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Introduction: Explanatory models of disease focus on individuals' and groups' understandings of diseases, revealing a disconnect between livestock keepers and animal health providers. Animal health providers rely on models grounded in their veterinary training and experience. At the same time, livestock keepers may construct models based on traditional knowledge and their lived experience with East Coast fever in their cattle herds. To better understand East Coast fever and develop more efficient management strategies, this ethnographic study used the explanatory models' framework to provide a structured way for comprehending and contrasting different beliefs and understandings of East Coast fever as perceived by the livestock keepers across the different livestock production systems. Method: Multiple data collection methods were employed, including unstructured observations, 30 in-depth interviews (IDIs), 18 focus group discussions (FGDs), and 25 key informant interviews (KIIs). Results: Adult cattle, calves and sheep were perceived as susceptible to East Coast fever. However, there were varying perceptions of livestock susceptible to East Coast fever in the different livestock production systems. East Coast fever was attributed to multiple factors, including ticks, tsetse flies, mosquitos, birds, stagnant, dirty, or contaminated water, and livestock-wildlife interactions. However, some aspects were specific to the production system. Livestock keepers classified diseases based on observable signs, grouping diseases with similar signs under the same classification. Moreover, livestock keepers described different forms of East Coast fever ranging from treatable to fatal, which could be distinguished by the signs they presented. Self-treatment with drugs from the local agro-vet shops was the initial course of action during suspected cases of East Coast fever. Animal health practitioners were the last resort if self-treatment did not produce the desired outcome. Livestock keepers perceived avoidance of stagnant or contaminated water, tick control, and fencing as effective control measures for East Coast fever in their livestock herd. Very few livestock keepers were aware of an East Coast fever vaccine. Discussion: Mechanistic explanations hold little significance in controlling East Coast fever. Instead, understanding and addressing livestock keepers' beliefs regarding ECF is crucial for promoting behaviors that support interventions across different livestock production systems. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a condition with high patient morbidity and mortality. Research shows that eliciting patient explanations about illness causes and treatment preferences promotes cross-cultural work and engagement in health services. These topics are in the Cultural Formulation Interview (CFI), a semi-structured interview first published in DSM-5 that applies anthropological approaches within mental health services to promote person-centered care. This study focuses on the New York City site of an international multi-site study that used qualitative-quantitative mixed methods to: (1) analyze CFI transcripts with 55 adults with OCD to explore perceived illness causes and treatment preferences, and (2) explore whether past treatment experiences are related to perceptions about causes of current symptoms. The most commonly named causes were circumstantial stressors (n = 16), genetics (n = 12), personal psychological traits (n = 9), an interaction between circumstantial stressors and participants' brains (n = 6), and a non-specific brain problem (n = 6). The most common treatment preferences were psychotherapy (n = 42), anything (n = 4), nothing (n = 4), and medications (n = 2). Those with a prior medication history had twice the odds of reporting a biological cause, though this was not a statistically significant difference. Our findings suggest that providers should ask patients about illness causes and treatment preferences to guide treatment choice. [ABSTRACT FROM AUTHOR]

The experience of bearing witness to the lack of appetite and involuntary weight loss that characterizes cancer anorexia–cachexia syndrome (CACS) is reported to be stressful for family members. Research identifies that family members engage in a wide range of behaviors in response to a relative who shows minimal interest in eating and is literally 'wasting away' before their eyes. Some families, though concerned about the symptoms of CACS, do not dwell excessively on the patient's nutritional intake while others continually harass the patient to eat and petition health care providers for aggressive nutritional interventions to eat in an attempt to stave off further physical deterioration. While studies have detailed how family members respond to a terminally ill relative with CACS, empirical work explicating the explanatory models of CACS that they hold is lacking. Explanatory models (EMs) reflect the beliefs and ideas that families have about why illness and symptoms occur, the extent to which they can be controlled, how they should be treated, and how interventions should be evaluated. To address this gap in the literature, a grounded theory study guided by Kleinman's Explanatory Model questions was conducted with 25 family members of advanced cancer patients. The core category of 'Wayfaring' integrates the key categories of the model and maps onto Kleinman's questions about CACS onset, etiology, natural course, physiological processes/anatomical structures involved, treatment, and the impacts of disease on patient and family. Findings suggest that a divergence between some biomedical constructions of CACS and explanatory models held by family members may fuel the family–health care provider conflict, thereby providing direction for communication with families about care of the patient with anorexia–cachexia. [ABSTRACT FROM AUTHOR]

It is difficult to describe the experience of living through the COVID-19 global pandemic while simultaneously teaching anthropology and sociology courses to undergraduates. My students and I experienced together not just the fear of sickness and death, but also social issues in the U.S. made more visible by the pandemic, such as racial tensions, challenges related to access to health care, and consequences of the social determinants of health. The “normal” that many are hoping we return to was heavily shaped by neoliberal policies that conceptualize health and illness as well as personhood in particular ways, such as through defining social problems as medical in nature and using medicine as a form of social control. The issue for us as educators, however, is that stress, depression, and anxiety are normal reactions to real conditions that we are all experiencing, albeit with strikingly different foundations and resources. In this paper I reflect on my own experiences in the classroom and discuss how I incorporated theoretical constructs of intersectional trauma, or trauma-informed pedagogy. I will showcase how I teach students these concepts through medical anthropology. I highlight how these concepts have helped students make sense of the impacts of the COVID-19 pandemic, and I argue that this framing is useful for understanding other crises for students and professors alike.

