The impact of an aging simulation program for dental students in two community dental clinics.

PURPOSE: Clinicians who have not experienced the difficulties that come with aging or disability may be unable to relate to the limitations and experiences of afflicted patients, which is necessary to improve patient-provider connection and treatment outcomes. The purpose of this study was to test the effectiveness of an aging-simulation experience on improving dental students' awareness of aging-related limitations, examine the students' perceptions, and assess planned patient-care modifications based on the aging-simulation experience. METHODS: A total of 78 dental students who rotated through two extramural clinic sites from August 2021 through October 2022 completed pre-simulation surveys, donned aging simulators in the dental operatory, initiated pre-defined tasks and their corresponding modifications, completed a post-simulation survey, and completed a reflection questionnaire containing structured and open-ended questions. Quantitative responses were analyzed using descriptive frequencies and paired sample t-tests, whereas thematic analyses were used to interpret free-text portion of the reflection questionnaire. RESULTS: Student awareness of the impact of the four aging-related disabilities improved after the experience. Visual impairment was identified as the most difficult symptom to experience during simulation. Students reported increased feelings of empathy and acknowledged the effectiveness of clinical practice modifications to accommodate elderly patients with limitations. Students also expressed intentions to make similar modifications in their future clinical practice and the need for exposure to longer periods of simulated experiences to further clinical practice modifications for elderly patients. CONCLUSION: The aging-simulation experience is an effective tool for raising dental students' awareness of aging-related difficulties, the need for clinical practice modifications, and increasing empathy.

Engram Studies: A Call for Historical, Philosophical, and Sociological Approaches.

In this chapter, we identify three distinct avenues of research on the philosophical, historical, and sociopolitical dimensions of engram research. First, we single out the need to refine philosophical understandings of memory within neuroscientific research on the engram. Specifically, we question the place of constructivist and preservationist philosophical claims on memory in the formulation of the engram concept and its operationalization in contemporary neuroscience research. Second, we delve into the received historiography of the engram claiming its disappearance after Richard Semon's (1859-1918) coinage of the concept. Differently from this view, we underline that Semon's legacy is still largely undocumented: Unknown are the ways the engram circulated within studies of organic memory as well as the role Semon's ideas had in specific national contexts of research in neurosciences. Finally, another research gap on the engram concerns a socio-anthropological documentation of the factual and normative resources this research offers to think about memory in healthcare and society. Representations of memory in this research, experimental strategies of intervention into the engram, as well as their translational potential for neurodegenerative (e.g., Alzheimer's disease) and psychiatric (e.g., post-traumatic stress disorder) conditions have not yet received scrutiny notwithstanding their obvious social and political relevance.All these knowledge gaps combined call for a strong commitment towards interdisciplinarity to align the ambitions of a foundational neuroscience of the engram with a socially responsible circulation of this knowledge. What role can the facts, metaphors, and interventional strategies of engram research play in the wider society? With what implications for philosophical questions at the foundation of memory, which have accompanied its study from antiquity? And what can neuro- and social scientists do jointly to shape the social and political framings of engram research?

How the knowledge shared using social media is taken up into health professions education practice: A qualitative descriptive study.

Social media may promote knowledge sharing but what users do with the new knowledge and how it may influence practice remains to be known. This exploratory study used a social constructivist lens to understand how health professions educators and researchers integrate knowledge from social media into their respective practices. We purposively sampled health professions educators and researchers using the hashtags #MedEd, #HPE, and #HealthProfessionsEducation on Twitter/X. We obtained informed consent, conducted interviews via videoconference, and engaged in multiple cycles of deductive and inductive coding and analysis. Participants identified as educators and researchers (n = 12), as researchers (n = 1), or as educators (n = 1) from Canada (n = 8), the United States (n = 3), and Switzerland, Ireland, and China (n = 1, respectively). Eight participants actively used social media (i.e., creating/posting original content); six participants indicated passive use (i.e., reading/retweeting content). They discussed the importance of crafting a consumable message and social media identity to streamline the content shared. Social media's accessible, non-hierarchical nature may facilitate knowledge-sharing, whereas the potential spread of misinformation and technological requirements (e.g., internet access, country-specific restrictions on platforms) present barriers to uptake. Participants described using knowledge gained from social media as teaching tools, new research methodologies, new theoretical frameworks, and low-risk clinical interventions. Previous research has demonstrated how social media has empirically been used for diffusion or dissemination rather than as an active process of evidence uptake. Using knowledge translation frameworks, like the Knowledge to Action or Theoretical Domains frameworks, to inform social media-based knowledge sharing activities in health professions education is recommended.

