Spontaneous playful teasing in four great ape species

Joking draws on complex cognitive abilities: understanding social norms, theory of mind, anticipating others' responses and appreciating the violation of others' expectations. Playful teasing, which is present in preverbal infants, shares many of these cognitive features. There is some evidence that great apes can tease in structurally similar ways, but no systematic study exists. We developed a coding system to identify playful teasing and applied it to video of zoo-housed great apes. All four species engaged in intentionally provocative behaviour, frequently accompanied by characteristics of play. We found playful teasing to be characterized by attention-getting, one-sidedness, response looking, repetition and elaboration/escalation. It takes place mainly in relaxed contexts, has a wide variety of forms, and differs from play in several ways (e.g. asymmetry, low rates of play signals like the playface and absence of movement-final 'holds' characteristic of intentional gestures). As playful teasing is present in all extant great ape genera, it is likely that the cognitive prerequisites for joking evolved in the hominoid lineage at least 13 million years ago.

Corrigendum: "Beyond laughter": a systematic review to understand how interventions utilise comedy for individuals experiencing mental health problems

[This corrects the article DOI: 10.3389/fpsyg.2023.1161703.].

"Beyond laughter": a systematic review to understand how interventions utilise comedy for individuals experiencing mental health problems

Introduction

There is evidence for the impact of comedy and humour for mental health and wellbeing. Existing systematic reviews have concluded laughter has a positive impact on wellbeing, however other potential benefits of comedy interventions have remained under explored. The aim of the current study was to synthesise current evidence for comedy/humour interventions and evaluate mechanisms through which comedy interventions may impact upon the recovery of those experiencing psychological distress, using the Connectedness, Hope, Identity, Meaning and Purpose and Empowerment (CHIME) framework.

Methods

Five electronic databases were searched for studies exploring the impact of interventions using comedy on wellbeing and mental health recovery, from earliest record until January 2023. Grey literature was obtained via contacting experts in comedy interventions for mental health and supplemented by an internet search for comedy interventions. To be eligible for inclusion, studies had to include primary data, published in English or German, and explore a population of adults, with self-reported distress or a self-reported/diagnosed mental health condition. Studies included only explored interventions which utilised comedy as the main intervention and aimed to induce 'simulated' laughter, in response to a stimulus. 17 studies were included in the review.

Results

Studies were found to have positive impact on mental health symptoms and several mechanisms of the CHIME framework for recovery, including connectedness, hope, identity and empowerment. Potential theorised mechanisms for change included confidence in new skills, promotion of social skills, opportunities for social interaction, laughter, vulnerability, and cognitive flexibility. The current review found that comedy/humour interventions are beneficial for mental health recovery and wellbeing and found preliminary evidence for a range of mechanisms through which comedy may have positive impact.

Discussion

Further research should focus on qualitative exploration of the mechanisms by which comedy interventions may have impact on wellbeing and mental health recovery for specific populations and within different settings. It is concluded that there is a need for transdisciplinary collaboration in research on comedy interventions, which brings together the expertise of comedians delivering/developing interventions, those with lived experience of mental health issues and researchers from both health sciences and humanities disciplines.

Effect of swearing on strength: Disinhibition as a potential mediator

Swearing fulfils positive functions, including benefitting pain relief and physical strength. Here we present two experiments assessing a possible psychological mechanism, increased state disinhibition, for the effect of swearing on physical strength. Two repeated measures experiments were carried out with sample sizes N = 56 and N = 118. Both included the measures of physical performance assessing, respectively, grip and arm strength, and both included the Balloon Analogue Risk Task (BART) to measure risky behaviour. Experiment 2, which was pre-registered, additionally assessed flow, emotion including humour, distraction including novelty, self-confidence, and anxiety. Experiments 1 and 2 found that repeating a swear word benefitted physical strength and increased risky behaviour, but risky behaviour did not mediate the strength effect. Experiment 2 found that repeating a swear word increased flow, positive emotion, humour, distraction, and self-confidence. Humour mediated the effect of swearing on physical strength. Consistent effects of swearing on physical strength indicate that this is a reliable effect. Swearing influenced several constructs related to state disinhibition, including increased self-confidence. Humour appeared to mediate the effect of swearing on physical strength, consistent with a hot cognitions explanation of swearing-induced state disinhibition. However, as this mediation effect was part of an exploratory analysis, further pre-registered experimental research, including validated measures of humour, is required.

