Phenomenology of Professional Practices in Education and Health Care: An Empirical Investigation

In this article a group of professionals working in education and health care explore professional practices and interactions from a phenomenological perspective, drawing on Max van Manen’s conceptualization of the phenomenology of practice and his knowledge interest in understanding and furthering sensitive, caring professional practice. Posing the question what is the meaning of interaction in encounters within education and health care, we look at practice experiences drawn from close observations and interviews during research concerning special needs education, physiotherapy and weight loss programs. Three anecdotes are offered as a way to ‘show,’ rather than interpret, the processes involved. Each anecdote is followed by reflections in which we draw on van Manen’s notion of pathic knowledge and Nancy’s ideas about co-existence to develop phenomenological insights about temporal, embodied and relational qualities of the phenomenon of interaction in professional practice. Such interaction seems to involve continuous negotiation. It emerges as a process of exchange, a movement back and forth between supporting and letting oneself be supported; between confronting and being confronted; between pushing and being pushed. Moments of active engagement give way to periods of waiting for the other to act. The experience is one of continuous back and forth movement in the relational space in-between.Phenomenology of Professional Practices in Education and Health Care: An Empirical InvestigationpublishedVersio

Objective assessment of motor activity in a clinical sample of adults with attention-deficit/hyperactivity disorder and/or cyclothymic temperament

Background Most research on patterns of motor activity has been conducted on adults with mood disorders, but few studies have investigated comorbid attention-deficit/hyperactivity disorder (ADHD) or temperamental factors that may influence the clinical course and symptoms. Cyclothymic temperament (CT) is particularly associated with functional impairment. Clinical features define both disorders, but objective, biological markers for these disorders could give important insights with regard to pathophysiology and classification. Methods Seventy-six patients, requiring diagnostic evaluation of ADHD, mood or anxiety disorders were recruited. A comprehensive diagnostic evaluation, including the CT scale of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego – Auto-questionnaire (TEMPS-A), neuropsychological tests and actigraphy, was performed. ADHD was diagnosed according to the DSM-IV criteria. There was a range of different conditions in this clinical sample, but here we report on the presence of CT and ADHD in relation to motor activity. Twenty-nine healthy controls were recruited. We analyzed motor activity time series using linear and nonlinear mathematical methods, with a special focus on active and inactive periods in the actigraphic recordings. Results Forty patients fulfilled the criteria for ADHD, with the remainder receiving other psychiatric diagnoses (clinical controls). Forty-two patients fulfilled the criteria for CT. Twenty-two patients fulfilled the criteria for ADHD and CT, 18 patients met the criteria for ADHD without CT, and 15 patients had neither. The ratio duration of active/inactive periods was significantly lower in patients with CT than in patients without CT, in both the total sample, and in the ADHD subsample. Conclusions CT is associated with objectively assessed changes in motor activity, implying that the systems regulating motor behavior in these patients are different from both healthy controls and clinical controls without CT. Findings suggest that actigraphy may supplement clinical assessments of CT and ADHD, and may provide an objective marker for CT.publishedVersio

Diurnal variation of motor activity in adult ADHD patients analyzed with methods from graph theory

Attention-deficit /hyperactivity disorder (ADHD) is a common neurodevelopmental syndrome characterized by age-inappropriate levels of motor activity, impulsivity and attention. The aim of the present study was to study diurnal variation of motor activity in adult ADHD patients, compared to healthy controls and clinical controls with mood and anxiety disorders. Wrist-worn actigraphs were used to record motor activity in a sample of 81 patients and 30 healthy controls. Time series from registrations in the morning and evening were analyzed using measures of variability, complexity and a newly developed method, the similarity algorithm, based on transforming time series into graphs. In healthy controls the evening registrations showed higher variability and lower complexity compared to morning registrations, however this was evident only in the female controls. In the two patient groups the same measures were not significantly different, with one exception, the graph measure bridges. This was the measure that most clearly separated morning and evening registrations and was significantly different both in healthy controls and in patients with a diagnosis of ADHD. These findings suggest that actigraph registrations, combined with mathematical methods based on graph theory, may be used to elucidate the mechanisms responsible for the diurnal regulation of motor activity.publishedVersio

