Moving Toward and Through Trauma: Participant Experiences of Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR)

Introduction: Military members and Veterans are at risk of developing combat-related, treatment-resistant posttraumatic stress disorder (TR-PTSD) and moral injury (MI). Conventional trauma-focused therapies (TFTs) have shown limited success. Novel interventions including Multi-modal Motion-assisted Memory Desensitization and Reconsolidation therapy (3MDR) may prove successful in treating TR-PTSD.Objective: To qualitatively study the experiences of Canadian military members and Veterans with TR-PTSD who received the 3MDR intervention.Methods: This study explored qualitative data from a larger mixed-method waitlist control trial testing the efficacy of 3MDR in military members and veterans. Qualitative data were recorded and collected from 3MDR sessions, session debriefings and follow-up interviews up to 6 months post-intervention; the data were then thematically analyzed.Results: Three themes emerged from the data: (1) the participants' experiences with 3MDR; (2) perceived outcomes of 3MDR; and (3) keys to successful 3MDR treatment. Participants expressed that 3MDR provided an immersive environment, active engagement and empowerment. The role of the therapist as a coach and “fireteam partner” supports the participants' control over their therapy. The multi-modal nature of 3MDR, combining treadmill-walking toward self-selected trauma imagery with components of multiple conventional TFTs, was key to helping participants engage with and attribute new meaning to the memory of the traumatic experience.Discussion: Preliminary thematic analysis of participant experiences of 3MDR indicate that 3MDR has potential as an effective intervention for combat-related TR-PTSD, with significant functional, well-being and relational improvements reported post-intervention.Conclusion: Military members and Veterans are at risk of developing TR-PTSD, with worse outcomes than in civilians. Further research is needed into 3MDR and its use with other trauma-affected populations.

CURA—An Ethics Support Instrument for Nurses in Palliative Care. Feasibility and First Perceived Outcomes

Evaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience.

The Experience of Locomotor Training From the Perspectives of Therapists and Parents of Children With Cerebral Palsy

Objective: The objective of this study was to explore the experiences of intensive locomotor training from the perspective of therapists and parents of children with cerebral palsy.Design: A qualitative study using semi-structured interviews was employed to capture perspectives following an intensive locomotor training intervention. Data were analyzed thematically, systematically coding and interpreted by grouping information into themes and sub-theme categories.Participants: Five therapists and seven parents of children with high daily physical assistance and equipment needs participated in the study.Setting: A pediatric tertiary hospital.Results: Experiences of locomotor training were described with relation to the suitability of locomotor training with sub-themes of intervention length and time, engagement within sessions, the importance of support, and the utility of locomotor training beyond a research context. Motivation for participating in locomotor training was described in relation to the enjoyment of movement and for increasing activity level. The barriers and facilitators who participated in locomotor training provided environmental and personal factor subthemes. Finally, the outcomes from the intervention were related to improvements in physical health, sleep, affect and emotion, and ambulation in daily activities.Conclusion: The experience of intensive locomotor training from the perspectives of parents of children who have high physical assistance and equipment needs and the therapists providing the intervention was described. Future studies should consider outcome measures beyond motor capacity to quantify the perceived outcomes of interventions that are meaningful to families.

The Return of the “Lurker”: A Longitudinal Study of Citizens’ Use of Social Media in Danish Elections 2011, 2015, and 2019

In this case study on Denmark, we particularly focus on trajectories of participation, the question of increasing mobilization, and the perceived outcomes in terms of efficacy. Contrary to other studies, we seek to establish a coherent perspective including the “silent majority.” By combining studies of participation, mobilization, and efficacy, we wish to provide not only a rigorous documentation of mobilization and efficacy of social media during election campaigns, but also a historic documentation of the participatory use and perception of social media as a democratic and political tool during three national election campaigns from 2011 to 2019.

The effect of rural superintendent credibility on principal and district outcomes mediated by motivating language

PurposeThe purpose of this study was to determine the influence of rural superintendent’s talk on the perceived outcomes of principal communication competence and organizational communication satisfaction. More specifically, this study explored whether the source credibility dimensions of goodwill, competency and trustworthiness had a greater impact on the perceived outcomes when mediated by motivating language (ML) than not.Design/methodology/approachDirect and indirect paths between superintendent and principal communication were modeled, analyzed and evaluated using descriptive and inferential methods, including R version 3.6.1 with the lavaan package and the Sobel mediation test.FindingsResearch findings indicated the importance of superintendent talk and motivating language theory (MLT) that, when combined, constitute the medium of superintendent practice and enable a superintendent to execute their roles and duties. Additionally, the authors found the dimensions of goodwill and competency had the most significant impact on the two outcomes mediated by ML. This finding indicates that principals are calling for a more empathetic and interactive form of credibility than the long-established form of credibility based on expertise and stewardship. Finally, as the authors call for an expanded role from the community in research, scholarship and implementation of MLT, they suggest due to the lack of significance in trustworthiness mediated by ML, future research into trustworthiness and trust.Originality/valueThis study’s value is to increase understanding of educational administration scholars of MLT and its power to influence employee and organizational outcomes and highlight a reframing of superintendent credibility away from say and do agreement and expertise and stewardship.

Contribution of interaction force to the sense of hand ownership and the sense of hand agency

When performing willed actions, we have the unified and coherent experience of owning and controlling our body. Body ownership is believed to emerge from the integration of coherent multisensory signals, while agency is believed to emerge from the coherence between predicted and perceived outcomes of actions. As a consequence, body ownership and agency can both be modulated by multisensory conflicts. The contribution of active movement generation to ownership and agency has not been parametrically explored. Here, we investigated the contribution of interaction force between the agent and the environment to the sense of hand ownership (SO) and the sense of hand agency (SA). By combining robotics and virtual reality, we manipulated the sensorimotor and visual information during immersive scenarios to induce and quantify altered states of SO and SA. First, we demonstrated that SO and SA could be successfully manipulated by our experimental paradigms. Second, we showed that interaction force strongly contributes to SA, but to a lesser extent to SO. Finally, we showed that SO and SA interact beyond their common multisensory basis. Our results, based on two independent studies, provide a direct link between sensorimotor interactions and subjective body experience and demonstrate a new dissociation between SO and SA.

Loving you from afar: Attraction to others (“crushes”) among adults in exclusive relationships, communication, perceived outcomes, and expectations of future intimate involvement

Crushes are uncommunicated, often unilateral, attractions to an individual, generally viewed as a state of unfulfilled longing. They are typically attributed to young people, but recent research suggests that these experiences might be common among adults as well, including among those in committed relationships. Combining findings from three studies across four datasets, this mixed-methods research explores crushes experienced by individuals in committed intimate relationships. Study 1 explored types of crushes, preferences and nature of exchanges among adults in committed relationships and compares their reports to a sample of single individuals. Study 2 examined perceived outcomes of crushes as a way to assess needs or goals served by crushes. Study 3 investigated expectations about whether and how the crush relationship might evolve into a more intimate relationship. A total of 3,585 participants (22–45 years, 53.1% women) completed anonymous online surveys addressing crush experiences and related dynamics. Those in committed relationships typically did not intend to communicate their attraction to the target, unlike single individuals. Associated outcomes were primarily positive, including excitement, increased esteem, and fantasy/escape. The vast majority reported no expectations that these crushes would evolve into more intimate relationships, replacing their current relationship. This work adds to our understanding of attraction outside of traditional human courtship processes, with implications for the study of intimate relationship development and maintenance.