Teaching stylistics: analysing cohesion and narrative structure in a short story by Ernest Hemingway

The main aim of this article is to propose an exercise in stylistic analysis which can be employed in the teaching of English language. It details the design and results of a workshop activity on narrative carried out with undergraduates in a university department of English. The methods proposed are intended to enable students to obtain insights into aspects of cohesion and narrative structure; insights, it is suggested, which are not as readily obtainable through more traditional techniques of stylistic analysis. The text chosen for analysis is a short story by Ernest Hemingway comprising only 11 sentences. A jumbled version of this story is presented to students who are asked to assemble a cohesive and well-formed version of the story. Their (re)constructions are then compared with the original Hemingway version. Much interest, it is argued, lies in the ways in which the students justify their own versions in terms of their expectations about well-formedness in narrative. The activity is also intended to encourage students to see literary texts as a valuable means of providing insights into the subtleties of linguistic form and function.

USING ‘NUTRITIONAL NARRATIVE’ AND FOCUS GROUPS TO UNDERSTAND HOW NUTRITIONAL CARE CAN BETTER PRIORITISED FOR OLDER PEOPLE IN HOSPITAL SETTINGS

Introduction: Poor nutritional status among older people is well documented with 40% of older people reported as malnourished on hospital admission. Poor nutrition contributes to increased infection, poorer patient outcomes and death and longer hospital stays. In this study, we assessed the ‘nutrition narrative’ from older hospital patients together with nutrition knowledge among nursing and medical staff and students.
Methods: The study used a convenience sample of older people (30, mean age 82 years) in two large geographically separate city hospitals. Patients mentally alert and consenting, gave a recorded ‘nutrition narrative’ to get a sense of how they felt their nutritional needs were being met in hospital. Main themes were identified by grounded analysis framework. Focus groups were recruited from medical/nursing teachers and students to assess their working knowledge of nutrition and the nutritional needs of the older patient group.
Results: Analysis of the ‘nutrition narrative’ suggested several themes (i) staff should listen to patients' needs/wishes in discussion with themselves and family members (ii) staff should continue to encourage and progress a positive eating experience (iii) staff should monitor food eaten/or not eaten and increase regular monitoring of weight. The focus groups with medical and nursing students suggested a limited knowledge about nutritional care of older people and little understanding about roles or cross-talk about nutrition across the multidisciplinary groups.
Conclusions: The ‘nutrition narrative’ themes suggested that the nutritional experience of older people in hospital can and must be improved. Nursing and medical staff providing medical and nursing care need better basic knowledge of nutrition and nutritional assessment, an improved understanding of the roles of the various multidisciplinary staff and of hospital catering pathways. Care professionals need to prioritise patient nutrition much more highly and recognise nutritional care as integral to patient healing and recovery

The effectiveness of peer mentoring in promoting a positive transition to higher education for first-year undergraduate students: a mixed methods systematic review protocol

Background: The global transfer of nursing and midwifery education to higher education institutes has led to student nurses and midwives experiencing challenges previously faced by traditional third-level students, including isolation, loneliness, financial difficulties and academic pressure. These challenges can contribute to increased stress and anxiety levels which may be detrimental to the successful transition to higher education, thus leading to an increase in attrition rates. Peer mentoring as an intervention has been suggested to be effective in supporting students in the transition to third-level education through enhancing a sense of belongingness and improving student satisfaction, engagement and retention rates. This proposed systematic review aims to determine the effectiveness of peer mentoring in enhancing levels of student engagement, sense of belonging and overall satisfaction of first-year undergraduate students following transition into higher education.
Methods: MEDLINE, Web of Knowledge, ProQuest, Embase, CINAHL, ERIC, PsycINFO and CENTRAL databases will be searched for qualitative, quantitative and mixed methods studies on the implementation of peer assessment strategies in higher education institutes (HEIs) or universities for full-time, first-year adult students (>17 years). Included studies will be limited to the English language. The quality of included studies will be assessed using a validated Mixed Methods Appraisal Tool (MMAT). The findings will be presented as a narrative synthesis or meta-analysis as appropriate following sequential explanatory synthesis.
Discussion: The review will provide clear, non-biased evidence-based guidance to all third-level educators on the effectiveness of peer-mentoring programmes for first-year undergraduates. The review is necessary to help establish which type of peer mentoring is most effective. The evidence from qualitative and quantitative studies drawn from the international literature will be utilised to illustrate the best way to implement and evaluate peer mentoring as an effective intervention and will be useful in guiding future research and practice in this area. These findings may be applied internationally across all disciplines.

