Multiprofessional Views on Older Patients' Participation in Care Planning Meetings in a Hospital Context

Care planning meetings (CPMs; sometimes referred to as family meetings) for older patients involve group decision-making between the multidisciplinary team, the older person and their family. However, service user participation is challenged by the inequity of knowledge and power between participants, together with organisational and resource pressures for timely discharge. The effective use and perhaps, potential misuse of communication strategies within CPMs is of ethical concern to all participants. Habermas' essential critique of participatory communication provides insight as to how older people's involvement can be either enabled or blocked by healthcare professionals (HCPs) depending on their use of communication strategies. Seven discipline-specific mini-focus groups provided an opportunity for HCPs to reflect on the participation of patients over 65 and their families in CPMs. Findings explore HCPs' understanding of older patients involvement based on key dimensions of communicative participation, namely, mutuality, inclusiveness, patient centredness and clear outcomes. Whilst the benefits of collaborative decision-making were confirmed, legitimate concerns as to the quality of participatory practices, limited attention to group work processes and the exclusion of older patients with cognitive impairment were identified. © 2013 Copyright British Association of Social Workers.

Real-life Social Attention in Children with Autism Spectrum Disorders

Autism is a neuro-developmental disorder defined by atypical social behaviour, of which atypical social attention behaviours are among the earliest clinical markers (Volkmar et al., 1997). Eye tracking studies using still images and movie clips have provided a method for the precise quantification of atypical social attention in ASD. This is generally characterised by diminished viewing of the most socially pertinent regions (eyes), and increased viewing of less socially informative regions (body, background, objects) (Klin et al., 2002; Riby & Hancock, 2008, 2009). Ecological validity within eye tracking studies has become an increasingly important issue. As of yet, however, little is known about the precise nature of the atypicalities of social attention in ASD in real-life. Objectives: To capture and quantify gaze patterns for children with an ASD within a real life setting, compared to two Typically Developing (TD) comparison groups. Methods: Nine children with an ASD were compared to two age matched TD groups – a verbal (N=9) and a non-verbal (N=9) comparison group. A real-life scenario was created involving an experimenter posing as a magician, and consisted of 3 segments: a conversation segment; a magic trick segment; and a puppet segment. The first segment explored children’s attentional preferences during a real-life conversation; the magic trick segment explored children’s use of the eyes as a communicative cue, and the puppet segment explored attention capture. Finally, part of the puppet section explored children’s use of facial information in response to an unexpected event. Results: The most striking difference between the groups was the diminished viewing of the eyes by the ASD group in comparison to both control groups. This was found particularly during the conversation segment, but also during the magic trick segment, and during the puppet segment. When in conversation, participants with ASD were found to spend a greater proportion time looking off-screen, in comparison to TD participants. There was also a tendency for the ASD group to spend a greater proportion of time looking to the mouth of the experimenter. During the magic trick segment, despite the fact that the eyes were not predictive of a correct location, both TD comparison groups continued to use the eyes as a communicative cue, whereas the ASD group did not. In the puppet segment, all three groups spent a similar amount of time looking between the puppet and regions of the experimenter’s face. However, in response to an unexpected event, the ASD group were significantly slower to fixate back on the experimenter’s face. Conclusions: The results demonstrate the reduced salience of socially pertinent information for children with ASD in real life, and they provide support for the findings from previous eye tracking studies involving scene viewing. However, the results also highlight a pattern looking off-screen for both the TD and ASD groups. This eye movement behaviour is likely to be associated specifically with real-life interaction, as it has functional relevance (Doherty-Sneddon et al., 2002). However, the fact that it is significantly increased in the ASD group has implications for their understanding of real life social interactions.

Reciprocal value propositions in practice: Constraints in digital markets

The value proposition concept, while forming a central foundational premise of service-dominant (S-D) logic, has nevertheless been treated somewhat ambiguously. Recent work in attempting to address this has focused through a S-D logic lens on the reciprocal nature of value propositions. Important to this work has been a focus on communicative interactions and resource integration between network suppliers and customers. Overall, value proposition thinking has not studied in detail their adoption and use in practice. Considering the compelling notion of reciprocity, there have been recent calls for research to consider reciprocal value propositions in practice. The overall aim of this paper, therefore, was to explore how reciprocal value propositions are developed (or not) in practice at the network level. The study was set in the mobile television (TV) sector, which, as an internet-driven sector, is viewed as particularly pertinent. To conduct the study an S-D logic and Industrial Marketing and Purchasing (IMP) Group framework are integrated for the first time. A key finding is that while the reciprocal value proposition concept is theoretically intuitive, it is by no means inevitable in practice. Reciprocal value propositions were found to be simultaneously constrained, and, potentially enabled by these constraints in practice. At an overall level this paper contributes to the ongoing collaborative process, which aims to move S-D logic from a framework to a theory. More specifically, we provide new insights into the development of reciprocal value propositions in practice.

