Medical Humanities最新文献

Robot swarms hold significant promise for humanitarian aid, offering scalable, autonomous solutions for search and rescue, aid delivery, and disaster response. Their ability to self-organise, adapt, and operate in hazardous or inaccessible environments makes them particularly well-suited to crisis scenarios. However, their effectiveness and safety depend not only on technical performance but also on how well they are designed with affected communities in mind. In conflict and post-disaster settings- - often in the Global South- - these systems risk being misinterpreted or rejected if deployed without culturally sensitive, participatory design, especially given that most swarm technologies are developed in the Global North. This article advocates for a shift toward participatory swarm design, an approach that integrates local knowledge, values, and perceptions into system development. It highlights the critical role of human-swarm interaction (HSI) in fostering trust, preventing miscommunication, and enabling safe deployment. By involving communities from the outset, designers can create swarm systems that are not only technically capable but also culturally appropriate, widely accepted, and truly effective in the contexts they aim to serve.

Background: COVID-19 drastically impacted access to teaching worldwide. Furthermore, for children who are hard-of-hearing (HoH), these challenges were exacerbated, especially within contexts of infrastructural and resource constraints. Necessary COVID-19 protocols had implications for teaching HoH learners (HoHL) online and in-person, where, for example, connectivity and facemask-muffled speech impacted on teaching. Moreover, the reliance on technology during COVID-19 South African level 5 to level 1 restrictions revealed particular challenges for teachers of HoHL and the learners themselves.

Methodology: This qualitative, cross-sectional study explored the experiences of teachers of oral HoHL in South Africa during the COVID-19 pandemic. 11 teachers of grades 1-7 oral HoHL who were recruited through purposive and snowball sampling participated in individual, online, semi-structured interviews. Thereafter, interview transcriptions underwent thematic analysis.

Findings: Participants reported that infrastructural constraints, information and communication technology resource limitations, interruptions in the continuity of education and COVID-19 precautions amplified challenges when teaching oral HoHL. Teachers reported behavioural and emotional challenges in the children whom they taught. Moreover, there seemed to be limited access to medical services for HoHL. Participants reported attempting to bridge the gap between the human and technology interfaces, notwithstanding the inconsistent and limited support services.

Conclusion: This study revealed that, as a consequence of COVID-19, South African teachers had to amend their teaching and assessment methodologies which emphasised the inequality in access to education in South Africa, especially the particular challenges related to education for HoHL. Teachers had to navigate an unknown terrain using modified methodologies and were reliant on technology within the constrained South African context where structural limitations further complicated the teaching of HoHL. COVID-19 highlighted that the confluence of disability, constrained resources and poor support mechanisms in South Africa threatens educational provision for learners with special needs.

In this article, we share participants' reflections on five workshops offering a co-creative movement practice with peers in cancer rehabilitation. Due to illness and treatment, many young adult cancer survivors experience mental and physical challenges for years post-treatment. Adolescents and Young Adult (AYA) patients with cancer are a group of patients aged 15-39. Using the term here, we refer solely to Young Adults, as participants in our study were 29-39 years old. In the workshops, co-creative movement scores were chosen to enhance bodily awareness and to gradually introduce bodily proximity with others as trust increased in the shared space. Themes were collectively identified at the beginning of the intervention. Shared group reflections, individual reflective work and ethnographic interviews bring participant voices to the front, sharing both narratives of the unique survivorship challenges faced by the participants and how the co-creative movement practice helped the group reconnect holistically with themselves after severe illness. Recurring in many reflections was the sentiment that the illness journey had made participants experience life beyond their years, prompting negotiations of a new self, a '2.0' version, impacted by severe illness. Many reflections touched on reclaiming bodily autonomy after having had to relinquish control of oneself during treatment. Participants described a reconnection being forged between mind and body during the intervention. Shifts in ontology and agency were reported throughout the course of the five workshops, suggesting that the bodywork was helpful in relation to working towards healing and sensing oneself as a whole human being post-treatment.