Phenomenology of Professional Practices in Education and Health Care: An Empirical Investigation

In this article a group of professionals working in education and health care explore professional practices and interactions from a phenomenological perspective, drawing on Max van Manen’s conceptualization of the phenomenology of practice and his knowledge interest in understanding and furthering sensitive, caring professional practice. Posing the question what is the meaning of interaction in encounters within education and health care, we look at practice experiences drawn from close observations and interviews during research concerning special needs education, physiotherapy and weight loss programs. Three anecdotes are offered as a way to ‘show,’ rather than interpret, the processes involved. Each anecdote is followed by reflections in which we draw on van Manen’s notion of pathic knowledge and Nancy’s ideas about co-existence to develop phenomenological insights about temporal, embodied and relational qualities of the phenomenon of interaction in professional practice. Such interaction seems to involve continuous negotiation. It emerges as a process of exchange, a movement back and forth between supporting and letting oneself be supported; between confronting and being confronted; between pushing and being pushed. Moments of active engagement give way to periods of waiting for the other to act. The experience is one of continuous back and forth movement in the relational space in-between

Phenomenology of Professional Practices in Education and Health Care: An Empirical Investigation

In this article a group of professionals working in education and health care explore professional practices and interactions from a phenomenological perspective, drawing on Max van Manen’s conceptualization of the phenomenology of practice and his knowledge interest in understanding and furthering sensitive, caring professional practice. Posing the question what is the meaning of interaction in encounters within education and health care, we look at practice experiences drawn from close observations and interviews during research concerning special needs education, physiotherapy and weight loss programs. Three anecdotes are offered as a way to ‘show,’ rather than interpret, the processes involved. Each anecdote is followed by reflections in which we draw on van Manen’s notion of pathic knowledge and Nancy’s ideas about co-existence to develop phenomenological insights about temporal, embodied and relational qualities of the phenomenon of interaction in professional practice. Such interaction seems to involve continuous negotiation. It emerges as a process of exchange, a movement back and forth between supporting and letting oneself be supported; between confronting and being confronted; between pushing and being pushed. Moments of active engagement give way to periods of waiting for the other to act. The experience is one of continuous back and forth movement in the relational space in-between

Phenomenology of Professional Practices in Education and Health Care: An Empirical Investigation

In this article a group of professionals working in education and health care explore professional practices and interactions from a phenomenological perspective, drawing on Max van Manen’s conceptualization of the phenomenology of practice and his knowledge interest in understanding and furthering sensitive, caring professional practice. Posing the question what is the meaning of interaction in encounters within education and health care, we look at practice experiences drawn from close observations and interviews during research concerning special needs education, physiotherapy and weight loss programs. Three anecdotes are offered as a way to ‘show,’ rather than interpret, the processes involved. Each anecdote is followed by reflections in which we draw on van Manen’s notion of pathic knowledge and Nancy’s ideas about co-existence to develop phenomenological insights about temporal, embodied and relational qualities of the phenomenon of interaction in professional practice. Such interaction seems to involve continuous negotiation. It emerges as a process of exchange, a movement back and forth between supporting and letting oneself be supported; between confronting and being confronted; between pushing and being pushed. Moments of active engagement give way to periods of waiting for the other to act. The experience is one of continuous back and forth movement in the relational space in-between.Phenomenology of Professional Practices in Education and Health Care: An Empirical InvestigationpublishedVersio

Linear and non-linear analyses of Conner’s Continuous Performance Test-II discriminate adult patients with attention deficit hyperactivity disorder from patients with mood and anxiety disorders

