Daniella Arieli

The paradox of participation in action research

Although participation is widely discussed in the action research literature, relatively few studies deal with building the participative relationship itself. This article attempts to fill that gap through a ‘first-person action research’ involving a relationship between Jewish researchers and a Palestinian Arab non-governmental organization in Israel that failed to live up to our espoused values of participation. It employs an action science method for joint critical reflecting on this relationship and analyzing the data from the reflection. It presents two ‘theories of action’: one aimed at explaining the paradox of participation and one for dealing with it more effectively. By opening our learning, including our errors, to the scrutiny of other action researchers, we hope to generate actionable knowledge that can contribute to building genuinely participative relationships in action research.

Negotiating Reality Conflict Transformation in Natural Spaces of Encounter

This article develops theory to address a dilemma experienced as “resistance” to a conflict transformation process among Jewish and Arab nursing students in Israel. This dilemma is analyzed from two theoretical perspectives: (a) the “postcolonial approach,” which applies ideas of critical conflict theory and group dynamics to generate change in intergroup relationships, and (b) the “negotiating reality approach,” which applies ideas of social constructionism and action science to enable participants to jointly shape a space in which they feel free to express their complex individual and group identities. We propose that the postcolonial approach offers a powerful interpretive framework but would likely engender greater resistance. We present a negotiating reality intervention model designed to offer a way out of the dilemma and increase cooperation in critical reflection, learning, and change. The discussion compares the implications of the two approaches, setting forth propositions for guiding further research and practice.

Cultural Safety and Nursing Education in DIVIDED SOCIETIES

Aim. This research explores the experiences of cultural safety among nursing students from majority and minority groups in a divided society with implications for academic satisfaction and success. Background. The study takes place in an academic nursing program in Israel, where Arab and Jewish students study together. Methods. A researcher‐developed questionnaire was used with 17 statements concerning social relations between students, faculty support, and the effects of social relations on academic satisfaction and outcomes. Results. Significant differences were found in the ways Arab and Jewish students perceived the cultural safety of the environment. Arab students perceived social relations and faculty attitude as less positive than Jewish students and perceived cultural safety as having greater influence on academic satisfaction and success. Conclusion. The findings indicate that students from different groups will perceive the same shared reality in significantly different ways. Nurse faculty and administrators need to make efforts to bring perceptions into closer alignment and to minimize the negative impact of external conflicts on feelings of cultural safety.

Fostering Cooperation While Engaging Conflict: An Inter-communal Case Study

The chapter presents an intervention carried with an entire cohort of Jewish and Palestinian Arab students in a nursing program at a public college in Northern Israel. It describes how the nursing students constructed their particular space of encounter in a way that recapitulated conflicts in the larger societal, institutional and organizational contexts. It then presents the story of a particular conflict that erupted, the planning process that led to the choice to primarily use Action Evaluation to plan the future rather than Conflict Engagement to deal with the past, the intervention itself, and the follow-up. In the discussion, the paper takes a critical look at the intervention and its outcomes relative to the aspirations for conflict engagement and its impact on the natural space of encounter.

Teaching qualitative research as a means of socialization to nursing

The aim of the present article is to present a model for teaching qualitative research as part of nursing education. The uniqueness of the course model is that it seeks to combine two objectives: (1) initial familiarization of the students with the clinical-nursing environment and the role of the nurse; and (2) understanding the qualitative research approach and inculcation of basic qualitative research skills. The article describes how teaching two central genres in qualitative research - ethnographic and narrative research - constitutes a way of teaching the important skills, concepts, and values of the nursing profession. The article presents the models structure, details its principal stages, and explains the rationale of each stage. It also presents the central findings of an evaluation of the models implementation in eight groups over a two-year period. In this way the article seeks to contribute to nursing education literature in general, and to those engaged in clinical training and teaching qualitative research in nursing education in particular.