Injecting fun? Humour, conspiracy theory and (anti)vaccination discourse in popular media

Conspiracy theories have accompanied vaccination since its mass introduction, circulating, among other forms, in humour - such as cartoons, and now, memes. Importantly, humour has targeted both vaccination and anti-vaccination stances. In this study, we discuss the peculiarities of humorous content within the vaccination debate and uncover the most popular thematic categories, forms and logical mechanisms of humour. We show that humorous and serious discussions on vaccination go hand-in-hand, but playfulness and ambiguity of humour complicate public understanding of the vaccination debate. Our analysis shows that vaccination humour often simplifies the complex issue of vaccination and makes it more understandable and more tangible for a broad audience.

Cultural Differences in How People Deal with Ridicule and Laughter: Differential Item Functioning between the Taiwanese Chinese and Canadian English Versions of the PhoPhiKat-45

The PhoPhiKat-45 measures three dispositions toward ridicule and laughter, including gelotophobia (i.e., the fear of being laughed at), gelotophilia (i.e., the joy of being laughed at), and katagelasticism (i.e., the joy of laughing at others). Despite numerous cultural adaptations, there is a paucity of cross-cultural studies investigating measurement invariance of this measure. Undergraduate students from a Canadian university (N = 1467; 71.4% females) and 14 universities in Taiwan (N = 1274; 64.6% females) completed the English and Chinese PhoPhiKat-45 measures, respectively. Item response theory and differential item functioning analyses demonstrated that most items were well-distributed across the latent continuum. Five of 45 items were flagged for DIF, but all values had negligible effect sizes (McFadden's pseudo R² < 0.13). The Canadian sample was further subdivided into subsamples who identified as European White born in Canada (n = 567) and Chinese born in China, Hong Kong, or Taiwan (n = 180). In the subgroup analyses, no evidence of DIF was found. Findings support the utility of this measure across these languages and samples.

You're joking: Exploring humour and humiliation as forms of shame and obstetric violence within medical encounters

Despite medical guidelines delineating respect towards patients, many encounters between patients and clinicians are problematic, in which patients feel disrespected, unheard, shamed or abused. This article uses an anthropological lens to focus on the imbrication of humour and humiliation as forms of shame and obstetric violence within obstetric encounters. Humour as a form of speech play creates a substrate for the occurrence of humiliation and shaming of obstetric patients. Humour enhances patients' feelings of shame, making them vulnerable to verbal and physical forms of obstetric violence. Ethnographic methods of observation and interviews were performed in two hospitals in the Mexican city of Puebla to uncover clinicians' perceptions and narratives about their patients as problematic others. Narratives about patient worth underscored interactions. Humour and humiliation were centrally present within these interactions. Ultimately, both humour and humiliation functioned as shaming mechanisms that increased the presence of obstetric violence in these encounters. The article examines whether an understanding of shame can improve clinical practice and concludes with implications to clinical practice.

Dehumanization through humour and conspiracies in online hate towards Chinese people during the COVID-19 pandemic

Since the beginning of the COVID‐19 pandemic, there have been widespread conversations about the origins of the virus and who to blame for it. This article focuses on the online hate directed at Chinese and Asian people during the pandemic. Taking a critical discursive psychological approach, we analysed seven online threads related to COVID‐19 and China from two Finnish websites (Suomi24 and Ylilauta) and one US (8kun) site. We identified three discursive trends associated with dehumanising Chinese populations: ‘monstrous Chinese’, ‘immoral Chinese’ and ‘China as a threat’, which created different forms of dehumanisation on a continuum from harsher dehumanisation to milder depersonalisation. The animalistic metaphors, coarse language, humorous frames and conspiracy beliefs worked to rhetorically justify the dehumanisation of Chinese individuals, making it more acceptable to portray them as a homogeneous and inhumane mass of people that deserves to be attacked. This study contributes to the field of discursive research on dehumanisation by deepening our knowledge of the specific features of Sinophobic hate speech.

