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Okada is one of the most internationally produced contemporary Japanese playwrights. American directors approach his work both as uniquely Japanese and as a synecdoche for the world. The story of Okada’s web of institutional, professional, and personal relationships is an object lesson in the foreign assembly of international works.

Preamble The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: (1) Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. (2) Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Swiss director Milo Rau holds a mirror up to theatre to call into question its assumptions, conventions, and relationship to daily life. Rau’s nonfictional story of the murder of Ihsane Jarfi takes place within two overarching narratives with different timeframes—what happens on the stage now, and what happened beyond the stage then. His dramaturgy cautions against both suspension of disbelief and catharsis and against confusing the fictional with the real.

ObjectivesWith few empirically supported treatments, functional movement disorders (FMD) can be challenging to manage. To enable service providers to better support people with FMD, this study sought to understand the lived experience of FMD: to gain insight into how individuals make sense of their experience from symptom onset through medical evaluation and diagnosis to post‐diagnostic adaptation.DesignAn interpretative phenomenological analysis (IPA) of patient accounts of living with FMD.MethodsEight participants were recruited from a UK teaching hospital adult neurology service: seven females, varying in age (20s‐70s), FMD symptom type (tremor, dystonia, and tics), and time to diagnosis (10 ‐ 192 months). Semi‐structured interviews facilitated participant accounts of key events. Interviews lasted 75‐125 minutes and were transcribed verbatim.ResultsThree super‐ordinate themes were apparent. The first covered the experiences of onset (‘Something is wrong with me’), including loss of control ‐ with the affected body part often described as a separate entity ‐ threats to identity and disturbance in relationships. ‘At last! What now?’ outlined the bittersweet experience of diagnosis and of treatments. Third, ‘Living my life with it’ incorporated ongoing experiences of coping with symptoms. While some continued to struggle with the emotional impact of symptoms, others developed a compassionate relationship with their self and maintained satisfying activities.ConclusionsFMD has a significant impact on patients’ relationships with themselves and others, which in turn affects well‐being. These findings suggest some nuanced additions to interventions (diagnosis, psychotherapy, physiotherapy, public education.)

There is little research into the subjective experience of adults whose childhoods were spent living with a parent with psychosis. This study explored these experiences; the sense people ma...

Objective; The evidence is that therapy only works for some. This study aimed to explore clients' subjective experience of non‐improvement; specifically how do participants who feel they have not benefitted from psychological therapy describe the experience and make sense of their therapy? Method; Eight people from a National Health Service Psychological Therapies Department in the UK who felt their therapy had not resulted in improvement took part in semi‐structured interviews, later analysed using interpretative phenomenological analysis. Results; Participants described a process, beginning with their difficulties, negative feelings about themselves, and initial hopes and anxieties for therapy. Once in therapy, participants described overwhelming fears of losing control and being judged. They described attempts to manage this, using self‐censoring and compliance. After therapy, while most could identify some gain, they felt disappointed and that they were having to ‘make do’. The sense of not having succeeded or being sufficiently deserving of further input, in turn, reinforced participants' initial negative self‐beliefs. Conclusion; Although participants identified themselves as not having improved through therapy, the accounts suggested more complexity. All participants reported detrimental effects and accounts contained qualified, thoughtful descriptions of these experiences: participants acknowledged some gains, even though they felt that therapy had not met their expectations.

Teaching the topic of genetics in relationship to ancestry and race generates many questions, and requires a teaching strategy that encourages perspective-based exploration and discussion. We have developed a set of dialogues for discussing the complex science of genetics, ancestry, and race that is contextualized in real human interactions and that contends with the social and ethical implications of this science. This article provides some brief historical and scientific context for these dialogues, describes their development, and relates how we have used them in different ways to engage diverse groups of science learners. The dialogue series can be incorporated into classroom or informal science education settings. After listening to or performing the dialogues and participating in a discussion, students will: (1) recognize misunderstandings about the relationship between DNA and race; (2) describe how DNA testing services assign geographic ancestry; (3) explain how scientific findings have been used historically to promote institutionalized racism and the role personal biases can play in science; (4) identify situations in their own life that have affected their understanding of genetics and race; and (5) discuss the potential consequences of the racialization of medicine as well as other fallacies about the connection of science and race.

