Exploring the post-genomic world: differing explanatory and manipulatory functions of post-genomic sciences

Richard Lewontin proposed that the ability of a scientific field to create a narrative for public understanding garners it social relevance. This article applies Lewontin's conceptual framework of the functions of science (manipulatory and explanatory) to compare and explain the current differences in perceived societal relevance of genetics/genomics and proteomics. We provide three examples to illustrate the social relevance and strong cultural narrative of genetics/genomics for which no counterpart exists for proteomics. We argue that the major difference between genetics/genomics and proteomics is that genomics has a strong explanatory function, due to the strong cultural narrative of heredity. Based on qualitative interviews and observations of proteomics conferences, we suggest that the nature of proteins, lack of public understanding, and theoretical complexity exacerbates this difference for proteomics. Lewontin's framework suggests that social scientists may find that omics sciences affect social relations in different ways than past analyses of genetics.     

Ascorbic acid, cognitive function, and Alzheimer's disease: a current review and future direction

This narrative review appraises the human and animal studies implicating ascorbic acid (AA) in normal cognitive function and Alzheimer's disease. A research framework for how nutrition affects brain aging is proposed with emphasis on AA intake, status, metabolism, and transport into brain tissue. A final synopsis highlights areas for future research regarding AA nourishment and healthy brain aging.     

A structural and functional analysis of dream narratives.

This article demonstrates that elicited dream narratives use a differing narrative structural and functional framework, as proposed by Labov and Waletzky's (1967) narrative framework on elicited personal narratives. A quantitative structural and functional analysis of five male and female collected samples showed that dream narratives follow a homogenous structure of (1) Topic introduction, (2) Orientation, (3) Complication, (4) Evaluation, and (5) Coda, consequently reflecting the omission of Labov and Waletzky's (1967) proposed resolution unit, which confirms Labov's (1997) suggestion of the difficulty to distinguish between resolution and coda. Moreover, this article devotes attention to specific structural particularities, proposing that analepses and prolepses might indicate, firstly, the simultaneous processing of new spatial information and new protagonists, and secondly, reflecting indirectly the experience of dream bizarreness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

History textbooks,racism and the critique of Eurocentrism: beyond rectification or compensation

This article is based on the theoretical framework developed within a research project on the construction of Eurocentrism and, more specifically, on the analysis of Portuguese history textbooks. We propose that the textbooks’ master narrative constitutes a power-evasive discourse on history, which naturalizes core processes such as colonialism, slavery and racism. Showing the limits of an approach that merely proposes the compensation or rectification of (mis)representations, we argue for the need to unbind the debate on Eurocentrism from a perspective that fails to make problematic the ‘very idea of Europe’. Accordingly, our analysis of Portuguese history textbooks focuses on three core narrative devices: (1) the chronopolitics of representation; (2) the paradigm of the (democratic) national state; and (3) the definitive bond between concepts and historical processes.     

Realist synthesis: illustrating the method for implementation research

ABSTRACT: BACKGROUND: Realist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question 'what interventions and strategies are effective in enabling evidence-informed healthcare?' The strengths and challenges of conducting realist review are also considered. METHODS: The realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses. RESULTS: Based on key terms and concepts related to various interventions to promote evidenceinformed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area. CONCLUSIONS: Realist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review.     

Responsibilities in elderly care: Mr Powell's narrative of duty and relations

In Western countries a considerable number of older people move to a residential home when their health declines. Institutionalization often results in increased dependence, inactivity and loss of identity or self-worth (dignity). This raises the moral question as to how older, institutionalized people can remain autonomous as far as continuing to live in line with their own values is concerned. Following Walker's meta-ethical framework on the assignment of responsibilities, we suggest that instead of directing all older people towards more autonomy in terms of independence, professional caregivers should listen to the life narrative of older people and attempt to find out how their personal identity, relations and values in life can be continued in the new setting. If mutual normative expectations between caregivers and older people are not carefully negotiated, it creates tension. This tension is illustrated by the narrative of Mr Powell, a retired successful public servant now living in a residential home. The narrative describes his current life, his need for help, his independent frame of mind, and his encounters with institutional and professional policies. Mr Powell sees himself as a man who has always cared for himself and others, and who still feels that he has to fulfil certain duties in life. Mr Powell's story shows that he is not always understood well by caregivers who respond from a one-sided view of autonomy as independence. This leads to misunderstanding and an underestimation of his need to be noticed and involved in the residential community.     

Causal models for a risk-based assessment of stressor pathways for an operational uranium mine

Protection of the environment and people from the potential impacts of uranium mining and milling is a global issue as the world's demand for power generation derived from uranium increases. We present a framework for deriving multiple stressor-pathway causal models for an operational uranium mine that can be used to identify research and monitoring needs for environmental protection. Additionally the framework enabled us to categorize the importance of pathways in the system. An interdisciplinary approach to causal model development was undertaken in order to ensure the potential impacts of mining on the natural environment and human health were identified and assessed by researchers with the appropriate knowledge. An example of a causal model and supporting narrative is provided for the most important stressor pathway, transport of inorganic toxicants via the surface water to surface water pathway. This risk-based screening approach can be applied to mining operations where environmental protection (including human health) is underpinned by quantitative interdisciplinary research and monitoring.     

