BACKGROUND: Mental health is an issue of social and economic importance. Sociocultural and scholarly attention has largely focused on the negative aspects of mental health. That is, on mental disorders and illness and how they adversely impact our lives. In contrast, this paper forms part of a recent alternative empirical perspective in discourse-based research, by focusing on the positive aspects of mental health. In this article, we investigate how end-of-life care workers construct their positive psychological states.
METHODS: Our data are 38 audio-recorded and transcribed semi-structured interviews with end-of-life care workers from Hong Kong and the United Kingdom. We utilized thematic analysis to identify common categorial strands across the data and discourse analysis to identify the linguistic strategies that these interviewees used to talk about their mental health.
RESULTS: Our thematic analysis generated a superordinate theme across the interviews-namely, that of end-of-life care workers talking about their positive psychological states. We identify three generic ways that end-of-life care workers talked about these psychological states; by \"foregrounding the positive,\" \"reformulating the negative,\" and \"dismissing the negative.\" Our analysis also explicates how interviewees connected social and organizational support to being a benefit to their psychological states.
CONCLUSIONS: Our work contributes to existing discourse-based and sociolinguistic research on mental health by turning their focus towards a consideration of its positive dimensions. We also identify recurrent linguistics strategies used by people to construct their mental health. Our analyses point to the importance of investigating mental health as a multidimensional concept that considers participants\' own reflections on their mental health.

The scientific literature shows that gender transition is effective in improving the general well-being of transgender people. However, so far, little attention has been paid to the actual role of the body concerning the existential dilemma that holds the person hostage during transition. This study investigates the relationship between the body-here considered in its concrete, experienced, imagined, and intersubjective dimensions-and gender identity. Twenty-five transgender people who live in Italy were interviewed to identify interpretive repertoires and identity positionings. Four main repertoires and positionings emerged: 1) Interpretative repertoires on the body in transition, where an enduring influence of gender binarism and biological determinants were observed; 2) Expectations regarding medically induced modifications of the body ranging from self-confidence to uncertainty; 3) Positionings toward medically induced bodily modifications, ranging from enthusiasm to resignation; and 4) Inter- and Intrapersonal positionings, where the other than self was found to act as a self-confirming resource or as a constant unpredictable and potentially threatening source of disconfirmation. Practitioners need to develop a stronger awareness of the different dimensions, meanings, and discourses surrounding bodily experience to more effectively intervene in their clinical practice with transgender people.

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.

BACKGROUND: The dramatic reconfigurations of work-family roles and social boundaries resulting from the social restrictions imposed during the Covid-19 pandemic led working mums to look for online sites as spaces of emotional support and regulation where they could vent their emotions, share their concerns and griefs, and seek advice. They also became interactional spaces where mums\' relevant identities were reassessed and enacted as they aimed to balance work-family roles and improve their wellbeing. The paper explores how working mums discursively negotiated their multiple identities in an online support forum during times of global struggle, how these identity constructions reflect the domains of Work-Family Conflict (WFC) and how working mums perceived these identities are related to their mental health.
METHODS: 127 posts of Chilean working mums published in a public online support forum for working mums collected during the first half of 2020 were analysed in three phases. The first one involved a thematic analysis to identify themes and subthemes related to working mums\' identity construction in the data. The second phase involved conducting a narrative analysis of working mums\' microstorias in order to identify a master narrative crafted by these working mums, and contesting and conforming ideologies of motherhood, among others. Finally, the third phase involved a fine-grained discourse analysis of the most representative extracts illustrating working mums\' identity negotiation.
RESULTS: The sociolinguistic analysis showed that working mums\' discourses displayed three themes of self-reflection, namely, diminishing self-care, reassessing their self, and enhancing self through self-care. Identity-related sub-themes for each main theme are discussed and discursively analysed. Two main points are emphasised: (1) the identity that was most salient in working mums\' discourse was their personal identity (rather than work-family roles and identities), and (2) microstorias allowed working mums to challenge the hegemonic power of dominant discourses around their identities and their work-family roles.
CONCLUSIONS: The study shows that a sociolinguistic approach to the exploration of working mums\' identity negotiation is useful to highlight the ways in which mums contest binary assumptions of work-family roles and the need to reconsider working mums\' life domains so that they reflect working mums\' actual identity needs and lived experiences. Future lines of research are outlined.

