Littérature scientifique sur le sujet « Friends to lover »

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Articles de revues sur le sujet "Friends to lover"

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Galambos, Nancy L., Shichen Fang, Rebecca M. Horne, Matthew D. Johnson et Harvey J. Krahn. « Trajectories of perceived support from family, friends, and lovers in the transition to adulthood ». Journal of Social and Personal Relationships 35, no 10 (5 juillet 2017) : 1418–38. http://dx.doi.org/10.1177/0265407517717360.

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Trajectories of perceived support from family, friends, and lovers were examined in 923 high school seniors surveyed across the transition to adulthood (ages 18, 19, 20, 22, and 25). Growth models revealed a cubic pattern of support from family members, which peaked at age 20, no change in friend support, and a linear decrease in lover support. Women reported higher levels of support than did men for all sources except fathers. Over time, friend and lover support decreased for women but increased for men. Both mother and father support were higher among young people who had left home, and cohabitation/marriage was associated with lower friend support and higher lover support. Support in close social relationships in the early 20s is dynamic; personal characteristics (e.g., gender) and life course transitions such as leaving home and marriage contribute to changing levels of perceived support.
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Kim, Hyun-Young, et Kyu-Won Sim. « Comparative study on national park visitation behavior of the MZ generation : Comparison of Old Millennials, Young Millennials, and Generation Z(2023) ». Korea National Park Research Institute 14, no 2 (30 novembre 2023) : 14–20. http://dx.doi.org/10.54406/jnpr.2023.14.2.014.

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The purpose of this study is to segment the MZ generation (Old Millennial/Young Millennial/Generation Z), which will lead future national park visiting culture and trends, to compare differences in national park visiting behavior and identify the characteristics of each generation. The results are as follow. First, the Old Millennial generation has the highest rate of visiting mountain-type national parks, but compared to Young Millennials and Generation Z, they are a generation with a higher rate of visiting marine & coastal-type and urban-type national parks. Additionally, this generation visits national parks by car with a variety of companions( friends/colleagues/lover, family, mountain climbing clubs/clubs). They mainly engage in accommodation travel and summit climbing activities, and enjoy linked tourism such as visiting tourist attractions both before and after visiting the national park as well as before or after visiting the national park. Second, young millennials mainly visit mountain-type national parks with friends/colleagues/ lover or alone by car, and the highest proportion of visitors enjoy summit climbing on day trips and visit national parks only. However, compared to Generation Z and Old Millennials, this generation has the highest rate of visiting other tourist destinations before or after visiting a national park. This generation is mainly comprised of office workers with an income of more than 2 million won to less than 4 million won who visit for the purposes of recreation/rest/healing, experience of appreciating natural scenery/cultural assets, and promoting friendship. Lastly, Generation Z mainly visits mountainous national parks with friends/colleagues/lover using various means of transportation such as private car and public transportation, and mainly climb to the top as a day trip. However, among the MZ generation, they explore lowlands the most. They have a higher rate of only visiting national parks than linked tourism, and visit for the purposes of recreation/rest/healing, promoting friendship, and experience of appreciating natural scenery/cultural assets. This generation is mainly comprised of students with an income of less than 4 million won. Based on the research results, we aim to contribute to improving the satisfaction of MZ generation visitors in national parks.
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Magnusson, Roger S. « “Underground Euthanasia” and the Harm Minimization Debate ». Journal of Law, Medicine & ; Ethics 32, no 3 (2004) : 486–95. http://dx.doi.org/10.1111/j.1748-720x.2004.tb00161.x.

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I have a hairstylist whose lover was very sick. I’d been seeing this stylist for ten years and we’re good friends. [His lover was] becoming an invalid, not able to get out of bed. He said “I hate to ask you this but would you mind writing a prescription to help us out?” [So] I wrote a prescription to a patient who I had never seen, and I sent it to him in the mail and I heard the next time I went in to get my hair cut that it was the most beautiful experience that my stylist had ever had. It was Valentine’s Day and they had a lovely meal with champagne. And they held each other and then, you know, his partner took his pills and was released.(Joseph, physician)
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Bollobás, Enikő. « Versions of Triangular Desire in Hungarian Literature : Reading Sándor Márai and Péter Nádas ». Hungarian Cultural Studies 11 (6 août 2018) : 48–56. http://dx.doi.org/10.5195/ahea.2018.321.

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Two Hungarian authors, Sándor Márai and Péter Nádas, seem to have one thing in common: their attraction to triangular relationships. Written between 1935 and 1942 and portraying human relations in pre-World War II Hungary, Márai’s two novels and one drama all turn on a very specific triangular structure between two close friends and the woman whom they both love(d). Now they conduct a painful tête-à-tête to decide on the final ownership (or simply fate) of the woman. Written in 1979 and portraying human relations in communist Hungary, Nádas’s play has only two actors on stage, a woman of aristocratic descent and a young man, the son of a high-ranking communist official, the woman’s long dead lover. This exchange between the two characters opens into an encounter of three, where the woman and the young man each use the other as a mediator to reach the third, the lover/father. Bollobás argues that the triangles displayed by the two authors represent two distinct types: the former is informed by fixed, hierarchical, subject-object power relations, while the latter by fluid, non-hierarchical, subject-subject relations.
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Praptiningsih, Novi Andayani, Herri Mulyono et Benni Setiawan. « Toxic relationship in youth communication through self-love intervention strategy ». Online Journal of Communication and Media Technologies 14, no 2 (1 avril 2024) : e202416. http://dx.doi.org/10.30935/ojcmt/14292.