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a heterogeneous disorder. Therefore it is important to look for factors that can contribute to better diagnosis and classification of these patients. The aims of the study were to characterize adult psychiatric out-patients with a mixture of mood, anxiety and attentional problems using an objective neuropsychological test of attention combined with an assessment of mood instability. Method: Newly referred patients (n = 99; aged 18–65 years) requiring diagnostic evaluation of ADHD, mood or anxiety disorders were recruited, and were given a comprehensive diagnostic evaluation including the self-report form of the cyclothymic temperament scale and Conner’s Continuous Performance Test II (CPT-II). In addition to the traditional measures from this test we have extracted raw data and analysed time series using linear and non-linear mathematical methods. Results: Fifty patients fulfilled criteria for ADHD, while 49 did not, and were given other psychiatric diagnoses (clinical controls). When compared to the clinical controls the ADHD patients had more omission and commission errors, and higher reaction time variability. Analyses of response times showed higher values for skewness in the ADHD patients, and lower values for sample entropy and symbolic dynamics. Among the ADHD patients 59 % fulfilled criteria for a cyclothymic temperament, and this group had higher reaction time variability and lower scores on complexity than the group without this temperament. Conclusion: The CPT-II is a useful instrument in the assessment of ADHD in adult patients. Additional information from this test was obtained by analyzing response times using linear and non-linear methods, and this showed that ADHD patients with a cyclothymic temperament were different from those without this temperament

Objective assessment of motor activity in a clinical sample of adults with attention-deficit/hyperactivity disorder and/or cyclothymic temperament

Background Most research on patterns of motor activity has been conducted on adults with mood disorders, but few studies have investigated comorbid attention-deficit/hyperactivity disorder (ADHD) or temperamental factors that may influence the clinical course and symptoms. Cyclothymic temperament (CT) is particularly associated with functional impairment. Clinical features define both disorders, but objective, biological markers for these disorders could give important insights with regard to pathophysiology and classification. Methods Seventy-six patients, requiring diagnostic evaluation of ADHD, mood or anxiety disorders were recruited. A comprehensive diagnostic evaluation, including the CT scale of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego – Auto-questionnaire (TEMPS-A), neuropsychological tests and actigraphy, was performed. ADHD was diagnosed according to the DSM-IV criteria. There was a range of different conditions in this clinical sample, but here we report on the presence of CT and ADHD in relation to motor activity. Twenty-nine healthy controls were recruited. We analyzed motor activity time series using linear and nonlinear mathematical methods, with a special focus on active and inactive periods in the actigraphic recordings. Results Forty patients fulfilled the criteria for ADHD, with the remainder receiving other psychiatric diagnoses (clinical controls). Forty-two patients fulfilled the criteria for CT. Twenty-two patients fulfilled the criteria for ADHD and CT, 18 patients met the criteria for ADHD without CT, and 15 patients had neither. The ratio duration of active/inactive periods was significantly lower in patients with CT than in patients without CT, in both the total sample, and in the ADHD subsample. Conclusions CT is associated with objectively assessed changes in motor activity, implying that the systems regulating motor behavior in these patients are different from both healthy controls and clinical controls without CT. Findings suggest that actigraphy may supplement clinical assessments of CT and ADHD, and may provide an objective marker for CT

HYPERAKTIV: An Activity Dataset from Patients with Attention-Deficit/Hyperactivity Disorder (ADHD)

Machine learning research within healthcare frequently lacks the public data needed to be fully reproducible and comparable. Datasets are often restricted due to privacy concerns and legal requirements that come with patient-related data. Consequentially, many algorithms and models get published on the same topic without a standard benchmark to measure against. Therefore, this paper presents HYPERAKTIV, a public dataset containing health, activity, and heart rate data from patients diagnosed with attention deficit hyperactivity disorder, better known as ADHD. The dataset consists of data collected from 51 patients with ADHD and 52 clinical controls. In addition to the activity and heart rate data, we also include a series of patient attributes such as their age, sex, and information about their mental state, as well as output data from a computerized neuropsychological test. Together with the presented dataset, we also provide baseline experiments using traditional machine learning algorithms to predict ADHD based on the included activity data. We hope that this dataset can be used as a starting point for computer scientists who want to contribute to the field of mental health, and as a common benchmark for future work in ADHD analysis.publishedVersio