Pragma-Dialectics and Health Communication: Arguing for behavioural change in advisory health brochures

In this paper, it is argued that a pragma-dialectical perspective on advisory health brochures can complement current research in the medical domain and vice versa. Advisory health brochures are characterized as a particular communicative activity type to show how this context influences the argumentative process. It is argued that the quality of argumentation in health communication needs more attention. Insights from behavioural theory and persuasion research may help to detect possibly fallacious manoeuvres

The study of metaphor in argumentation theory

This paper offers a review of the argumentation-theoretical literature on metaphor in argumentative discourse. Two methodologies are combined: the pragma-dialectical theory is used to study the argumentative functions attributed to metaphor, and distinctions made in metaphor theory and the three-dimensional model of metaphor are used to compare the conceptions of metaphor taken as starting point in the reviewed literature. An overview is provided of all types of metaphors distinguished and their possible argumentative functions. The study reveals that not all possible argumentative functions of metaphor have been taken into account, such as the role of conventional direct metaphors in standpoint and starting point. Novel direct metaphor as part of an analogy argument has received most attention, while indirect metaphor can constitute argumentative moves as well, such as the introduction of a standpoint, starting point or connection premise. The overview also shows that certain combinations of variables seem to be impossible of unlikely to occur. These results have a bearing on the analysis of metaphors in argumentative discourse and show the omission in current studies of metaphor. Being aware of these dimensions of metaphor ánd of its potential in argumentation would enrich argumentation studies and metaphor studies alike

Choosing variants of pragmatic argumentation in anticipation of countermoves in health brochures

In this paper, I will determine the strategic function of the use of four variants of pragmatic argumentation in the context of advisory health brochures. I argue that each variant functions as a strategic manoeuvre that deals with potential countermoves: with variant I and II writers can address anticipated doubt with respect to the standpoint and with variants III and IV they can strategically erase potential criti-cism or possible alternatives to the proposed actio

Types of Resistance to Metaphor

The appropriateness and persuasiveness of using metaphors has become subject of debate in both the academic and the public arena. Recent studies have shown that particular metaphors give rise to resistance, yet the nature of metaphor resistance is still hardly explored. This paper therefore examines the ways in which metaphors can be explicitly resisted, focusing on metaphors that are used in argumentative discourse. We propose an analytical tool, a typology of resistance to metaphor, to distinguish grounds for language users to reject unacceptable metaphors, based on the parameter of focus of the resistance and norms appealed to in the resistance. We applied the typology in a small corpus-analytical study using Twitter replies. Our results show that most resistance was based on discussion rules and focused on the proposition of metaphor, yet resistance focused on the situation, person or locution also occurred.</p

Machines, journeys, prisons and yo-yos:Metaphors of pain, illness and medicine in consultations with chronic pain patients

Introduction: This paper examines pain, illness and medicine metaphors as used in consultations between chronic pain patients and anaesthesiologists, physiotherapists and psychologists in a Belgian pain clinic. As metaphors frame and highlight aspects of understanding and experiences of life events, including illness, they can provide insight in how health professionals and patients construct illness, pain and medicine in interaction. Materials and method: 16 intake consultations (collected in Belgium in April–May 2019) between 6 patients and 4 health professionals were qualitatively coded twice ATLAS. TI by a team of 3 coders, using an adjusted form of the Metaphor Identification Procedure. Each metaphor was labelled for source domain, target domain and speaker. Results: A number of metaphors that have been previously documented in past research were frequent in our data too, such as journey and machine metaphors, although sometimes also used differently, like war metaphors. Our data set also contained many few-used and sometimes more novel metaphors, such as ILLNESS IS A YO-YO. Many metaphors highlight particular aspects of living with and talking about chronic pain, such as its duration and persistent presence, a lack of agency and feelings of powerlessness, and a dualistic perspective on body and mind. Discussion and conclusion: The metaphors used by health professionals and patients give insight in the lived experience of having and treating chronic pain. In this way, they can contribute to our understanding of patients’ experiences and challenges, how they recur in clinical communication, and how they are related to wider discourses on health, illness and pain.</p

The third party in shared decision making:The role of extra participants in discussions between health professionals and patients