The troubling concept of class: reflecting on our ‘failure’ to encourage sociology students to re-cognise their classed locations using autobiographical methods

The troubling concept of class: reflecting on our ‘failure’ to encourage sociology students to re-cognise their classed locations using autobiographical methods Abstract This paper provides a narrative of the four authors‟ commitment to auto/biographical methods as teachers and researchers in „new‟ universities. As they went about their work, they observed that, whereas students engage with the gendered, sexualised and racialised processes when negotiating their identities, they are reluctant or unable to conceptualise „class-ifying‟ processes as key determinants of their life chances. This general inability puzzled the authors, given the students‟ predominantly working-class backgrounds. Through application of their own stories, the authors explore the sociological significance of this pedagogical „failure‟ to account for the troubling concept of class not only in the classroom but also in contemporary society.

Learning English as an adult: a narrative of women's improvised and empowered lives /

This thesis is a narrative inquiry of learning English as an adult. It stories the journey of 7 women, including me, and unravels lived experiences that serve as learning models. Learning English as an adult presents challenges and results in lifelong implications both in personal and professional life. Every learner's experience is imique and, when reflected upon, each experience is a valuable source of knowledge for constructing meanings and forging new identities. The stories are testimony to the participants' lives: interrupted yet improvised, silenced yet roused, dependent yet independent, intimidated yet courageous, vulnerable yet empowered. The personal experiences elucidate the passion, the inner voices, the dreams, and the rewards that compel persistence in learning a new language and releaming new social roles. The stories provide encouragement and hope to other women who are learning or will learn English in their adult years, and the lived experiences will offer insights for English language teachers. This thesis employs the phenomenology methodology of research with heuristic (discovery) and hermeneutical (interpretative) approaches using the reflective-responsivereflexive writing and interviewing methods for data gathering and unravelling. The narrative inquiry approach reaffirms that storytelling is an important tool in conducting research and constructing new knowledge. This thesis narrates a new story about sharing experiences, interconnecting, and continuing to learn.

Teaching Adolescents to Think and Act Responsibly Through Narrative Film-making: A Qualitative Study

The current qualitative study examined an adapted version of the psychoeducational program, Teaching Adolescents to Think and Act Responsibly: The EQUIP Approach (DiBiase, Gibbs, Potter, & Blount, 2012). The adapted version, referred to as the EQUIP – Narrative Filmmaking Program, was implemented as a means of character education. The purpose of this study was three-fold: 1) to examine how the EQUIP – Narrative Film-making Program influenced student’s thoughts, feelings, and behaviours; 2) to explore the students’ and the teacher’s perception of their experience with the program; and 3) to assess whether or not the integrated EQUIP – Narrative Film-making Program addressed the goals of Ontario’s character education initiative. Purposive sampling was used to select one typical Grade 9 Exploring Technologies class, consisting of 15 boys from a Catholic board of education in the southern Ontario region. The EQUIP – Narrative Film-making Program required students to create moral narrative films that first portrayed a set of self-centered cognitive distortions, with follow-up portrayals of behavioural modifications. Before, during, and after intervention questionnaires were administered to the students and teacher. The student questionnaires invited responses to a set of cognitive distortion vignettes. In addition, data was collected through student and teacher interviews, and researcher observation protocol reports. Initially the data was coded according to an a priori set of themes that were further analyzed according to emotion and values coding methods. The results indicated that while each student was unique in his thoughts, feelings, and behavioural responses to the cognitive distortion vignettes after completing the EQUIP program, the overall trends showed students had a more positive attitude, with a decreased proclivity for antisocial behaviour and self-serving cognitive distortion portrayed in the vignettes. Overall, the teacher and students’ learning experiences were mainly positive and the program met the learning expectations of Ontario’s character education initiative. Based on these results of the present study, it is recommended that the EQUIP – Narrative Film-making Program be further evaluated through quantitative research and longitudinal study.