The intersection between logical empiricism and qualitative nursing research: a post-structuralist analysis.

PURPOSE: To shed light on and analyse the intersection between logical empiricism and qualitative nursing research, and to emphasize a post-structuralist critique to traditional methodological constraints. METHODS: In this study, a critical examination is conducted through a post-structuralist lens, evaluating entrenched methodologies within nursing research. This approach facilitates a nuanced exploration of the intersection between logical empiricism and qualitative nursing research, challenging traditional methodological paradigms. RESULTS: The article focusing on the "what abouts" of sample size, analytic framework, data source, data analysis, and rigour and methodological considerations, challenging the predominance of semi-structured interviews and the reliance on spoken voice as primary data sources, and re-evaluating the conventional notion of "rigour". CONCLUSIONS: I advocate for a shift from qualitative positivism towards more interpretive and post-qualitative inquiries, this work proposes new trajectories through interpretive, critical, post-qualitative, and artistic turns in nursing research, aiming to transcend positivist limitations and foster a plurality of perspectives and research as praxis. Implications emphasize the need for nursing researchers to expand methodological horizons, incorporating visual and artistic methods to enrich understanding and representation of health experiences, moving beyond positivist norms towards a more inclusive and ethically sound research paradigm.

Death as the extinction of the source of value: the constructivist theory of death as an irreversible loss of moral status.

In 2017, Michael Nair-Collins formulated his Transitivity Argument which claimed that brain-dead patients are alive according to a concept that defines death in terms of the loss of moral status. This article challenges Nair-Collins' view in three steps. First, I elaborate on the concept of moral status, claiming that to understand this notion appropriately, one must grasp the distinction between direct and indirect duties. Second, I argue that his understanding of moral status implicit in the Transitivity Argument is faulty since it is not based on a distinction between direct and indirect duties. Third, I show how this flaw in Nair-Collins' argument is grounded in the more general problems between preference utilitarianism and desire fulfillment theory. Finally, I present the constructivist theory of moral status and the associated moral concept of death and explain how this concept challenges the Transitivity Argument. According to my view, brain death constitutes a valid criterion of death since brain death is incompatible with the preserved capacity to have affective attitudes and to value anything.

Teaching a Canadian Experiential Course in Religion and Spirituality for Undergraduates in Addiction Counseling and Health Sciences: A Social Constructivist Framework.

Religion and spirituality (RS) are integral to counseling and health but their incorporation into the curricula of these professions is still lacking. Limited literature is available on how to effectively teach such courses. This article presents a promising experiential, interactive model for an RS course designed for undergraduate students pursuing careers in addictions counseling, therapeutic recreation, and public health. An online course conducted during the COVID-19 pandemic adopted a social constructivist framework that encompassed four key components in its design and delivery: assessing prior knowledge, creating cognitive dissonance, applying new knowledge with feedback, reflecting on learning. Students' feedback in the course indicated their broadened understanding of the plurality of RS orientations and their acquisition of foundational skills with an increased confidence in bringing RS conversations into their practice. This article provides a conceptual and practical framework for educators to develop an RS course for a diverse representation of students and encourages further evaluation of the proposed model to assess its impact on learning outcomes.

Using Social Constructivist Learning Theory to Unpack General Practitioners' Learning Preferences of End-of-Life Care: A Systematically Constructed Narrative Review.

General practitioners play a vital role in providing community-based palliative care to patients reaching end of life. In order for GPs to upgrade their skills at end-of-life care delivery, it is imperative that training programs be aligned to their learning needs and preferences. A narrative review was conducted using the electronic databases PubMed, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science, and Cochrane from 01/01/1990 to 31/05/2021. 23 articles (of 10037 searched) were included for the review. Following themes were generated: Value attributed to end-of-life care learning, experience and reflection as a departure point for learning, learning as embedded in the clinical context; autonomy to decide upon their learning needs and learning preferences, learning as a transformative process; and learning as embedded in social interaction and interpretation. Training programs that are aligned to the preferences of GPs will encourage a larger clientele of GPs to access them.

Twelve tips for creating online learning units for the health professions in low-and middle-income countries.