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This study set out to identify and analyze toxic relationships in interpersonal communication among adolescents. The toxic relationship, as an unhealthy relationship, does have an impact on the occurrence of internal conflicts. Such relationships often cause the people involved to encounter unproductiveness and mental disorders, which can trigger an emotional outburst that leads to violence. A qualitative approach was used as the research method. The data collection techniques comprised FGD, observation, and in-depth interviews with informants/participants as primary data. The study findings show that first, the perpetrators of toxic relationships, namely toxic people, could be those closest to the victims, such as the nuclear family (father, mother, and siblings). In addition, the perpetrator could be a lover in an unhealthy romantic relationship or peers and even friends who often do the bullying via verbal, physical, or even sexual violence. Second, toxic relationships can be categorized into several forms, namely unhealthy relationships with friends (‘toxic friendship’), parents/family (‘toxic parenting’), lovers, and cheating parents, which can affect a child’s mentality. Actions necessary include the raising of awareness and concern for the community. If violent behavior occurs, it is not permissible to act permissive. The individual approach carried out during victim assistance can entail consultations in the form of ‘vent sessions’. A powerful way to anticipate being trapped in an unhealthy relationship is via self-love. Counselling is carried out with a self-healing approach to restore victims’ self-confidence and maintain their mental health.
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Menn, Esther. « THWARTED METAPHORS : COMPLICATING THE LANGUAGE OF DESIRE IN THE TARGUM OF THE SONG OF SONGS ». Journal for the Study of Judaism 34, no 3 (2003) : 237–73. http://dx.doi.org/10.1163/15700630360702794.

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AbstractContrary to what might be expected, the allegorical interpretation of the Song of Songs set forth in the Targum of the Song of Songs does not consistently portray God and Israel as male lover and female beloved. Instead, the Targum presents a multiplicity of additional metaphors suggesting the intimacy between divine and human counterparts throughout their history together, including the affective relationships between male friends and scholarly colleagues, siblings, infant and nurse, father and son, gardener and plants, and farmer and animals. Ambivalence towards sexual love and marriage as appropriate theological metaphors, sensitivity to the rich symbolic language of the Song of Songs and other scriptural passages, and celebration of the primacy of Torah study with male colleagues in rabbinic culture all contribute to this diversification of imagery, which builds on the emotive intensity of the Song of Songs even as it complicates the language of desire.
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Luthfiah, Yasmin Rifdah, Hasbi Assiddiqi et Udayani Permanaludin. « IDEAL ROMANCE FORMULA IN THE MOVIE SCRIPT OF EMMA (2020) AND PERSUASION (2022) : COMPARATIVE LITERATURE ». Saksama 2, no 1 (14 juillet 2023) : 25–42. http://dx.doi.org/10.15575/sksm.v2i1.24820.

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Romance movie scripts are one of the most popular types of popular literature. But most fans don't know that in a work of popular literature there is a formula that is quite important because it influences the plot of the story and helps the audience to understand more about the story. Examples of romance movie scripts that have this formula are Emma (2020) and Persuasion (2022). This research will discuss the ideal romance formula in the movie scripts Emma (2020) and Persuasion (2022) using Radway's ideal romance formula theory and comparative literature theory. The purpose of this study is to find out the differences of the ideal romance formula in the movie scripts of Emma (2020) and Persuasion (2022). This research is qualitative research with a comparative descriptive research method. The results obtained from this research are that Emma fulfills 10 out of 13 functions with the 4th, 5th, and 10th functions which are not fulfilled. Meanwhile, Persuasion also fulfills 10 out of 13 functions with the 3rd, 4th, and 10th functions which are not fulfilled. This is due to the theme of romance which is raised differently. Emma (2020) has the theme from best friends to lover, while Persuasion (2022) has the theme from ex to lover.
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Van der Merwe, Dirk. « THE WOMAN IN SONG OF SONGS ». Journal for Semitics 25, no 2 (9 mai 2017) : 572–94. http://dx.doi.org/10.25159/1013-8471/2536.

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The woman in Song of Songs seems to be the main character in dialogue with a lover and friends. Over many centuries several hypotheses have appeared about the epistemological questions concerning the identity and character of this woman as well as the interpretation of her dialogue with other characters in the Song. The unencumbered, rich and vibrant metaphoric text of Song of Songs describes the woman as a most beautiful and dynamic character. This research intends not to become involved in these debates but only to attempt to investigate in a coherent way the following topics, “A literary interpretation and some general remarks”, “The identity of the woman”, “The character of the woman”, “The woman in different relationships” and finally “The function of the woman in the rhetoric of the author”.
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Rus, Annemarije. « What Happens Stays ». Journal of Festive Studies 5 (13 novembre 2023) : 190–207. http://dx.doi.org/10.33823/jfs.2023.5.1.134.

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Although celebration is a classic anthropological subject, little research has been done on party holidays. After high school graduation, Dutch youth head to Lloret de Mar in Spain for a party holiday to losgaan, or get loose. This term implies the breaking of boundaries, a sense of liberation and freedom. But to get loose, you need to hold on: to friends, a holiday lover, gender and nationality identifications, and to your phone. The visual ethnographic film titled Lloret ’18 invites you to question the freedom implied in nightlife, tag along with Dutch youth on their adventures and reflections, and consider the ways social media shapes our realities. This article considers the value of ethnographic filming in a party setting as well as the ethical issues that its practice raises. (Watch the film.)
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Guo, Jiaying. « Toni Morrison’s Hope for African American : A Psychoanalytic analysis of God Help the Child, A Story of Trauma ». International Journal of Linguistics, Literature and Translation 4, no 4 (27 avril 2021) : 01–04. http://dx.doi.org/10.32996/ijllt.2021.4.4.1.

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In God Help the Child, Morrison narrates a story of trauma with the strategy of magical realism, explaining how African American women survive in American and how they get along with folks, friends and lover in the face of race and patriarchy. Morrison also rests her hope on God Help the Child, where black values and African Americans do not concern their colour. This paper employs a descriptive research approach to study the trauma narrative and Morrison’s hope. We accompany childhood trauma for a lifelong time, and we must resolve to balance life and the traumatic experience. After the eventful years, Morrison has settled her sternness and indignation in her later years, and she turns to a relatively mild tone towards the racial problems. In short, she hopes the African American could forget the former racial trauma and open a new chapter of life.
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Thèses sur le sujet "Friends to lover"

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Kim, Bradford Jean-Hyuk. « Aristotle on the value of friends ». Thesis, University of Oxford, 2018. http://ora.ox.ac.uk/objects/uuid:7a7d2d16-2514-457c-a217-968af1111a60.