In the fall of 2021, the Wick Poetry Center, a recognized international leader in creative writing interventions, launched the website Sacred Breath: Voices of Ohio Nurses in Response to COVID-19 (sacredbreathproject.com) with funding from the Ohio Nurses Foundation. The purpose of the website was to offer Ohio nurses an accessible platform to reflect on their personal and professional lived experiences as caregivers during an historic time of pandemic, sacrifice, uncertainty, and scarcity, and to share their voice with others. What resulted was 204 submissions over a three-month period with participant responses touching on widespread sentiments including grief, fatigue, anger, and resilience. It was from the gap in the current literature on pandemic narratives that the researchers of this study began a basic qualitative thematic analysis of the Sacred Breath project website (SBP) responses to gain a better understanding of how nurses, nurse educators, and nursing students made sense of and gave voice to their personal and professional lived experiences during the ongoing COVID-19 pandemic. While stories of nursing during the Covid-19 pandemic have been widely available and disseminated by popular media, academic studies have been slower to utilize qualitative and experimental methods to specifically address pandemic narratives and the resulting discourses by nurses working in and around clinical settings. The Wick Poetry Center at Kent State University has spent nearly forty years working in the community to address urgent social needs using expressive writing methods that are often overlooked by traditional social and arts outreach. The Wick Poetry Center engaged local academic networks and community health partners to invite nurses, nursing students, and nurse educators the Sacred Breath Project By evaluating responses to the intervention website, this qualitative study is aimed to fill this gap in the current literature as well as begin to understand how nurses made sense of their work lives during the ongoing Covid-19 pandemic. What does this paper contribute to the wider global clinical community? What is already known: What this paper adds.

Designing effective childhood vaccination counseling guidelines, public health campaigns, and school-entry mandates requires a nuanced understanding of the information ecology in which parents make vaccination decisions. However, evidence is lacking on how best to \"catch the signal\" about the public\'s attitudes, beliefs, and misperceptions. In this study, we characterize public sentiment and discourse about vaccinating children against SARS-CoV-2 with mRNA vaccines to identify prevalent concerns about the vaccine and to understand anti-vaccine rhetorical strategies. We applied computational topic modeling to 149 897 comments submitted to regulations.gov in October 2021 and February 2022 regarding the Food and Drug Administration\'s Vaccines and Related Biological Products Advisory Committee\'s emergency use authorization of the COVID-19 vaccines for children. We used a latent Dirichlet allocation topic modeling algorithm to generate topics and then used iterative thematic and discursive analysis to identify relevant domains, themes, and rhetorical strategies. Three domains emerged: (1) specific concerns about the COVID-19 vaccines; (2) foundational beliefs shaping vaccine attitudes; and (3) rhetorical strategies deployed in anti-vaccine arguments. Computational social listening approaches can contribute to misinformation surveillance and evidence-based guidelines for vaccine counseling and public health promotion campaigns.

This study addresses the underexplored issue of climate migration in non-governmental organisations (NGOs) communication, which is particularly relevant given the anticipated effects of climate change on migratory patterns. It paints a richer picture of NGOs\' visual and textual discourses on climate migration and delves into the ways in which NGOs\' depictions of climate migrants reinforce the \'us\' and \'them\' dichotomy that characterises policy and media circuits\' wider debate on this issue. NGOs visual practises and textual narratives depoliticize climate migrants by underlining their otherness and propensity to bring social instability and disturbance. This raises doubts about the efficacy of climate migration-related online public education and policy advocacy efforts run by NGOs. This paper innovates as it encourages NGOs to create new ways of depicting climate refugees. It provides a framework for thinking about the role that NGOs could play in creating new ways of discussing climate migration.