Mise à l’essai et évaluation qualitative d’une intervention inspirée de la pédagogie narrative destinée aux infirmières soignant des personnes âgées en état confusionnel aigu

Les personnes âgées occupent une proportion importante des lits dans les centres hospitaliers de soins de courte durée québécois et leur présence est en augmentation. Parmi ces personnes, plusieurs présentent un état confusionnel aigu (ÉCA), voire un délirium, au cours de leur hospitalisation. Les soins infirmiers qu’elles requièrent sont complexes et les études portant sur la formation continue des infirmières tiennent peu compte de cette réalité. Les approches utilisées dans les études sont surtout centrées sur l’acquisition de connaissances et d’habiletés techniques et négligent les aspects créatifs, relationnels, critiques, réflexifs et éthiques essentiels à une prestation de soins infirmiers de qualité. On y retrouve également peu d’informations sur la conception de l’intervention éducative et sur son évaluation. C’est dans cette perspective que le but de l’étude était de mettre à l’essai et d’évaluer qualitativement le processus et les résultats d’une intervention éducative auprès d’infirmières soignant des personnes âgées hospitalisées en ÉCA. Plus particulièrement, ce sont les conditions facilitant et contraignant l’intervention, les aspects les plus utiles pour la pratique, les différents savoirs exprimés et les résultats de soins perçus par les participantes qui étaient recherchés. C’est en s’inspirant de la pédagogie narrative de Diekelmann (2001) et des savoirs infirmiers de Chinn et Kramer (2008) que l’intervention a été conçue et évaluée. La description d’expériences de soins vécues par les infirmières et la création d’un environnement d’apprentissage favorisant l’interprétation, en groupe, de ces expériences à l’aide d’informations théoriques et empiriques caractérisent la pédagogie narrative à la base de cette intervention. Pour atteindre le but, une étude de cas a été retenue. La stratégie d’échantillonnage par choix raisonné a permis de sélectionner des participantes travaillant sur les trois quarts de travail, ayant différents niveaux de formation et une expérience comme infirmière variant de huit mois à 36 ans, dont l’âge variait de 23 à 64 ans. L’échantillon, composé de 15 infirmières soignant fréquemment des personnes en ÉCA et travaillant sur des unités de soins chirurgicaux cardiologiques et orthopédiques, était réparti dans trois groupes égaux de cinq participantes. L’intervention éducative comprenait quatre journées de formation offertes à intervalle de trois semaines pour une durée totale de 12 semaines. Au cours de chacune de ces journées, les participantes devaient effectuer un travail écrit réflexif concernant une situation de soins vécue avec une personne en ÉCA et, par la suite, partager, interpréter et s'interroger sur ces situations en faisant des liens avec des informations théoriques et empiriques sur l’ÉCA dans le cadre d’un atelier de groupe. Une triangulation de méthodes de collecte de données, incluant des notes de terrain de l’investigatrice, les travaux réflexifs des participantes, des questionnaires complétés par les participantes après chaque journée de formation et une entrevue individuelle avec chaque participante réalisée par une intervieweuse externe à la fin de l’intervention, a permis de décrire la mise à l’essai de l’intervention et d’évaluer qualitativement son processus et ses résultats. Une analyse de contenu des données qualitatives intra et inter participante a été effectuée. La mise à l’essai de l’intervention a mis en évidence l’importance de tenir compte des besoins variés des participantes et d’ajuster l’intervention éducative d’un groupe à l’autre, notamment eu égard aux contenus théoriques et empiriques sur l’ECA. L’évaluation du processus souligne que l’intervention a été facilitée par les attitudes et la diversité des expériences des participantes, ainsi que par l’utilisation de situations de soins réelles permettant d’intégrer la théorie dans la pratique. L’accès à de nouveaux outils d’évaluation des personnes en ÉCA a été perçu particulièrement utile par les participantes. Quant à l’évaluation des résultats, elle a permis de rendre visibles de nombreux savoirs empiriques, éthiques et esthétiques et certains savoirs personnels et émancipatoires exprimés par les participantes. Les participantes ont, entre autres, réalisé des évaluations plus approfondies des personnes en ÉCA, ont réduit ou évité les mesures de contrôle physiques des personnes atteintes et ont impliqué davantage les familles dans les soins. L’évaluation a aussi permis de décrire certains résultats perçus par les participantes sur le bien-être physique et psychologique des personnes soignées et sur les familles. Les personnes en ECA étaient, entre autres, rassurées, plus calmes et soulagées et les familles moins inquiètes et davantage impliquées dans les soins. Les résultats de l’étude mettent en évidence l’applicabilité d’une intervention éducative narrative basée sur un cadre de référence en sciences infirmières et son utilité pour la formation continue dans les milieux de soins. L’étude ouvre la porte à des possibilités de transfert de l’intervention à d’autres populations d’infirmières soignant des clientèles ayant des besoins complexes, notamment en gériatrie, en oncologie ou en soins palliatifs. Des études visant à évaluer l’intervention auprès d’un échantillon plus important et à explorer ses effets sur les personnes soignées et leurs familles sont proposées.