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In this dissertation, I argue that Aristotle's account of friendship is egoistic. Focusing on the Nicomachean Ethics, I begin with VIII.2. Here Aristotle claims that in all friendships, friends love only because of the lovable (φιλητóv), which divides into the useful, pleasant, and good. I argue that "because of (διὰ)" refers to at least the final cause and that "the lovable" refers to what appears to contribute one's own happiness (εuδαιμoνία); therefore Aristotle claims that in all friendships, friends love only for the sake of their own happiness. This result may seem incompatible with some types of concern Aristotle principally attributes to his normative paradigm of complete friendship: wishing goods for the sake of the other and loving the other for himself. One might argue that these types of concern are altruistic, and so it cannot be the case that in all friendships, friends love only for the sake of their own happiness. I argue that these types of concern ultimately hinge on one's own happiness. The object is the lovable (what appears to contribute to one's own happiness), specifically the good instantiated by the other's virtue; further, what a virtuous person takes as valuable about another's virtue is how it facilitates her own virtuous activity, that is, her own happiness. From here I turn to Aristotle's notion of 'another self'. One popular interpretation of other selfhood defies the altruism/egoism divide. Here the essential feature of other selfhood is virtue, which allows for no prioritization among virtuous people; there is no prioritization of the other over oneself (as in altruism) nor of oneself over the other (as in egoism), since the relevant parties are equal in moral standing (they are virtuous). Assessing the instances of 'another self' in the Nicomachean Ethics VIII.12, IX.4, and IX.9, I argue for an egoistic interpretation of other selfhood; the essential feature of other selfhood is involvement in one's own actualization. That is, what makes other selves valuable is how they facilitate one's own virtuous activity, one's own happiness. Finally, I address the doctrine of self-love in the Nicomachean Ethics IX.8. Again, some interpreters derive non-prioritization from the text; Aristotle claims that all virtuous people identify with the understanding (voũç), so, the non-prioritization interpretation goes, there can be no prioritization among virtuous agents, as they are identical in the relevant way. I argue for an egoistic interpretation of IX.8; Aristotle endorses praiseworthy self-love, which involves maximizing the superlatively valuable fine (καλòν) for oneself over others. Moreover, such self-prioritization occurs precisely by gratifying the understanding, that which was supposed to ground non-prioritization.
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Utter, Helena. « “I’m Anti Love as Such.” : Female Friendship in Sally Rooney’s Conversations with Friends ». Thesis, Högskolan Väst, Avd för utbildningsvetenskap och språk, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-16851.

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Guest, Paul Martin. « Lovers, friends and enemies : the determinants and effects of UK takeover bids, 1985-95 ». Thesis, University of Cambridge, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268960.

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Bachir, Bacha Aïcha. « Animas Altas' “Friezes Building”. Being Paracas At The Lower Ica Valley ». Pontificia Universidad Católica del Perú, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/113445.

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This paper presents and discusses the results of recent investigations carried out by the Ánimas Altas Archaeological Program, in the Ica department, southern Peru. A particular emphasis is put on the excavations conducted at a frieze-decorated building. The analysis of the material culture registered in this building, particularly of the icons depicted on the friezes, not only offers some interpretations regarding Paracas symbology and cosmovision but also sheds lights on critical aspects related to identity as well as the territorial dynamics of the Paracas social formations from the lower section of the Ica valley. Furthermore, imagery depicted on friezes support the idea that social interactions promoted by the Paracas were not limited to the adjacent highland. Even more, potential links with the north and central coast from remote timesneed to be further investigated. The stylistic and technological variations registered at the «Building of Friezes» – which are not diachronically manifested, can reveal diverse phenomena such as the occupation of the territory by several groups that gave shape to socio-political identities in Late Paracas times. The comparison between the data obtained from the excavation at the «Building of Frizes» and other Paracas sites´will allow Paracas scholars to formulate interpretations and hypotheses about both the political and cultural spaces of the ancient Paracas.
En este artículo, se presentan y se discuten los resultados de las recientes investigaciones llevadas a cabo en el marco del Programa Arqueológico Ánimas Altas, Ica, Perú. Se enfatizan las excavaciones realizadas en un edificio decorado con frisos. El análisis de la cultura material de este edificio —en particular, de los íconos plasmados en los frisos— ofrece algunas interpretaciones no solamente respecto a la simbología y cosmovisión paracas; también, arroja luces sobre aspectos relacionados con dinámicas identitarias y territoriales de las formaciones sociales paracas en el valle bajo de Ica. Los íconos plasmados en los frisos apoyan la idea según la cual las interacciones de los paracas no se limitaron a la sierra adyacente. Más aún, existen nexos con la costa norte y central desde épocas remotas que quedan por investigar. Las variacionesestilísticas y tecnológicas observadas en el Edificio de los Frisos —que no se manifiestan en diacronía— pueden revelar varios fenómenos, entre ellos, la ocupación del territorio por varios grupos que formaron entidades sociopolíticas en la época Paracas Tardío. Las comparaciones entre los datos proporcionados por las excavaciones del Edificio de los Frisos con los de otros sitios permitirán formular interpretaciones e hipótesis sobre el espacio político y cultural de los paracas.
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Chunhacha, Nitan. « Baby Blue : The Making of ». Thesis, Konstfack, Grafisk design & ; illustration, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:konstfack:diva-7377.

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Baby Blue is a comic book about friendship and romantic love that is told by two characters. I want to explore more on understanding a complicated feeling between romantic love and friendship love. Since relationships are very complicated and difficult to understand, I think it’s a good way to go through a journey with the main character and see how she’s dealing with her own feelings. In this report, I explained more about my process and everything you need to know about Baby Blue.
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Vandborg, Claire. « God as friend a model of God in the writings of Mary Ward and Sallie McFague / ». Online full text .pdf document, available to Fuller patrons only, 2001. http://www.tren.com.

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Moore, J. Brian. « Critical friends groups at Lower Canada College : the impact of collaborative communities on teachers' professional growth and classroom practices ». Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81506.

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This qualitative inquiry into Critical Friends Groups (CFGs) at Lower Canada College (LCC), a coeducational, bilingual, K-12, private, day school in suburban Montreal, focusses on the impact of CFGs on teachers' professional growth and classroom practices. Using interviews, focus groups, participant observations and a questionnaire, I examined the recursive cycle of professional growth and transformation, and rooted the inquiry within the theoretical frameworks of reflective practice, the dialogic imagination, social constructivist learning and critical theory. I conceptualize teachers' professional growth as the transformation of professional practices through the deepening knowledge and expertise that arises out of collaborative inquiry and collegial dialogue. The major assumption supported by this study is that teachers learn from one another through engaging in ongoing and site-based critical dialogue focussed on classroom practices. This inquiry has implications for professional development programmes, school leadership and teacher empowerment.
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Sperens, Jenny. « My Friend Is the Man : Changing Masculinities, Otherness and Friendship in The Good Soldier and Women in Love ». Thesis, Umeå universitet, Institutionen för språkstudier, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-135734.

