Expanding the reflexive space: resilient young adults, institutional cultures, and cognitive schemas

For many U.S. young adults, being resilient to stressful events hinges on making meaning of such events and thereby minimizing their negative emotional impact. Yet why are some better able to do this than others? In this study, which uses an innovative outlier sampling strategy and linked survey and interview data, we argue that one important factor is connection to institutional cultures associated with higher education, religion/spirituality, and the military. Such cultures provide material for the development of cognitive schemas that can be adopted and applied to their stressful experiences, which include narratives of social progress, divine providence, and self‐discipline. Using a metaphor adapted from the pragmatist philosopher Charles Sanders Peirce, we argue the resulting schemas have the effect of “expanding the space” of reflexive thought, providing new cognitive material for interpreting stress and supporting resilience. Finally, we argue this framing improves in several ways on the concept of meaning making often used in stress process research.Accepted manuscrip

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

the good high school: potraits of character and culture

What makes a good school? A prominent Harvard educator looks for the answers in six schools that have earned reputations for excellence: George Washington Carver High School in Atlanta; John F. Kennedy High School in the Bronx, New York; Highland Park High School near Chicago; Bookline High School in Brookline, Massachusetts; St. Paul's in Concord, New Hampshire; and the Milton Academy, near Boston.Sara Lawrence-Lightfoot is Professor at the Harvard Graduate School of Education and MacArthur genius award winner. (A named chair was created this spring in her honor.) She is the author of The Good High School (Basic), Balm in Gilead (AWL and Penguin), and I've Known Rivers (AWL and Penguin). Each of these books, as well as Respect, uses a vivid technique of portraiture, for which she has become known both to scholars and devoted readers.399 p.; 21 cm

Will Anybody Know Who I Am? On Education, Justice, and Respect

On April 2, 2003, Professor of Education, Sara Lawrence-Lightfoot of Harvard University, delivered the Georgetown Law Center’s twenty-third Annual Philip A. Hart Memorial Lecture: Will Anybody Know Who I Am? On Education, Justice, and Respect. Sara Lawrence-Lightfoot, a sociologist, examines the culture of schools, the broad ecology of education, and the relationship between human development and social change. She has written nine books: Worlds Apart: Relationships Between Families and Schools (1978), Beyond Bias: Perspectives on Classrooms (1979), and The Good High School: Portraits of Character and Culture (1983), which received the 1984 Outstanding Book Award from the American Educational Research Association. Her book, Balm In Gilead: Journey of A Healer (1988), which won the 1988 Christopher Award, given for literary merit and humanitarian achievement, was followed by I\u27ve Known Rivers: Lives of Loss and Liberation (1994), and The Art and Science of Portraiture (1997), which documents her pioneering approach to social science methodology; one that bridges the realms of aesthetics and empiricism. In, Respect: An Exploration (1999), Lawrence-Lightfoot reaches deep into human experience to find the essence of this powerful quality. The Essential Conversation: What Parents and Teachers Can Learn From Each Other (2003), captures the crucial exchange between parents and teachers, a dialogue that is both mirror and metaphor for the cultural forces that shape the socialization of our children, and The Third Chapter: Risk, Passion, and Adventure in the Twenty-Five Years After 50 (2009) explores new learning during one of the most trans-formative and generative times in our lives. Lawrence-Lightfoot has been a fellow at the Bunting Institute and at the Center for Advanced Study in the Behavioral Sciences at Stanford University. In 1984, she was the recipient of the prestigious MacArthur Prize, and in 1993 she was awarded Harvard\u27s George Ledlie Prize given for research that makes the most valuable contribution to science and the benefit of mankind.” In 1995, she became a Spencer Senior Scholar; and in 2008, she was named the Margaret Mead Fellow by the Academy of Political and Social Sciences. Lawrence-Lightfoot has been the recipient of 28 honorary degrees from colleges and universities in the United States and Canada. In 1993, the Sara Lawrence-Lightfoot Chair, an endowed professorship was established at Swarthmore College; and in 1998, she was the recipient of the Emily Hargroves Fisher Endowed Chair at Harvard University, which upon her retirement, will become the Sara Lawrence-Lightfoot Chair, making her the first African-American woman in Harvard’s history to have an endowed professorship named in her honor

I\u27ve Known Rivers: Lives Of Loss And Liberation

https://works.swarthmore.edu/alum-books/2535/thumbnail.jp

The Third Chapter: Passion, Risk, And Adventure In The 25 Years After 50

https://works.swarthmore.edu/alum-books/2537/thumbnail.jp

Beyond Bias: Perspectives On Classrooms

https://works.swarthmore.edu/alum-books/4634/thumbnail.jp

Worlds Apart: Relationships Between Families And Schools

https://works.swarthmore.edu/alum-books/2536/thumbnail.jp

Balm In Gilead: Journey Of A Healer

https://works.swarthmore.edu/alum-books/2534/thumbnail.jp