At the age of a failing economic system and undeniable evidence of the effects humankind has had over the planet, it is necessary to look for alternatives to the way we live locally. This article explores the use of designing narratives and metanarratives to co-create imaginaries serving as the needed alternatives. This research starts by considering the historical factors to understand how industrialisation and the loss of traditional practices created a culture of disconnection from Nature in the Girona area, but also looks at why people start now reconnecting with it. The analysis is the foundation for speculative design practices to co-create a new local narrative of connection and regeneration. The project adopted the Integrative Worldviews Framework and used paradoxes to create possible future worldviews based on historical factors and literature. Citizens participated in conversational future-visioning workshops to develop and evaluate their local imagery of the previously created worldviews. This conversation-based exercise evidenced the potential of paradoxes in destructive futures to create imaginaries of regeneration. These imaginaries merge and form future stories. From the future narratives, the practice created cultural artefacts embodying a new culture of connection based on storytelling, traditional jobs, and a mythological understanding of Nature. Finally, as observed at the end of the project, these artefacts allow citizens to adopt them as their culture and expand their current worldview.
Across all health care settings, certain patients are perceived as ‘difficult’ by clinicians. This paper’s aim is to understand how certain patients come to be perceived and labelled as ‘difficult’ patients in community mental health care, through mixed-methods research in The Netherlands between June 2006 and October 2009. A literature review, a Delphi-study among experts, a survey study among professionals, a Grounded Theory interview study among ‘difficult’ patients, and three case studies of ‘difficult’ patients were undertaken. Analysis of the results of these qualitative and quantitative studies took place within the concept of the sick role, and resulted in the construction of a tentative explanatory model. The ‘difficult’ patient-label is associated with professional pessimism, passive treatment and possible discharge or referral out of care. The label is given by professionals when certain patient characteristics are present and a specific causal attribution (psychological, social or moral versus neurobiological) about the patient’s behaviours is made. The status of ‘difficult’ patient is easily reinforced by subsequent patient and professional behaviour, turning initial unusual help-seeking behaviour into ‘difficult’ or ineffective chronic illness behaviour, and ineffective professional behaviour. These findings illustrate that the course of mental illness, or at least the course of patients’ contact with mental health professionals and services, is determined by patient and professional and reinforced by the social and mental health care system. This model adds to the broader sick role concept a micro-perspective in which attribution and learning principles are incorporated. On a practical level, it implies that professionals need to look into their own role in the perpetuation of difficult behaviours as described here.
At this moment, no method is available to objectively estimate the temperature to which skeletal remains have been exposed during a fire. Estimating this temperature can provide crucial information in a legal investigation. Exposure of bone to heat results in observable and measurable changes, including a change in colour. To determine the exposure temperature of experimental bone samples, heat related changes in colour were systemically studied by means of image analysis. In total 1138 samples of fresh human long bone diaphysis and epiphysis, varying in size, were subjected to heat ranging from room temperature to 900 °C for various durations and in different media. The samples were scanned with a calibrated flatbed scanner and photographed with a Digital Single Lens Reflex camera. Red, Green, Blue values and Lightness, A-, and B-coordinates were collected for statistical analysis. Cluster analysis showed that discriminating thresholds for Lightness and B-coordinate could be defined and used to construct a model of decision rules. This model enables the user to differentiate between seven different temperature clusters with relatively high precision and accuracy. The proposed decision model provides an objective, robust and non-destructive method for estimating the exposure temperature of heated bone samples.
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