Introduction:Research into the experiences of those with a diagnosis of young onset dementia is extremely limited and the research that does exist tends to be loss orientated.Aim:This paper will focus on a doctoral study which aimed to explore the full spectrum of lived experience of those with young onset dementia, whilst considering the unique impact of diagnosis at a younger age and the possibility of personal growth.Methods:Five individuals took part in semi-structured interviews within which they were invited to bring along artefacts that helped them to share their experiences. Transcribed interviews were analysed using Interpretative Phenomenological Analysis and superordinate and subordinate themes were identified.Findings:Four superordinate themes emerged: ‘Fear’, ‘Anger’, ‘Sadness’, ‘Contentment’ with thirteen subordinate themes. The findings indicated that participants experienced feelings of fear and vulnerability in response to their diagnosis. Participants felt angry that they did not have a voice, not enough was being done for those with dementia and they were being stereotyped. Participants spoke of a depressive state of mind in which they grieved for their past self, experienced isolation and loneliness, and feelings of hopelessness and despair. Finally, participants spoke of a sense of contentment in relation to a preserved self, a sense of living alongside their dementia and a desire to live in the present; making the most of the here and now.Conclusions:The findings highlight the transitory nature of participants’ experiences as a result of multiple and repeated challenges to psychological equanimity. It suggested that these experiences could best be understood using lenses of lifespan development, bereavement and grief. The findings suggest that approaches to dementia care that focus on developing present-mindedness, acceptance and compassion may be particularly helpful.

A growing body of evidence demonstrates that home-based, multicomponent interventions can effectively reduce exposures to asthma triggers and decrease asthma symptoms. However, few of these studies have targeted adults. To address this and other research gaps, we designed and implemented a pragmatic randomized clinical trial, the Houston Home-based Integrated Intervention Targeting Better Asthma Control (HIITBAC) for African Americans, to assess the effectiveness of a home-based intervention to improve asthma control and quality of life in African-American adults-a population disproportionately affected by asthma. The primary goals were to help participants reduce allergens and irritants in their homes and better manage their disease through knowledge, improved medication use, and behavior change. HIITBAC had two groups: clinic-only and home-visit groups. Both groups received enhanced clinical care, but the home-visit group also received a detailed home assessment and four additional home visits spaced over roughly one year. We recruited 263 participants. Of these, 152 (57.8%) were recruited through electronic health record data, 51 (19.4%) through Emergency Medical Services data, and 60 (22.8%) through other efforts (e.g., emergency departments, community events, outreach). Seventy participants (26.6%) were lost to follow up, substantially more in the home-visit than in the clinic-only group. We describe the HIITBAC methodology and cohort, discuss lessons learned about recruitment and retention, and highlight adaptations we implemented to address these lessons.

Not enough is currently known about how people with learning disabilities experience and understand the ageing process. This is particularly important as the population of older people with learning disabilities is growing due to increased life expectancy. This study aims to fill this gap in the literature by exploring how people with learning disabilities experience and make sense of the ageing process and old age. Seven people with learning disabilities aged 60 or over were interviewed, and their accounts were analysed using Interpretative Phenomenological Analysis. An individual analysis of each participant’s account is presented, followed by the group analysis. The master themes arising from the group analysis were: quality of relationships is central to enjoyment of life, including sub-themes on the importance of affection and companionship, distress at lack of closeness, and anxiety about ability to satisfy others; powerlessness; needing a sense of purpose; and making sense of getting older, including sub-themes on reactions to changes with age, life review and looking to the future. The findings of the study are discussed in relation to the existing literature. Clinical implications of the findings include the need for services to support older people with learning disabilities in maintaining friendships and meaningful activities. This study demonstrates that some older people with learning disabilities can engage in a process of life review and learning disability services could play a useful role in facilitating this process. Understanding of the ageing process varied between participants, and tended towards a negative, stereotypical view of ageing. The findings suggest that people with learning disabilities could benefit from psychoeducation on the ageing process to aid them in making sense of the changes they experience as they get older.

