Alex Gillespie

Cognitive Function and Assistive Technology for Cognition: A Systematic Review

The relationship between assistive technology for cognition (ATC) and cognitive function was examined using a systematic review. A literature search identified 89 publications reporting 91 studies of an ATC intervention in a clinical population. The WHO International Classification of Functioning, Disability and Health (ICF) was used to categorize the cognitive domains being assisted and the tasks being performed. Results show that ATC have been used to effectively support cognitive functions relating to attention, calculation, emotion, experience of self, higher level cognitive functions (planning and time management) and memory. The review makes three contributions: (1) It reviews existing ATC in terms of cognitive function, thus providing a framework for ATC prescription on the basis of a profile of cognitive deficits, (2) it introduces a new classification of ATC based on cognitive function, and (3) it identifies areas for future ATC research and development.

The use of symbolic resources in developmental transitions

This paper introduces the idea of symbolic resources as the use of cultural elements to mediate the representational work occasioned by ruptures or discontinuities in the smooth experience of ordinary life, moments when the ‘taken-for-granted’ meanings cease to be taken for granted. In particular we are concerned with the use of symbolic resources in moments of developmental transitions, that is, the mobilization of symbolic elements ranging from shared bodies of knowledge or argumentative strategies to movies, magazines or art pieces. The paper begins with a brief theoretical sketch of these ideas, and then presents three case studies, each of which involves the use of a different type of symbolic resource within a particular age group. In the first, children are observed in interaction with a peer about a conservation problem. In the second, adolescents are observed negotiating the meaning of their art productions with their peers, teachers and parents. The third example looks at Western tourists searching for spirituality, adventure and freedom in Ladakh as an alternative to the materialism of modernity. In each case the analysis of the symbolic resources employed indicates the significance of the gaze of the other in the construction of meanings, and of the various constraints operating within specific situations. The analysis also reveals different modes of use of symbolic resources, linked to changing forms of reflectivity.

Patient complaints in healthcare systems: a systematic review and coding taxonomy

Background Patient complaints have been identified as a valuable resource for monitoring and improving patient safety. This article critically reviews the literature on patient complaints, and synthesises the research findings to develop a coding taxonomy for analysing patient complaints. Methods The PubMed, Science Direct and Medline databases were systematically investigated to identify patient complaint research studies. Publications were included if they reported primary quantitative data on the content of patient-initiated complaints. Data were extracted and synthesised on (1) basic study characteristics; (2) methodological details; and (3) the issues patients complained about. Results 59 studies, reporting 88 069 patient complaints, were included. Patient complaint coding methodologies varied considerably (eg, in attributing single or multiple causes to complaints). In total, 113 551 issues were found to underlie the patient complaints. These were analysed using 205 different analytical codes which when combined represented 29 subcategories of complaint issue. The most common issues complained about were ‘treatment’ (15.6%) and ‘communication’ (13.7%). To develop a patient complaint coding taxonomy, the subcategories were thematically grouped into seven categories, and then three conceptually distinct domains. The first domain related to complaints on the safety and quality of clinical care (representing 33.7% of complaint issues), the second to the management of healthcare organisations (35.1%) and the third to problems in healthcare staff–patient relationships (29.1%). Conclusions Rigorous analyses of patient complaints will help to identify problems in patient safety. To achieve this, it is necessary to standardise how patient complaints are analysed and interpreted. Through synthesising data from 59 patient complaint studies, we propose a coding taxonomy for supporting future research and practice in the analysis of patient complaint data.

A Pragmatist Approach to the Problem of Knowledge in Health Psychology

The multiplicity of forms of health-related knowledge, including biomedical knowledge, lay knowledge and critical constructionist knowledge, raises challenges for health researchers. On one hand, there is a demand for a pluralist acceptance of the variety of health-related knowledge. On the other, the need to improve health calls for action, and thus for choices between opposing forms of knowledge. The present article proposes a pragmatist approach to this epistemological problem. According to pragmatism, knowledge is a tool for action and as such it should be evaluated according to whether it serves our desired interests. We identify implications for research methodology and the choice of research goals.

The Metaphor of the Triangle in Theories of Human Development

Developmental psychologists have a long history of using triangle metaphors to conceptualise the social constitution of psychological development. In this paper, we present a genealogy of triadic theories, to clarify their origins, distinctions between them, and to identify key themes for theoretical development. The analysis identifies three core triangle models in the developmental literature. Each theory relies on some combination of the terms subject, object, other and sign, and they can be distinguished by the core psychological dynamic which they entail. We distinguish an emotional triangle rooted in psycho-analysis, a mediational triangle rooted in the work of Vygotsky, and a sociocognitive triangle originating with Piaget. Despite their differences, the analysis reveals a common theme of the transformation from external mediation to internal mediation. Contemporary research and possible future directions are discussed in the light of the theoretical distinctions that our genealogy has revealed.