Health professions educators in low-and middle-income countries are often sceptical about developing online learning units. This scepticism stems from the belief that online programmes are limited in developing clinical competence, and there are concerns about digital proficiency and resource availability. A social constructivist approach in designing online work-based learning units may overcome such scepticism. In this article, we use our experience in developing an online learning unit for healthcare education to suggest 12 tips for developing online learning units in a low-and middle-income context. The tips are nested in a 'promoting theory-practice integration framework' and include context, establishing communities of learning and practice, establishing foundational knowledge, practise in a work-based environment, and showcasing attainment of learning outcomes. By integrating the guidelines and framework, healthcare educators will be better equipped to develop online learning units and contribute to learning.

Teaching Patients About Pain: The Emergence of Pain Science Education, its Learning Frameworks and Delivery Strategies.

Since it emerged in the early 2000's, intensive education about 'how pain works', widely known as pain neuroscience education or explaining pain, has evolved into a new educational approach, with new content and new strategies. The substantial differences from the original have led the PETAL collaboration to call the current iteration 'Pain Science Education'. This review presents a brief historical context for Pain Science Education, the clinical trials, consumer perspective, and real-world clinical data that have pushed the field to update both content and method. We describe the key role of educational psychology in driving this change, the central role of constructivism, and the constructivist learning frameworks around which Pain Science Education is now planned and delivered. We integrate terminology and concepts from the learning frameworks currently being used across the PETAL collaboration in both research and practice-the Interactive, Constructive, Active, Passive framework, transformative learning theory, and dynamic model of conceptual change. We then discuss strategies that are being used to enhance learning within clinical encounters, which focus on the skill, will, and thrill of learning. Finally, we provide practical examples of these strategies so as to assist the reader to drive their own patient pain education offerings towards more effective learning. PERSPECTIVE: Rapid progress in several fields and research groups has led to the emergence 'Pain Science Education'. This PETAL review describes challenges that have spurred the field forward, the learning frameworks and educational strategies that are addressing those challenges, and some easy wins to implement and mistakes to avoid.

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training.

BACKGROUND: Patient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics. METHODS: We organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach. RESULTS: Based on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time. CONCLUSION: The emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

Evaluating an inquiry-based learning program.

Inquiry-based learning (IBL) is a promising educational framework that is understudied in graduate medical education. To determine participant satisfaction and engagement with phases of an IBL postgraduate education program, a mixed-methods study collected data via survey statements and open-ended responses. The authors included participants attending an intensive care medicine (ICM) IBL program from May to November 2020. Quantitative outcomes included participants' satisfaction with the IBL format and impact of engagement with IBL on the learning experience. Qualitative outcomes explored determinants of engagement with IBL phases and the impact on the learning experience. Of 378 attendees, 167 submitted survey responses (44.2%). There was strong agreement relating to overall satisfaction (93.4%). Responses indicated engagement with "orientation" (94.6%), "conceptualization" (97.3%), "discussion" (91.1%), and "conclusion" (91.0%) but limited engagement with the "investigation" phase (48.1%). Greater engagement with IBL phases had positive impacts, with repeat attenders having clearer learning objectives (79.1% vs. 56.6%, P < 0.05) and enhanced learning through collaborative discussion (65.9% vs. 48.7%, P < 0.05). Qualitative analysis showed that ICM learners value active learning principles, clear objectives, and a safe environment to expand their "knowledge base." Sessions facilitated "clinically relevant learning," with application of theoretical knowledge. Learners transformed and "reframed their understanding," using the input of others' experiences. ICM learners were highly satisfied with the IBL format and reported valuable learning. Participants engaged strongly with all IBL phases except the investigation phase during the sessions. IBL facilitated learners' active construction of meaning, facilitating a constructivist approach to learning.NEW & NOTEWORTHY An inquiry-based learning (IBL) program was launched as part of a novel binational intensive care medicine education program. Postgraduate intensive care medicine practitioners participated in this education intervention, where facilitated group discussions explored core intensive care medicine concepts. Survey responses indicated overall satisfaction, engagement with the IBL format, and a constructivist approach to learning. This study provided new insights into the benefits and challenges of an IBL program in the context of practicing clinicians.

What Do Medical Students Learn about Community Care from Discussions with General Physicians? A Thematic Analysis.