Explanatory models are culturally informed representations of illness that convey understandings of the etiology and expected course of disease. Substantial research has explored lay explanatory models, but examining physicians' clinical explanatory models can also provide insight into patients' understandings of illness because physicians are a foundational source of authoritative knowledge that shapes lay concepts of illness and disease. This study characterized the explanatory models used by pediatric gastroenterologists when explaining inflammatory bowel disease (IBD) to children. We conducted semi-structured qualitative interviews with 20 pediatric gastroenterologists across the United States about their clinical communication and explanatory models. We identified two primary explanatory models used to describe immune dysregulation in pediatric IBD: the defense and protection model, which characterizes the immune system as an army that erroneously sees the body as "non-self" and attacks it; and the switch model, which conceptualizes treatment as activating a switch that turns off a faulty immune response. We also identified two models used by some physicians to describe inflammation: the scratch and scrape model, which compares IBD inflammation to scratches or scrapes on the skin; and the bonfire model, which compares inflammation to a fire in need of extinguishing. While the use of militaristic metaphors is pervasive in medicine, describing autoimmunity as a battle against the self may lead children to perceive their body as the enemy. This may be compounded by describing the immune system as "confused" while noting its ongoing protective function. Use of these explanatory models may nevertheless improve patient disease-related knowledge. [ABSTRACT FROM AUTHOR]

This paper explores the explanatory models of mental challenges among Black Africans in England. It argues that understanding these models is critical for providing culturally appropriate care to this population. The study employed qualitative methodology, and interpretative phenomenological analysis (IPA). Twelve mental health service users who are living in England and self‐identified as first or second‐generation Black Africans were purposively selected. The data were gathered using face‐to‐face semistructured interviews. Data were manually analysed in accordance with IPA concepts of searching for common, unique and idiosyncratic themes across transcripts. The findings revealed three themes Black Africans associated to their explanatory model of mental health challenges: complexities of migration, African‐centred worldview and negative life experiences. To help alleviate the Eurocentric nature of mental health practice in England, it is hoped that this explanatory model will become an integral part of mental health practice in England and around the world. [ABSTRACT FROM AUTHOR]

IntroductionExplanatory models of disease focus on individuals’ and groups’ understandings of diseases, revealing a disconnect between livestock keepers and animal health providers. Animal health providers rely on models grounded in their veterinary training and experience. At the same time, livestock keepers may construct models based on traditional knowledge and their lived experience with East Coast fever in their cattle herds. To better understand East Coast fever and develop more efficient management strategies, this ethnographic study used the explanatory models’ framework to provide a structured way for comprehending and contrasting different beliefs and understandings of East Coast fever as perceived by the livestock keepers across the different livestock production systems.MethodMultiple data collection methods were employed, including unstructured observations, 30 in-depth interviews (IDIs), 18 focus group discussions (FGDs), and 25 key informant interviews (KIIs).ResultsAdult cattle, calves and sheep were perceived as susceptible to East Coast fever. However, there were varying perceptions of livestock susceptible to East Coast fever in the different livestock production systems. East Coast fever was attributed to multiple factors, including ticks, tsetse flies, mosquitos, birds, stagnant, dirty, or contaminated water, and livestock-wildlife interactions. However, some aspects were specific to the production system. Livestock keepers classified diseases based on observable signs, grouping diseases with similar signs under the same classification. Moreover, livestock keepers described different forms of East Coast fever ranging from treatable to fatal, which could be distinguished by the signs they presented. Self-treatment with drugs from the local agro-vet shops was the initial course of action during suspected cases of East Coast fever. Animal health practitioners were the last resort if self-treatment did not produce the desired outcome. Livestock keepers perceived avoidance of stagnant or contaminated water, tick control, and fencing as effective control measures for East Coast fever in their livestock herd. Very few livestock keepers were aware of an East Coast fever vaccine.DiscussionMechanistic explanations hold little significance in controlling East Coast fever. Instead, understanding and addressing livestock keepers’ beliefs regarding ECF is crucial for promoting behaviors that support interventions across different livestock production systems.

Introduction: the diagnostic criteria of craving for substance use addition disorder was included in the Diagnostic and Statistical Manual of Mental Disorders DSM-5 in 2013. However, this remains a complex phenomenon that requires further attention. Objective: the present study aimed to review explanatory models of craving, describe the factors involved in the anxiety of maintaining an addictive behavior and point out the treatments that have been proposed so far to control craving. Method: systematic review of literature oriented according to the criteria of Cochrane Collaboration, included 100 articles selected from keywords and Boolean search engines in the databases of Scielo, Dialnet, Scopus, PubMed, Web of Science and EBSCOhost. Results: craving represents a phenomenon of great complexity underlying all kinds of addictive behavior, which is interpreted from different models such as: neurobiological, tolerance and abstinence, emotional regulation, learning and conditioning, information processing and meeting needs. Likewise, multiple factors associated with the phenomenon are evident from the cognitive, emotional, social and environmental aspects, forcing the search for and implementation of therapeutic approaches of a broad range from pharmacological, cognitive-behavioral to innovative with virtual reality and mindfulness. Conclusions: contribution of the diagnostic criteria of craving obliges to consider the integral and interdisciplinary intervention and prevention processes, aimed at addressing biopsychosocial and environmental factors and aspects to optimize recovery and prevent relapses in both chemical and behavioral addictions.Keywords: craving, chemical and behavioral addictions, explanatory models, biopsychosocial factors, therapeutic approaches.

