The new brain: concepts, challenges, and opportunities for mental health nursing

The new paradigm that the brain is able change itself (neuroplasticity) is acknowledged and teased out in terms of the ramifications for mental illnesses. Parallel studies in pain (central sensitization) and mirror neurones are examined to conceptually clarify these ramifications in relation to mental health, and to expand our understanding of empathy and social inclusion beyond good ideas to being a part of our nature. The paper then focuses on making clear what the concepts, challenges, and opportunities for mental health nursing might be; even advancing possibilities for recovery through better understanding the third space or intersubjective. What ramifications this has for mental health nursing is reviewed in terms of a paradigm change and the necessity for conceptual clarity, as it relates to the uniqueness of the person right before our very eyes. The author contends that to embrace this new paradigm is not only necessary but ethically obligatory, as it opens up new possibilities for understanding ourselves and this changeable person.     

医院智能化指数概念模型研究

目的/意义 构建医院智能化指数概念模型,为医院智能化程度量化评价奠定基础,助力医院智能化建设。方法/过程 介绍智能化内涵,阐述医院信息化建设评价标准体系,从结构－功能－效果角度切入,考量医院智能化应用。结果/结论 构建包含智能化基础、智能化能力和智能化效果3个一级指标、8个二级指标、33个三级指标的医院智能化指数概念模型,作为持续改进医疗服务的工具,通过定期评估医院智能化水平,可促进医疗质量和患者体验提升,助力医院高质量发展。     

概念隐喻类型述评

隐喻类型有一般性和具体性两类,“基本概念隐喻”和“规的化隐喻”没有实质上的区别;成语的理解涉及有具体靶域和无具体靶域两种情况,但两种情况的工作和理解机制是不同的：无具体靶域时,具体的源域映射到一般性的概念域,是具体到一般的映射;在有具体靶域的场合,如果先从具体抽象到一般,然后再从一般回到具体。那么隐喻只能说明映射过程的前半部分而不能涵盖从一般到具体部分。而缺少具体靶域时,犬链条就是典型的转喻而不是隐喻。     

从认知角度看中医语言的容器隐喻

认知语言学概念隐喻理论认为,人类普遍利用容器隐喻去认识、理解一些抽象概念。本文以中医经典古籍为研究语料,举例说明中医语言在容器图式抽象结构的基础上,普遍运用了容器隐喻来表达身体及其部位、器官、腠理汗孔、藏府、经络等较为抽象和复杂的中医概念,从而建构了解释人体生理现象和病理机制的中医理论体系。本研究不仅证实了认知语言学容器隐喻理论在一定程度上的普遍性,也印证了中医语言具有概念隐喻的认知特征。     

Computational analysis of 140 years of US political speeches reveals more positive but increasingly polarized framing of immigration

We classify and analyze 200,000 US congressional speeches and 5,000 presidential communications related to immigration from 1880 to the present. Despite the salience of antiimmigration rhetoric today, we find that political speech about immigration is now much more positive on average than in the past, with the shift largely taking place between World War II and the passage of the Immigration and Nationality Act in 1965. However, since the late 1970s, political parties have become increasingly polarized in their expressed attitudes toward immigration, such that Republican speeches today are as negative as the average congressional speech was in the 1920s, an era of strict immigration quotas. Using an approach based on contextual embeddings of text, we find that modern Republicans are significantly more likely to use language that is suggestive of metaphors long associated with immigration, such as “animals” and “cargo,” and make greater use of frames like “crime” and “legality.” The tone of speeches also differs strongly based on which nationalities are mentioned, with a striking similarity between how Mexican immigrants are framed today and how Chinese immigrants were framed during the era of Chinese exclusion in the late 19th century. Overall, despite more favorable attitudes toward immigrants and the formal elimination of race-based restrictions, nationality is still a major factor in how immigrants are spoken of in Congress.