Evaluation of the impact of humor used in contraception education on the attitudes of university students towards contraceptive methods

OBJECTIVE

This study has been performed as a parallel randomised controlled study to evaluate the impact of humour benefitted in contraception education of university students on the attitudes of students towards contraception methods.

METHODS

The study sample was composed of 88 students (44 experiments, 44 controls) studying at a public university in Turkey. The study data were collected using the Questionnaire Form and the Family Planning Attitude Scale. The students were divided into experimental and control groups as per the pre-test score of the Family Planning Attitude Scale and gender using stratified block randomisation. The students were divided into groups of 10 people, and each group received a one-time education of 45-60 min. The content of the education was the same for the experimental and control groups, but additionally, the humour method was used during the education of the experimental group. The Family Planning Attitude Scale was re-applied to the students one month after the education. Number, percentage, mean value, Student t-test Mann Whitney-U test, and Chi-square test were used to evaluate the data.

RESULTS

While there was no statistically significant difference between the pre-test mean scores of the students in the experimental and control groups (p > 0.05); the post-test showed a significantly higher mean score in the experimental group (p < 0.05) (1-β: 0.921, Cohen's d: 0.658). While there was no significant difference between the pre-test and post-test total mean scores of the students in the control group (p > 0.05); the post-test mean score of the students in the experimental group was significantly higher than the pre-test mean (p < 0.05) (1-β: 1.000, Cohen's d: 1.556).

CONCLUSIONS

The method of contraception education with humour given to university students is more effective than the education given ordinarily in developing attitudes towards contraceptives.

How does the use of humour in the UK ambulance service affect a clinician's well-being?

Introduction:

Paramedics and ambulance staff face many different stresses in today’s UK ambulance service, with many having reported an effect on their well-being and mental health. Humour is widely used by staff as a coping mechanism, but little is known about this topic. This literature review aims to find out how humour is used and how it can affect clinicians’ well-being.

Methods:

A total of nine medical databases were searched for relevant literature – Cochrane, Scopus, CINAHL Complete, Science Direct, Medline Complete, Complementary Index, Academic Search Complete, Emerald Insight and Supplemental Index. Articles were included if they were published in 2005 or after, if they were a UK-based original study and if they studied humour in relation to paramedics’ well-being.

Results:

After limiters were applied, a total of 26 articles were found. Only four articles met all the inclusion and exclusion criteria. Two of the articles studied humour directly, whereas two found humour as a result of studying the resilience and strategies used to cope with the stresses of ambulance work. Four key themes were identified: different types of humour, the source and boundaries of humour, offloading and camaraderie.

Conclusion:

This review of the literature found that many in the ambulance community view their use and expression of humour as a positive coping strategy that helps them to relieve the stresses of the job. Further research is needed to investigate any negative effects that humour has on a clinician’s well-being and larger studies are needed to give a better representation of the ambulance community.

A systematic review of humour-based strategies for addressing public health priorities

OBJECTIVE

To systematically review research into the use of humour-based health promotion strategies for addressing public health issues during the past 10 years.

METHOD

The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Thirteen studies were included in the review. Mental health, breast and testicular cancer self-examination, safe sex, skin cancer and binge drinking public health issues were targeted. Humour-based strategies were used to influence health attitudes and behaviours, encourage interpersonal sharing to indirectly affect health behaviour, and investigate the level of threat and humour associated with positive outcomes. Findings provided some evidence to support the use of humour-based strategies as determined by the right combination of audience characteristics, level of humour and amusement evoked, and message persuasion and behaviour change methods underpinning strategies.

