Exploring Identity and Negotiation among Women Military Interrogators through Interpretative Phenomenological Analysis

Post-modern feminist security studies explore how our discourse about gender and war affects the construction of security as a concept. Military narratives valorizing the masculine over the feminine have long marginalized women warriors. In recent years, images of the torture and abuse of detainees have appropriated the representation of women interrogators during the Global War on Terrorism in particular. This research applied interpretative phenomenological analysis to the narratives of women interrogators in order to challenge the silence concerning their lived experiences by addressing how women interrogators understand their experiences both as woman and as interrogators, and how they negotiated socially constructed contradictions between these identities. Based on an analysis of semi-structured interviews with eight participants, the findings produced seven, interrelated themes. First, the findings explored the integration of gender with other markers of identity. Next, the findings demonstrated women interrogators recognize gender as a context-dependent role negotiated within the military institution through the development and demonstration of technical prowess. Then, the findings described interrogation as a complex adaptive system in which women interrogators harnessed to achieve their goals. Finally, the findings determined that the intersection of women interrogators’ identities and their interactions in the context of interrogation operations generated the perception of women interrogators as non-threatening. Women interrogators learned to exploit the meaning of this emergent phenomenon through introspection and the development of self-awareness

Indigenous Peoples’ Right to Self-Determination and Other Rights Related to Access to Justice: Normative Framework

When speaking of Indigenous Peoples and access to justice, it is important to understand the historical contextual framework for the litany of injustices perpetrated against Indigenous Peoples in order to determine if we can in fact ever “reconcile” the dramatically different worldviews of Indigenous Peoples and others, and in particular nation-States. In my view, the cultural clashes experienced by most, if not all, Indigenous Peoples across the globe have crystallized or hardened to the point that full reconciliation may not ever be possible. I have been asked to provide an overview of the normative framework needed to begin to right the wrongs concerning access to justice, including truth and reconciliation. The normative framework necessary has been established by the Declaration—the most comprehensive international human rights instrument specifically concerning Indigenous Peoples. And, in this regard, the Declaration articles must be read as a whole and in context. Like all other human rights, these minimum standards are inter-related, inter-dependent, indivisible, and inter-connected. I would like to emphasize the right of self-determination and a number of articles relevant to the collective rights of Indigenous Peoples, then conclude with a few comments on developments in Alaska, as a hopeful example of improving access to justice through Indigenous self-determination and “partnership” or cooperation with others

Vulnerable Narcissism and First-Person Singular Pronoun Use

Who talks about themselves most frequently? Recent research has explored the top correlates of self-focused language use. Depression and negative emotionality tend to appear as key positive correlates. Surprisingly, narcissism—which is largely known for its trait of self-centeredness—is not a major correlate of self-focused language use. Studies demonstrating this null effect have only measured grandiose narcissism, while entirely neglecting vulnerable narcissism. By using a survey methodology with carefully-selected trait inventories and a language task, the purpose of this study is to fill the gap in the literature—to see whether vulnerable narcissism accounts for talking about oneself, above and beyond the common correlates of depression and negative emotionality. Our findings from a large number of college students (valid N = 471) indicated that vulnerable narcissism is significantly positively correlated with first-person singular pronoun use; however, it does not predict the outcome above and beyond traditional predictors. Along with establishing this novel correlation, these findings have clear practical implications which will be detailed further in this paper

A study of dropout characteristics and school-level effects on dropout prevention

This sequential, three-phase study used quantitative analyses to examine the characteristics of student dropouts and the characteristics of schools successful and unsuccessful in mediating dropouts. Narrative profiles were created to describe types of students and types of dropouts. Phase I consisted of three parts, each using the student as the unit of analysis. Part One examined the profile of all Louisiana dropouts. Part Two involved the creation of clusters of dropouts and non-dropouts combined. Part Three focused on the creation of dropout clusters. In Phase II, the percents of potential dropouts were calculated for 301 schools using the dropout characteristics from Phase I. The purpose of this phase was to classify schools into one of nine cells in a 3 x 3 contingency table that crossed three levels of Percent of Actual Dropouts with three levels of Percent of Potential Dropouts. In Phase III, a MANOVA was conducted using a 1 x 4 design. The levels of the independent variable were four school categories from the Phase II contingency table: consistently high dropouts schools, consistently low dropouts schools, schools more effective in dropout prevention, and schools less effective dropout prevention. The cluster analysis results for the non-dropouts and dropouts yielded three clusters: high achievers, average achievers, and low achievers. The cluster analysis for the dropouts also resulted in three clusters: quiet dropouts, typical dropouts, and high-achieving pushouts. The MANOVA produced overall significant differences among the set of dependent variables (attendance rate, class size, student achievement, suspension rate, teacher certification, and teacher test scores). The planned contrasts results showed that consistently low dropouts schools had significantly higher student achievement than the less effective schools, while the more effective schools had significantly higher attendance rates and student achievement than the consistently high dropouts schools. These findings have two major implications for dropout prevention. First, dropout prevention programs should have components that reach all types of potential dropouts. Second, more extensive efforts should be made to obtain the reasons individual students drop out. Students who drop out for like reasons could be studied to develop prevention measures for similar students

The hippocampus and visual perception

In this review, we will discuss the idea that the hippocampus may be involved in both memory and perception, contrary to theories that posit functional and neuroanatomical segregation of these processes. This suggestion is based on a number of recent neuropsychological and functional neuroimaging studies that have demonstrated that the hippocampus is involved in the visual discrimination of complex spatial scene stimuli. We argue that these findings cannot be explained by long-term memory or working memory processing or, in the case of patient findings, dysfunction beyond the medial temporal lobe (MTL). Instead, these studies point toward a role for the hippocampus in higher-order spatial perception. We suggest that the hippocampus processes complex conjunctions of spatial features, and that it may be more appropriate to consider the representations for which this structure is critical, rather than the cognitive processes that it mediates

