Patrick Colm Hogan

Affective narratology : the emotional structure of stories

Introduction: A Passion for Plot: Story as Feeling One. Before Stories: Emotional Time and Anna Karenina Two. Stories and Works: From Ancient Egypt to Post-Modernism Three. Universal Narrative Prototypes: Sacrifice, Heroism, and Romantic Love Four. Cross-Cultural Minor Genres: Attachment, Lust, Revenge, and Criminal Justice Afterword: On the Future of Feeling: Stories and the Training of Sensibility

How Do Mobile Phone Diabetes Programs Drive Behavior Change? Evidence From a Mixed Methods Observational Cohort Study

Purpose The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. Methods This was a mixed methods observational cohort study. Study participants were members of the University of Chicago Health Plan (UCHP) who largely reside in a working-class, urban African American community. Surveys were conducted at baseline, 3 months (mid-intervention), and 6 months (postintervention) to test the hypothesis that the intervention would be associated with improvements in self-efficacy, social support, health beliefs, and self-care. In addition, in-depth individual interviews were conducted with 14 participants and then analyzed using the constant comparative method to identify new behavioral constructs affected by the intervention. Results The intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating) and improvements in 1 or more measures of self-efficacy, social support, and health beliefs (perceived control). Qualitatively, participants reported that knowledge, attitudes, and ownership were also affected by the program. Together these findings were used to construct a new behavioral model. Conclusions This study’s findings challenge the prevailing assumption that mobile phones largely affect behavior change through reminders and support the idea that behaviorally driven mobile health interventions can address multiple behavioral pathways associated with sustained behavior change.

Using mobile health to support the chronic care model: developing an institutional initiative

Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.

Using Patient-Generated Health Data From Mobile Technologies for Diabetes Self-Management Support: Provider Perspectives From an Academic Medical Center

Background: Mobile health and patient-generated health data are promising health IT tools for delivering self-management support in diabetes, but little is known about provider perspectives on how best to integrate these programs into routine care. We explored provider perceptions of a patient-generated health data report from a text-message-based diabetes self-management program. The report was designed to relay clinically relevant data obtained from participants’ responses to self-assessment questions delivered over text message. Methods: Likert-type scale response surveys and in-depth interviews were conducted with primary care physicians and endocrinologists who pilot tested the patient-generated health data report in an actual clinical encounter. Interview guides were designed to assess providers’ perceptions of the feasibility and utility of patient-generated health data in routine clinical practice. Interviews were audiotaped, transcribed, and analyzed using the constant comparative method. Results: Twelve providers successfully piloted the summary report in clinic. Although only a minority of providers felt the report changed the care they provided (3 of 12 or 25%), most were willing to use the summary report in a future clinical encounter (9 of 12 or 75%). Perceived benefits of patient-generated health data included agenda setting, assessment of self-care, and identification of patient barriers. Major themes discussed included patient selection, reliability of patient-generated health information, and integration into clinical workflow. Conclusion: Providers perceived multiple benefits of patient-generated health data in overcoming common barriers to self-management support in clinical practice and found the summary report feasible and usable in a clinical context.

Fictions and Feelings: On the Place of Literature in the Study of Emotion

Explanatory accounts of emotion require, among other things, theoretically tractable representations of emotional experience. Common methods for producing such representations have well-known drawbacks, such as observer interference or lack of ecological validity. Literature offers a valuable supplement. It provides detailed instructions for simulating emotions; when successful, it induces empathic emotions. It too involves distortions, through emotion-intensifying idealization and ideological biases. But these also relate to emotion study. There are three levels at which literature bears on emotion research: (1) the individual work; (2) generic and related patterns; and (3) properties found widely across individual works and genres. Even at the third, most general level, literature suggests potentially important hypotheses about our pleasure in emotional simulation and our need to share emotional experiences.Explanatory accounts of emotion require, among other things, theoretically tractable representations of emotional experience. Common methods for producing such representations have well-known drawbacks, such as observer interference or lack of ecological validity. Literature offers a valuable supplement. It provides detailed instructions for simulating emotions; when successful, it induces empathic emotions. It too involves distortions, through emotion-intensifying idealization and ideological biases. But these also relate to emotion study. There are three levels at which literature bears on emotion research: (1) the individual work; (2) generic and related patterns; and (3) properties found widely across individual works and genres. Even at the third, most general level, literature suggests potentially important hypotheses about our pleasure in emotional simulation and our need to share emotional experiences.

The politics of interpretation : ideology, professionalism, and the study of literature

While affirming the profound importance of political analysis, Hogan is critical of prevalent doctrines. Specifically, Hogan examines and criticizes several influential post-structuralist positions, advocating logical analysis and empirical enquiry, guided by Kantian ethics, in their stead.

Some prolegomena to the study of literary difference

Abstract A great deal of work on gender differences has been seriously methodologically flawed. It is the purpose of the following essay to outline and exemplify the most common methodological problems in this work and to indicate how they might be avoided. The discussion is organized around three main points. First of all, research on gender must be founded upon statistical analysis. There are four common alternatives to such analysis: anecdotes, introspective and experiential intuitions, raw numbers, and exemplars. The first main section argues that each of these alternatives is probatively valueless. Secondly, even research which is based on statistical analysis is frequently biased in the direction of gender stereotypes. Thus this research too must be approached skeptically. Specifically,bias may enter in reporting, interpreting, or designing research. In the second main section, the most common biases are discussed and exemplified. Finally, the explanatory distinctions drawn by researchers in this field are often too blunt. The third main section refines the standard opposition between nature and nurture by articulating a spectrum of social determination; it also distinguishes differences of output or behavior from differences of principle governing that output or behavior. It then illustrates the explanatory value of these distinctions.

