Narration und Diagrammatik. Eine Vorüberlegung und sieben Thesen

[Narrative and the Diagrammatic. Preliminary Thoughts and Seven Theses.] This article proposes a view of narrative that does not depend on the traditional perspective of temporal sequence but emphasizes the spatial structure of literary narrative. Contrary to the prevalent treatment of space in narrative theory, the notion of spatiality in this context refers not to the space that is represented by the narrative (e.g. the setting and other spatial elements of the fictional world) but to the space that represents it: first, the graphic surface of the text; second, the (quasi-)spatial mental representation of its content that is produced in the process of reception. It is argued that these conditions form the primary ontological mode of narrative, whereas the temporal development of a story is an aesthetic illusion that has been specifically stimulated by the narrative conventions of approximately the past three centuries and must thus be considered a secondary effect. The diagrammatic, as a way of both depicting data and perceiving relations through spatial representation, thus forms a more adequate methodological approach to understanding narrative structure than approaches that are implicitly derived from the 'grammar' of narrative in the structuralist sense and its sequential logic.

Mechanisms of action of brief alcohol interventions remain largely unknown - a narrative review.

A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

L'exploration temporelle comme modalité du voyage imaginaire dans la bande dessinée franco-belge (1930-1980)

In this paper, I explore the motif of time travel in science fictional French comics until the eighties. Time travel incorporates a fascinating potential for narrative representation, since moving back in time may multiply timelines, according to the well-known paradox of the grandfather. This virtuality has become very popular in novels and in movies, since In his Bootstraps (Heinlein, 1941) and La Jetée (Marker, 1962) until the recent Looper (Johnson, 2012) but it has been rarely represented in French comics before the eighties and the apparition of time paradoxes in series like "Yoko Tsuno" and, mostly, "Valérian agent spatio-temporel". Firstly, many modalities of time travel do not engender time paradoxes, like exploration of prehistoric sanctuaries, imaginary travel, or cryogenic sleep followed by an awakening if a future world with no hope to return in the past. Secondly, time travel has been mostly interpreted as a mere extension of the classic motif of the "extraordinary journey", as exemplified for centuries in fictions by Verne, Mercier, Swift, or Stevenson. Thus, the graphic potential of time travel for the representation of spectacular exotic worlds has predominated in French comic tradition, and this tendency has been encouraged by the dominant mode of publication until the end of the sixties. Indeed, complex scriptwriting involving multiple timelines would not fit the form of a weekly feuilleton addressed to a young audience, because it would be too demanding cognitively speaking. It illustrates also the dominance of graphic concerns over a taste for complex scriptwriting in many comics of this period. Still, the development of time paradoxes in Pierre Christin scriptwriting underlines the potential of the media when it is published in series of albums or in graphic novels. At the same time, Jean-Claude Mézières drawings-featuring spectacular representations of foreign worlds-show that the visual interest of spectacular time travels remains a central issue for this popular graphic medium. Cette étude porte sur le motif du voyage temporel dans la bande dessinée franco-belge de science- fiction jusque dans les années quatre-vingt. Le voyage temporel intègre un potentiel fascinant pour la représentation narrative, étant donné que le retour dans le passé est susceptible d'engendrer des lignes temporelles multiples, selon le paradoxe bien connu du « grand-père ». Cette virtualité est devenue très populaire dans les romans et dans les films, depuis In his Bootstraps (Heinlein, 1941) et La Jetée (Marker, 1962) jusqu'au récent Looper (Johnson, 2012), mais elle a rarement été représentée dans la bande dessinée franco-belge avant les années quatre-vingt et l'apparition de paradoxes temporels dans des séries comme « Yoko Tsuno » et, surtout, « Valérian agent spatio-temporel ». Tout d'abord, de nombreuses modalités du voyage dans le temps n'engendrent aucun paradoxe, par exemple l'exploration de sanctuaires préhistoriques, le voyage illusoire ou le sommeil cryogénique suivi d'un réveil dans le futur, sans espoir de revenir dans le passé. Deuxièmement, le voyage dans le temps a été plus souvent interprété comme une simple extension du motif classique du « voyage extraordinaire », tel qu'on le retrouve, depuis le XVIIIe siècle, les fictions de Verne, Mercier, Swift ou Stevenson. Ainsi, le potentiel graphique du voyage dans le temps pour la représentation de mondes exotiques spectaculaires a prédominé dans la tradition franco-belge et cette tendance a été encouragée par le mode de publication dominant jusqu'à la fin des années soixante. En effet, l'écriture de scénarios complexes impliquant de multiples lignes temporelles ne semble pas adaptée à la forme d'un feuilleton hebdomadaire destiné à un jeune public, parce qu'il aurait été trop exigeant, cognitivement parlant. Cela illustre également la prédominance de préoccupations graphiques sur l'écriture de scénarios complexes dans de nombreuses bandes dessinées de cette période. Pourtant, le développement de paradoxes temporels dans les scénarios de Pierre Christin souligne le potentiel du média quand il est publié en série d'albums ou dans des romans graphiques. Parallèlement, les dessins de Jean-Claude Mézières, qui proposent des représentations spectaculaires de mondes étrangers, montre que l'intérêt visuel du voyage dans le temps demeure une question centrale pour ce média populaire.

Standard care practices and psychosocial interventions aimed at reducing parental distress following stillbirth: A systematic narrative review

Objective: To summarise and critically evaluate the evidence informing the provision of standard care practices and psychosocial interventions following stillbirth. Background: Stillbirth is increasingly recognised as a significant bereavement experience with the potential to cause substantial psychological distress for parents. Standard care practices and psychosocial interventions to support parents have undergone dramatic changes, with limited basis in evidence. Methods: A systematic narrative review was conducted of quantitative studies examining interventions designed to reduce psychological distress in parents following the loss of a stillborn baby. Results: Twenty-five studies met the inclusion criteria for the review. Substantial methodological weaknesses were identified among reviewed studies, including small and heterogeneous loss samples, weak study designs and lack of clarity in reported methods and outcomes. Inadequate replication of many findings substantially limits the generalisability of the evidence. Conclusion: Tentative evidence was found for the provision of mementoes of the baby and information regarding the cause of the loss, support group attendance, and cognitive behavioural interventions for parents identified with clinical levels of distress. Contradictory findings for the impact of contact with the baby prevent the formation of clear conclusions for this practice. Due to the methodological weaknesses prevalent in the research identified, the current evidence base is not considered sufficiently able to reliably inform care practices and intervention approaches. High-quality research evidence in this field is urgently required.

The economic cost of hospital malnutrition in Europe; a narrative review

Background: Malnutrition among hospitalized patients increases length of stay (LOS) and carries extra hospitalization costs. Objective: To review the impact of malnutrition on hospital LOS and costs in Europe. Methods: PubMed and Google Scholar search. All articles from January 2004 until November 2014 were identified. Reference lists of relevant articles were also manually searched. Results: Ten studies on LOS and nine studies on costs were reviewed. The methods used to assess malnutrition and to calculate costs differed considerably between studies. Malnutrition led to an increased LOS ranging from 2.4 to 7.2 days. Among hospitalized patients, malnutrition led to an additional individual cost ranging between 1640 V and 5829 V. At the national level, the costs of malnutrition ranged between 32.8 million V and 1.2 billion V. Expressed as percentage of national health expenditures, the values ranged between 2.1% and 10%. Conclusions: In Europe, malnutrition leads to an increase in LOS and in hospital costs, both at the individual and the national level. Standardization of methods and results reported is needed to adequately compare results between countries. © 2015 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.