Falling into the depths of his mind: Action research as a way of maintaining a relationship with a loved one with dementia

Maintaining a meaningful relationship with a loved one who is diagnosed with dementia and hospitalized is significant, both for the person with dementia and for his/her relatives and friends. Nevertheless, the process of dementia poses great challenges and obstacles for communication. This article’s aim is to discuss the potential contributions of action research (AR) as an effective way for managing these challenges. Based on the researcher’s personal experience of using AR cycles of action–reflection–action in interactions with a loved one with dementia, the study identifies and discusses four such cycles: 1) negotiating the diagnosis; 2) sliding between reality and delusion; 3) reflecting on the mental experiences of dementia; 4) positioning myself in relation to the loved one and the institutional setting. The article contributes to the development of AR theory in two major ways: first, it explores the possibility and challenges of conducting AR when the participants’ ability to conduct a dialogue cannot be taken-for-granted and is itself the topic of inquiry. Second, it explores the potential contributions of AR for coping with situations that are usually described and approached in medical terms.

Talking with Dementia: The patterns and characteristics of a unique communication

T brain injury (TBI) is the best-known environmental risk factor for Alzheimer’s disease (AD), whose defining pathologic features include tauopathy made of hyperphosphorylated tau (PHF-tau) and is characterized by acute neurological dysfunction. However, tauopathy is undetectable acutely after TBI and how TBI leads to tauopathy which in turn would increase risk of AD is unknown. Here we identify a neurotoxic cis conformation of phosphorylated tau at Thr231 as a major early driver of TBI and neurodegeneration that is effectively blocked by the conformation specific monoclonal antibody. We found robust cis p-tau after sportand military-related TBI in humans and mice. Acutely after TBI in mice and stress in vitro, neurons prominently produce cis p-tau, which disrupts axonal microtubule network and transport, spreads to other neurons, and leads to apoptosis, a pathogenic process, which we nominated “cistauosis” that appears long before known tauopathy. Treating TBI mice with cis antibody not only blocks early cistauosis, but also prevents tauopathy development and spread, and restores brain histopathological and functional outcomes. These results uncover cistausosis as an early precursor of tauopathy and an early marker of neurodegeneration after sport and military TBI. We anticipate that cis p-tau will be a new early biomarker and that cis p-tau antibody or vaccines may be used to treat or even prevent TBI, chronic traumatic encephalopathy and AD.RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young) is an EU Joint Programme - Neurodegenerative Disease Research (JPND) initiative that aims to improve information and support for families living with young onset dementia (YOD). Defined by symptom presentation before the age of 65 years, YOD is relatively rare and associated with diagnosis difficulties. Extensive family impact includes carer burden and stress, relationship disruptions and financial decline, all of which are exacerbated by a lack of age-appropriate services, support and information. This multidisciplinary collaboration across six European countries developed an internet-based e-learning program for families living with YOD. Information and policies related to YOD were analysed from on-line reviews completed in all countries. Carer perspectives on needs and experiences were explored using in-depth interviews in the Netherlands, followed by focus groups in England, France, Germany, Portugal and Sweden. An intervention based on an on-line support program was considered appropriate due to relatively low prevalence of YOD, georgraphical spread and mobility restrictions resulting from the condition. Findings from early research stages informed the design and content of the 7-Part program, which explained clinical background, psychosocial perspectives, family issues, legal aspects and the importance of carer support. Produced in English, German and French, the intervention was tested by volunteer family carers in England, Germany and France.This is a challenging case of an elderly female patient, 86 years old that has been diagnosed with delirium superimposed on depression (DSD). This frustrated patient developed DSD in parallel with venous thrombosis (VT) of her right leg. Venous thrombosis was initially superficial, affecting the Great Saphenous Vein (GSV), that later progressed into Deep Venous Thrombosis (DVT), which was confirmed by radiology (Doppler study) and laboratory investigations (D-dimer level assessment).

Multi-faceted identities and interactions in mixed health teams

The literature in the area of the health workforce and societies in conflict encompasses a wide range of studies and potential directions. Lately, Keshet and Popper-Giveon reported on a study based on interviews with 13 Arab Israeli nurses who work in Israeli hospitals. This preliminary study describes how being an Arab nurse in Israel is experienced and perceived by those nurses. The results indicate the need for further studies on the complexity of health workers’ experiences in their changing and multi-faceted professional, cultural, gender and national identities. In order to manage health systems, in particular in divided societies that are characterized by inter-group conflicts, special attention should be given to studying the everyday processes in mixed teams.