An fMRI study of Joint Attention Experience

Although much is now known about eye movement detection, little is known about the higher cognitive processes involved in joint attention. We developed video stimuli which when watched, engender an experience of joint attention in the observer. This allowed us to compare an experience of joint attention to nonjoint attention within an fMRI scanning environment. Joint attention was associated with activity in the ventromedial frontal cortex, the left superior frontal gyrus (BA10), cingulate cortex, and caudate nuclei. The ventromedial frontal cortex has been consistently shown to be activated during mental state attribution tasks. BA10 may serve a cognitive integration function, which in this case seems to utilize a perception–action matching process. The activation we identified in BA10 overlaps with a location of increased grey matter density that we recently found to be associated with autistic spectrum disorder. This study therefore constitutes evidence that the neural substrate of joint attention also serves a mentalizing function. The developmental failure of this substrate in the left anterior frontal lobe may be important in the etiology of autistic spectrum disorder.

The experience of cancer cachexia: A qualitative study of advanced cancer patients and their family members

Background
Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective
The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design
An interpretative phenomenological approach was employed.

Setting and participants
A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method
Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results
Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions
Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.

An exploration of the experience of cancer cachexia: What patients and their families want from health care professionals

The aim of this paper is to investigate the perceptions of patients and family members with regard to care received for cancer cachexia. A qualitative study recruited 27 participants, of which 15 were patients with advanced cancer who had primary cachexia and 12 were family members. Participants were recruited from a regional cancer centre in the UK. All participants took part in a domiciliary interview, which was transcribed verbatim for analysis. A major finding from analysis was ‘lack of response from health care professionals’ in relation to cancer cachexia management. This finding illuminated that patients and their family members wanted three things from healthcare professionals. They wanted their profound weight loss acknowledged, they wanted information about it and why it was happening and they wanted interventions to deal with it. This paper provides powerful messages for healthcare professionals and highlights the needs of patients and their family regarding cancer cachexia management. Patients and their families want this problem addressed by healthcare professionals. This client group requires supportive healthcare interventions, so that they can understand the nature and impact of this syndrome.

Carrying religion into a secularising Europe: Montserratian migrants' experiences of global processes in British methodism

Migrants to Europe often perceive themselves as entering a secular society that threatens their religious identities and practices. Whilst some sociological models present their responses in terms of cultural defence, ethnographic analysis reveals a more complex picture of interaction with local contexts. This essay draws upon ethnographic research to explore a relatively neglected situation in migration studies, namely the interactions between distinct migration cohorts - in this case, from the Caribbean island of Montserrat, as examined through their experiences in London Methodist churches. It employs the ideas of Weber and Bourdieu to view these migrants as 'religious carriers', as collective and individual embodiments of religious dispositions and of those socio-cultural processes through which their religion is reproduced. Whilst the strategies of the cohort migrating after the Second World War were restricted through their marginalised social status and experience of racism, the recent cohort of evacuees fleeing volcanic eruptions has had greater scope for strategies which combat secularisation and fading Methodist identity.

The nonformative elements of religious life: questioning the ‘sociology of spirituality’ paradigm

Sociological assertions of religious vitality in Euro-American societies have developed a paradigm of spirituality in which, following earlier studies of the New Age, a distinction is drawn between external authority and self-authority. Methodologically and theoretically problematic, this paradigm diverts attention from people’s social practices and interactions, especially in relation to multiple religious authorities. Drawing upon ethnographic fieldwork with an English religious network, and building upon the work of Pierre Bourdieu, this paper considers situations in which multiple authorities tend to relativize each other. Conceptualizing this in terms of nonformativeness - the lack of authorities’ abilities formatively to shape religious identity, habitus, and competition over religious capital - a new understanding of individual secularization emerges that questions assertions of vitality.

Strategy in a religious network: A bourdieuian critique of the sociology of spirituality

Within the sociology of religion there has emerged a discourse on spirituality that views contemporary developments as involving the assertion of individuals’ self-authority. This perspective’s theoretical roots have been persistently criticised for their conceptualisation of agency; in contrast, this paper draws upon Bourdieu’s concept of strategy to examine action in an English religious network of the sort often classified ‘New Age’. In particular, one informant is discussed in order to provide focus for an understanding of what Lahire calls sociology at the level of the individual. Her actions, better explained as strategic improvisations than as choices made on the basis of self-authority, help to illuminate the peculiarities of this religious setting, which is characterised in terms of ‘nonformativeness’. By emphasising social contextualisation, this approach addresses people’s meaningful actions in a way that may be applied not only more widely within the religious field but also in other fields of action.

An experience of attempting to apply the randomised controlled trial (RCT) design in a ‘real world’ community-based clinical setting – one family therapist’s current journey. Context, 99, 6-9.

This paper describes an early career researcher's expereince of using randomised controlled trial methodology to investigarte the effectiveness of psychotherapeutic interventions for traumatised families in a 'real world' setting.