Laughing brains: On the cognitive mechanisms and reproductive functions of mirth

Abstract Mirth is a central feature of our experience of literature and related arts. This essay considers the nature and origins of mirth. It begins with a suggestion by Greimas regarding the structure of jokes. Greimass view dovetails nicely with empirical research on the neurobiology that underlies our appreciation of humor, in particular the generation of meaning in the right hemisphere of the brain. The essay turns from this research to a componential analysis of emotion, considering what elements must enter into a cognitive account of an emotion. Ideally, such an account will include systemic/functional, neurobiological, and evolutionary components. Moreover, it is crucial to distinguish between the mechanisms produced by evolution and the reproductive functions that those mechanisms approximate. Having treated some of the neurobiological material, the essay takes up the systemic/functional aspect of mirth. Specifically, it argues that mirth is produced by particular practices (including right hemisphere meaning generation) that are characteristic of children when they are striving to accomplish tasks beyond their developmental level. Even in cases where mirth is distinctly ‘adult’ (e.g., in obscenity), the mechanism at issue is characteristic of children. The final section argues that this mechanism is comprehensible in evolutionary terms as it fosters bonding and an appropriate degree of attention to children.

Rasa Theory and Dharma Theory: From The Home and the World to Bandit Queen

The topic of this essay is a large one-the value of pre-colonial, South Asian aesthetic and ethical theory in the study of South Asian cinema. It is a topic large enough, I hope, to do some justice to Indian culture in Indian cinema, large enough to expand the theoretical discussion of South Asian film beyond the fairly narrow and almost entirely European confines in which it has been located (at least insofar as this is possible within the compass of a single article). India has long traditions of powerful and lucid theorizing about literature and about moral duty. These traditions are passed over in silence by almost all post-colonial critics of South Asian literature and film. The shunning of these theories in favor of the post-structural ideas that dominate the western academy is so extreme that it appears most critics are even unaware that there was any aesthetic or ethical theorization in the subcontinent before the arrival of the East India Company. In this way, post-colonial theories-which are, again, almost entirely post-structural in provenance-might be seen as instances of a new Eurocentrism. This new Eurocentrism asserts multicultural values and celebrates diverse cultural identities. But it tacitly attributes all abstract, explanatory conceptualization to Europe. It is as if we were still in the time of Hegel. The East remains the place of vague, emotional ideas, incoherence, and allegory. The West stands alone as the place of Knowing. The difference, of course, is that now we are careful not to place the hemispheres in an explicit hierarchy. In the following pages, I shall argue that one misses a great deal of what is going on in South Asian films-and underappreciates them-if one ignores the non-European theories of aesthetics and ethics that pervade those films. Sometimes, the theories are incorporated self-consciously into dialogue, acting, music, and dance. Sometimes, they enter implicitly, through the literary, religious, and other cultural traditions in which screenwriters, film directors, and others make movies. In either case, they are a significant and consequential presence. In order to treat this topic, I shall begin by laying out some basic principles of rasa theory-an aesthetic theory first formulated some 2,500 years ago, then developed by various philosophers for about a millennium and a half thereafter. After this, I shall discuss the ethical theories and principles surrounding dharrna, as well as those surrounding jihad and the shahid. Dharma is, of course, linked with Hinduism, while jihad and the shahid are Islamic concepts. However, my point is not to tie these to specific sets of spiritual beliefs. Both sets of ethical ideas-as well as the aesthetic principles of rasa theorycirculate throughout South Asian society. A Hindu or an atheist may easily come to think

Literary aesthetics: beauty, the brain, and Mrs. Dalloway.

Empirical research indicates that beauty is in part a matter of prototype approximation. Some research suggests that unanticipated pattern recognition is important as well. This essay begins by briefly outlining an account of beauty based on these factors. It goes on to consider complications. Minor complications include the partial incompatibility of these accounts and the importance of differentiating judgments of beauty from aesthetic response. More serious issues include the relative neglect of literature in neurologically-based discussions of beauty, which tend to focus on music or visual art. There is also a relative neglect of emotion, beyond the reward system. Finally, there is the almost complete absence of the sublime. After considering these problems broadly, the essay turns to Virginia Woolfs Mrs. Dalloway, examining its treatment of beauty and sublimity. The aim of this section is not merely to illuminate Woolfs novel by reference to neuroscientific research. It is equally, perhaps more fully, to expand our neuroscientifically grounded account of aesthetic response by drawing on Woolfs novel. In Mrs. Dalloway, there are gestures toward prototypes and patterns in beauty. But the key features are clearly emotional. Specifically, the emotions at issue in feelings of beauty and sublimity appear to be primarily attachment, on the one hand, and a profound sense of isolation, on the other. Woolfs novel also points us toward other features of aesthetic experience, crucially including the emotion-sharing that is a key function of the production and circulation of art.