Valuing the talk of young people: are we nearly there yet?

This paper examines reasons why young people’s talk about themselves and their educational experiences do not seem to be valued in public discourse about education. Drawing on a national dataset of student focus groups, it illustrates how students talk about themselves in educational contexts in a way that is entirely different and more complex than how they are conceptualised by an adult audience and symbolic elites. It demonstrates, contrary to dominant adult perceptions, the critical, communicative and creative use of language offered by young people when asked about their educational experiences, and highlights the potential innovation being missed by not listening.

A system lifeworld perspective on dying in long term care settings for older people:Contested states in contested places

In many Western countries, older people live and die in long-term institutional care settings. Habermas's concepts of lifeworld, system and communicative action are drawn upon to illuminate the experience of living and dying in this particular place. It is proposed that dying older adults, their family and care staff occupy different contested states and long term care settings are contested places, located in a wider system. This wider system, mediated through care homes, can colonise the life world experiences of dying individuals. The development of communicative space bridges the lifeworld and system and offers a way for the lifeworld of dying individuals, and those around them to be reintegrated into, and influence the wider system. © 2010 Elsevier Ltd.

Categorizations of physical gesture in piano teaching: A preliminary enquiry

The significance of the “physicality” involved in learning to play a musical instrument and the essential role of teachers are areas in need of research. This article explores the role of gesture within teacher–student communicative interaction in one-to-one piano lessons. Three teachers were required to teach a pre-selected repertoire of two contrasting pieces to three students studying piano grade 1. The data was collected by video recordings of piano lessons and analysis based on the type and frequency of gestures employed by teachers in association to teaching behaviours specifying where gestures fit under (or evade) predefined classifications. Spontaneous co-musical gestures were observed in the process of piano tuition emerging with similar general communicative purposes as spontaneous co-verbal gestures and were essential for the process of musical communication between teachers and students. Observed frequencies of categorized gestures varied significantly between different teaching behaviours and between the three teachers. Parallels established between co-verbal and co-musical spontaneous gestures lead to an argument for extension of McNeill’s (2005) ideas of imagery–language–dialectic to imagery–music–dialectic with relevant implications for piano pedagogy and fields of study invested in musical communication.

Politeness and honesty contribute additively to the interpretation of scalar expressions

Scalar terms have been the focus of much recent attention. People can interpret such terms narrowly, for example, interpreting A or B to convey A or B but not both, on the grounds that a speaker would have explicitly used a more informative term (i.e., and) had he or she been in a position to do so; or they can interpret such terms broadly (A or B or both). Examined here are the effects of politeness contexts and self-rated honesty on people’s interpretation of the scalar connective or. In two experiments, it is shown that participants are less likely to adopt the narrow interpretation when the communicative context is face threatening, and that regardless of context, participants high in self-rated honesty adopt the narrow interpretation to a greater extent than those low in self-rated honesty. These results are consistent with the claim that an assumption of honesty underlies certain pragmatic inferences and suggest that personality may be an important source of individual differences in language interpretation.

Non-governmental Organizational Accountability: Talking the Talk and Walking the Walk?

Concern for NGO accountability has been intensified in recent years, following the growth in the size of NGOs and their power to influence global politics and curb the excesses of globalization. Questions have been raised about where the sector embraces the same standards of accountability that it demands from government and business. The objective of this paper is to examine one aspect of NGO accountability, its discharge through annual reporting. Using Habermas’ (1984; 1987) theory of communicative action, and specifically its validity claims, the research investigates whether NGOs use their annual reporting process to account to the host societies in which they operate or steer stakeholder actions toward their own self-interests. The results of the study indicate that efforts by organizations to account are characterized by communicative action through the provision of truthful disclosures, generally appropriate to the discharge of accountability and in a manner intended to improve their understandability. At the same time, however, some organizations exhibit strategically oriented behaviors in which the disclosure content is guided by the opportunity to present organizations in a particular light and there appears a lack of rhetor authenticity. The latter findings cast doubt on the ethical inspiration of NGOs and the values they demand from business communities, and questions arise as to why such practices exist and what lessons can be learnt from them.