Abstract Background Alcohol use disorder (AUD) is a major clinical problem in Uganda. Explanatory models (EMs) of illness are important as they have consequences for treatment. Clinicians´ knowledge about patients´ EMs can improve understanding of the latter´s perspectives and adapting treatments. There is a lack of African studies about EMs of AUD. The aim of this study was to explore EMs for AUD among hospitalized patients and their relatives at the alcohol and drug unit (ADU) at Butabika hospital in Uganda. Methods An adapted version of the Explanatory Model Interview Catalogue (EMIC) was used for interviews with ten patients and five relatives to investigate how both hospitalized patients with AUD and their relatives understand the disease. Data were analysed for themes with a qualitative content analysis and support of the software program, OpenCode 4.03. Results Five major themes were identified from the patient interviews: “Context promotes AUD”; “Alcohol is part of culture”; “Spiritual causes of AUD in the community”; “Help through Western medicine and religious sources is preferred” and “Social problems and stigmatization”. Six major themes identified from the interviews with relatives were: “Numerous causes of drinking alcohol”; “Devastating consequences of drinking alcohol”; “Exploiting persons with AUD”; “Others’ suffering”; “Relatives struggling for help” and “Suggested solutions”. Conclusions Patients’ EMs of AUD included social and spiritual explanations. Alcohol is seen as an important part of the Ugandan culture among both patients and their relatives. The results indicate it is important in clinical contexts to investigate the EMs of the patients and relatives to individually tailor treatment interventions.

Abstract Background 98% of people with surgical conditions living in low- and middle-income countries (LMICs) do not receive safe, timely and affordable surgical and anesthesia care. Research exploring barriers to receiving care has tended to be narrow in focus, often facility-based and ignoring the community beliefs, experiences and behaviours that will be an essential component of closing the gap in surgical care. Using qualitative methods, we captured diverse community perspectives in rural Ethiopia: exploring beliefs, perceptions, knowledge and experiences related to surgical conditions, with the overall aim of (re)constructing explanatory models. Methods Our study was nested within a community-based survey of surgical conditions conducted in the Butajira Health and Demographic Surveillance Site, southern Ethiopia, and a follow-up study of people accessing surgical care in two local hospitals. We carried out 24 semi-structured interviews. Participants were community members who needed but did/did not access surgical care, community-based healthcare workers and traditional bone-setters. Interviews were conducted in Amharic, audio-recorded, transcribed, and translated into English. We initially carried out thematic analysis and we recognized that emerging themes were aligned with Kleinman’s explanatory models framework and decided to use this to guide the final stages of analysis. Results We found that community members primarily understood surgical conditions according to severity. We identified two categories: conditions you could live with and those which required urgent care, with the latter indicating a clear and direct path to surgical care whilst the former was associated with a longer, more complex and experimental pattern of help-seeking. Fear of surgery and poverty disrupted help-seeking, whilst community narratives based on individual experiences fed into the body of knowledge people used to inform decisions about care. Conclusions We found explanatory models to be flexible, responsive to new evidence about what might work best in the context of limited community resources. Our findings have important implications for future research and policy, suggesting that community-level barriers have the potential to be responsive to carefully designed interventions which take account of local knowledge and beliefs.

Digital transformation has been one of the main trends in organizations in recent years, and digital literacy is a critical factor in the success of this transformation. Digital transformation involves the use of digital technologies to improve an organization’s processes, products, and services. For this transformation to be successful, it is necessary for employees to have knowledge of and skills in digital technologies. Digital literacy allows employees to understand technologies and their applications, know how to use them efficiently and safely, evaluate and select the most appropriate digital tools for each task, and be prepared to deal with problems and challenges that arise in the digital environment. Thus, this study is relevant because it seeks to understand how digital literacy can impact Digital Transformation in organizations and, through the construction of an explanatory model, allows the identification of variables that influence this relationship by developing strategies to improve the digital literacy of employees in organizations.

Literature about bipolar disorder and religion is scarce and primarily encompasses studies with a quantitative design. Results of such studies do not lead to unambiguous conclusions about the relation between bipolar disorder and religion that could be applied in clinical practice. The main focus of this article will be on the domain of religious experiences/religious delusions and hallucinations as explored in two recent PhD studies regarding mixed methods and qualitative research, conducted in the Netherlands and in Canada. In the narrative review of the two studies, the occurrence of different types of religious experiences and various explanatory models of patients to interpret them are presented. The interpretation of religious experiences, often related to mania, proves to be an intense quest, and often a struggle for many patients, whereby fluctuations in mood, course of the illness, religious or philosophical background, and the reactions of relatives and mental health professionals all play a role. Patients combine various explanatory models, both medical and religious/cultural, to interpret their experiences and these may fluctuate over the years. The two studies are placed in the context of literature about bipolar disorder and various aspects of religion to date. Finally, the challenges for future research and the implications for clinical practice will be outlined. [ABSTRACT FROM AUTHOR]

Introduction: Psychotherapy research has long preferred explanatory over predictive models. As a result, psychotherapy research is currently limited in the variability that can be accounted for in the process and outcome of treatment. The present study is a proof-of-concept approach to psychotherapy science that uses a datadriven approach to achieve robust predictions of the process and outcome of treatment. Methods: A trial including 65 therapeutic dyads was designed to enable an adequate level of variability in therapist characteristics, overcoming the common problem of restricted range. A mixed-model, data-driven approach with crossvalidation machine learning algorithms was used to predict treatment outcome and alliance (within- and between-clients; client- and therapist-rated alliance). Results and discussion: Based on baseline predictors only, the models explained 52.8% of the variance for out-of-sample prediction in treatment outcome, and 24.1-52.8% in therapeutic alliance. The identified predictors were consistent with previous findings and point to directions for future investigation. Although limited by its sample size, this study serves as proof of the great potential of the presented approach to produce robust predictions regarding the process and outcome of treatment, offering a potential solution to problems such as p-hacking and lack of replicability. Findings should be replicated using larger samples and distinct populations and settings. [ABSTRACT FROM AUTHOR]