BACKGROUND: The WHO advocates patient and public involvement as an ethical imperative, due to the value of the lived experience of patients. A deeper understanding of the shared meanings and underlying beliefs of healthcare professionals and managers for and against including patients in care pathway development.
OBJECTIVE: To explore the considerations of healthcare professionals and managers on the involvement of patients and public in care pathway development.
METHODS: In a medical rehabilitation centre we conducted a single case study that was part of a 2-year action research programme on blended care pathway development. Following 14 semistructured interviews with healthcare professionals and managers, we analysed their discourses on the value of patient involvement as well as the potential threats and opportunities.
RESULTS: We identified four discourses. Patient as expert frames involvement as relevant, as adding new perspectives and as required to fully understand the patient\'s needs. Skills and representation is based on the construct that obtaining valuable insights from patients requires certain skills and competences. Self-protection focusses on personal, interprofessional objections to patient involvement. Professional knows best reveals expertise-related reasons for avoiding or postponing involvement.
CONCLUSIONS: These discourses explain why patient and public involvement in care pathway development is sometimes postponed, limited in scope and level of participation, and/or avoided. The following strategies might minimise the paralysing effect of these discourses: strengthen the capabilities of all stakeholders involved; use a mix of complementary techniques to gain involvement in distinct phases of care pathway development; and create/facilitate a safe environment. Put together, these strategies would foster ongoing, reciprocal learning that could enhance patient involvement.
UNASSIGNED: This study belonged to an action research programme on blended care pathway development (developing an integrated, coordinated patient care plan that combines remote, digital telehealth applications, self-management tools and face-to-face care). Multidisciplinary teams took a quality collaborative approach to quality improvement (considering patients as stakeholders) to develop 11 blended care pathways. Although professionals and managers were instructed to invite patients onto their teams and to attend care pathway design workshops, few teams (3/11) actually did. Unravelling why this happened will help improve patient and public involvement in care pathway development.

This article examines how intrauterine device (IUD) self-removal is framed in online sources containing the views of contraceptive providers. While research has explored power and knowledge hierarchies in clinical interactions between contraceptive users and providers, and has highlighted the safety of IUD self-removal, little is known about how self-removal is represented by providers in accessible online sources that may be relied upon by contraceptive users for information. A discourse analysis of 42 provider-generated online sources found that provider authority over contraception is reinforced through biomedical constructions of risk and safety in framings of self-removal. The data reveal how the sharing of self-removal experiences between IUD users via online platforms was perceived to threaten contraceptive provider expertise, resulting in the dismissal of users\' experiential knowledge. While some sources were supportive, the framings of self-removal discussed in this paper typically mirror the unequal power relations of in-person contraceptive user/provider interactions. The sources analysed therefore demonstrate how power and knowledge hierarchies are reproduced and extend beyond clinical interactions to the digital context, reflecting broader socio-structural controls over bodies, knowledge, and reproductive decision-making.

BACKGROUND: Suicidal ambivalence is a recognized phenomenon in suicidology, yet not much is known about it in the context of progression from suicidal ideation to action. The current study addresses this gap. We explore narrative dynamics of suicidal ambivalence in stories about transition from suicidal ideation to action.
METHODS: We employ an experiential qualitative approach to gain in-depth understanding of narrated experience of suicidal ambivalence. We conducted semi-structured interviews with 22 patients hospitalized after a suicide attempt. For a detailed analysis, we selected 11 interviews in which the interviewees\' accounts spontaneously referred to their ambivalence about attempting suicide. We used a text-oriented version of Critical Discourse Studies (CDS) to analyze the semantics and syntax, as well as the functions of what was said within the local context, and the social actions thus accomplished.
RESULTS: Our study shows primarily that ambivalence is not resolved. Rather, it is set aside and removed from the narrative and replaced by an action-focused narrative with no references to mental activities.
CONCLUSIONS: We propose that ambivalence recedes and gives way to action and that qualitative research provides a useful evidence base for conceptualizing and understanding the role of ambivalence in transition from suicidal ideation to action.