Using Resources: Conceptualizing the Mediation and Reflective Use of Tools and Signs

The idea that culture comprises resources that are used has become a popular means to re-conceptualize the culture—agency antinomy. However, the theorization of using resources is fragmented. The present article reviews several attempts to theorize resources, arguing that there has been too much focus upon the resources themselves, while the notion of use has been neglected. Focusing upon mode of use, as opposed to the resources used, the article underscores the importance of distinguishing between tools, which are used to act upon the world, and signs, which are used to act upon the mind. The article also argues for a distinction between non-reflective use, or mediation, and reflective use of resources. Future research should focus upon the transformation of tools into signs and the transformation of mediation into reflective use. The article concludes by discussing problematic issues that remain in conceptualizing the use of resources.

Four problems for researchers using social categories

Research on lay categorization processes has revealed that it can lead to distortions. Yet researchers routinely categorize people into groups and cultures. We argue that researchers should be aware that social categories are (1) perspectival, (2) historical, (3) disrupted by the movement of people, and (4) re-constitutive of the phenomena they seek to describe. We illustrate these problems with reference to contemporary research on globalization and the “clash of cultures”. It is argued that problematizing cultural categories would do more to reduce inter-group conflict than reifying them.

Patient neglect in healthcare institutions: a systematic review and conceptual model

BackgroundPatient neglect is an issue of increasing public concern in Europe and North America, yet remains poorly understood. This is the first systematic review on the nature, frequency and causes of patient neglect as distinct from patient safety topics such as medical error.MethodThe Pubmed, Science Direct, and Medline databases were searched in order to identify research studies investigating patient neglect. Ten articles and four government reports met the inclusion criteria of reporting primary data on the occurrence or causes of patient neglect. Qualitative and quantitative data extraction investigated (1) the definition of patient neglect, (2) the forms of behaviour associated with neglect, (3) the reported frequency of neglect, and (4) the causes of neglect.ResultsPatient neglect is found to have two aspects. First, procedure neglect, which refers to failures of healthcare staff to achieve objective standards of care. Second, caring neglect, which refers to behaviours that lead patients and observers to believe that staff have uncaring attitudes. The perceived frequency of neglectful behaviour varies by observer. Patients and their family members are more likely to report neglect than healthcare staff, and nurses are more likely to report on the neglectful behaviours of other nurses than on their own behaviour. The causes of patient neglect frequently relate to organisational factors (e.g. high workloads that constrain the behaviours of healthcare staff, burnout), and the relationship between carers and patients.ConclusionA social psychology-based conceptual model is developed to explain the occurrence and nature of patient neglect. This model will facilitate investigations of i) differences between patients and healthcare staff in how they perceive neglect, ii) the association with patient neglect and health outcomes, iii) the relative importance of system and organisational factors in causing neglect, and iv) the design of interventions and health policy to reduce patient neglect.

Negotiating Multiplicity: Adaptive Asymmetries within Second-Generation Turks’ “Society of Mind”

If identities are socially produced, what happens when individuals grow up participating in divergent or conflicting social contexts? This article reports on research with second-generation Turkish adolescents in London. Using the concept of the dialogical self, the research examines the dialogical structure of these young Turks’ selves. The analysis is Bakhtinian and seeks to identify the different discourses through which these young Turks talk about themselves. Three distinct discourses, or I-positions, are identified. These are then related to the sociocultural context within which these youth live, and specific attention is given to the constraints on these youth in expressing aspects of their identity. We demonstrate that the asymmetries and tensions within these adolescents’ dialogical selves are adaptive to the fractured and asymmetrical social contexts in which they are embedded.

A Neo-Meadian approach to human agency: relating the social and the psychological in the ontogenesis of perspective-coordinating persons

How can human agency be reconciled with bio-physical determinism? Starting with a discussion of the long standing debate between determinism and agency, we argue that the seeds of a reconciliation can be found in George Herbert Mead’s ideas concerning social acts, perspectives, differentiation, self-other interactivity, and conscious understanding. Drawing on more recent reformulations of Mead’s ideas, we present an integrated account of the ontogenesis of human agency. Human agency, we argue, should be conceptualized in terms of distanciation from immediate experience, and we show how social interactions, institutions and symbolic resources foster the development of agency in increasingly complex ways. We conclude by situating our work in relation to other developmental accounts and the larger project of theorizing and empirically supporting a compatibilist rendering of human agency as the “determined” self-determination of persons.