Do College Students Perceive Stigma the Same Way Experts Do? An Experimental Test of Lay Perceptions of Body-Size Stigma

Personal experience with weight-based stigma is negatively associated with selfesteem (Myers & Rosen, 1999). This study examined how self-esteem is affected by exposure to weight-based stigma communication that is directed at another person. Using Smith’s (2007a) stigma communication framework, I created a 2 (Stigma Level: high, low) x 2 (Gender of stigmatized person: male, female) x 2 (Body Size of stigmatized person: large, small) posttest-only experiment. Participants’ self-esteem was not impacted after viewing stigmatizing messages directed at another person. This suggests that selfesteem is more stable than some researchers indicate (Wagner, Lüdtke, and Trautwein, 2016). My results suggest that stigma communication message features, marking and personal responsibility, are more obvious in high stigma level conditions. Furthermore, results indicate that aspects of stigma are recognized in larger bodies more often than small bodies. These results suggest that perceptions about stigma communication vary by the stigma level and the stigma target’s attributes, namely body size. Implications are discussed

Weight-Based Stigma and Self-Esteem: A Test and Extension of the Stigma Communication Model

Personal experience with weight-based stigma is negatively associated with self-esteem (Myers & Rosen, 1999). Our study examines how self-esteem is affected by exposure to weight-based stigma communication that is directed at another person. Using Smith’s (2007) stigma communication framework, we created a 2 (Stigma level: high, low) x 2 (Gender of stigmatized person: male, female) x 2 (Body of stigmatized person: large, small) posttest-only experiment. Participants’ self-esteem was highest after seeing a small body subjected to intense stigma and lowest after seeing a large body subjected to intense stigma. Additionally, we observed three-way interactions affecting the perceptions of two stigma-communication message features: marking and linking to social peril. Our results suggest that perceptions about stigma communication vary by the stigma level and the stigma target’s attributes. Implications are discussed

General practice–a fertile lagoon in the ocean of medical knowledge

General practitioners (GPs) often find that linear, deductive knowledge does not provide a sufficient map for clinical management. But experience, accompanied by enduring familiarity with individual patients, may offer unique complementary skills to interpret a patient’s symptoms and navigate skilfully through diagnosis, treatment, follow-up and prevention. In this article, we draw attention to the nature of this tacit knowing that is executed by many GPs every day. We argue that the nonlinear, unpredictable complexity of this domain nurtures a particular logic of clinical knowing. This kind of knowledge is not intuition and can to some extent be intersubjectively accessible. We substantiate and discuss how and why general practice research can contribute to knowledge development by transforming reflection-in-action to reflection-on-action. We briefly present some concepts for reflection-on-action of clinical knowing in general practice. The VUCA model (volatility, uncertainty, complexity, ambiguity) embraces dynamic and confusing situations in which agile work (adaptive, flexible and responsive behaviour and cognitive creativity) is assumed to be an appropriate response. Using such perspectives, we may sharpen our gaze and apply reflexivity and analytic elaboration to interpret unique incidents and experiences and appreciate the complexity of general practice. In this way, exploratory research can fertilize general practice and offer innovation to the entire domain of clinical knowledge.publishedVersio

Taxation of fuel and vehicles when emissions are constrained

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Weight-Based Stigma and Self-Esteem: A Test and Extension of the Stigma Communication Model

Personal experience with weight-based stigma is negatively associated with self-esteem (Myers & Rosen, 1999). Our study examines how self-esteem is affected by exposure to weight-based stigma communication that is directed at another person. Using Smith’s (2007) stigma communication framework, we created a 2 (Stigma level: high, low) x 2 (Gender of stigmatized person: male, female) x 2 (Body of stigmatized person: large, small) posttest-only experiment. Participants’ self-esteem was highest after seeing a small body subjected to intense stigma and lowest after seeing a large body subjected to intense stigma. Additionally, we observed three-way interactions affecting the perceptions of two stigma-communication message features: marking and linking to social peril. Our results suggest that perceptions about stigma communication vary by the stigma level and the stigma target’s attributes. Implications are discussed

Exploring Expectancy Violations Theory and Proxemics with the Impractical Jokers

Proxemics and expectancy violations theory (EVT) are the groundwork for understanding interpersonal and nonverbal communication. Previous research has indicated students retain information long-term when humor and videos that form memorable messages are incorporated into the classroom. The activity discussed in this GIFT uses the popular comedy show, Impractical Jokers, to help students apply abstract concepts to real-life examples. Several discussion questions are suggested to help students critically analyze the videos and recognize proxemics and EVT. The second set of discussion questions asks students to consider their expectations, how their expectations are formed, why some individuals have different expectations, and why expectations may vary in some circumstances based on proxemics. Limitations of this activity are discussed, and alterations are suggested to address the limitations

