IntroductionThe message of palliative care can be promoted using creative thinking and gamification. It can be an innovative strategy to promote changes in behaviour, promote thinking, and work on skills such as empathy.AimDesign, test and evaluate a gamified social intervention to enhance palliative care awareness among young university students from non-health background.MethodsParticipatory action research study with mixed methods, Design Thinking and using the Public Engagement strategy. Forty-three undergraduate students participated in a Palliative Care Stay Room and completed the Test of Cognitive and Affective Empathy (TECA) before and after the game. At the end of the game, a ten-minute debriefing was held with the participants, which was concluded with an open conversation. The content analysis was done independently and the sum of the scores of each dimension was compared before and after the activity.FindingsThe Stay Room improved the participants' knowledge and new perspectives about palliative care. Before the game, their views focused on the end of life and after the game on their values, highlighting the dedication of the healthcare professionals who do not treat death but the life until death. After de game, participants (N = 43: female = 23; male = 20; x 19.6 years old) presented higher values in perspective adoption (intellectual ability to put oneself in the other's place) p = 0.046 and in emotional understanding (ability to recognize emotional states) p = 0.018, and had high scores on empathic joy (p = 0.08).ConclusionGamification can be used in teaching and transmitting positive attitudes. Palliative Care and can help young university students to think positively about care issues.

Aim: The aims of this paper are (1) to present the results of the development, content validation and imple-mentation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. Background: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, at-titudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented.Design: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation.Methods: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators.Results: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process.Conclusions: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a mea-surement tool.Tweetable abstract: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help eval-uate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/ families, as reflected by nurses' clinical narratives.

The need to provide novel but meaningful ways to reason and talk about an unprecedented crisis such as the Covid-19 pandemic has resulted in a surge of creative metaphoric expressions in a variety of communicative settings. In order to investigate novel ways of conceptualizing the pandemic, we consider the metaphors included in the #ReframeCovid collection, a crowdsourced dataset of metaphors for the pandemic that rely on nonwar frames. Its heterogeneous makeup of multilingual and multimodal examples (to date, over 550 examples - monomodal and multimodal in 30 languages) offers a unique opportunity to explore the ways in which metaphors have been used creatively to describe different aspects of the coronavirus pandemic. The patterns of metaphor creativity discussed in this paper include: creative realizations (verbal and visual) of wide-scope mappings, the use of one-off source domains, shifts in the valence of the source domain evoked, and the exploitation of source domains that are specific to particular discourse communities. The analysis of multimodal examples contributes to our understanding of the role of metaphor in sense-making and communication at a time of an extraordinary global crisis and will also provide new insights into metaphor creativity as a multidimensional phenomenon that integrates conceptual, discursive and cultural factors.

OBJECTIVE:Cultural backgrounds and values have a decisive impact on the phenomenon of the wish to die (WTD), and examination of this in Mediterranean countries is in its early stages. The objectives of this study were to establish the prevalence of WTD and to characterise this phenomenon in our cultural context. METHODS:A cross-sectional study with consecutive advanced inpatients was conducted. Data about WTD (Assessing Frequency & Extent of Desire to Die (AFFED) interview) and anxiety and depression (Edmonton Symptom Assessment System-revised (ESAS-r)) were collected through two face-to-face clinical encounters. Data were analysed with descriptive statistics, ¿2 and analysis of variance. RESULTS:201 patients participated and 165 (82%) completed both interviews. Prevalence of WTD was 18% (36/201) in the first interview and 16% (26/165) in the second interview (p=0.25). After the first interview, no changes in depression (p=0.60) or anxiety (p=0.90) were detected. The AFFED shows different experiences within WTD: 11% of patients reported a sporadic experience, while 7% described a persistent experience. Thinking about hastening death (HD) appeared in 8 (22%) out of 36 patients with WTD: 5 (14%) out of 36 patients considered this hypothetically but would never take action, while 3 (8%) out of 36 patients had a more structured idea about HD. In this study, no relation was detected between HD and frequency of the appearance of WTD (p=0.12). CONCLUSIONS:One in five patients had WTD. Our findings suggest the existence of different experiences within the same phenomenon, defined according to frequency of appearance and intention to hasten death. A linguistically grounded model is proposed, differentiating the experiences of the 'wish' or 'desire' to die, with or without HD ideation.

Background University students are the future professionals who will influence society. It is thus essential to improve students' understanding of palliative care (PC), especially those in the non-health field, to generate and encourage propitious opinions about PC. This study describes the perceptions of PC among university students from different disciplines. Method Qualitative exploratory study using virtual focus groups (FGs) and design thinking (DT) approach. An intentional sample of students from various disciplines, universities and cities from Spain were selected. Numerous researchers from different fields were involved in the discussion of the final thematic analysis. Results Four themes and seven subthemes were found: i) Students have an ambiguous understanding about PC; ii) PC is not a common issue for non-health students; ii) Students see PC as an important and necessary field; iii) Students build counter-narratives against PC myths, demonstrating PC brings key benefits into people's lives; iv) PC is a synonym of death. Conclusion Despite the fact that students do not know much about PC, the topic easily arouses reflection and positive discussion. Through the conversations they find positive values and arguments against misunderstand- ing. Students from different disciplines could be the target of innovative educational initia- tives and the social debate on PC.