All too common in medical discourse, phrases like 'failed treatment' or 'failed therapy' describe situations where a medication or intervention did not achieve the desired outcome. Using these terms risks making patients feel it is their fault for not achieving better outcomes largely determined by complex biological and social factors most often beyond their control. These terms undermine the therapeutic relationship and negatively impact mental and physical health alike. We must make a conscious effort to remove failure-based language from the collective medical lexicon by modelling alternative phrasing and advocating for corresponding policy change.

This commentary discusses how professionalisation and expertise is both a positive, constructive project as well as an exclusionary one. The discussion suggests that global health, rather than being a new sub-field of science catalysed by new discoveries, is better understood as being part of the economic and scientific expansionism of the few richest G7 countries. It is argued that global health expertise, aside from scientific expertise, also involves expertise in being a driver of the expansionism. It also points to ethical expansionism and signs of epistemic domination of global health ethics by scholars from 2-3 countries. The collection of contributions in this first Black and Brown in Bioethics topic collection is described as being an effort to resist the exclusionary and expansionist aspects of global health expertise, while also exhorting to do better at saving lives with better ethics.

The focus of this paper is the discourse of the 'endgame' of disease elimination linked to the 2030 Agenda of Sustainable Development Goals (SDGs). The aim is to explore how policy promise is sustained in the face of faltering progress, such as when targets are missed or appear unreachable. Viewed via Lauren Berlant's work on the 'cruel optimism' of unmet promise, with Ben Anderson's work on affective attachments, the analysis looks first at the 2030 SDGs and then at disease elimination through the examples of hepatitis C and HIV. The materials for analysis include political declarations, global progress reports and strategy documents. These materials sustain imaginaries of a universal endgame promise as if there cannot be an otherwise. We see how 'crisis' is enacted to account for failure as well as to sustain promise. We also see that the threat of failure gives rise to recalibrated promise in what might be described as an emerging 'elimination otherwise'. Here, the figure of crisis affords increasing attention to disease elimination as a 'problem of the social'. Discourses of the disease elimination endgame act as sites of potential, even in crisis.

Older adults are at risk of having their stories defined for them based on cultural expectations about the values and preferences of certain generations. In music therapy, these expectations can manifest in assumptions about how older adults relate to and engage with music. The resulting conflict between the authentic story and the assumed story is transgenerational narrative distortions where members of one generation disrupt, destabilise and deconstruct the lived experiences of another generation through a cultural projection of values, expectations and perspectives. Older adults stand to benefit from a process of narrative repair amplifying their authentic stories through a focus on whole persons defined by past, present and future experiences. Narratology provides a theoretical structure for shaping narrative repair processes through the theoretical constructs of 'historical epics' and 'novel': whereas historical epics frame the past as fixed and unmoving, novels understand characters to be in continuous evolution. Older adults in music therapy who are received as novels are subsequently empowered to continue forming identity through the full spectrum of their life. Clinical vignettes are provided to illustrate the harms of narrative distortions in music therapy, and how narrative repair can be reflexively integrated into culturally responsible assessment and clinical decision-making. Recommendations for clinicians include (A) Continued exploration of aspirational cultural humility, particularly as it relates to messaging about age and identity formation, (B) Development of reflexive assessments that navigate multiple areas of knowledge to determine health-optimising music experiences for older adults, and (C) Expansion of the repertories and intervention designs introduced in music therapy.

This study investigates how linguistic structures and metaphorical frameworks in patient narratives shape coping strategies, emotional resilience and agency among people living with cancer. Semistructured interviews with 10 participants were analysed thematically, revealing four key patterns: rejection of militaristic metaphors in favour of journey-based narratives, narrative coherence and identity reconstruction, cognitive reframing and meaning-making, and the role of social support in emotional regulation. Illustrative participant quotes demonstrate how individuals actively reshape their illness stories to assert agency, integrate emotional experiences and maintain psychological stability. Findings highlight the influence of language and metaphor on patient well-being, showing that narrative framing and emotional agency are closely intertwined with relational and clinical communication outcomes. These insights provide actionable guidance for clinicians, suggesting that adopting narrative-sensitive and metaphor-sensitive approaches can enhance patient engagement, emotional adaptation and culturally sensitive care. This study underscores the value of integrating qualitative narrative analysis into oncology practice, offering an empirically grounded framework for interventions that support patient empowerment and holistic care.