IntroductionPsychotherapy research has long preferred explanatory over predictive models. As a result, psychotherapy research is currently limited in the variability that can be accounted for in the process and outcome of treatment. The present study is a proof-of-concept approach to psychotherapy science that uses a datadriven approach to achieve robust predictions of the process and outcome of treatment.MethodsA trial including 65 therapeutic dyads was designed to enable an adequate level of variability in therapist characteristics, overcoming the common problem of restricted range. A mixed-model, data-driven approach with cross-validation machine learning algorithms was used to predict treatment outcome and alliance (within- and between-clients; client- and therapist-rated alliance).Results and discussionBased on baseline predictors only, the models explained 52.8% of the variance for out-of-sample prediction in treatment outcome, and 24.1–52.8% in therapeutic alliance. The identified predictors were consistent with previous findings and point to directions for future investigation. Although limited by its sample size, this study serves as proof of the great potential of the presented approach to produce robust predictions regarding the process and outcome of treatment, offering a potential solution to problems such as p-hacking and lack of replicability. Findings should be replicated using larger samples and distinct populations and settings.

Culturally differing approaches to the distinction between physical and mental health contribute to cultural differences in explanatory models of what we call "mental" health in a Western context. For this reason, we use "(mental) health" in this study when referring to these models or differences in understanding. This interpretative, interview-based qualitative study focuses on Belgian mental health professionals' perceptions of the (mental) health explanatory models held by their patients of sub-Saharan African (SSA) descent. The study goals were threefold: first, to assess professionals' perceptions of the explanatory models of their patients of SSA descent; second, to examine how these perceptions influence treatment practices; and third, to investigate the role of the professionals' cultural backgrounds, comparing the results between professionals with and without an SSA background. Twenty-two in-depth interviews with mental health professionals were thematically analyzed, with ten of the participants of SSA descent. Results show that all professionals perceived differences between Western and SSA explanatory models of (mental) health. Causal beliefs were mentioned as the most important difference, including their influence on coping strategies and health-seeking behavior among patients of SSA descent. Professionals' perceptions and familiarity with SSA explanatory models of (mental) health affected their treatment practices. Language and conceptual interpretation difficulties were encountered less frequently by professionals of SSA descent. Those with a Western background applied "culturally sensitive" practices, while professionals of SSA descent implemented an integrated approach. These results contribute to ongoing discussions about what is considered "cultural competency." [ABSTRACT FROM AUTHOR]

Background: Schizophrenia may cause significant impairment in social and economic aspects of a patient's life. Current evidence suggests that cognitive deficits may affect the functioning of a person with schizophrenia more than positive or negative symptoms. There is a lack of literature on explanatory models of cognitive deficits in schizophrenia that can influence help-seeking behavior. Objectives: This study aimed to estimate the prevalence of cognitive deficits and assess their relationship with socio-demographic and clinical characteristics among patients with schizophrenia. We also planned to explore the explanatory models of cognitive deficits in these patients. Methods: Consecutive outpatients with schizophrenia who met eligibility criteria were recruited after obtaining informed consent. The Addenbrooke's Cognitive Examination Tamil version (ACE III) and Observable Social Cognition -- A Rating Scale (OSCARS) and Positive and Negative Symptom Scale (PANSS) were used to assess cognitive functioning and symptom profile, respectively. Beliefs about illness were recorded using the modified Short Explanatory Model Interview (SEMI). Socio-demographic and treatment-related details were collected with a structured proforma. Statistical analysis was done using SPSS for Windows (version 16.0.1). Results: One hundred and forty patients participated in the study. The prevalence of cognitive deficits was 75.7% using ACE-III scores, 19.3% on OSCARS, and 40% based on subjective reports. Though the majority (81.4%) of patients reported a medical explanatory model for cognitive impairment, a significant number of them (70.7%) also held non-medical models simultaneously. Conclusion: Cognitive deficits are prevalent in the majority of patients with schizophrenia. Poor test performance on cognitive testing was observed in those with a significant family history. Multiple contradictory explanatory models for the causation of cognitive deficits were reported. [ABSTRACT FROM AUTHOR]

In their highly influential paper, Yarkoni, Tal, and Jacob Westfall. 2017. "Choosing Prediction over Explanation in Psychology: Lessons from Machine Learning." Perspectives on Psychological Science 12 (6):1100–1122. the authors highlight difficulties in traditional explanatory research in the field of psychology and argue in favour of novel data-driven science. By applying machine-learning methods to large data sets, predictive power has been shown to increase significantly. Geological engineers are responsible for a wide range of applications, including the design of tunnels, dams, foundations, and mines. While the field of geological engineering stands on solid mechanistic grounds, we argue that its predictive aspect aligns more closely with psychology than other mechanistic sciences. We therefore propose a paradigm shift in geological engineering research towards a prediction-centric approach. Potentially, this could enhance cost-effectiveness in structural design and lead to substantial societal savings. [ABSTRACT FROM AUTHOR]