Regelmatig nemen patiënten een begeleider mee naar medische consulten. Het verloop van shared decision making (SDM) in consulten met drie partijen heeft tot nu toe echter weinig aandacht gekregen. In deze studie wordt nagegaan welke invloed de derde partij kan hebben op het beslisproces. Daartoe specificeren we de rollen die deze partij op zich kan nemen en bespreken we, vanuit een pragma-dialectisch perspectief, hoe deze rollen zich vertalen naar rollen binnen een discussie. Tot slot zetten we op basis van voorbeelden uiteen hoe deze rollen tot uiting kunnen komen in het besluitvormingsproces. In een consult met drie partijen blijken vanuit argumentatief oogpunt twaalf complexe discussiesituaties te kunnen ontstaan, afhankelijk van de aard van het geschil, eventuele coalitievorming en de rollen die de partijen op zich nemen. In een aantal discussiesituaties kan de derde partij een actieve rol spelen en zodoende deelnemen aan het besluitvormingsproces. Alle drie partijen kunnen daarnaast anderen bij de discussie betrekken (bijvoorbeeld door hun mening te vragen) of een coalitie suggereren (bijvoorbeeld door in de wij-vorm te spreken). Indien een derde partij een coalitie suggereert, kan dit enerzijds SDM ten goede komen, doordat de begeleider de patiënt in het besluitvormingsproces steunt. Anderzijds kan dit ook het besluitvormingsproces bemoeilijken wanneer de derde partij (bewust of onbewust) ten onrechte namens de patiënt spreekt. Op eenzelfde wijze kan een derde partij meer of minder constructieve bijdragen leveren aan de besluitvorming door standpunten of argumenten te baseren op de eigen (vermeende) expertise.FGW – Publications not associated with a particular research are

Beliefs, barriers and preferences of European overweight women to adopt a healthier lifestyle in pregnancy to minimize risk of developing gestational diabetes mellitus: an explorative study

Introduction: Overweight and obese women are at high risk of developing gestational diabetes mellitus (GDM). Lifestyle programs might help curb the GDM risk. We explored beliefs, perceived barriers and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future high quality lifestyle interventions. Methods: An explorative mixed methods, two-staged study was conducted to gather information from pregnant European women (BMI≥25kg/m2). In three European countries (Belgium, Netherlands, United Kingdom) interviews were conducted, followed by questionnaires in six other European countries (Austria, Denmark, Ireland, Italy, Poland, Spain). Content analysis, descriptive and chi square statistics were applied (p&#60;0.05). Results: Women preferred to obtain detailed information about their personal risk. The health of their baby was major motivating factor. Perceived barriers for physical activity included pregnancy-specific issues such as tiredness and experiencing physical complaints. Insufficient time was a barrier more frequently reported by women with children. Abstaining from snacking was identified as a challenge for the majority of women, especially for those without children. Women preferred to obtain support from their partner, as well as health professionals and valued flexible lifestyle programs. Conclusions: Healthcare professionals need to inform overweight pregnant women about their personal risk, discuss lifestyle modification and assist in weight management. Lifestyle programs should be tailored to the individual, taking into account barriers experienced by overweight first-time mothers and multipara women

Correction to: The Effects of Lifestyle and/or Vitamin D Supplementation Interventions on Pregnancy Outcomes: What Have we Learned from the DALI Studies? (Current Diabetes Reports, (2019), 19, 12, (162), 10.1007/s11892-019-1282-7)

The original version of this review article unfortunately contained a mistake

Creation of an Enhanced Recovery after Surgery (ERAS) Guideline for neonatal intestinal surgery patients: A knowledge synthesis and consensus generation approach and protocol study

Introduction: Enhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identify and attempt to bridge the gaps between current practices and best evidence. Our study is the first paediatric ERAS protocol endorsed by the International ERAS Society. Methods: A research team consisting of international clinical and family stakeholders as well as methodological experts have iteratively defined the scope of the protocol in addition to individual topic areas. A modified Delphi method was used to reach consensus. The second phase will include a series of knowledge syntheses involving a rapid review coupled with expert opinion. Potential protocol elements supported by synthesised evidence will be identified. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) system will be used to determine strength of recommendations and the quality of evidence. The third phase will involve creation of the protocol using a modified RAND/UCLA Appropriateness Method. Group consensus will be used to rate each element in relation to the quality of evidence supporting the recommendation and the appropriateness for guideline inclusion. This protocol will form the basis of a future implementation study. Ethics and dissemination: This study has been registered with the ERAS Society. Human ethics approval (REB 18-0579) is in place to engage patient families within protocol development. This research is to be published in peer-reviewed journals and will form the care standard for neonatal intestinal surgery