The role of entrepreneurial networking on internationalization of a micro-sized Born Global Swedish fashion company : A narrative ethnographic research

Background: In recent studies a lot of attention is drawn to the connection between networking and entrepreneurship. Many scholars consider successful business and networking inseparable. Taking into consideration the topicality of the two notions discussed above the authors of this thesis decided to conduct the research dedicated to these phenomena in the field that interests them most – in the field of Swedish fashion. Purpose: The purpose of the thesis is to gain a deeper insight into entrepreneur’s experiences to point out the role of entrepreneurial networking in the process of internationalization of a micro-sized Swedish fashion company and to contribute to the research in this field by telling its unique story. Method: To achieve the purpose of the research a narrative ethnographic research was conducted. This research strategy was chosen because it suits the purpose best by giving an opportunity to get fresh insights into the field of entrepreneurial networking from the point of view of the entrepreneur. The data collected has a narrative nature therefore narrative analysis is used to present it. The methods of gathering the data are face-to-face interview and documents. Conclusion: we can define the most important role of entrepreneurial networking on the internationalization process of Odeur as an effective accelerator and a tool to fulfil the knowledge and expertise gaps in certain areas through other actors in the network.

Managerial leadership for research use in nursing and allied health care professions : a narrative synthesis protocol

BACKGROUND: Nurses and allied health care professionals (physiotherapists, occupational therapists, speech and language pathologists, dietitians) form more than half of the clinical health care workforce and play a central role in health service delivery. There is a potential to improve the quality of health care if these professionals routinely use research evidence to guide their clinical practice. However, the use of research evidence remains unpredictable and inconsistent. Leadership is consistently described in implementation research as critical to enhancing research use by health care professionals. However, this important literature has not yet been synthesized and there is a lack of clarity on what constitutes effective leadership for research use, or what kinds of intervention effectively develop leadership for the purpose of enabling and enhancing research use in clinical practice. We propose to synthesize the evidence on leadership behaviours amongst front line and senior managers that are associated with research evidence by nurses and allied health care professionals, and then determine the effectiveness of interventions that promote these behaviours.Methods/design: Using an integrated knowledge translation approach that supports a partnership between researchers and knowledge users throughout the research process, we will follow principles of knowledge synthesis using a systematic method to synthesize different types of evidence involving: searching the literature, study selection, data extraction and quality assessment, and analysis. A narrative synthesis will be conducted to explore relationships within and across studies and meta-analysis will be performed if sufficient homogeneity exists across studies employing experimental randomized control trial designs. DISCUSSION: With the engagement of knowledge users in leadership and practice, we will synthesize the research from a broad range of disciplines to understand the key elements of leadership that supports and enables research use by health care practitioners, and how to develop leadership for the purpose of enhancing research use in clinical practice.