Perspectives on symptom experiences and symptom reporting among individuals on hemodialysis

Background: Individuals on hemodialysis bear substantial symptom burdens, but providers often underappreciate patient symptoms. In general, standardized, patient-reported symptom data are not captured during routine dialysis care. We undertook this study to better understand patient experiences with symptoms and symptom reporting. In exploratory interviews, we sought to describe hemodialysis nurse and patient care technician perspectives on symptoms and symptom reporting. Methods: We conducted semi-structured interviews with 42 US hemodialysis patients and 13 hemodialysis clinic personnel. Interviews were conducted between February and October 2017 and were analyzed using thematic analysis. Results: Seven themes were identified in patient interviews: (i) symptoms engendering symptoms, (ii) resignation that life is dependent on a machine, (iii) experiencing the life intrusiveness of dialysis, (iv) developing adaptive coping strategies, (v) creating a personal symptom narrative, (vi) negotiating loss of control and (vii) encountering the limits of the dialysis delivery system. Overall, patient symptom experiences and perceptions appeared to influence symptom-reporting tendencies, leading some patients to communicate proactively about symptoms, but others to endure silently all but the most severe symptoms. Three themes were identified in exploratory clinic personnel interviews: (i) searching for symptom explanations, (ii) facing the limits of their roles and (iii) encountering the limits of the dialysis delivery system. In contrast to patients, clinic personnel generally believed that most patients were inclined to spontaneously report their symptoms to providers. Conclusions: Interviews with patients and dialysis clinic personnel suggest that symptom reporting is highly variable and likely influenced by many personal, treatment and environmental factors

A Person-Centered Interdisciplinary Plan-of-Care Program for Dialysis: Implementation and Preliminary Testing

RATIONALE & OBJECTIVE: Despite growing interest in individualizing care, routine dialysis processes, including the interdisciplinary plan of care, often fail to account for patient-identified priorities. To better align dialysis care with patient priorities and improve care planning experiences, we implemented a person-centered care plan program at a single clinic. We also sought to gain insight into key implementation considerations and areas for program improvement. STUDY DESIGN: 6-month quality improvement project with research substudy. SETTING & PARTICIPANTS: 49 hemodialysis patients and 14 care team members at a North Carolina dialysis clinic. QUALITY IMPROVEMENT ACTIVITIES: Implementation of My Dialysis Plan, a person-centered care plan program. OUTCOMES: Participant perspectives and care plan meeting characteristics (quality improvement); pre- to postprogram change in patient-reported autonomy support, patient-centeredness of care, and dialysis care individualization (research). ANALYTICAL APPROACH: We used the Consolidated Framework for Implementation Research to guide implementation and evaluation. We conducted pre-, intra-, and post-project interviews with clinic stakeholders (patients, clinic personnel, and medical providers) to identify implementation barriers, facilitators, and perceptions. We compared pre- and post-project care plan meeting content and patient-reported outcome survey scores. RESULTS: We conducted 54 care plans with 49 patients. Overall, care teams successfully used My Dialysis Plan to elicit and link patient priorities to actionable aspects of dialysis care. Participants identified interdisciplinary team commitment, accountability, and the structured yet flexible meeting approach as key implementation elements. Throughout the project, stakeholder input guided program modifications (eg, implementation practices and resources) to better meet clinic needs, but follow-up on care plan-identified action items remained challenging. Among the 28 substudy participants, there was no difference in pre- to post-project patient-reported outcome survey scores. LIMITATIONS: Single clinic implementation. CONCLUSIONS: My Dialysis Plan has the potential to enhance dialysis care individualization and care plan experiences. Evaluation of program impact on patient-reported and clinical outcomes is needed

Development and content validity of a hemodialysis symptom patient-reported outcome measure

PurposeTo describe the process and preliminary qualitative development of a new symptom-based patient-reported outcome measure (PROM) intended to assess hemodialysis treatment-related physical symptoms.MethodsExperienced interviewers conducted concept elicitation and cognitive debriefing interviews with individuals receiving in-center hemodialysis in the United States. Concept elicitation interviews involved eliciting spontaneous reports of symptom experiences and probing to further explore and confirm concepts. We used patient-reported concepts to generate a preliminary symptom PROM. We conducted 3 rounds of cognitive debriefing interviews to evaluate symptom relevance, item interpretability, and draft item structure. We iteratively refined the measure based on cognitive interview findings.ResultsForty-two adults receiving in-center hemodialysis participated in the concept elicitation interviews. A total of 12 symptoms were reported by >10% of interviewees. We developed a 13-item initial draft instrument for testing in 3 rounds of cognitive interviews with an additional 52 hemodialysis patients. Participant responses and feedback during cognitive interviews led to changes in symptom descriptions, division of the single item "nausea/vomiting" into 2 distinct items, removal of daily activity interference items, addition of instructions, and clarification about the recall period, among other changes.ConclusionsSymptom Monitoring on Renal Replacement Therapy-Hemodialysis (SMaRRT-HD™) is a 14-item PROM intended for use in hemodialysis patents. SMaRRT-HD™ uses a single treatment recall period and a 5-point Likert scale to assess symptom severity. Qualitative interview data provide evidence of its content validity. SMaRRT-HD™ is undergoing additional testing to assess measurement properties and inform measure scoring