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This essay explores how masculinity is portrayed in The Good Soldier (Ford Madox Ford) and Women in Love (D.H Lawrence), and how Victorian and Edwardian masculinity ideals impact the friendships between the characters John Dowell and Edward Ashburnham and Rupert Birkin and Gerald Crich. The novels portray how hegemonic masculinity in Edwardian Britain changed from one type of masculinity, based on physical dominance, to include another, which drew on expert knowledge, capitalism and rationalism. In the texts, these masculinities are buttressed by the comparison to a male Other. In The Good Soldier, Edward Ashburnham stands for the ideals connected to dominance through his roles as landlord and soldier, and he is depicted as the “manlier” character in comparison to John Dowell. The same kind of coupling is found in Women in Love, where Gerald Crich represents both older ideals of dominance and newer ideals of expertise and rationality and Rupert Birkin is the relational opposite. Both Rupert Birkin and John Dowell are categorized as “not man” in the texts in order to emphasize that Edward Ashburnham and Gerald Crich are the “real” men. However, when the “manlier” characters have died both John Dowell and Rupert Birkin perpetuate masculine ideals, either by emulating hegemonic ideals or by redefining them. Furthermore, the Victorian and Edwardian conceptions of masculinity and male friendship inhibit the characters from forming emotionally close friendships. In both texts, emotional intimacy is portrayed as precarious and a more impersonal from of friendship that entails loyalty to a group or cause, camaraderie, is preferred.
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Gonzalez, Bilkowskij Marlen Barbara. « La responsabilidad Social Pet Friendly y su impacto en el comportamiento de compra de los consumidores pet lovers de 22 a 35 años de Plaza Vea de Lima Metropolitana ». Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2020. http://hdl.handle.net/10757/653572.

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Muchas empresas han sido impactadas por la tendencia pet friendly, la cual ha tomado protagonismo en diversos establecimientos comerciales y en las estrategias que elaboran las empresas de distintas categorías en el mercado. Asimismo, ha impactado también en el comportamiento de compra de las personas, el gasto que realizan en el hogar y en su estilo de vida en general. Es así que las empresas están adoptando una posición firme frente a los problemas sociales que afectan a las mascotas, como el maltrato y abandono animal, y se han vuelto parte de la solución adoptando estos problemas dentro de su responsabilidad social. Asumiendo esta realidad, lo que se busca en esta investigación es entender el impacto que puede tener en el consumidor la responsabilidad social que muestra una marca retail tan grande como Plaza Vea y que además se vea ligada a la tendencia pet friendly, fuertemente valorada por los consumidores actualmente. Para ello, se evaluará cuál es el comportamiento de compra de los consumidores, entendiendo primero su satisfacción con la marca y su grado de lealtad.
Many companies have been impacted by the pet friendly trend, which has taken center stage in various commercial establishments and in the strategies developed by companies of different categories in the market. Likewise, it has also had an impact on people's buying behavior, their spending at home and their lifestyle in general. Thus, companies are taking a firm position on the social problems that affect pets, such as mistreatment and neglect of animals, and have become part of the solution by adopting these problems within their social responsibility. Assuming this reality, what is sought in this research is to understand the impact that the social responsibility shown by a retail brand as large as Plaza Vea can have on the consumer and that it is also linked to the pet friendly trend, highly valued by consumers. consumers. consumers currently. To do this, the buying behavior of consumers will be evaluated, first understanding their satisfaction with the brand and their degree of loyalty.
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Gomes, Jenna M. « The Things He Left Behind ». University of Dayton / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1525359214648996.

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Livres sur le sujet "Friends to lover"

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Loving Mr. Spock : Understanding a lover with Asperger's syndrome. Arlington, Tex : Future Horizons, 2003.

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Clarkson, Wensley. Bindon : Fighter, gangster, actor, lover : the true story of John Bindon, a modern legend. London : John Blake, 2007.

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Walker, Shiloh. Her Best Friend's Lover. Ellora's Cave, 2004.

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Pardon, Nicolle. From Friends to Lover : Best Mates. Independently Published, 2020.

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Publishing, Crafter. Weekend Forecast : Scrapbooking Friends Handmade Chocolate Lover. Independently Published, 2019.

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My lover, my friend : True-life stories of lesbian romance between friends. Los Angeles, CA : Alyson Books, 2003.

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Elder, Lindsey. My Lover, My Friend : True-Life Stories of Lesbian Romance Between Friends. Alyson Books, 2003.

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Publishing, Notebook. Best Friends : Couples I Love I Friends I Donuts & Coffee I Food Lover. Independently Published, 2019.

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Publishing, Publishing. Best Friends : Couples I Love I Friends I Donuts & Coffee I Food Lover. Independently Published, 2019.

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Publishing Notebook & Journal. Best Friends : Couples I Love I Friends I Donuts & Coffee I Food Lover. Independently Published, 2019.

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Chapitres de livres sur le sujet "Friends to lover"

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Vernon, Mark. « Friends and Lovers ». Dans The Meaning of Friendship, 43–72. London : Palgrave Macmillan UK, 2010. http://dx.doi.org/10.1007/978-0-230-27535-5_3.

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Macrae, Alasdair D. F. « Friends and Loves ». Dans W. B. Yeats, 102–25. London : Palgrave Macmillan UK, 1995. http://dx.doi.org/10.1007/978-1-349-23749-4_6.

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Vernon, Mark. « Friends and Lovers ». Dans The Philosophy of Friendship, 29–49. London : Palgrave Macmillan UK, 2005. http://dx.doi.org/10.1057/9780230204119_3.

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Stein, Alexandra. « Family and friends ». Dans Terror, Love and Brainwashing, 88–107. New York : Routledge, [2017] : Routledge, 2016. http://dx.doi.org/10.4324/9781315559223-6.