Introduction. The study focuses on methods providing mathematical substantiation of discrepancies between actual incidence rates of Astrakhan rickettsial fever (ARF) and Crimean-Congo hemorrhagic fever (CCHF) and predicted rates due to the indirect impact of weather conditions during the current epidemic season. The purpose of the study was to develop explanatory models for ARF and CCHF incidence using satellite monitoring (remote sensing) data and to present the results of their practical evaluation in the Stavropol Territory and Astrakhan Region. Materials and methods. The materials included climate data provided by the Space Research Institute of the Russian Academy of Sciences as well as epidemiological data on CCHF and ARF incidence from 2005 to 2021. The explanatory models incorporated the Bayes theorem and Wald sequential analysis. All the calculations were completed using the Microsoft Excel 2010-based program developed by the authors. Results. It has been found that the greatest indirect effect on development of the CCHF epidemiological situation is produced by the normalized difference vegetation index and relative air humidity in June-July in the Stavropol Territory and by the maximum, minimum and average air temperature in October as well as the minimum air temperature in July in the Astrakhan Region. ARF incidence rates depend on the indirect effect of the annual average and average annual maximum temperature, maximum temperature and the normalized difference vegetation index in April-July. The match between explanatory model-based results and prediction model-based results ranged within 46.2-100%. Discussion. In addition to projecting incidence rates, which could be reached with the observed values of climatic factors in the current year, the explanatory models can be used for indirect verification of prediction models and for identification of factors causing differences in results. Conclusion. The practical evaluation of explanatory models confirms the prospects and benefits of the study that should be continued, involving other regions highly endemic for tick-borne infections.

Genuinely new discovery transcends existing knowledge. Despite this, many analyses in systems neuroscience neglect to test new speculative hypotheses against benchmark empirical facts. Some of these analyses inadvertently use circular reasoning to present existing knowledge as new discovery. Here, I discuss that this problem can confound key results and estimate that it has affected more than three thousand studies in network neuroscience over the last decade. I suggest that future studies can reduce this problem by limiting the use of speculative evidence, integrating existing knowledge into benchmark models, and rigorously testing proposed discoveries against these models. I conclude with a summary of practical challenges and recommendations.

Jusqu'à tout récemment, la population générale avait tendance à croire qu'une femme ne pouvait être l'auteur de comportements sexuels coercitifs. Tandis qu'il est difficile d'identifier les éléments ayant pu alimenter cette croyance, il est possible que celle-ci soit associée à des conceptions erronées concernant les comportements féminins (exemple : une femme est rarement violente, elle est plutôt la cible de violences) et/ou les agressions sexuelles (exemple : une agression sexuelle consiste en un viol, cela implique nécessairement une pénétration vaginale pénienne). Cependant, la recherche a mis en évidence ces dernières années que les femmes sont aussi capables de commettre des infractions sexuelles (exemple : attouchements), seules ou avec un partenaire, parfois sous la contrainte et d'autres fois de leur propre initiative. Qui sont donc ces femmes ? Dans le cadre de cet entretien avec Jean-Pierre Bouchard, c'est à cette question qu'Alexandre Gauthier, Ingrid Ménard, Tamsin Higgs et Jonathan James tentent de répondre, en abordant : les fausses croyances entourant cette forme de délinquance et leurs impacts sur les taux de prévalence ; le profil type de la délinquante sexuelle, en distinguant celles qui agissent seules de celles qui agissent avec un partenaire ; et les principaux modèles explicatifs de cette forme de délinquance. Les chercheurs terminent en présentant les principaux paramètres à prendre en considération dans la prise en charge de ces femmes dans un contexte thérapeutique. Until recently, the general population tended to believe that a woman could not be the perpetrator of coercive sexual behavior. While it is difficult to identify what may have fueled this belief, it may be associated with misconceptions about female behavior (example: a woman is rarely violent, but rather the target of violence) and/or sexual assault (example: a sexual assault is rape, which necessarily involves penile vaginal penetration). However, research in recent years has shown that women are also capable of committing sexual offenses (example: touching), alone or with a partner, sometimes under duress and other times on their own initiative. Who are these women? During this interview with Jean-Pierre Bouchard, Alexandre Gauthier, Ingrid Ménard, Tamsin Higgs, and Jonathan James attempt to answer this question by addressing: the false beliefs surrounding this form of delinquency and their impact on prevalence rates; the typical profile of female sexual offenders, distinguishing between those who act alone and those who act with a partner; and the main explanatory models of this form of delinquency. The researchers conclude by presenting the main parameters to be considered in the management of these women in a therapeutic context. [ABSTRACT FROM AUTHOR]

Abstract Background Afghan refugees and asylum seekers constitute one of the largest groups that live in camp settings in Greece. While they experience psychological distress, they are facing significant barriers in accessing appropriate mental health care. Explanatory Models (EMs) provide a context-sensitive framework for understanding the differences between health professionals, refugees and NGOs that operate on the field. This study aims at further understanding how Afghan refugees perceive and explain depression and largely psychological distress, and how this influences their choices for coping strategies and help-seeking. Methods This qualitative study included six vignette-based semi-structured focus-group discussions with Afghan refugees and asylum-seekers (total N = 19, 12 female and 7 male) residing largely in camp settings in Northern Greece. The vignette describes a fictional person with symptoms of depression in line with DSM-5 and ICD-10 criteria. The interviews were recorded, transcribed, and analysed through template analysis. Results EMs for depression are explained through Pre-migration Traumatic Experiences (PMTE) and Post-migration Living Difficulties (PMLD) relating to camp settings. Female participants identified gender-based and domestic violence as contributing to psychological distress while males highlighted conflict and persecution. Life in the camp with associated inactivity, and uncertainty for the future, was perceived as a significant risk factor for psychological distress among females and males. In terms of coping strategies, females tended to focus on mobilizing collective resources within the camp (e.g. safe space for women facilitating emotional support), while males advocated for self-empowerment and solution-oriented coping. The value of engagement in peer helper-roles was highlighted. Conclusions The results highlight the potential value of community-based psychosocial approaches to support and promote mental health within camp settings. Additionally, they may inform policies and practices regarding access to appropriate mental health care for Afghan refugees. Further research is needed to establish the efficiency of such interventions in this context.

