Culture and Cognitive Theory: Toward a Reformulation

In a provocative and important recent article Anthony Marsella (1998) makes an eloquent plea for the forging of a new metadiscipline of psychology that he labels global-community psychology. Marsella argues that we need a radical rethinking of the fundamental premises of psychology, rooted as they are in Western cultural traditions. Features of an emergent global-community psychology include an emphasis on multicultural and multidisciplinary approaches to human behavior that draw attention to the importance of context and meaning in human lives. Marsella's call for a global-community psychology reflects, in part, a growing body of literature that demonstrates the importance of cultural factors in a diver-sity of psychological domains such as cognition, emotion, social behavior, and psychopathology

Outdoor provision for babies and toddlers: Exploring the practice/policy/research nexus in English ECEC settings

A wealth of research evidences the positive impact of the outdoors for young children. Yet there is little relating to the experiences of babies and toddlers who attend daycare settings. This paper offers new knowledge about outdoor provision for under twos in the English context where there is a lack of explicit policy support for outdoor practice. Findings, captured through an online survey from Early Childhood Education and Care (ECEC) settings in one geographically diverse county, reveal a generally positive picture. This suggests that practice is ahead of research. However, the survey also highlights significant variability in outdoor provision. We suggest that, in the absence of a strong policy driver ECEC settings may be inadvertently laying the foundations for inequality of access to the outdoors. Furthermore, a lack of research evidence to inform practice may be contributing to an underdevelopment of the pedagogic value of outdoor environments

Making connections with their world: outdoor provision for under-twos in early childhood settings in Kent

This report is the second stage of a research project, A life ‘in and with nature?’ An exploration of outdoor provision in baby rooms, made possible by funding from the Froebel Trust. The outdoors is central to Froebelian philosophy and practice and, for Froebel, experiences in the earliest period of childhood were particularly significant since the ‘whole being is here only an appropriating eye…’ This research is inspired by his understanding that, ‘Life in and with nature, and with the clear, still objects of nature must be fostered at this time by the parents and members of the family as the chief point of reference of the whole child-life’1 and seeks to explore its significance in contemporary practice. The growing number of very young children in the UK and beyond who now spend time in formal day care suggest that it is important to know more about outdoor provision for under twos

Understanding the attitudes and experiences of people living with potentially stigmatised long-term health conditions with respect to collecting and sharing health and lifestyle data

Background: The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data. Methods: This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task. Results: The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data. Conclusions: We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future

Existing evidence on the use of participatory scenarios in ecological restoration: a systematic map

Background and context The scale of land degradation worldwide has led to nearly one billion hectares committed to restoration globally. However, achieving such restoration targets will necessitate complex trade-offs against limited time, competing knowledge, costs, resources and varying stakeholder and societal preferences. Participatory scenarios allow a way to identify collaborative solutions for restoration planning and implementation best suited for the local cultures and societies they are tied to. They can be used to navigate uncertainties surrounding future trajectories of restored areas by evaluating trade-offs in outcomes. This research aims to systematically map the evidence on the use of participatory scenarios in restoration planning. We use the following research question: What evidence exists on the use of participatory scenarios in ecological restoration? This is answered by examining the characteristics of the evidence base, types of study design, types of outcomes, trade-offs in outcomes, and the role of participants. Methods A comprehensive and reproducible search strategy was followed using bibliographic databases, webbased searches, and targeted searching. Search results underwent a two-step screening process according to eligibility criteria. Metadata on key areas of interest were extracted from included texts and were narratively synthesised alongside data visualisations to answer the research questions. Review findings 18,612 records were initially identified, and 106 articles were included in the final map. Most studies were conducted in Europe and North America, focusing on restoring agricultural land or forests. Most texts used mixed methods and explored multiple outcome types, but environmental outcomes were the most assessed. Within environmental outcomes, indicators for ecological function were assessed more frequently than structural or compositional indicators. The most common reason for choosing outcomes and indicators was stakeholder interest. Tradeoffs in social, ecological, and economic outcomes were mainly examined across space using mapping techniques, while far fewer studies looked at trade-offs across stakeholders and time. Participants were mostly included in the scenario creation step and were usually chosen purposefully by the research team. Conclusions It is difficult to understand how useful scenarios are for restoration planning because few texts reported how scenarios fed into the process. Despite this, the range of outcomes used and different method types adopted suggests participatory scenarios allow for integrating different knowledge and approaches, alongside facilitating the use of qualitative or semi-quantitative data when this is more appropriate or quantitative data is not widely available. To better use participatory scenarios as a tool for ecological restoration planning, decision-makers can push for greater levels and definitions of participation from the offset of restoration projects with specified, regular, and structured communication and participation channels. We also recommend more systematic methods of participant selection, such as stakeholder analysis. Further research is needed to understand the effectiveness of participatory scenarios in restoration planning and whether the participation of stakeholders was successful in meeting objectives. To improve the evidence base, future studies should clearly evaluate their effectiveness in the restoration planning process and their success in meeting their participatory objectives. Evidence synthesis, Stakeholder engagement, Collaboration, Alternative futures, Socioecological systems, Co-productionpublishedVersio