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Paice, Rosamund. « The Anti-Friend ». Dans Milton's Loves, 114–48. New York : Routledge, 2023. http://dx.doi.org/10.4324/9781003348061-5.

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Gustafson, Karl. « 9. Wives, Lovers, Friends ». Dans The Crossing of Heaven, 113–23. Berlin, Heidelberg : Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/978-3-642-22558-1_9.

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Duncan, Sam. « Family, friends and lovers ». Dans Oral Literacies, 83–103. London ; New York : Routledge, 2020. | Series : Literacies : Routledge, 2020. http://dx.doi.org/10.4324/9780367087005-ch6.

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Erber, Ralph, et Maureen Wang Erber. « Strangers, Friends, and Lovers ». Dans Intimate Relationships, 1–9. 4e éd. New York : Routledge, 2024. http://dx.doi.org/10.4324/9781003356790-1.

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Brereton, Geoffrey. « Patrons, Friends and Lovers ». Dans Jean Racine, 144–69. London : Routledge, 2022. http://dx.doi.org/10.4324/9781003282655-14.

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Erber, Ralph, et Maureen Wang Erber. « Strangers, Friends, and Lovers ». Dans Intimate Relationships, 1–10. Third Edition. | New York : Routledge, 2018. | Revised edition of the authors’ Intimate relationships, c2011. : Psychology Press, 2017. http://dx.doi.org/10.4324/9781315110103-1.

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Actes de conférences sur le sujet "Friends to lover"

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Juariah, Juariah. « Factors Associated with Dating Behavior of Adolescents in North Coastal Line, West Java ». Dans The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.02.17.

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Background: Interest to the opposite sex is one changing that is happened in adolescence. Dating behavior of adolescents can be the beginning of premarital sex that will impact on the emergence of adolescent reproductive health problems such as unintended pregnancy and STDs/HIV/AIDS. The purpose of this study was to give description of factors related to dating behavior of early adolescents in North Coastal line, West Java. Subject and Methods: Type of this research was descriptive analytic with cross sectional design. The research was conducted in Pusakajaya Public Junior High School 1 and 2, Subang Regency. Population of this study was all of students at class VII in the selected schools. Sample of the study determined by purposive sampling technique with criteria the students ever had a lover or currently they were having a boyfriend/girlfriend. Number of respondents were 269 students. Data collection was done by interview using questionnaire as a tool. Data was reviewed using univariate and bivariate analysis. Results: Results of this study showed that 36,8% of the respondent had risky dating behavior, 25,7% did not live with their parent, 57,2% of them had low religiosity,74,7% had lack of knowledge in sexuality, 47,6% had negative attitude toward risky dating, 53,9% ever accessed pornography content and 48,3% had friend with risky dating behavior. Using Chi Square test to analyze showed that factors related to risky dating behavior were low religiosity (OR=44,68 ;95%CI=15,65 to 127,56; p=0,000), lack of knowledge (OR=14,34; 95%CI=5,03 to 40,87; p=0,000), negative attitude (OR=34,73; 95%CI=16,01 to 75,35; p=0,000), accessed pornography content (OR=79.02; 95%CI=23,89 to 261,33; p=0,000) and negative behavior of friends (OR=201,3 ;95%CI=47,19 to 859,04; p=0,000). Conclusion: There was a significant relationship between religiosity, knowledge, attitude, access to pornography content and dating behavior of friends with risky dating behavior. Keywords: factors, risky, dating behavior, early adolescent, north coastal line Correspondence: Juariah.The Agency of Research and Development West Java Province. Jl. Kawaluyaan Indah Raya No. 6, Bandung, Indonesia. E-mail: ai_arriandhi@yahoo.co.id. Mobile: 081313452500 DOI: https://doi.org/10.26911/the7thicph.02.17
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Anand, Sarabjot Singh. « Session details : Friends and lovers ». Dans RecSys '10 : Fourth ACM Conference on Recommender Systems. New York, NY, USA : ACM, 2010. http://dx.doi.org/10.1145/3257562.

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Li, Xueying, Xilei Wang, Wenwu Dai et Ning Jia. « THE INFLUENCE OF POWER AND SOCIAL DISTANCE ON FAIRNESS PERCEPTION IN THE MULTIPLAYER ECONOMIC GAME ». Dans International Psychological Applications Conference and Trends. inScience Press, 2021. http://dx.doi.org/10.36315/2021inpact100.

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"Objective: The goal of this research was to explore the influence of power and social distance on individual fair perception in the context of income. Methods: College students were selected to investigate and 197 answers, including 58 boys and 139 girls. Average age was 22.01 years (SD=2.52). The subjects were randomly divided into different groups, including 62 mothers ,75 friends and 60 strangers. The experimental design was 2[power: low power(be a responder), high power(be an allocators)]×3[social distance: near (mother), middle (friend), far (stranger)] mixed experimental design. There is one allocator and two responders in the game. The experiment was divided into two subtasks according to the role of the participants: Subtask 1, stranger A is allocator, the participant is one responder, and the other responder is Mother/Friend/Stranger B. Subtask 2, the participant is allocator, stranger A is one responder, the other responder is still Mother/Friend/Stranger B. Results: (1) The participants had a lower sense of fairness to the same distribution scheme when their role changed from responder to allocator. (2) When friends and strangers got more money than themselves, the participants had a lower sense of fairness. (3) No matter what kind of distribution scheme, as long as the sum of the amount of money received by the participant and his mother is the same, he had the same fairness perception. Conclusion: First, the change of power will affect the individual's fair perception, and the higher demand for fairness after the power increases; Second, the influence of social distance reflects the characteristics of the Chinese self, that is, the self of Chinese people contains his/her mother."
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Davis, Josh Urban, et Johann Wentzel. « Font Your Friends and Loved Ones : On the Utility of Ugly Interfaces ». Dans CHI '21 : CHI Conference on Human Factors in Computing Systems. New York, NY, USA : ACM, 2021. http://dx.doi.org/10.1145/3411763.3450371.

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Sathyaprabha, R., S. Vigneshwaran, Ravi Manishaa, S. Vivek, S. Ajith, Sivabalan Mani et VR Sanal Kumar. « Design of Environmental Friendly Chevron Nozzles for Lower Stage Rockets ». Dans 52nd AIAA/SAE/ASEE Joint Propulsion Conference. Reston, Virginia : American Institute of Aeronautics and Astronautics, 2016. http://dx.doi.org/10.2514/6.2016-4910.

