuidado e cotidiano do idoso. Método: estudo exploratório, descritivo, com abordagem qualitativa. Integraram-se 10 enfermeiras da APS de Santa Catarina. A coleta de dados ocorreu por meio de entrevista semiestruturada, entre julho e setembro de 2021, com chamada de vídeo em aplicativo devido à pandemia. Para a organização e avaliação das informações, utilizou-se a análise de conteúdo. Resultados: emergiram duas categorias: Repercussões da COVID-19 no cuidado ao idoso na APS; COVID-19 e as transformações no cotidiano dos idosos para o cuidado em saúde. Conclusão: a pandemia gerou restrições sociais e afetivas, além de reduzir atividades presenciais realizadas na APS, culminando em alterações na saúde. Portanto, a reflexão e o planejamento de ações perante o cuidado ao idoso na APS são fundamentais, principalmente quanto à saúde mental, afetada na conjuntura pandêmica

Fcγ Receptors in Solid Organ Transplantation.

In the current era, one of the major factors limiting graft survival is chronic antibody-mediated rejection (ABMR), whilst patient survival is impacted by the effects of immunosuppression on susceptibility to infection, malignancy and atherosclerosis. IgG antibodies play a role in all of these processes, and many of their cellular effects are mediated by Fc gamma receptors (FcγRs). These surface receptors are expressed by most immune cells, including B cells, natural killer cells, dendritic cells and macrophages. Genetic variation in FCGR genes is likely to affect susceptibility to ABMR and to modulate the physiological functions of IgG. In this review, we discuss the potential role played by FcγRs in determining outcomes in solid organ transplantation, and how genetic polymorphisms in these receptors may contribute to variations in transplant outcome.MRC is supported by the NIHR Cambridge BRC, the NIHR Blood and Transplant Research Unit (Cambridge) and by a Medical Research Council New Investigator Grant (MR/N024907/1).This is the final version of the article. It first appeared from Springer via https://doi.org/10.1007/s40472-016-0116-