Background and Objectives: Sustainable healthcare is fundamentally rooted in community medicine education. The COVID-19 pandemic disrupted global advancement in integrating traditional teaching and experiential learning. Additionally, an alarming decline in interest in community care has been observed among senior medical students. Here, we examined the perspectives on community care obtained from conversations with general physicians in rural medical universities. Materials and Methods: Using a constructivist lens, a qualitative methodology was employed to examine the perceptions of second-year medical students from Shimane University Medical School regarding community care, informed by dialogues with general physicians. We conducted a thematic analysis at Shimane University, Japan, an area known for its aging population. In 2023, 116 second-year students participated, none of whom had prior formal training in community care. The study was structured into three phases: (1) Pre-education: Students wrote essays about their initial understanding of community care, its advantages, disadvantages, and potential improvements; (2) Dialogue: Grouped by topic, students engaged in discussions that culminated in a comprehensive session with general physicians; and (3) Reflection: After discussions, students wrote essays reflecting any shift in their views on community care. A thematic analysis of essays from the pre-education and reflection phases provided a comparative perspective on the students' understanding. Results: Five dominant themes emerged from the thematic analysis: (1) Re-evaluating community care: Recognizing diversity and addressing societal challenges; (2) Interdisciplinary collaboration: Promoting shared roles and teamwork; (3) Learning and practice: Emphasizing hands-on experience and self-reflection; (4) Technological influence: The mutual relationship between community care and technological advancements; and (5) Challenges and resolutions: Identifying problems and crafting solutions. Conclusions: This study sheds light on the evolution of medical students' views on community care and underscores the importance of continuous adaptation in medical education programs.

Aprendizaje significativo y su aplicación en la educación médica / Meaningful Learning and its Application in Medical Education

Introducción: El aprendizaje significativo se genera a partir de que el alumno es constructor de su propio conocimiento, relaciona los conceptos a aprender y les da un sentido según la estructura conceptual que ya posee. Objetivo: Exponer las experiencias socializadas por autores que promueven el aprendizaje significativo en la educación médica. Métodos: Se utilizó el método científico análisis del contenido, a partir de informaciones disponibles en la biblioteca electrónica en línea SciELO y el motor de búsqueda de Google Académico, teniendo en cuenta los diez últimos años: 2011 (enero) hasta diciembre de 2021. Después de aplicados los criterios de inclusión y exclusión, fueron seleccionados y analizados 16 artículos académicos. Resultados: El 56,25 por ciento utilizó un diseño de tipo cualitativo y las muestras utilizadas oscilaron entre un mínimo de 7 hasta un máximo de 246 estudiantes. Medicina se mostró como la carrera que más estudiaba el aprendizaje de tipo significativo. El aprendizaje basado en problemas en formato intracurricular constituyó la metodología más usada para desarrollarlo. Las principales limitaciones reportadas tuvieron relación con el instrumento y la muestra. Conclusiones: Se hace necesario realizar investigaciones para estudiar el aprendizaje significativo en estudiantes de las ciencias de la salud. De esta manera se podrían tener resultados contextualizados para realizar comparaciones que contribuirían a precisar los diferentes factores que se ven involucrados en el desarrollo de dicha teoría(AU)

Introduction: Meaningful learning is generated from the fact that the student is the constructor of his or her own knowledge, relates the concepts to be learned, and gives them a meaning based on the already existing conceptual structure. Objective: To present the experiences socialized by authors who promote meaningful learning in medical education. Methods: The scientific method of content analysis was used, based on information available in the SciELO online electronic library and the Google Scholar search engine, taking into account the last ten years: January 2011 to December 2021. After applying the inclusion and exclusion criteria, 16 academic articles were selected and analyzed. Results: 56.25 percent used a qualitative design, while the used samples ranged from a minimum of 7 to a maximum of 246 students. Medicine was shown as the major that most studied meaningful learning. Problem-based learning in the intracurricular format was the most used methodology to develop it. The main reported limitations were related to the instrument and the sample. Conclusions: It is necessary to conduct research to study meaningful learning in health sciences students. In this way, contextualized results could be obtained to make comparisons that would contribute to clarify the different factors involved in the development of this theory (AU)

Analysis of self-healing of depression by helping others in adolescents from the perspective of constructivism.