From the beginning of the COVID-19 pandemic, governments, health agencies, public institutions and the media around the world have made use of metaphors to talk about the virus, its effects and the measures needed to reduce its spread. Dominant among these metaphors have been war metaphors (e.g. battles, front lines, combat), which present the virus as an enemy that needs to be fought and beaten. These metaphors have attracted an unprecedented amount of criticism from diverse social agents, for a variety of reasons. In reaction, #ReframeCovid was born as an open, collaborative and non-prescriptive initiative to collect alternatives to war metaphors for COVID-19 in any language, and to (critically) reflect on the use of figurative language about the virus, its impact and the measures taken in response. The paper summarises the background, aims, development and main outcomes to date of the initiative, and launches a call for scholars within the metaphor community to feed into and use the #ReframeCovid collection in their own basic and applied research projects

This study is an analysis on the Spanish media coverage of the Covid-19 crisis and the role of information on health and healthcare professionals within it. We studied the treatment given to healthcare sources and topics in news broadcasts released by Radiotelevisión Española (RTVE) between December 31, 2019, and June 8, 2020. To this end, we conducted a quantitative content analysis on 452 news items from 21 news broadcasts. The results showed that debates on political issues were the main topics and politicians were the main sources, in the broadcasts analyzed, ahead of health issues and healthcare professionals. Our study thus confirms the lack of visibility of healthcare professionals in the television news coverage of the Covid-19 crisis in Spain.

Psycholinguistic evidence shows that spatial domains are automatically activated when processing temporal expressions. Speakers conceptualize time as a straight line deployed along different axes (mostly sagittal, though also vertical). The use of the lateral axis, which cannot be lexicalized in any language, has nonetheless been attested in temporal tasks in laboratories using a variety of experiments. This leads to the question of what axes are actually at work when conceptualizating time in oral communication. The present study examines a great number of temporal expressions, taken from television shows, noting their associated co-speech gestures. Our results show that (1) speakers overwhelmingly use the lateral axis; (2) they are not performing simple space-to-time mappings, but are using instead a "timeline", a material anchor which is a far more complex construct and that can explain some of the intricacies and contextual variations shown in the pattern of results.

The development of large-scale corpora has led to a quantum leap in our understanding of speech in recent years. By contrast, the analysis of massive datasets has so far had a limited impact on the study of gesture and other visual communicative behaviors. We utilized the UCLA-Red Hen Lab multi-billion-word repository of video recordings, all of them showing communicative behavior that was not elicited in a lab, to quantify speech-gesture co-occurrence frequency for a subset of linguistic expressions in American English. First, we objectively establish a systematic relationship in the high degree of co-occurrence between gesture and speech in our subset of expressions, which consists of temporal phrases. Second, we show that there is a systematic alignment between the informativity of co-speech gestures and that of the verbal expressions with which they co-occur. By exposing deep, systematic relations between the modalities of gesture and speech, our results pave the way for the data-driven integration of multimodal behavior into our understanding of human communication.

Despite the apparent novelty and fluidity of the media today, there is strong evidence that patterns are emerging which both reflect and extend the evaluative paradigms previously observed in the print and broadcast media. In this complex scenario, discourse analysis offers a rich and varied methodology for understanding the different types of evaluation conveyed through media texts and the way these project, reflect and develop their relationships with their audience. The chapters in this volume draw on a variety of analytical tools, including appraisal analysis, argumentation theory, multimodal approaches and corpus linguistics, to address the issue of evaluation in media discourse. The theoretical underpinning for these chapters ranges from corpus-informed discourse studies, through critical discourse analysis and semio-communicative approaches, to Bakhtinian perspectives. Although the chapters are all in English, the scope of the volume is broadly European, covering aspects of the British, Spanish, Dutch and German media in their traditional and online manifestations, as well as contrastive studies

En este capítulo se explora, desde una perspectiva semiótica y cognitiva, el potencial argumentativo que posee en la publicidad el empleo de lo que se ha dado en llamar «metáforas» y «metonimias multimodales». Partiendo de la premisa de que la metáfora y la metonimia se conforman primariamente como modelos cognitivos o de pensamiento, se analiza la manifestación que dichos modelos pueden tener en los distintos niveles del lenguaje publicitario o, dicho de otro modo, en los diversos «modos» o canales de comunicación que intervienen en la construcción de los mensajes en este ámbito. Se analiza, de este modo, la frecuente imbricación existente en la publicidad entre las metáforas/metonimias visuales y las metáforas/metonimias verbales, desarrollándose, además, un análisis diferenciado de su articulación en la publicidad comercial e institucional, por un lado, y audiovisual y de la prensa, por otro. Al hilo de este análisis, se apuntan, asimismo, algunas relaciones que los tropos multimodales suelen establecer con otros recursos expresivos habituales en la publicidad