An increased prevalence in mental disorders, addictive disorders, and dual disorders is one of the most relevant public health problems worldwide. The understanding of these disorders in the Mexican population must improve in order to adjust public strategies and policies focused on prevention and treatment. The aim of this article is to delve into elements of illness perception guided by the proposed explanatory models of Kleinman and their impact on health care services for these disorders. A study of illness perception in our population could contribute significantly toward a comprehensive understanding of the disease process, which, in turn, would favor the design of culturally sensitive psychoeducational and therapeutic interventions when treating individuals experiencing these health conditions, proper clinical practice, timely care, stronger therapeutic adherence, and a better prognosis. [ABSTRACT FROM AUTHOR]

There is scarce and conflicting information on how Turkish immigrants express, experience, and understand common mental health difficulties (CMHDs) as well as their preferences and needs. This conflict often emerges in the literature around symptom presentation and the causal attributions of CMHDs. Since inconsistent information may have real life consequences for Turkish immigrants it is important to investigate this area. The aim of this review was to explore the experiences and understandings of common mental health difficulties of Turkish immigrants. A systematic review using thematic synthesis adopted from Thomas & Harden (2008) was conducted to evaluate the existing literature. CINAHL, MEDLINE, PsycArticles and PsychInfo were searched. Only qualitative studies conducted with Turkish immigrants with lived experience were included (n = 10). The analysis was data-driven (inductive) leading to three themes with twelve subthemes being generated. Participants reported experiencing both emotional and physical symptoms. They linked their distress to significant life events and chronic adverse conditions, interpersonal conflict, immigration and discrimination related problems and problematic encounters with healthcare workers. Traditional/spiritual and biological understandings of mental health were also discussed. Family and social support, personal resources, and the utilisation of medical and traditional/spiritual resources were reported as coping strategies, though some were sceptical about the latter. This review found that Turkish immigrants experienced and expressed their distress in both emotional and physical terms, just like many other communities. Their understandings were mainly psychosocial but contained elements of biomedical and traditional models. Since research in this area is limited, further and better research is recommended. Policy makers and practitioners are also advised to provide meaningful and effective care for every community, including Turkish immigrants. [ABSTRACT FROM AUTHOR]

Engaging students in epistemic and conceptual aspects of modeling practices is crucial for phenomena-based learning in science classrooms. However, many students and teachers still struggle to actualize the reformed vision of the modeling practice in their classrooms. Through a discourse analysis of 150 students' explanatory models (as social semiotic spaces) from 14 classes, we propose a qualitative framework that investigates conceptual coherence and epistemic discourses to achieve a gapless explanation of scientific phenomena. Our framework draws attention to four critical components of students' explanatory models: (a) key ideas based on evidence, (b) the discourse modalities of how evidence is presented, (c) scientific representations from the cultures of scientific disciplines, (d) systems thinking approaches directly and indirectly related to oceans and marine ecosystems. Our results indicate that students struggled to construct cohesive explanatory models that communicated all key ideas and the relationships among them, with the majority of student-developed models in our study categorized as 'insufficiently' cohesive (lacking key ideas and the relationships among them), and only a small percentage of the models considered 'extensively' cohesive (all key ideas attended to, as well as the relationships among them). [ABSTRACT FROM AUTHOR]

Literature about bipolar disorder and religion is scarce and primarily encompasses studies with a quantitative design. Results of such studies do not lead to unambiguous conclusions about the relation between bipolar disorder and religion that could be applied in clinical practice. The main focus of this article will be on the domain of religious experiences/religious delusions and hallucinations as explored in two recent PhD studies regarding mixed methods and qualitative research, conducted in the Netherlands and in Canada. In the narrative review of the two studies, the occurrence of different types of religious experiences and various explanatory models of patients to interpret them are presented. The interpretation of religious experiences, often related to mania, proves to be an intense quest, and often a struggle for many patients, whereby fluctuations in mood, course of the illness, religious or philosophical background, and the reactions of relatives and mental health professionals all play a role. Patients combine various explanatory models, both medical and religious/cultural, to interpret their experiences and these may fluctuate over the years. The two studies are placed in the context of literature about bipolar disorder and various aspects of religion to date. Finally, the challenges for future research and the implications for clinical practice will be outlined.