Purpose: This study aims to explore the mechanism of psychological qualities constructed in helping others with depression and guide adolescents to actively participate in the practical activities of helping others to prevent and self-heal depression. Method: Symptom self-rating scale, trait coping style questionnaire, and self-administered helper scale were employed. A total of 1,086 valid on-site questionnaires were collected from adolescents. Result: The depression levels of adolescents were negatively correlated with helping beliefs, behaviors and total scores (r = -0.500, -0.401, and -0.530). Helping others had a significantly negative predictive effect on depression, effectively inhibiting depression levels. Although the positive coping style had an inhibitory effect on depression, it exerted no predictive effects on depression under the influence of helping others. In contrast, the negative coping style had a significantly positive predictive effect on depression. Conclusion: Proactively participating in helping others is an important way to prevent and eliminate depression in adolescents. They should be instructed to give full play to their initiatives to participate in social practice and assist others actively, thus constructing positive psychological qualities, improving mental health, and achieving self-healing of depression and self-help through helping others.

Earlier smartphone acquisition negatively impacts language proficiency, but only for heavy media users. Results from a longitudinal quasi-experimental study.

There is a growing debate about the proper age at which teens should be given permission to own a personal smartphone. While experts in different disciplines provide parents and educators with conflicting guidelines, the age of first smartphone acquisition is constantly decreasing and there is still limited evidence on the impact of anticipating the age of access on learning outcomes. Drawing on two-wave longitudinal data collected on a sample of 1672 students in 2013 (at grade 5) and 2016 (at grade 8), this study evaluates whether obtaining the first personal smartphone at 10 or 11 years old, during the transition to lower secondary school (early owning), affected their language proficiency trends compared to receiving it from the age of 12 onwards (late owning). Results indicate an overall null effect of smartphone early owning on adolescents' language proficiency trajectories, while a negative effect is found on those who were already heavy screen media users before receiving the device.

El Cerebro en Pañales. ¿Puede Estar un Cerebro en un Cuerpo Equivocado? / The Brain in Diapers. Can a Brain be in the Wrong Body?

En este trabajo se intenta analizar críticamente el libro de Antonio Guillamón Fernández Identidad de género. Una aproximación psicobiológica (2021). Para ello se contextualiza su publicación dentro de la oleada “cerebrocentrista” contemporánea y se discute el marco teórico que subyace a la presentación del material empírico que se realiza en sus capítulos. Se sugiere, desde un punto de vista constructivista, que el libro asume una ontología monista y un enfoque reduccionista que lastran la interpretación de dicho material empírico, el cual podría interpretarse mejor incluyendo procesos psicosociales de identificación que, a su vez, dependen de fenómenos históricos y culturales concretos.(AU)

The aim of this paper is to critically analyze Antonio Guillamón Fernández’s book Gender identity. A psychobiological approach (2021). In order to do so, the book is contextualized within the current “brain-centric” deluge, and I also discuss the theoretical framework underlying the presentation of empirical material. From a constructivist point of view, I suggest that Guillamón assumes a monistic ontology and a reductionist approach that block the interpretation of this empirical material, which could be better understood by including psychosocial identification processes that, in turn, depend on specific historical and cultural phenomena.(AU)

Assembling the climate story: use of storyline approaches in climate-related science.

Storylines are introduced in climate science to provide unity of discourse, integrate the physical and socioeconomic components of phenomena, and make climate evolution more tangible. The use of this concept by multiple scholar communities and the novelty of some of its applications renders the concept ambiguous nonetheless, because the term hides behind a wide range of purposes, understandings, and methodologies. This semi-systematic literature review identifies three approaches that use storylines as a keystone concept: scenarios-familiar for their use in IPCC reports-discourse-analytical approaches, and physical climate storylines. After screening peer-reviewed articles that mention climate and storylines, 270 articles are selected, with 158, 55, and 57 in each category. The results indicate that each scholarly community works with a finite and different set of methods and diverging understandings. Moreover, these approaches have received criticism in their assembly of storylines: either for lacking explicitness or for the homogeneity of expertise involved. This article proposes that cross-pollination among the approaches can improve the usefulness and usability of climate-related storylines. Among good practices are the involvement of a broader range of scientific disciplines and expertise, use of mixed-methods, assessment of storylines against a wider set of quality criteria, and targeted stakeholder participation in key stages of the process.

Is Continuous Glucose Monitoring a Tool, an Intervention, or Both?