Immigration is one of the most important and divisive topics in American public life. From the rise of vocal antiimmigrant politicians in recent years, it is tempting to conclude that attitudes toward immigration are more negative—or at least more polarized—than ever before. However, resistance to newcomers has always been a central part of our public discourse about immigration. From anti-Chinese fearmongering in the 1880s to concerns about Southern and Eastern European immigrants in the 1920s to the antiimmigration rhetoric of the Trump administration (2017 to 2020), claims that certain types of immigrants can never truly join American society have been a perennial part of our discourse. For example, Senator Henry Cabot Lodge, an architect of antiimmigrant legislation, declared a century ago, “[Immigration] is bringing to the country people whom it is very difficult to assimilate” (1, p. 35) because immigrants are from “races most alien to the body of the American people” (1, p. 32).We seek to move beyond individual anecdotes to ask, how have attitudes toward immigrants in the United States changed over the past century? How does recent political debate over immigration compare to the long sweep of US history? This question is a challenge because public opinion polls that asked about attitudes toward immigration only began in the 1960s and were then only asked about immigration sporadically until recent years. We instead turn to the Congressional Record and other sources of political speech, using quantitative text analysis methods to systematically investigate the language used in congressional and presidential speeches about immigration over the past 140 y.Our paper considers the full corpus of more than 17 million congressional speeches from 1880 to the present, of which we identify ∼200,000 speeches relevant to the topic of immigration. We also incorporate presidential communications from the same time period, making this a comprehensive quantitative analysis of American political speech about immigration at the federal level, covering the entire time period from the Chinese Exclusion Act of 1882 to the present day.Numerous studies have analyzed the political history of US immigration using qualitative approaches and historical archives (2–7); quantitative work on immigration has also used data such as migration and census records (8, 9). Rhetorical aspects of immigration debates have been studied qualitatively—especially the use of dehumanizing language and metaphors such as “vermin” and “cargo” (10–13)—but these authors have not rigorously quantified how common such language is over time. Last, other scholars have applied computational methods from natural language processing to study coverage of immigration in news media and Congress (14–18), but none have used these tools to investigate such a long time span or comprehensive corpus of speeches about US immigration with a consistent methodology.Our analysis is based on a combination of methods. To identify relevant speeches, along with a corresponding tone (proimmigration, antiimmigration, or neutral), we make use of automated text classification based on extensive human annotations. Using a semiautomated process, we also curate and apply a set of lexicons for analyzing relevant frames (i.e., ways of characterizing immigrants and immigration). Finally, to quantify implicit dehumanizing metaphors in speeches, we develop an approach using neural contextual embedding models to measure if references to immigrants are suggestive of various metaphorical categories (Materials and Methods).We find that political speeches about immigration today are far more likely to be positive than in the past, with the shift from negative to positive mostly taking place between World War II (WWII) and the passage of the 1965 Immigration and Nationality Act, and being net positive on average in nearly all sessions of Congress since the early 1950s. Extending this analysis to presidential communications, we find President Trump to be a stark exception, as the first president in modern American history to express sentiment toward immigration that is more negative than the average member of his own party. As with many political issues, the two parties have become increasingly polarized over time, and we find a linear increase in polarization on immigration, beginning in the late 1970s under President Carter. Today, Democrats are unprecedentedly positive about immigration, whereas Republicans are as negative as the average legislator was in the 1920s during the push for strict immigration quotas. This divergence is clearly part of a broader trend toward polarization on many issues (Discussion); for immigration specifically, our analysis reveals the beginnings of this, predating the rise in generic political polarization observed in Gentzkow et al. (19) by more than a decade.Along with the polarization by party, nationality of immigrants continues to matter greatly, with speeches mentioning Mexican immigration being consistently more negative than the average (dramatically so in comparison to European groups). Moreover, there is a striking similarity between how Mexican immigrants are framed today and how Chinese immigrants were framed during the period of Chinese exclusion in the 19th century: more negative in tone; greater explicit emphasis on frames such as “crime,” “labor,” and “legality”; and significantly greater use of implicit dehumanizing metaphors, in comparison to European groups.Thus, while far more members of Congress today express favorable attitudes toward immigration than in the past, there remains a strong and growing strain of antiimmigration speech, especially among Republicans, along with perennial references to threats, legality, and crime. Despite the elimination of country-specific immigration quotas in the 1960s, expressed opinions toward immigrants still vary greatly by country of origin, and enduring rhetorical strategies continue to be deployed against more marginalized groups.     