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Jašková, Ľudmila. « THREE PROGRAMMING ENVIRONMENTS FRIENDLY TO BLIND STUDENTS IN LOWER SECONDARY EDUCATION ». Dans 14th International Conference on Education and New Learning Technologies. IATED, 2022. http://dx.doi.org/10.21125/edulearn.2022.1917.

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Abboud, Amir, Thomas Dueholm Hansen, Virginia Vassilevska Williams et Ryan Williams. « Simulating branching programs with edit distance and friends : or : a polylog shaved is a lower bound made ». Dans STOC '16 : Symposium on Theory of Computing. New York, NY, USA : ACM, 2016. http://dx.doi.org/10.1145/2897518.2897653.

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Pandey, Jyoti Shanker, Negar Nazari, Kaj Thomsen et Reza Barati. « A Novel Equipment-Friendly and Environment-Friendly Well Stimulation Fluid for Carbonate Reservoirs : Better Wormholes and Lower Corrosion at Reservoir Conditions ». Dans SPE International Conference and Exhibition on Formation Damage Control. Society of Petroleum Engineers, 2018. http://dx.doi.org/10.2118/189496-ms.

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Rohde, Barukh Ben. « Towards lower-cost, user friendly acoustic detection systems for hidden insect infestations in trees ». Dans 2016 International Congress of Entomology. Entomological Society of America, 2016. http://dx.doi.org/10.1603/ice.2016.115333.

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Egan, Kathleen, et Melissa Cox. « Variations in likelihood to use protective behavioral strategies for marijuana across physical and social contexts of use ». Dans 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.29.

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Protective behavioral strategies for marijuana (PBSM) are intended to reduce harms associated with use of marijuana. Harms may vary based on the physical and social contexts in which individuals use marijuana resulting in people employing PBSM differentially across contexts. We examined where and with whom young adults are likely to employ PBSM when using marijuana. In Fall 2021, we conducted an online survey with 506 young adults who were current users of marijuana and lived in the U.S. (N=506; 55.6% female, 62.6% White). Participants were evenly distributed across states according to marijuana policy (33% each in recreational, medicinal, or neither). Participants rated their likelihood (‘not at all,’ ‘somewhat,’ or ‘extremely/very likely’) to engage in 8 strategies derived from the PBSM Scale that focused on using marijuana only with trusted peers, minimizing intoxication, and driving a vehicle after using marijuana. Participants indicated their likelihood to use each strategy in 4 physical contexts (own home, friend’s home, someone else’s home, public location) and 3 social contexts (alone, one or few closest friends, large group). We conducted generalized logit mixed models with a multinomial dependent variable, treating the respondent as a random effect, to assess differences in likelihood to use PBSM across physical and social contexts. Separate models were run for each PBSM by physical (referent: at own home) and social (referent: alone) context. Physical context: Odds of being ‘somewhat likely’ or ‘extremely likely’ (referent: ‘not at all likely’) to ‘use marijuana only among trusted peers’ were lower when using marijuana at someone else’s home or in a public location compared to their own home. Odds of being ‘somewhat likely’ or ‘extremely likely’ (referent: ‘not at all likely’) to ‘use a little marijuana and then wait to see how you feel before using more,’ ‘avoid mixing marijuana with other drugs,’ and ‘avoid driving a car after using marijuana’ were lower when using marijuana in public settings compared to their own home. Odds of being ‘somewhat likely’ (referent: ‘not at all likely’) to ‘limit the amount of marijuana they use in one setting’ were lower when using marijuana in public settings compared to their own home. Social context: Odds of being ‘somewhat likely’ (referent: ‘not at all likely’) to ‘avoid mixing marijuana with other alcohol’ were greater when using marijuana with a few close friends than alone. Odds of being ‘extremely likely’ (referent: ‘not at all likely’) to ‘use a little marijuana and then wait to see how you feel before using more’ and ‘avoid driving a car after using marijuana’ were lower when using marijuana at an event with a large number of people compared to alone. Our findings suggest that people differentially utilize PBSM based on the physical and social contexts in which they are using marijuana. People may be less likely to engage in PBSM in public locations and large groups of people compared to when they use marijuana at their home or alone. Interventions for young adult marijuana use should consider the context of use when providing behavioral intervention strategies.
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Rapports d'organisations sur le sujet "Friends to lover"

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Hertel, Thomas, Roman Keeney, Maros Ivanic et Alan Winters. Why Isn’t the Doha Development Agenda More Poverty Friendly ? GTAP Working Paper, avril 2007. http://dx.doi.org/10.21642/gtap.wp37.

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The breakdown of the WTO negotiations under the Doha Development Agenda has inspired critics to highlight the lack of effort on the part of rich countries to reform their agricultural policies. In this paper, we focus instead the poverty impacts of developing country tariff cuts – particularly those in agriculture. We argue that the Doha Development Agenda is fundamentally less poverty-friendly than it could be -- in large part due to the absence of tariff cuts on staple food products in developing countries. Such cuts would give the poor access to food at world prices, thereby reducing the cost of living at the poverty line. We also explore the contention that such tariff cuts will hurt the poor working in agriculture. Based on our analysis of the impacts of multilateral trade policy reforms on a sample of fifteen developing countries, we find there is some evidence of poverty increases in agriculture. However, such effects are minimized by ensuring that agricultural tariffs are cut in all developing countries. Overall, the poverty-reducing impact of lower food prices dominates; we conclude that the Doha Development Agenda would be more poverty friendly if it were to include deeper cuts in developing country agricultural tariffs. This contrasts sharply with calls for special products exemptions by many developing country advocates.
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Xourafi, Lydia, Polyxeni Sardi et Anastasia Kostaki. Exploring psychological vulnerability and responses to the COVID-19 lockdown in Greece. Verlag der Österreichischen Akademie der Wissenschaften, juillet 2022. http://dx.doi.org/10.1553/populationyearbook2022.dat.5.