Studies that investigate use of diabetes technologies such as blood glucose monitoring (BGM) and continuous glucose monitoring (CGM) often report contradictory findings regarding efficacy and clinical utility. Whereas some studies of a given technology have shown no benefit, others have reported significant benefits. These incongruities derive from how the technology is viewed. Is it viewed as a tool, or is it an intervention? In this article, we discuss earlier studies that illustrate the contrast between use of BGM as a tool versus use as an intervention, compare and contrast the roles of BGM and CGM as tools and/or interventions in diabetes management, and suggest that CGM can function effectively as both.

Developing a Culturally and Linguistically Congruent Digital Storytelling Intervention in Vietnamese and Korean American Mothers of Human Papillomavirus-Vaccinated Children: Feasibility and Acceptability Study.

BACKGROUND: The high morbidity, mortality, and economic burden attributed to cancer-causing human papillomavirus (HPV) call for researchers to address this public health concern through HPV vaccination. Disparities of HPV-associated cancers in Vietnamese and Korean Americans exist, yet their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve their HPV vaccination rates. We adopted digital storytelling (DST) that combines oral storytelling with computer-based technology (digital images, audio recording, and music) as a promising approach for facilitating the communication of culturally relevant health messages. OBJECTIVE: This study aimed to (1) assess the feasibility and acceptability of intervention development through DST workshops, (2) conduct an in-depth analysis of the cultural experience that shapes HPV attitudes, and (3) explore aspects of the DST workshop experience that could inform future formative and intervention work. METHODS: Through community partners, social media, and snowball sampling, we recruited 2 Vietnamese American and 6 Korean American mothers (mean age 41.4, SD 5.8 years) who had children vaccinated against HPV. Three virtual DST workshops were conducted between July 2021 and January 2022. Our team supported mothers to develop their own stories. Mothers completed web-based surveys before and after the workshop and provided feedback on each other's story ideas and the workshop experience. We used descriptive statistics to summarize quantitative data and constant comparative analysis to analyze qualitative data collected in the workshop and field notes. RESULTS: Eight digital stories were developed in the DST workshops. They were well accepted, and the mothers showed overall satisfaction and relevant indicators (eg, would recommend it to others, would attend a similar workshop, it was worth their time; mean 4.2-5, range 1-5). Mothers found the process rewarding and appreciated the opportunity to share their stories in group settings and learn from each other. The 6 major themes that emerged from the data reflect the mothers' rich personal experiences, attitudes, and perceptions about their child's HPV vaccination, which included (1) showing parents' love and responsibility; (2) HPV and related knowledge, awareness, and attitudes; (3) factors influencing vaccine decision-making; (4) source of information and information sharing; (5) response to children's being vaccinated; and (6) cultural perspectives on health care and HPV vaccination. CONCLUSIONS: Our findings suggest that a virtual DST workshop is a highly feasible and acceptable approach to engaging Vietnamese American and Korean American immigrant mothers in developing culturally and linguistically congruent DST interventions. Further research is needed to test the efficacy and effectiveness of digital stories as an intervention for Vietnamese American and Korean American mothers of unvaccinated children. This process of developing an easy-to-deliver, culturally and linguistically aligned, and holistic web-based DST intervention can be implemented with other populations in other languages.

Technocratic economic governance and the politics of UK fiscal rules.

This exploration of UK fiscal rules and the establishment of an independent UK fiscal watchdog focuses on the practical enactment of rules-based fiscal policy to analyse the politics of technocratic economic governance. Analysing UK macroeconomic policy rules and their operation unearths numerous dimensions of the politics of technocratic fiscal policy-making. Firstly, policy rules are marshalled for partisan purposes. Secondly, a politics of economic ideas surrounds the invention, revision and interpretation of fiscal rules. Thirdly, technocratic economic governance entails a 'politics of method', selecting methodological approaches necessarily built on particular political economic assumptions. Finally, a 'politics of numbers' sees politicians cooking the books to present their economic record favourably against fiscal yardsticks. Successive governments have altered UK fiscal rules, informed by different political economic principles. The Office for Budget Responsibility (OBR) sees itself as a technocratic and apolitical institution, yet its operational work entails contrasting accounts of the economy and policy. The scale of discretion and judgement inherent in operating fiscal rules is under-appreciated. This article finds technocratic economic governance to be a much more social and political process than many advocates of economic rules-based policy acknowledge. It engenders new forms of distinctive fiscal politics within elite statecraft and expert technocracy.