Background: People diagnosed with mental illness develop a variety of explanatory models of their conditions in the face of uncertainty. Explanatory models matter because they are associated with internalized stigma and illness behaviors such as treatment preferences. Aims: This paper explores how working professionals in the United States draw on biological and/or environmental factors to explain the cause(s) of their diagnoses of bipolar or depression. Method: Findings are derived from an analysis of transcripts of in-depth interviews with 52 individuals from across the United States who were invited to participate in a study of working professionals diagnosed with mental illness. About 25 self-identified as having bipolar disorder and 27 as having major depression. Transcript data were analyzed following the principles of flexible coding with the goal of establishing a typology of explanatory models of self-identified bipolar versus depression. Results: Six types of explanatory models emerged from the analysis. One was exclusively biological, a second was exclusively environmental, and the remaining four combined biological and environmental factors in different ways. Quotations from the interviews are provided to illustrate each type, and comparisons between types are made based on primary diagnosis (bipolar vs. depression), and self-reports of trauma and stressful experiences. Conclusion: Implications for the future research on explanatory models and how they may impact people who are diagnosed with a mental illness across multiple dimensions of their lives are presented. [ABSTRACT FROM AUTHOR]

Background: Afghan refugees and asylum seekers constitute one of the largest groups that live in camp settings in Greece. While they experience psychological distress, they are facing significant barriers in accessing appropriate mental health care. Explanatory Models (EMs) provide a context-sensitive framework for understanding the differences between health professionals, refugees and NGOs that operate on the field. This study aims at further understanding how Afghan refugees perceive and explain depression and largely psychological distress, and how this influences their choices for coping strategies and help-seeking. Methods: This qualitative study included six vignette-based semi-structured focus-group discussions with Afghan refugees and asylum-seekers (total N = 19, 12 female and 7 male) residing largely in camp settings in Northern Greece. The vignette describes a fictional person with symptoms of depression in line with DSM-5 and ICD-10 criteria. The interviews were recorded, transcribed, and analysed through template analysis. Results: EMs for depression are explained through Pre-migration Traumatic Experiences (PMTE) and Post-migration Living Difficulties (PMLD) relating to camp settings. Female participants identified gender-based and domestic violence as contributing to psychological distress while males highlighted conflict and persecution. Life in the camp with associated inactivity, and uncertainty for the future, was perceived as a significant risk factor for psychological distress among females and males. In terms of coping strategies, females tended to focus on mobilizing collective resources within the camp (e.g. safe space for women facilitating emotional support), while males advocated for self-empowerment and solution-oriented coping. The value of engagement in peer helper-roles was highlighted. Conclusions: The results highlight the potential value of community-based psychosocial approaches to support and promote mental health within camp settings. Additionally, they may inform policies and practices regarding access to appropriate mental health care for Afghan refugees. Further research is needed to establish the efficiency of such interventions in this context. [ABSTRACT FROM AUTHOR]

Abstract Background The current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway. Methods We conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria. Results The findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes. Conclusion The practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients’ perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives.

The objective of this study was to characterize the different explanatory models of internalized stigma in people with mental disorders. A systematic search and review of the literature were conducted, and 13 articles were selected. Five explanatory models of internalized stigma were identified: the socio-cognitive model; the model of personal discrimination, internalized stigma, and intention to participate in collective actions; the internalized stigma model; the socio-cognitive-behavioral model; and the causality model of self-stigma-related factors in people with anxiety disorders. The models were found to include psychosocial, self-concept, and mental health variables. Notably, while the socio-cognitive model was the most tested, only some of the associated studies were fully validated. The model of personal discrimination, internalized stigma, and intention to participate in collective actions was fully validated; the rest were partially validated. Thus, it was concluded that models of internalized stigma explain this phenomenon from psychosocial variables such as acceptance and application of stereotypes. Cognitive-behavioral strategies, peer support, disclosure, and psychoeducational strategies are the most relevant for reducing internalized stigma. [ABSTRACT FROM AUTHOR]

Assegid Negash,1,2 Matloob Ahmed,1 Girmay Medhin,3 Dawit Wondimagegn,1 Clare Pain,4 Mesfin Araya1 1Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Psychology, Wolaita Sodo University, Wolaita Sodo, Ethiopia; 3Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Psychiatry, University of Toronto, Toronto, CanadaCorrespondence: Assegid Negash Email assegidn@gmail.comBackground: Socio-culturally determined processes account for how individuals give meanings to health, illness, causal attributions, expectations from treatment, and related outcomes. There is limited evidence of explanatory models for mental distress among higher education institutions in Ethiopia. The objective of this study was to explore the explanatory models for mental distress among Wolaita Sodo University.Methods: The current study used a phenomenological research approach, and we collected data from 21 students. The participants were purposively recruited based on eligibility criteria. Semi-structured interviews were conducted from December 2017 to January 2018 using the Short Explanatory Models Interview. The interviews were audio-recorded, transcribed into the Amharic language and translated into English. Data were analyzed using framework analysis with the assistance of open code software 4.02.Results: Most students experienced symptoms of being anxious, fatigue, headaches and feelings of hopelessness. They labeled these symptoms like anxiety or stress. The most commonly reported causal explanations were psychosocial factors. Students perceived that their anxiety or stress was severe that mainly affected their mind, which in turn impacted their interactions with others, academic result, emotions and motivation to study. Almost all the students received care from informal sources, although they wanted to receive care from mental health professionals. They managed their mental distress using positive as well as negative coping strategies.Conclusion: The policy implication of our findings is that mental health interventions in higher education institutions in Ethiopia should take into account the explanatory models of students’ psychological distress.Keywords: explanatory models, mental distress, university students, Ethiopia