Why do doctors in Norway choose general practice and remain there? A qualitative study about motivational experiences

Objective: To explore experiences motivating doctors to become and remain GPs. Design and contributors: Qualitative analysis of written responses from an open-ended question about motivational experiences posted on an internet discussion list for GPs in Norway. Texts from 25 contributors were analysed with Systematic Text Condensation, supported by theories about calling as motivation. Results: Analysis revealed numerous aspects of motivation to become and remain a general practitioner. Inspirations from early experiences and skilled role models had conveyed values and offered insight into a fascinating world of care, gratitude and respect. Close and continuous relationships with patients provided GPs with humbling experiences and learning moments. Contributors described how these encounters became rewarding sources of insight and mutual trust, improving interpersonal skills. Also, the extensive variety of tasks during the workday and the space for autonomy and independence was emphasised. Implications: Understanding motivational experiences influencing GPs’ choice of medical career is necessary to develop strategies for recruitment and stability and contribute to prevention of burn-out and improper work-life balance. GPs’ professional identities and commitments should be recognized and developed in dialogues between authorities and GPs to enhance communication, improve the structural frames of work environment and thereby sustainable recruitment. Key points GPs regard their choice of medical career as strongly influenced by motivational experiences in childhood, adolescence and as medical students Role models, diversity of work, feelings of being able to contribute and rewarding and continuous relationships with patients were mentioned to activate and maintain general practice commitment Knowledge about motivational influences, professional identities and commitment for GPs is crucial for medical education and dialogue to promote general practice as a career choice and prevent dangers of work overload and burnoutpublishedVersio

Diagnostic knowing in general practice: interpretative action and reflexivity

Background: Getting the right diagnosis is supposed to provide an explanation of a patient’s health problem and inform health care decisions. As a core element of clinical reasoning, diagnosis deserves systematic and transparent analysis. Conceptual tools can make doctors become aware of and explore diagnostic knowing. Methods: We demonstrate diagnostic knowing analysed as interpretative and contextualised activity. Our analysis is based on Lonergan’s theory of knowing, constituting the cognitive structures as experiencing, understanding, and judging, in a general practice case. Findings: Analysis makes the complexity of diagnostic knowing in this context more transparent, in this case concluding with four diagnostic labels: a corn, constipation, headache and atrial fibrillation. We demonstrate how a medically significant diagnosis does not necessarily evolve deductively from complaints. The opening lines from the patient give ideas of where to look for possible explanations – questions for understanding – rather than diagnostic hypotheses. Such questions emerge from the GP’s experiences from meeting the patient, including imaginations and interpretations. When ideas and questions regarding diagnoses have been developed, they may be judged and subjected to reflection. Questioning may also emerge as transitory concerns, not extensively ruled out. Lonergan’s theory demonstrated a strong fit with these aspects of diagnostic knowing in general practice. Implications: Analysis demonstrated systematic, transparent approaches to diagnostic knowing, relevant for clinical teaching. We argue that an interpretative understanding of diagnosis can change clinical practice, complementing hypothetico-deductive strategies by recognising additional substantial diagnostic modes and giving access to scholarly reflection.publishedVersio

Improving Early Detection of Refugee-Related Stress Symptoms: Evaluation of an Inter-Professional and Inter-Cultural Skills Training Course in Sweden

Twenty-three of 26 participants, mainly women from six local agencies involved in the reception of refugees, completed a university course titled “Refugee-related stress and mental health—local cooperation”, which was spread over seven days in 2011. The course was based on evidence and clinical experience and was commissioned to serve as competency training by Stockholm County Council and Södertälje Municipality. It received funding from the Swedish National Board of Health and Welfare. It was a continuation of an earlier one-week full-time university course from 2010 with the same title. As a result of a new law relating to refugee reception, which led to organizational change, the participants requested a continuation of the original course. The learning objectives were met (5.4 on a 6-point scale; 1 = strongly disagree, 6 = strongly agree). The general assessment of the course as a whole by the participants was 5.7 (on a 6-point scale, 1 = very unsatisfied, 6 = very satisfied). The participants thought that their skills had increased, and their perception was that they had significantly better control of their work situation following completion of the course. The most important findings were that participants from different agencies at the local level: (1) perceived that they had developed the sense that there was a local inter-cultural and inter-professional inter-agency collaboration in the reception of newly arrived refugees and (2) will continue efforts to stabilize and develop this together. This method of teaching, in terms of skills training, is not a “quick fix.” It is a process, and it needs support from those in power in order to continue