Understanding the Barriers and Facilitators to Sharing Patient-Generated Health Data Using Digital Technology for People Living with Long-Term Health Conditions: A Narrative Review

Using digital technology to share patient-generated health data has the potential to improve the self-management of multiple long-term health conditions. Sharing these data can allow patients to receive additional support from healthcare professionals and peer communities, as well as enhance their understanding of their own health. A deeper understanding of the concerns raised by those living with long-term health conditions when considering whether to share health data via digital technology may help to facilitate effective data sharing practices in the future. The aim of this review is to identify whether trust, identity, privacy and security concerns present barriers to the successful sharing of patient-generated data using digital technology by those living with long-term health conditions. We also address the impact of stigma on concerns surrounding sharing health data with others. Searches of CINAHL, PsychInfo and Web of Knowledge were conducted in December 2019 and again in October 2020 producing 2,581 results. An iterative review process resulted in a final dataset of 23 peer-reviewed articles. A thorough analysis of the selected articles found that issues surrounding trust, identity, privacy and security clearly present barriers to the sharing of patient-generated data across multiple sharing contexts. The presence of enacted stigma also acts as a barrier to sharing across multiple settings. We found that the majority of literature focuses on clinical settings with relatively little attention being given to sharing with third parties. Finally, we suggest the need for more solution-based research to overcome the discussed barriers to sharing

Understanding the attitudes and experiences of people living with potentially stigmatised long-term health conditions with respect to collecting and sharing health and lifestyle data

Background: The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data. Methods: This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task. Results: The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data however there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data. Conclusions: We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future

Collecting and sharing self-generated health and lifestyle data: understanding barriers for people living with long-term health conditions – a survey study

Background: The growing popularity of collecting self-generated health and lifestyle data presents a valuable opportunity to develop our understanding of long-term health conditions (LTHCs) and improve care. Barriers remain to the effective sharing of health and lifestyle data by those living with LTHCs which include beliefs around concepts of Trust, Identity, Privacy and Security (TIPS), experiences of stigma, perceptions of risk and information sensitivity.Method:We surveyed 250 UK adults who reported living with a range of LTHCs. We recorded data to assess self-reported behaviours, experiences, attitudes and motivations relevant to sharing self-generated health and lifestyle data. We also asked participants about their beliefs about TIPS, stigma, and perceptions of risk and information sensitivity regarding their health and lifestyle data.Results: Three quarters of our sample reported recording information about their health and lifestyle on a daily basis. However two thirds reported never or rarely sharing this information with others. TIPS concerns were considered to be ‘very important’ by those with LTHCs when deciding whether or not to share self-generated health and lifestyle data with others, with security concerns considered most important. Of those living with a LTHC, 58 reported experiencing stigma associated with their condition. The greatest perceived risk from sharing with others was the potential for future harm to their social relationships.Conclusions:Our findings suggest that, in order for health professionals and researchers to benefit from the increased prevalence of self-generated health and lifestyle data, more can be done to address security concerns and to understand perceived risks associated with data sharing. Digital platforms aimed at facilitating the sharing of self-generated health and lifestyle data may look to highlight security features, enable users to control the sharing of certain information types, and emphasise the practical benefits to users of sharing health and lifestyle data with others

Securing the Downside Up: Client and Care Factors Associated with Outcomes of Secure Residential Youth Care