Communicating musical knowledge through gesture: Piano teachers’ gestural behaviours across different levels of student proficiency

Teachers’ communication of musical knowledge through physical gesture represents a valuable pedagogical field in need of investigation. This exploratory case study compares the gestural behaviour of three piano teachers while giving individual lessons to students who differed according to piano proficiency levels. The data was collected by video recordings of one-to-one piano lessons and gestures were categorized using two gesture classifications: the spontaneous co-verbal gesture classification (McNeill, 1992; 2005) and spontaneous co-musical gesture classification (Simones, Schroeder & Rodger, 2013). Poisson regression analysis and qualitative observation suggest a relationship between teachers’ didactic intentions and the types of gesture they produced while teaching, as shown by differences in gestural category frequency between teaching students of higher and lower levels of proficiency. Such reported agreement between teachers’ gestural approach in relation to student proficiency levels indicates a teachers’ gestural scaffolding approach whereby teachers adapted gestural communicative channels to suit students’ specific conceptual skill levels.

Introducing Students to Pre-Nineteenth-Century Poetry in the Language Classroom

We as language instructors are tasked with preparing students to transition from language to literature courses. The shorter length of many poems makes them ideal for presentation in the language classroom, where the acquisition of communicative competence is the priority. Introductory and intermediate textbooks’ poetry offerings, however, are frequently drawn from a canon of poems by only a few nineteenth- and twentieth-century authors (Verlaine, Apollinaire, Prévert) and fail to expose students to broader aspects of French literature. This article offers strategies for presenting pre-nineteenth-century poetry to first- and second-year students of French using dizains from Scève’s Délie as examples.

Reducing Child Protection Error in Social Work: Towards an Holistic-Rational Perspective

Social work in the United Kingdom remains embroiled in concerns about child protection error. The serious injury or death of vulnerable children continues to evince much consternation in the public and private spheres. Governmental responses to these concerns invariably draw on technocratic solutions involving more procedures, case management systems, information technology and bureaucratic regulation. Such solutions flow from an implicit use of instrumental rationality based on a ‘means-end’ logic. While bringing an important perspective to the problem of child protection error, instrumental rationality has been overused limiting discretion and other modes of rational inquiry. This paper argues that the social work profession should apply an enlarged form of rationality comprising not only the instrumental-rational mode but also the critical-rational, affective-rational and communicative-rational forms. It is suggested that this combined, conceptual arsenal of rational inquiry leads to a gestalt which has been termed the holistic-rational perspective. It is also argued that embracing a more rounded perspective such as this might offer greater opportunities for reducing child protection error.

Dublin’s ephemeral and imaginary architectures

In 1989, the Irish architectural practice O’Donnell and Tuomey were commissioned to build a temporary pavilion to represent Ireland at the 11 Cities/11 Nations exhibition at Leeuwarden in the Netherlands. Citing Peter Smithson, John Tuomey suggested the pavilion, which drew inspirations from the forms and materials of the modern Irish barn, embodied an intention ‘not just to build but to communicate’. Its subsequent reassembly for the inauguration of the Irish Museum of Modern Art in the courtyard of the seventeenth-century Royal Hospital Kilmainham in Dublin in 1991, drew comparisons between the urban sophistication of this colonial building, its svelte new refit, and the rural expression of O’Donnell + Tuomey’s barn. It was, one critic recently noted, as if ‘a wedding had been crashed by a country cousin who had forgotten to clean his boots’.
It has been argued that temporary or ephemeral pieces of architecture, unburdened by the traditional constraints of firmitas or utilitas, have the ability to offer a concise distillation of meaning and intention. Approaching the qualities of rhetoric, such architectures share similarities with the monument and yet differ in fundamental ways. Their rapid construction in lightweight materials can allow for an almost instantaneous negotiation of zeitgeist. And, unlike the monument, from the outset the space and form of these installations is designed to disappear.
This paper analyses the ephemeral architectures of Dublin in the modern period contextualising their qualities and intentions as they manifest themselves across colonial, post-colonial and contemporary epochs. It finds origins in the theatrical sets of the late eighteenth century and traces their movements into the semi-public sphere of the pleasure garden and finally into the theatre of the streets. It is here that temporary architecture in the city has been at its most potent, allowing the amplification or subversion of the meanings of much larger spaces. Historically, much of Dublin’s most conspicuous instances of ephemeral architecture have been realised as a means of articulating mass spectacle in political, religious or nationalistic events. And while much of this has sought to confirm dominant ideologies, it has also been possible to discern moments of opposition.
The contemporary period, however, has arguably witnessed a shift in ephemeral architectures from explicitly representing ‘positive ideologies’ towards something more oblique or nebulous. This turn towards abstraction in form and space has rendered an especially communicative form of architecture particularly elusive. By examining continuities within the apparent disjuncture between historical and contemporary examples, this paper begins to unpick the language of recent ephemeral architecture in Dublin and situate it within wider global trends where political and economic imperatives are often simultaneously obscured and expressed in public space by a vocabulary of universality. As Jurgen Habermas has suggested, the contemporary value given to the transitory and the ephemeral ‘discloses a longing for an undefiled, immaculate and stable present’.