Drivers of urban metabolism: Toward a framework for urban transformations

The environmental and social crises in cities call for radical future visions that can incite transformative change. Yet, urban metabolism research typically adopts an explanatory, retrospective approach to the drivers of urban flows and stocks, resulting in conservative, business-as-usual future outlooks. In this study, we present the results of a narrative literature review on drivers and futures of urban metabolism, and consequently use these results to propose and apply a framework that can be used by researchers (i) to systematically identify the drivers of urban metabolism, and (ii) to critically engage with these drivers for the development of transformative future visions. The framework comprises seven thematic categories of drivers (demographic, economic, cultural, political, technological, environmental, and infrastructural) and an eighth category (power) to be used as the lens through which the interactions between drivers, activities, and flows in the city are critically examined. Applying the framework to the case study of biowaste management in Rennes, France, we found it useful for the systematic identification of often overseen drivers. The proposed framework, allowing for a combined analysis of flows and drivers, can become a useful tool toward a solution-oriented urban metabolism research.     

The Ethics of Engaged Presence: A Framework for Health Professionals in Humanitarian Assistance and Development Work

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure for examining the moral dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships.     

A framework for quantifying environmental sustainability

Recent concepts of environmental sustainability have focused on narrative economic and societal aspects rather than quantitative ones. Many key sustainability indicators also lack a consistent definition of sustainability, have perspectives that are too short-term, and are unable to model the dynamics of complex environmental utilization which can then result in inappropriate projection of long-term sustainability and/or sustainability indication. Here I propose a generalized quantitative framework of environmental sustainability requiring that (1) environmental capacities and utilization rates are identified, (2) their complex temporal dynamics are quantitatively modeled or estimated (3) while also adjusting for uncertainties, and finally, (4) using one of three options, determining which cumulative utilization pathways can be sustained for a (usually well-defined) period of time. Using the example of wood volume and its growth as capacities and harvest as utilization, and the example of global greenhouse gas emissions as the utilization component and the capacity of the air to absorb these emissions, I demonstrate how the proposed framework can be applied in practice, how sustainability indicators could be developed, and also how they can inform policies and measures to ensure sustainability.     

Strategies to enhance patient adherence: making it simple

The problem of poor patient adherence has been extensively researched, but the rates of nonadherence have not changed much in the past 3 decades. Healthcare providers play a unique and important role in assisting patients' healthy behavior changes. We conducted a narrative review of the current literature to help providers become more familiar with proven interventions that can enhance patient adherence. We then grouped the interventions into categories that can be remembered by the mnemonic "SIMPLE":1. Simplifying regimen characteristics; 2. Imparting knowledge; 3. Modifying patient beliefs; 4. Leaving the bias; and 6. Evaluating adherence. Chronic lifestyle behavior change often requires a combination of all the aforementioned strategies. We suggest a conceptual framework, which calls for a multidisciplinary approach with the above strategies in the context of a healthcare team and system-related factors. We hope that this framework would not only help design scientifically proven interventions, but also reduce the time and cost involved with implementing these strategies in a healthcare setting.     

Dignity and Narrative Medicine

Critiques of the dehumanising aspects of contemporary medical practice have generated increasing interest in the ways in which health care can foster a holistic sense of wellbeing. We examine the relationship between two areas of this humanistic endeavour: narrative and dignity. This paper makes two simple arguments that are intuitive but have not yet been explored in detail: that narrative competence of carers is required for maintaining or recreating dignity, and that dignity promotion in health care practice is primarily narrative in form. The multiple meanings that dignity has in a person’s life are what give the concept power and can only be captured by narrative. This has implications for health care practice where narrative work will be increasingly required to support patient dignity in under-resourced and over-subscribed health care systems.     

Personhood diagnostics: personal attributes and clinical explanations of pain

This article examines an explanation circulating within a U.S. multidisciplinary pediatric pain clinic that links the neurobiology of functional pain disorders to desirable personal attributes such as smartness and creativity. Drawing on ethnographic observations and the analysis of video-recorded clinical interactions and focusing on two cases, I introduce the term personhood diagnostics to explore how the explanatory framework worked not only to pinpoint a pathophysiological mechanism for pain to legitimize it as "real" but also to cast patients as virtuous persons. In doing so, it laid the groundwork for an ethic of clinical care that privileged the patient's responsibility for treatment. Within this narrative logic, diagnostic explanations reveal not only causal pathways but also predictive claims about recovery. By considering what is at stake when personal attributes are marshaled within a neurobiological diagnostic register that also lays out the patient's role in healing, this article complicates psychosomatic accounts of pain.     