Although secure residential care has the potential of reducing young people's behavioral problems, it is often difficult to achieve positive outcomes. Research suggests that there are several common success factors of treatment, of which the client's motivation for treatment and the quality of the therapeutic relationship between clients and therapists might be especially relevant and important in the context of secure residential care. The objective of the present study was to explore the association of these potential success factors with secure residential care outcomes. A repeated measures research design was applied in the study, including a group of adolescents in a secure residential care center that was followed up on three measurements in time. Interviews and questionnaires concerning care outcomes in terms of adolescents' behavior change during care were administered to 22 adolescents and 27 group care workers. Outcomes in terms of adolescents' treatment satisfaction were assessed by the use of questionnaires, which were completed by 51 adolescents. Adolescents reported some positive changes in their treatment motivation, but those who were more likely to be motivated at admission were also more likely to deteriorate in treatment motivation from admission to departure. Treatment satisfaction was associated with better treatment motivation at admission and with a positive adolescent-group care worker relationship. The results suggest that outcomes can be improved by a more explicit treatment focus on improving the adolescent's treatment motivation and the quality of the adolescent-care worker relationship during secure residential care

Carfilzomib and dexamethasone versus bortezomib and dexamethasone for patients with relapsed or refractory multiple myeloma (ENDEAVOR): And randomised, phase 3, open-label, multicentre study

Background: Bortezomib with dexamethasone is a standard treatment option for relapsed or refractory multiple myeloma. Carfilzomib with dexamethasone has shown promising activity in patients in this disease setting. The aim of this study was to compare the combination of carfilzomib and dexamethasone with bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma. Methods: In this randomised, phase 3, open-label, multicentre study, patients with relapsed or refractory multiple myeloma who had one to three previous treatments were randomly assigned (1:1) using a blocked randomisation scheme (block size of four) to receive carfilzomib with dexamethasone (carfilzomib group) or bortezomib with dexamethasone (bortezomib group). Randomisation was stratified by previous proteasome inhibitor therapy, previous lines of treatment, International Staging System stage, and planned route of bortezomib administration if randomly assigned to bortezomib with dexamethasone. Patients received treatment until progression with carfilzomib (20 mg/m2 on days 1 and 2 of cycle 1; 56 mg/m2 thereafter; 30 min intravenous infusion) and dexamethasone (20 mg oral or intravenous infusion) or bortezomib (1·3 mg/m2; intravenous bolus or subcutaneous injection) and dexamethasone (20 mg oral or intravenous infusion). The primary endpoint was progression-free survival in the intention-to-treat population. All participants who received at least one dose of study drug were included in the safety analyses. The study is ongoing but not enrolling participants; results for the interim analysis of the primary endpoint are presented. The trial is registered at ClinicalTrials.gov, number NCT01568866. Findings: Between June 20, 2012, and June 30, 2014, 929 patients were randomly assigned (464 to the carfilzomib group; 465 to the bortezomib group). Median follow-up was 11·9 months (IQR 9·3-16·1) in the carfilzomib group and 11·1 months (8·2-14·3) in the bortezomib group. Median progression-free survival was 18·7 months (95% CI 15·6-not estimable) in the carfilzomib group versus 9·4 months (8·4-10·4) in the bortezomib group at a preplanned interim analysis (hazard ratio [HR] 0·53 [95% CI 0·44-0·65]; p<0·0001). On-study death due to adverse events occurred in 18 (4%) of 464 patients in the carfilzomib group and in 16 (3%) of 465 patients in the bortezomib group. Serious adverse events were reported in 224 (48%) of 463 patients in the carfilzomib group and in 162 (36%) of 456 patients in the bortezomib group. The most frequent grade 3 or higher adverse events were anaemia (67 [14%] of 463 patients in the carfilzomib group vs 45 [10%] of 456 patients in the bortezomib group), hypertension (41 [9%] vs 12 [3%]), thrombocytopenia (39 [8%] vs 43 [9%]), and pneumonia (32 [7%] vs 36 [8%]). Interpretation: For patients with relapsed or refractory multiple myeloma, carfilzomib with dexamethasone could be considered in cases in which bortezomib with dexamethasone is a potential treatment option. Funding: Onyx Pharmaceuticals, Inc., an Amgen subsidiary