'You come as a human being ': exploring sense of equality in arts interventions through an ethnographic study of Shared Reading.

Research shows that the arts hold a particular potential for promoting health, well-being and social inclusion for vulnerable people. However, the use and consumption of the arts tend to be socially skewed in favour of people with high cultural, social and economic capital. While extensive research has been conducted on how to create equal access to arts activities for vulnerable groups, little research has investigated how to ensure meaningful engagement with the arts by this group. Shared Reading (SR) has had considerable success in engaging vulnerable groups in collective literary practices, and research suggests that this may partly be due to the unique forms of social and literary engagement that the concept fosters. These forms of engagement, we suggest, lay the foundation for a sense of equality among participants that may promote social connectedness and well-being. On this basis, the present study aims to investigate whether and how a sense of equality may play a role in SR practices. The study found that SR promotes a sense of equality by creating a space where social interaction and relatedness does not hinge on social roles, but rather on lived experiences-and vulnerabilities inherent to these-conveyed through literary texts and shared among participants. However, to promote a sense of equality in SR, meaningful engagement for all participants must be ensured, making facilitation an essential element of SR practices and an important focus in arts interventions in general. We conclude that SR, and arts interventions more generally, may be a promising way to promote a sense of equality, but further research is needed on the specific qualities of and potential contexts for the promotion of a sense of equality.

Deprescribing in primary care without deterioration of health-related outcomes: A real-life, quality improvement project.

Medication reviews focusing on deprescribing can reduce potentially inappropriate medication; however, evidence regarding effects on health-related outcomes is sparse. In a real-life quality improvement project using a newly developed chronic care model, we investigated how a general practitioner-led medication review intervention focusing on deprescribing affected health-related outcomes. We performed a before-after intervention study including care home residents and community-dwelling patients affiliated with a large Danish general practice. The primary outcomes were changes in self-reported health status, general condition and functional level from baseline to 3-4 months follow-up. Of the 105 included patients, 87 completed the follow-up. From baseline to follow-up, 255 medication changes were made, of which 83% were deprescribing. Mean self-reported health status increased (0.55 [95% CI: 0.22 to 0.87]); the proportion with general condition rated as 'average or above' was stable (0.06 [95% CI: -0.02 to 0.14]); and the proportion with functional level 'without any disability' was stable (-0.05 [95% CI: -0.09 to 0.001]). In conclusion, this general practitioner-led medication review intervention was associated with deprescribing and increased self-reported health status without the deterioration of general condition or functional level in real-life primary care patients. The results should be interpreted carefully given the small sample size and lack of control group.

Developing the CARE intervention to enhance ethical self-efficacy in dementia care through the use of literary texts.

BACKGROUND: Dementia care is essential to promote the well-being of patients but remains a difficult task prone to ethical issues. These issues include questions like whether manipulating a person with dementia is ethically permissible if it promotes her best interest or how to engage with a person who is unwilling to recognize that she has dementia. To help people living with dementia and their carers manage ethical issues in dementia care, we developed the CARE intervention. This is an intervention focused on promoting the ethical self-efficacy of people living with dementia and carers, i.e., their confidence that they can manage ethical issues when they occur. The purpose of this paper is to explain and discuss how we have developed the CARE intervention to promote the ethical self-efficacy of people living with dementia, their family, and professional carers through a specific and, we believe, new use of literary texts. METHODS: The CARE intervention has been developed in two phases: First, we conducted a needs assessment of the occurrence of ethical issues in dementia care and the need for an intervention to support people living with dementia and their carers in managing such issues. Second, in a design phase, we developed the CARE intervention to meet identified needs. RESULTS: To address identified ethical issues in dementia care we designed the CARE intervention as a workshop format where people living with dementia and carers can meet, discuss literary texts, and deliberate on how to solve such issues. The workshop is structured by the following elements: An agenda of ethical issues, a collection of literary cases exemplifying ethical issues, a moderator with an understanding of dementia care, and an overview of the ethical principles relevant to the discussion of ethical issues. >This workshop concept is operationalized in three applications tailored to meet the specific ethical issues of each of the study´s three target groups: people living with dementia and family carers, professional and family carers, and professional carers. CONCLUSION: We conclude the paper by stating that it is possible to develop an intervention that promotes the ethical self-efficacy of people living with dementia and family and professional carers.

"It's not that I don't have things to do. It just all revolves around me" - men's reflections on meaning in life in the transition to retirement in Denmark.

Retirement may bring about significant changes for those who retire. Studies have shown that men find it harder than women to adapt to retirement, putting them at greater risk of identity and meaning loss, which may reduce subjective well-being and increase the risk of depression. While men may experience retirement as a challenging life event that triggers processes of meaning-making motivated by an appropriation of meaning to a new life situation, their experiences of meaning in retirement are yet to be investigated. The aim of this study was to explore Danish men's reflections on meaning in life in the transition to retirement. Forty in-depth interviews were carried out with newly retired men between fall 2019 and fall 2020. Interviews were recorded, transcribed, coded, and analyzed using an abductive approach informed by an ongoing interaction between empirical insights and psychological and philosophical perspectives on meaning in life. Six themes central to men's meaning-making in the transition to retirement were identified: family ties, social connectedness, structure of everyday life, contribution, engagement, and time. On this basis, it is suggested that reestablishing a sense of belonging and engagement are central to meaningfulness in the transition to retirement. Having a web of relations, a sense of being part of a social entity, and engaging oneself in something that provides intersubjective value may replace senses of meaning found previously in work life. A better understanding of meaning in men's transitions to retirement may provide a valuable knowledge base for efforts seeking to strengthen men's transition to retirement.

Modern tragedies in self-help literature, blogs and online universes: conceptions of resilience as a literary phenomenon.

Focusing on the configuration of the relationship between fate and freedom of action, this article analyses recent self-help literature and online communities, particularly the genre that centres on the concept of resilience. The selected works and websites all address readers who suffer from depression, anxiety and stress. The article focuses on how the relationship between fate and freedom is represented in three literary figures: the reader, who is promised recovery; the narrator, who promises to save the reader from the mental illnesses; and the plot that the reader forms by his or her personal thoughts, feelings and experiences. Furthermore, fate and freedom will be analysed in a series of allegories and metaphors. We argue that each literary figure reflects a radical understanding of individual autonomy, that is, freedom of action. However, we also argue that each literary figure has a shadowy disadvantage, which activates a tragic reversal of fate. The article analyses how this self-help genre reflects a notion of tragedy in relation to mental suffering.