Hagiographic narrative and monastic practice: Buddhist morality and mastery amongst Thai Buddhist nuns

Drawing on ethnographic analysis of the life-story of a contemporary Thai Buddhist nun ( mae chee ), this article argues that narrative convention must be understood as constitutive as well as communicative. In hagiographic convention and ascetic discipline gender distinctions are not understood as relevant for spiritual attainment. The use of hagiography by male and female religious professionals located in a gendered hierarchy suggests that religious practice may not be sufficiently accounted for through an analytical framework of domination and subordination. Rather, power is more usefully located within the relations and practices that form the conditions of the subject.  

Résumé

En procédant à l'analyse ethnographique de l'histoire de la vie d'une nonne bouddhiste ( mae chee ) thaïe, l'auteur avance que la convention narrative doit être appréhendée comme constitutive aussi bien que communicative. Dans la convention hagiographique et la discipline ascétique, les distinctions entre les sexes ne sont pas considérées comme pertinentes pour atteindre l'illumination. L'usage de l'hagiographie par les religieux, hommes et femmes, placés dans le cadre d'une hiérarchie sexuée, suggère que le cadre analytique de domination et de subordination est peut-être insuffisant pour appréhender la pratique religieuse, et qu'il serait plus utile de situer le pouvoir dans les relations et pratiques qui conditionnent le sujet.     

Once upon a time in the West? Stories of migration and modernity from Kerala, South India

This article explores how members of an ex-untouchable, 'backward' community of South India – the Izhavas of Kerala – represent and make sense of their entanglements within 'modernity'. Izhava narratives suggest ambivalence: while failure stories remain individualized, narrated in terms of bad luck or others' cheating, success stories are presented as exemplars of a twentieth-century global master narrative of progress. We note many correspondences between this ex-untouchable community's optimistic master narrative and another powerful and pervasive meta-narrative – the global story of modernity as development, promoted by state government, reform movements, and development theorists alike. Life-history narratives forcibly bring us – European interlocutors – into the same space as the tale-tellers, speak of encounters between Indians and Europeans, and urge us to recognize that we live in 'one world'. Malayalis stake claims for equal participation in modernity's projects even as they point out ways in which coevalness is denied. This prompts us to suggest that narratives of modernity in India and the UK should occupy the same analytical space, contrary to moves to theorize multiple modernities. With our Malayali respondents, we are participating in a confabulation/confabrication of a shared story which appears to be one about the nature of global capitalism. Modernity produces dream and disillusionment, promising progress to all while delivering to a few. In its seemingly endless capacity for self-regeneration and reinvention it is, as a phenomenon in global history, far from over. Even as theorists try to write it off as a moment past or a project failed, it still holds out its promises and provides a structuring framework for contemporary life-stories.     

The Practical Application of Narrative Medicine at Mayo Clinic: Imagining the Scaffold of a Worthy House

American health care institutions increasingly recognize narrative medicine as a means to developing quality patient care. More commonly applied in health care professional development settings, narrative medicine is less overtly employed with patient populations. In this article, we describe the application of various narrative practices in the patient care and medical education programs of a major health care center in Minnesota. We discuss the impact of these programs on their participants in relation to the evidence based in current scholarship. Further, we examine narrative externalization of illness in Katherine Butler Hathaway’s disability memoir “The Little Locksmith,” a text which implicates the work of metaphor-making as a transformative step in healing. While several reports demonstrate that patients can find creative writing during times of illness to be therapeutic, there are many for whom the practice is problematic or unattractive, obstacles to practice implementation that the authors discuss. However, based on the experience of our institution, for health care institutions seeking to build a legacy of leadership in empathic patient care, narrative—employed in mentoring physicians in training and in establishing strong, dialogic relationships with patients and colleagues—should serve as a central strategy, or scaffold.     

Thinking Temporally or Modernizing Anthropology

Recent changes within social and cultural anthropology have made history a key issue, but in this essay I argue that the field has yet to develop the resources that are required to deal with temporality. This point is made through an extended examination of Jean and John Comaroffs work on Christianity and colonialism in southern Africa. Arguably, the Comaroffs read history backward and then present its unfolding as a kind of inexorable logic. In doing so, they homogenize missionary and Tswana "cultures" and attribute agency to abstractions rather than to people acting in particular material contexts. In contrast, I argue for a narrative approach to historical anthropological explanation. The emergent qualities of events—and the variable ways in which capitalism, hegemony, Protestantism, and vernacular modernisms relate—require narrative for explanation, narrative that encompasses within itself the narratives of social actors themselves, [historical anthropology, narrative, the modern, South Africa]     

Active Memory

Collective memory is a phenomenon that receives a different interpretation depending on the discipline within which it is examined. In my research, I will employ ideas and concepts developed within the framework of a sociocultural approach (Wertsch, 2002; Cole, 1996). In particular, I will proceed from the definition of collective memory developed by James Wertsch (2002), who treats collective memory as textually mediated memory, conditioned by various—mainly historical—narratives. Historical narratives (annals, chronicles, history textbooks, etc.) are considered to be cultural instruments promoting collective remembrance. A category I borrow from Wertsch's work (2002) is the concept of the "schematic narrative template," which I will apply as analytic tool in my investigation of the phenomenon of collective memory phenomenon.