Discourse and bipolar disorder: Narrative therapy on northeast Brazil

Background: The expression 'bipolar disorder' refers to any of several psychological disorders of mood that alternate episodes of depression and mania. Also called manic depression or manic-depressive illness, it is a relatively common but unknown pathology that brings some stigmas for patients and provokes deleterious effects for their lives. This research aimed to comprehend actions, behaviors and emotions involved with bipolar disorder, through narratives of patient's personal and familiar histories. Methods: We surveyed 30 patients from a psychiatric service located in Aparecida, Paraiba, Brazil. Selected patients had bipolar disorder according to DSM-IV. For data collection, we used non-structured interview, approaching specific aspects related to bipolar disorder. Quantitative and qualitative analysis were done and Hamilton Rating Scale for Depression (HAMD) was used. Results: Most of patients presented depressive actions associated with moderate euphoria. 11 of them related familiar history of psychopathology. Mania and hippomania were prevalent on male gender, while psychotic symptoms overlay ate female. Conclusion: Patients lack a translation of behavioral and temperamental processes to minimize harm caused to their lives.

The complexity of narrative interferes in the use of conjunctions in children with specific language impairment

PURPOSE: To verify the use of conjunctions in narratives, and to investigate the influence of stimuli's complexity over the type of conjunctions used by children with specific language impairment (SLI) and children with typical language development. METHODS: Participants were 40 children (20 with typical language development and 20 with SLI) with ages between 7 and 10 years, paired by age range. Fifteen stories with increasing of complexity were used to obtain the narratives; stories were classified into mechanical, behavioral and intentional, and each of them was represented by four scenes. Narratives were analyzed according to occurrence and classification of conjunctions. RESULTS: Both groups used more coordinative than subordinate conjunctions, with significant decrease in the use of conjunctions in the discourse of SLI children. The use of conjunctions varied according to the type of narrative: for coordinative conjunctions, both groups differed only between intentional and behavioral narratives, with higher occurrence in behavioral ones; for subordinate conjunctions, typically developing children's performance did not show differences between narratives, while SLI children presented fewer occurrences in intentional narratives, which was different from other narratives. CONCLUSION: Both groups used more coordinative than subordinate conjunctions; however, typically developing children presented more conjunctions than SLI children. The production of children with SLI was influenced by stimulus, since more complex narratives has less use of subordinate conjunctions.

Combination of Psychological Intervention and Phosphodiesterase-5 Inhibitors for Erectile Dysfunction: A Narrative Review and Meta-Analysis

INTRODUCTION Erectile dysfunction (ED) is an increasing health problem that demands effective treatment. There is evidence that phosphodiesterase-5 inhibitors (PDE5-Is) and psychological intervention (PI) are effective treatment options; however, little is known about their comparative efficacy and the efficacy of combined treatments. AIM The aim of this systematic review and meta-analysis is to evaluate the comparative efficacy of PI, PDE5-Is, and their combination in the treatment of ED. MAIN OUTCOME MEASURES Primary outcome was ED symptoms, and secondary outcome was sexual satisfaction of the patient. METHODS A systematic literature search was conducted in order to identify relevant articles published between 1998 and 2012. We included randomized controlled trials and controlled trials comparing PI with PDE5-I treatment or one of them against a combination of both. RESULTS Eight studies with a total number of 562 patients were included in the meta-analysis. The results of the included studies are inconclusive, though they show a trend towards a larger effect of combined treatment compared with PI or PDE5-I treatment alone. The meta-analysis found that, overall, combined treatment was more efficacious for ED symptoms than PDE5-I treatment or PI alone. Combined treatment was more efficacious than PDE5-I use alone on sexual satisfaction. No differences were found between PDE5-Is and PI as stand-alone treatments. None of the moderators (treatment duration, methodological quality, or researcher allegiance) altered the effects. CONCLUSIONS The combination of PI and PDE5-Is is a promising strategy for a favorable outcome in ED and can be considered as a first-choice option for ED patients. Stronger RCTs are required to confirm this initial finding. Schmidt HM, Munder T, Gerger H, Frühauf S, and Barth J. Combination of psychological intervention and phosphodiesterase-5 inhibitors for erectile dysfunction: A narrative review and meta-analysis. J Sex Med **;**:**-**.