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This study explores the psychosocial impact of the COVID-19 pandemic on the population in Greece during the general lockdown period. Specifically, depression, anxiety and stress scores, as well as the factors associated with vulnerability to developing mental health conditions during this period, were investigated. A total of 911 adults participated in an online survey by completing a self-reporting questionnaire that included demographic questions, DASS-42 items (anxiety, stress and depression scales) and other questions related to personal experience. Regression modelling uncovered a significant relationship between gender and DASS scores, with women having significantly higher scores than men for all mental health problems. Participants aged 20–39 years were especially vulnerable to experiencing poor mental health. Unemployed participants reported having worse mental health than others. Having more perceived psychosocial support during the pandemic was associated with lower overall scores. Thus, women, young adults and the unemployed exhibited particularly high levels of vulnerability, while individuals who received social support from relatives and friends during the lockdown were more resilient to the effects of social isolation.
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Sistac, Sistac, Lliteras M et Sistac Palacín JM. Study in a Simulated Scenario of the Influence of Training and Personality in the Resolution of Critical Situations in Anaesthesiology Residents. Science Repository, janvier 2023. http://dx.doi.org/10.31487/j.acr.2022.04.01.sup.

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Introduction: Empowerment of simulations in emergent situations by resident medical interns has positively demonstrated the acquisition of clinical skills [1]. Even so, it remains unclear what psychological factors influence when assuming leadership in carrying out these simulations or in a real situation. This study aims to analyse, by simulating critical situations in the operating room, the influence of training and personality among anaesthesiology residents on the predisposition to assume such leadership Materials and Methods: A study was carried out on 22 residents both trained (11) and untrained in simulation, assessing their personality and degree of stress using the Typi and Stay Trait. By observation it was determined that he was the leader, when entering a simulated model of ventricular fibrillation in pairs. Resolution capacity was not valued, but rather the characteristics that define the personality of the resident who assumed leadership. Results: Regarding personality, measured with the TIPI test, the leaders turned out to score high in agreeableness but low in extraversion compared to the helpers. This suggests that they are altruistic, compassionate, trusting, frank, empathic and sensitive to others and on the other hand reserved, socially distant except with close friends. In the trained group, the Stai Trait test revealed a slightly lower mean in helpers compared to the total mean, in addition to a significantly higher SD in leaders (4.57) than in helpers (2.87), obtaining a p> 0.02. In Stai Estado, the opposite occurred in terms of the averages, lower in the group of leaders with respect to the global average. And a very similar SD was obtained in both groups (4.91 and 4.21). In the TIPI test, the leading group stands out with a low score in extraversion, compared to the total mean and compared to assistants, justified data with a p>0.02. Conclusion: The residents of the trained group turned out to have lower anxiety in the stressful situation of the simulation compared to the other group. In addition, the women who turned out to be leaders in the trained group demonstrated control of the situation with lower HRs than the leaders in the untrained group, thus demonstrating the influence of training in resolving critical situations.
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Scarpini, Celeste, Oyebola Okunogbe et Fabrizio Santoro. The Promise and Limitations of Information Technology for Tax Mobilisation. Institute of Development Studies, février 2023. http://dx.doi.org/10.19088/ictd.2023.005.

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As digital technologies continue gaining momentum in Africa and lower-income countries, more and more tax authorities are adopting them to improve their core functions and collect revenue more efficiently. This paper reviews recent literature on using technology for tax administration. Technology has the potential to improve tax collection in three areas: identifying the tax base, monitoring compliance, and facilitating compliance. But even the most user-friendly technology will hardly function without basic infrastructure and a stable internet connection. The potential benefits of new technology are further hampered by resistance from taxpayers and collectors, an unsupportive regulatory environment and lack of strategy for adoption by institutions. We close by proposing reforms to ensure investments in new technology improve efficiency and revenue collection.
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Elshurafa, Amro, Hatem Al Atawi, Fakhri Hasanov et Frank Felder. Cost, Emission, and Macroeconomic Implications of Diesel Displacement in the Saudi Agricultural Sector : Options and Policy Insights. King Abdullah Petroleum Studies and Research Center, août 2022. http://dx.doi.org/10.30573/ks--2022-dp03.

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The Saudi agricultural sector relies on diesel for irrigation, which is provided to farmers at a much lower price than the average global price, implying significant opportunity costs. With the aid of soft-coupled power and macro-econometric models, we assess the cost and macroeconomic implications of electrifying irrigation activities in the Saudi agricultural sector. Three electrification scenarios are considered: electrifying each individual farm with a dedicated hybrid renewable micro-grid, electrifying the entire farm cluster with central generation and connecting the entire cluster via transmission to the national grid. Compared with the base-case, connecting the farm cluster to the national grid is found to be the most economical but the least environmentally friendly. The renewable and central generation scenarios are costlier (compared with the transmission scenario) due, respectively, to the high battery costs and gas infrastructure needed.
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Thomas, Meinzen, Diane M. Debinski, Laura A. Burkle et Robert J. Ament. Identifying Patterns, Protecting Monarchs, and Informing Management. Idaho Transportation Department, juillet 2023. http://dx.doi.org/10.15788/1691525473.

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Pollinating insects provide vital ecosystem services and are facing global declines and habitat loss . Roadsides are increasingly regarded as important potential areas for enhancing pollinator habitat. Understanding which roadsides best support pollinators — and why — is essential to helping locate and prioritize pollinator conservation efforts across roadside networks. To support this effort, we assessed butterfly, bee, and flowering plant species richness and abundance on a set of 63 stratified randomized roadside transects in State -managed rights -of -way in SE Idaho. Our research evaluated pollinator diversity as a function of highway class (interstate, U.S., and state highways), remotely sensed NDVI values (a measure of vegetation greenness), and floral resources. We found that smaller highways and lower (less green) maximum NDVI values were associated with significantly more bee species and total bees. Roadsides bordering sagebrush habitats typically had low NDVI values and higher bee and butterfly species richness, potentially contributing to this observed pattern. Butterfly richness increased in association with higher floral abundance in roadsides. Additionally, we identified and mapped 1,363 roadside patches of milkweed (Asclepias speciosa), larval host plant for the imperiled monarch butterfly (Danaus plexippus), in a survey of over 900 miles of southern Idaho highways. Based on these results and a literature review, we recommend management strategies to promote the health of pollinator populations in Idaho’s rights-of-way and provide data to help ITD prioritize areas for pollinator -friendly management practices and habitat restoration within their highway system.
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Chong, Alberto E., et Florencio López-de-Silanes. Privatization in Mexico. Inter-American Development Bank, août 2004. http://dx.doi.org/10.18235/0010832.