一种以身体经验感知为基础形成的理论——以“六淫”中的风为例分析中医病因的隐喻特征

本文简要回顾了中医认识病因的方法,并以“六淫”中的风为例,系统分析中医病因的隐喻特征,认为风之所以成为致病因素、有如此致病特征,是古代中医学家将人们对自然界风的认识移植到中医理论之中,从认知语言学的角度看是一种“隐喻认知”,是以我们熟悉的事物说明我们不熟悉事物的一种方式,作为病因概念的六淫是一种概念隐喻。     

应用Walker经典概念分析法界定老年人跌倒恐惧内涵

目的 应用Walker和Avant的经典概念分析法分析跌倒恐惧的概念内涵。方法 系统检索中国知网、万方数据库、维普数据库、PubMed、Web of Science等数据库,采用Walker与Avant提出的概念分析法对纳入的41篇文献进行分析。结果 老年人跌倒恐惧的定义属性包括以下几个方面：①与跌倒呈非必然关系；②情绪机制：对跌倒的担忧或持久关注；③认知机制：避免跌倒的低自我效能感；④特定于某些环境、情景之中；⑤并不一定存在精神病学内涵；⑥受过去经验、他人经验、社会说服的影响；⑦并非完全呈负面影响。 结论 鉴于跌倒恐惧的高发生率和不良后果,临床医护人员应认识到跌倒恐惧的存在及其重要性,通过早期识别高风险人群构建并开展针对性的护理计划,为降低老年人跌倒恐惧发挥积极作用。     

Complex adaptive phenomenology: A conceptual framework for healthcare research

Rationale

Healthcare research exploring the lived experiences of health care professionals from different disciplines, such as nursing, medicine, and allied health, has repeatedly highlighted many methodological challenges, especially in understanding the individual human experience within complex systems. In response, complexity theory and phenomenological approaches emerged and evolved in ways that potentially offered researchers frameworks to inform an understanding of the individual human experience. However, while these two theoretical approaches inform a method of inquiry, there is a gap in understanding the phenomenon of ‘being’ and how this is embodied within complex systems such as the healthcare system.

The Aims and Objectives

The aim of this paper is to present an integrated theoretical framework, namely complex adaptive phenomenology (CAP). CAP aims to address this inquiry gap by offering a structured conceptual framework wherein complexity theory and phenomenology are complementary but multi-dimensional. The key objective of CAP was to synthesize and integrate two methods of inquiry that examine the relational aspects of ‘being’, that is the gestalt of perception, action, and context, The authors argue that CAP is well-suited to complex research contexts such as healthcare. The framework focuses on the reciprocal, co-constructive relationships extant between perception, meaning, context, and action that shape experiences of ‘being’ within complex systems. Complexity theory's connectionist orientation explains the relationships that are formative of the experience of being, while phenomenology explores the manifestations of these formative relationships by attending to the notion of ‘being’ itself.

Conclusion

The authors propose that an integrated framework, of phenomenology and complexity theory, can provide a platform for deeper understandings of the experiences of health professionals and contribute to healthcare scholarship.     

护理数字职业精神的概念分析

运用经典概念分析法，从护理数字职业精神的概念、概念应用、属性、案例、前置/后置因素和实证性测评工具等方面进行整合分析，界定护理数字职业精神的概念，为护理人员以专业身份使用数字媒体时遵循护士职业精神的标准，从而体现护理人员的专业性、权威性和利他性的行为及态度，最终达到促进大众健康，树立个人和专业形象，维护健康互联网医疗环境的目的。为护理数字职业精神的深入研究、护理教育与护理管理层开发相应评估工具提供理论参考。