Applying quantitative methods in the assessment of outcomes of pharmacotherapy of psoriasis

Healthcare providers and policy makers are faced with an ever-increasing number of medical publications. Searching for relevant information and keeping up to date with new research findings remains a constant challenge. It has been widely acknowledged that narrative reviews of the literature are susceptible to several types of bias and a systematic approach may protect against these biases. The aim of this thesis was to apply quantitative methods in the assessment of outcomes of topical therapies for psoriasis. In particular, to systematically examine the comparative efficacy, tolerability and cost-effectiveness of topical calcipotriol in the treatment of mild-to-moderate psoriasis. Over the years, a wide range of techniques have been used to evaluate the severity of psoriasis and the outcomes from treatment. This lack of standardisation complicates the direct comparison of results and ultimately the pooling of outcomes from different clinical trials. There is a clear requirement for more comprehensive tools for measuring drug efficacy and disease severity in psoriasis. Ideally, the outcome measures need to be simple, relevant, practical, and widely applicable, and the instruments should be reliable, valid and responsive. The results of the meta-analysis reported herein show that calcipotriol is an effective antipsoriatic agent. In the short-tenn, the pooled data found calcipotriol to be more effective than calcitriol, tacalcitol, coal tar and short-contact dithranol. Only potent corticosteroids appeared to have comparable efficacy, with less short-term side-effects. Potent corticosteroids also added to the antipsoriatic effect of calcipotriol, and appeared to suppress the occurrence of calcipotriol-induced irritation. There was insufficient evidence to support any large effects in favour of improvements in efficacy when calcipotriol is used in combination with systemic therapies in patients with severe psoriasis. However, there was a total absence of long-term morbidity data on the effectiveness of any of the interventions studied. Decision analysis showed that, from the perspective of the NHS as payer, the relatively small differences in efficacy between calcipotriol and short-contact dithranol lead to large differences in the direct cost of treating patients with mildto-moderate plaque psoriasis. Further research is needed to examine the clinical and economic issues affecting patients under treatment for psoriasis in the UK. In particular, the maintenance value and cost/benefit ratio for the various treatment strategies, and the assessment of patient's preferences has not yet been adequately addressed for this chronic recurring disease.

From art for arts sake to art as means of knowing:a rationale for advancing arts-based methods in research, practice and pedagogy

This paper advances a philosophically informed rationale for the broader, reflexive and practical application of arts-based methods to benefit research, practice and pedagogy. It addresses the complexity and diversity of learning and knowing, foregrounding a cohabitative position and recognition of a plurality of research approaches, tailored and responsive to context. Appreciation of art and aesthetic experience is situated in the everyday, underpinned by multi-layered exemplars of pragmatic visual-arts narrative inquiry undertaken in the third, creative and communications sectors. Discussion considers semi-guided use of arts-based methods as a conduit for topic engagement, reflection and intersubjective agreement; alongside observation and interpretation of organically employed approaches used by participants within daily norms. Techniques span handcrafted (drawing), digital (photography), hybrid (cartooning), performance dimensions (improvised installations) and music (metaphor and structure). The process of creation, the artefact/outcome produced and experiences of consummation are all significant, with specific reflexivity impacts. Exploring methodology and epistemology, both the "doing" and its interpretation are explicated to inform method selection, replication, utility, evaluation and development of cross-media skills literacy. Approaches are found engaging, accessible and empowering, with nuanced capabilities to alter relationships with phenomena, experiences and people. By building a discursive space that reduces barriers; emancipation, interaction, polyphony, letting-go and the progressive unfolding of thoughts are supported, benefiting ways of knowing, narrative (re)construction, sensory perception and capacities to act. This can also present underexplored researcher risks in respect to emotion work, self-disclosure, identity and agenda. The paper therefore elucidates complex, intricate relationships between form and content, the represented and the representation or performance, researcher and participant, and the self and other. This benefits understanding of phenomena including personal experience, sensitive issues, empowerment, identity, transition and liminality. Observations are relevant to qualitative and mixed methods researchers and a multidisciplinary audience, with explicit identification of challenges, opportunities and implications.