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Over the last 20 years, Mexico redefined the role of the state in its economy through an ambitious program to liberalize trade, promote efficiency and reduce the size and scope of the state-owned sector. In Mexico, privatization led to a significant improvement in firm performance, as profitability increased 24 percentage points and converged to levels similar to those of private firms. From this increase, at most 5 percent can be attributed to higher prices and 31 percent to transfers from workers, with the remaining 64 percent representing productivity gains. There is evidence that privatization provides other social benefits, as greater access to services, which usually follows privatization, leads to welfare gains for the poorest consumers that outweigh any increase in prices. Moreover, an often-overlooked aspect of privatization is its fiscal impact, whereby the proceeds from the sale are augmented by reduced subsidies and increased taxes and can help pay off debt or finance social spending. The Mexican privatization program can provide a valuable guide to privatization dos and donts: First, the privatization process must be carefully designed and run in a transparent way. Special requirements such as bans on foreign direct investment or cash-only payments lead to substantial price discounts for firms sold, while simplicity breeds competition and leads to higher prices. A transparent program can also help quell the tendency of politicians to favor their friends by tweaking the rules of the game. Second, restructuring firms prior to privatization is counterproductive in raising net sale prices and should be avoided. Governments spend substantial resources on politically motivated investment or efficiency programs that are not valued by bidders and which can rarely be justified on the social ground on which they are sold. Additionally, restructuring programs lengthen the privatization process considerably and lower prices for firms sold in the case of Mexico, each month of delay reduced the sale price by 2.2 percent. Finally, this paper argues that it is essential to carefully deregulate and re-regulate privatized firms to ensure that they behave appropriately as well as to provide a corporate governance framework to ensure firms are able to finance their operations without relying on the Government for help.
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Mizrahi, Itzhak, et Bryan A. White. Exploring the role of the rumen microbiota in determining the feed efficiency of dairy cows. United States Department of Agriculture, octobre 2011. http://dx.doi.org/10.32747/2011.7594403.bard.

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Expanding world hunger calls for increasing available food resources. Ruminants have the remarkable ability to convert human-indigestible plant biomass into human-digestible food products, due to a complex microbiome residing in the rumen compartment of their upper digestive tract. One way to tackle the problem of diminishing food resources is to increase the animals' energetic efficiency, i.e., the efficiency with which they convert energy from feed, thereby increasing food availability while lowering the environmental burden, as these animals would produce more and eat less. We hypothesize that the cow's feed efficiency is dependent on the taxonomic composition, coding capacity and activity of its reticulorumenmicrobiota. To test this hypothesis, three aims are defined: (1) Evaluation of the feed efficiency of 146 dairy cows and defining two groups representing the highest and lowest 25% using the Israeli group's unique facility; (2) Comparing these two groups for microbiota diversity, identity and coding capacity using next-generation sequencing and metagenomic approaches; (3) Comparing the reticulorumenmicrobiota metabolic activity parameters. We measured feed efficiency in 146 milking cows and analyzed the taxonomic composition, gene content, microbial activity and metabolomic composition of rumen microbiomes from the 78 most extreme animals. Lower richness of microbiome gene content and taxa was tightly linked to higher feed efficiency. Microbiome genes and species accurately predicted the animals' feed-efficiency phenotype. Specific enrichment of microbes and metabolic pathways in each of these microbiome groups resulted in increasing valuable metabolites and decreasing unusable ones such as methane in efficient animals. This ecological and mechanistic understanding of the rumen microbiome could lead to an increase in available food resources and environmentally friendly livestock agriculture.
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Mizrahi, Itzhak, et Bryan A. White. Uncovering rumen microbiome components shaping feed efficiency in dairy cows. United States Department of Agriculture, janvier 2015. http://dx.doi.org/10.32747/2015.7600020.bard.

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Ruminants provide human society with high quality food from non-human-edible resources, but their emissions negatively impact the environment via greenhouse gas production. The rumen and its resident microorganisms dictate both processes. The overall goal of this project was to determine whether a causal relationship exists between the rumen microbiome and the host animal's physiology, and if so, to isolate and examine the specific determinants that enable this causality. To this end, we divided the project into three specific parts: (1) determining the feed efficiency of 200 milking cows, (2) determining whether the feed- efficiency phenotype can be transferred by transplantation and (3) isolating and examining microbial consortia that can affect the feed-efficiency phenotype by their transplantation into germ-free ruminants. We finally included 1000 dairy cow metadata in our study that revealed a global core microbiome present in the rumen whose composition and abundance predicted many of the cows’ production phenotypes, including methane emission. Certain members of the core microbiome are heritable and have strong associations to cardinal rumen metabolites and fermentation products that govern the efficiency of milk production. These heritable core microbes therefore present primary targets for rumen manipulation towards sustainable and environmentally friendly agriculture. We then went beyond examining the metagenomic content, and asked whether microbes behave differently with relation to the host efficiency state. We sampled twelve animals with two extreme efficiency phenotypes, high efficiency and low efficiency where the first represents animals that maximize energy utilization from their feed whilst the later represents animals with very low utilization of the energy from their feed. Our analysis revealed differences in two host efficiency states in terms of the microbial expression profiles both with regards to protein identities and quantities. Another aim of the proposal was the cultivation of undescribed rumen microorganisms is one of the most important tasks in rumen microbiology. Our findings from phylogenetic analysis of cultured OTUs on the lower branches of the phylogenetic tree suggest that multifactorial traits govern cultivability. Interestingly, most of the cultured OTUs belonged to the rare rumen biosphere. These cultured OTUs could not be detected in the rumen microbiome, even when we surveyed it across 38 rumen microbiome samples. These findings add another unique dimension to the complexity of the rumen microbiome and suggest that a large number of different organisms can be cultured in a single cultivation effort. In the context of the grant, the establishment of ruminant germ-free facility was possible and preliminary experiments were successful, which open up the way for direct applications of the new concepts discovered here, prior to the larger scale implementation at the agricultural level.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, juillet 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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