Background: Depression is a major public health problem but there is a huge treatment gap in India. Cultural beliefs influence conception of illness, personal meaning, help-seeking behaviors, and adherence to treatment. Research on explanatory models of depression attempt to explore these unique characteristics in an individual and the community. We set out to examine explanatory models of depression in a rural community of coastal Karnataka and explore the association between sociodemographic variables and explanatory models of depression. Methods: A cross-sectional household survey in the rural community of Harekala village, Mangaluru taluk, Dakshina Kannada district, Karnataka, was done using Kish tables. A total of 200 individuals were interviewed with an adaptation of the Short Explanatory Model Interview in a local language using a case vignette of depression. Results: Around 40% of the individuals perceived the problem as tension/stress/excessive worrying and did not perceive it as mental illness. A scant 10% of the participants recognized some mental illness. Around one-fifth of the individuals attributed the problem to evil spirits and black magic; female participants were more likely to endorse consulting a doctor (P = 0.003**) or a psychiatrist (P = 0.012*). In addition, participants belonging to Islam were less likely to consult a doctor (P = 0.028*) and psychiatrist (P = 0.021*). Also, participants belonging to lower social class were less likely to endorse psychiatric consultation (P = 0.018*) Conclusions: A vast majority of the study subjects failed to identify depression as an illness or acknowledge biomedical causation. Gender, religion, and socioeconomic class may influence help-seeking behavior. [ABSTRACT FROM AUTHOR]

ObjectivesTo assess the impact of the initial two-dose-schedule mass vaccination campaign in Chile toward reducing adverse epidemiological outcomes due to SARS-CoV-2 infection.MethodsPublicly available epidemiological data ranging from 3 February 2021 to 30 September 2021 were used to construct GAMLSS models that explain the beneficial effect of up to two doses of vaccination on the following COVID-19-related outcomes: new cases per day, daily active cases, daily occupied ICU beds and daily deaths.ResultsAdministered first and second vaccine doses, and the statistical interaction between the two, are strong, statistically significant predictors for COVID-19-related new cases per day (R2 = 0.847), daily active cases (R2 = 0.903), ICU hospitalizations (R2 = 0.767), and deaths (R2 = 0.827).ConclusionOur models stress the importance of completing vaccination schedules to reduce the adverse outcomes during the pandemic. Future work will continue to assess the influence of vaccines, including booster doses, as the pandemic progresses, and new variants emerge.Policy ImplicationsThis work highlights the importance of attaining full (two-dose) vaccination status and reinforces the notion that a second dose provides increased non-additive protection. The trends we observed may also support the inclusion of booster doses in vaccination plans. These insights could contribute to guiding other countries in their vaccination campaigns.

Engaging students in epistemic and conceptual aspects of modeling practices is crucial for phenomena-based learning in science classrooms. However, many students and teachers still struggle to actualize the reformed vision of the modeling practice in their classrooms. Through a discourse analysis of 150 students’ explanatory models (as social semiotic spaces) from 14 classes, we propose a qualitative framework that investigates conceptual coherence and epistemic discourses to achieve a gapless explanation of scientific phenomena. Our framework draws attention to four critical components of students’ explanatory models: (a) key ideas based on evidence, (b) the discourse modalities of how evidence is presented, (c) scientific representations from the cultures of scientific disciplines, (d) systems thinking approaches directly and indirectly related to oceans and marine ecosystems. Our results indicate that students struggled to construct cohesive explanatory models that communicated all key ideas and the relationships among them, with the majority of student-developed models in our study categorized as ‘insufficiently’ cohesive (lacking key ideas and the relationships among them), and only a small percentage of the models considered ‘extensively’ cohesive (all key ideas attended to, as well as the relationships among them).

Schizophrenia, as currently operationalized, is a serious public health concern everywhere in the globe. Occurring at a rate of approximately 4.6 per 1000 population at any point of observation and between 3.0 and 6.0 per 1000 over the lifetime, the condition is responsible for 7% of disability adjusted live years caused by mental and substance use disorders. The impact of the disorder on affected persons and communities across the world is thus considerable. In Africa, where schizophrenia is seen as the prototypical "mental disorder" by the lay public, it constitutes a major cause of human rights abuses as well as experienced stigma and discrimination. The delineation of the disorder, including its construct validity and cultural applicability, is of interest not only to researchers but also to mental health practitioners and policy makers. Studies conducted on the continent have demonstrated that the construct of schizophrenia, as described in the global classificatory systems, is recognizable and applicable in the African settings. But such studies have been largely designed from an etic perspective leaving open the question of whether the diagnostic construct has sufficient cultural and social fit as well as salience to African populations. This commentary seeks to highlight ways in which existing gap in knowledge can be addressed in providing an African perspective on the future status of schizophrenia as a diagnostic construct and as a descriptive label of a clinical state. [ABSTRACT FROM AUTHOR]

Objective: Personal narratives of lived experience with psychiatric illness and distress remain central in the epistemology of mental illness. We provide a commentary on this potential bridging of patient narrative-based epistemology, and medico-scientific epistemology used by psychiatrists used for diagnosis, formulation, prognosis and treatment. Conclusion: Discussion and planning of psychiatric care can be framed by understanding the narrative-based epistemology of a patient's illness as highlighted by five key questions to explore the patient's illness explanatory models. We propose five key questions for the psychiatrist's complementary consideration of medico-scientific epistemology that frame conceptual models of aetiology, pathophysiology, diagnosis, formulation, prognosis and treatment, which are embedded in the predominant socio-cultural environment. These questions assist in bridging patient narrative and medico-scientific explanatory models to facilitate more effective collaborative care planning. [ABSTRACT FROM AUTHOR]

Background: The current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway. Methods: We conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria. Results: The findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes. Conclusion: The practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients' perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives. [ABSTRACT FROM AUTHOR]