‘Reading Aran knitting: stitches, text andinterpretation’

The densely textured surfaces of Aran knitting seem to invite interpretation. They have been ‘read’ as identity documents, family trees, references to natural and spiritual phenomena, or even maps. This paper traces the search for meaning in Aran knitting, examining how these stitch patterns have been ‘read’ in the contexts of tourism, fine art and fashion. As Jo Turney (2013:55) argues, the idea of knitted textiles as communicative media in non-literate societies ‘consigns the garments to a preindustrial era of more rural and simple times’, situating them in an imagined state of ‘stasis’. Thus the ways in which Aran stitches are ‘read’ sometimes obscure the processes through which they are ‘written’, whether in terms of individual authorship and creativity, or in terms of their manufacture. Regardless of the historical veracity of claims that particular Aran stitch patterns index features of the social, natural or spiritual worlds, analysing the ways they have been ‘read’ in the context of comparable textile traditions, other crafts which have taken on ‘heritage’ souvenir status, and Irish national identity, reveals how Aran knitting has performed broader communicative functions (see Sonja Andrew 2008), which continue to be subverted and elaborated by fine artists, and translated into couture and mass market fashion products.

The use of eye-tracking to explore social difficulties in cognitively able students with autism spectrum disorder: A pilot study

Individuals with autism spectrum disorder do not just 'grow out of' their early difficulties in understanding the social world. Even for those who are cognitively able, autism-related difficulties continue into adulthood. Atypicalities attending to and interpreting communicative signals from others can provide barriers to success in education, employment and relationships. In the current study, we use eye-tracking during real social interaction to explore attention to social cues (e.g. face, eyes, mouth) and links to social awareness in a group of cognitively able University students with autism spectrum disorder and typically developing students from the same University. During the interaction, students with autism spectrum disorder showed less eye fixation and more mouth fixation than typically developing students. Importantly, while 63% of typically developing participants reported thinking they were deceived about the true nature of the interaction, only 9% of autism spectrum disorder participants picked up this subtle social signal. We argue that understanding how these social attentional and social awareness difficulties manifest during adulthood is important given the growing number of adults with autism spectrum disorder who are attending higher level education. These adults may be particularly susceptible to drop-out due to demands of coping in situations where social awareness is so important.

Turing’s Menagerie: Talking Lions, Virtual Bats, Electric Sheep and Analogical Peacocks: Common Ground and Common Interest are Necessary Components of Engagement

This theoretical paper attempts to define some of the key components and challenges required to create embodied conversational agents that can be genuinely interesting conversational partners. Wittgenstein’s argument concerning talking lions emphasizes the importance of having a shared common ground as a basis for conversational interactions. Virtual bats suggests that–for some people at least–it is important that there be a feeling of authenticity concerning a subjectively experiencing entity that can convey what it is like to be that entity. Electric sheep reminds us of the importance of empathy in human conversational interaction and that we should provide a full communicative repertoire of both verbal and non-verbal components if we are to create genuinely engaging interactions. Also we may be making the task more difficult rather than easy if we leave out non-verbal aspects of communication. Finally, analogical peacocks highlights the importance of between minds alignment and establishes a longer term goal of being interesting, creative, and humorous if an embodied conversational is to be truly an engaging conversational partner. Some potential directions and solutions to addressing these issues are suggested.