In Becoming - Corpus Ximena Garnica and Shige Moriya have created a work about the misapprehensions of what appears before us followed by revelations of what we are able to see: illusion without magic or otherworldliness, fantastical imagery linking memory to the lurking presence of the uncanny.

This brief paper outlines some of the changes in thinking about ageing, drawn primarily from a comparison of two texts on adult development and ageing, published over 20 years apart. The aim of the article is to encourage clinicians to think about how and if models of ageing have changed, and what implications this may have for service development and clinical practice.

The notion that documents provide incontrovertible evidence has long been in question. Yet documents, in both their material and digital forms, are still well respected and are used as sources of information with consequences for the creation of meaning in historical accounts, in legal procedures, and on theatre stages. The theatrical life of documents may or may not contain anything real, in the sense of actual, physical, factual, or material. What is the document, what is its province, and what kinds of meanings does the way in which it is staged produce? I will address these questions in relation to three international performances: Double Edge Theatre’s The Grand Parade directed by Stacy Klein (2013), The Year I Was Born (2010), and The Pixelated Revolution (2011).

How should we understand the mobile phone images uploaded to the internet during the ongoing Syrian Revolution? Are the broken-up and incomplete images taken by Syrians an extension of their physical experiences? Are mobile phones extensions of photographers' brains, of their bodies, of their beings?

Aim: To identify therapists’ views on sexual boundaries and the strategies they employ to manage them in therapeutic practice. Method: In-depth qualitative interviews were conducted with a sample of 13 accredited, experienced practitioners of psychotherapy or counselling. A grounded theory approach, informed by principles from Free Association Narrative methodology, was employed, in which team members used debriefing sessions for extending depth of understanding of the interviews. Findings: There is consensus about boundaries at the extremes, but variability about fantasy, flirtation and touch. A core process was generated from accounts of successful management of sexual attraction. We identified four problematic ways of reacting to boundary pressure, each with potential to harm clients and therapy. Discussion: A participant-observer stance was conceptualised as essential for managing threats to boundaries, consistent with the empathic stance. Minor boundary crossings were viewed by interviewees ...

Carol Martin and Rachel Chavkin discuss the intellectual formation and working methods of the young American theatre company, the TEAM—Theatre of the Emerging American Moment.

BACKGROUND: delirium is likely to be particularly common in care homes, given the clustering of known risk factors in these settings. Preventing delirium should result in significant benefits, including better quality of care and improved outcomes for residents. OBJECTIVE: to test the feasibility of 'Stop Delirium!', an intervention to prevent delirium in care homes for older people, and to optimise parameters to inform the design of a future trial evaluation. Method: we delivered Stop Delirium! to six care homes over 10 months, in a mixed methods before and after study. RESULTS: Stop Delirium! was successfully implemented in the study homes. We found evidence supporting positive changes in staff attitudes and practice after the intervention. Although qualitative data suggested it was too early to expect changes in resident outcomes, we also found preliminary evidence suggesting potential improvements in a range of outcomes, including a reduction in the number of falls and prescribed medications. CONCLUSION: a complex intervention for delirium prevention in care homes is feasible and has the potential to improve staff practice and outcomes for residents. This work provides the basis for the next phase of the evaluation to establish its effectiveness and cost-effectiveness. Language: en

Documentary theatre is created from archived materials that foreground the nonfictional, even as it uses the literary and theatrical devises of fiction. The extratextual language of the body of the actor separates evidence from testimony, creating a space where the archive is interpolated by the repertory.