CONCLUSION

Methodologies varied limiting comparability, although overall results indicate that humour-based health promotion strategies may be a useful tool for increasing awareness and help-seeking behaviour for public health priorities, particularly those associated with stigma. Implications for public health: Humour interventions vary widely because there can never be a standardised approach to evoking humour. Further research examining humour and public health promotion is needed.

[Humour in the time of Coronavirus]

In this study, we measure psychological suffering and emotional coping using humour among a sample of adult people during Italian lockdown to contain SARS-CoV-2 virus during 2020. We hypothesize that humour is a protective factor against a depressive state development, with the exception of some kind of humour style as aggressive or self-defeating. We revealed important psychopathology levels among subjects, the humour, more precisely self-enhancing one, is a protective factor against most psychopathological disorder, while there we did not find a significant correlation with depression and other humour scales, finding correlation with other humour styles and hostility, paranoia, and psichoticism scales.

Something Old, Something New, Something Borrowed, Something Taboo: Interaction and Creativity in Humour

In this paper we treat humorous situations as a series of events underpinned by topoi, principles of reasoning recognised within a socio-cultural community. We claim that humorous effect in jokes and other discourse is often created by the juxtaposition of topoi evoked. A prerequisite for this is that there is a shift where the interpreter of the discourse updates their information state with regard to a second topos being evoked. This view of humour is consistent with an incremental analysis of dialogue, and we therefore argue that interaction is central both for humour creation and interpretation. We point out some different ways in which topoi are juxtaposed in humorous dialogues as well as in jokes published in social media or in joke books, and take jokes from the coronavirus pandemic as an example because this makes lots of new topoi available and therefore offers the opportunity of creating novel jokes based on the juxtaposition of the new and existing topoi. We explore how the mechanisms of inference in dialogue can be applied to humour through the four elements from our title: old (existing), new (not previously existing), borrowed (associated with a different situation) and taboo (inappropriate in the context).

Emotional Response to Humour Perception and Gelotophobia Among Healthy Individuals and Patients with Schizophrenia and Depression, with Signs of a High Clinical Risk of Psychosis

Introduction

Investigating early changes in the emotional sphere within the schizophrenia course is a perspective direction in clinical psychology and psychiatry. Intactness of positive emotions, in particular, humour perception, may be a very important resource for patients. At the same time, humour perception is very sensitive to pathological conditions, such as the fear of being laughed at, known as gelotophobia. Those with gelotophobia perceive laughter as dangerous, rather than pleasant, and they can hardly distinguish between teasing and ridicule. Gelotophobia was confirmed to be expressed among people with mental disorders. Nonetheless, knowledge relating to the fear of being laughed at, was mostly generated among the non-clinical samples.

Objectives

Thus, the aim of the study was to provide more clinical data on gelotophobia manifestations associated with schizophrenia spectrum disorders; the emotional response and facial expression of patients with gelotophobia were studied, in particular, regarding their perception of humour, including during the early stages of disorders, by comparison with healthy individuals.

Methods

n=30 controls and n=32 patients with schizophrenia and with depression with signs of a high clinical risk of psychosis took part. Two short videos, comic and neutral, were shown to the participants, while videotaping their facial expression, followed each by a self-reported measure of emotional responses. Participants also completed the State-Trait Anxiety Inventory, the PhoPhiKat30 and the Toronto Alexithymia Scale.

Results

Gelotophobia was significantly higher within the clinical group. It correlated with a lower frequency of grins among the patients during the comic video, while this was not the case in the control group. Gelotophobia was related to state and trait anxiety in both groups, but only in the clinical group did state anxiety increase after watching the comic video. Gelotophobia correlated with alexithymia and was twice higher among the patients compared to the controls.

Conclusion

Thus, gelotophobia has not only quantitative, but also qualitative specifics in patients with schizophrenia, and those with depression with signs of a clinically high risk of psychosis, compared to healthy controls.

Just kidding: the evolutionary roots of playful teasing

Accounts of teasing have a long history in psychological and sociological research, yet teasing itself is vastly underdeveloped as a topic of study. As a phenomenon that moves along the border between aggression and play, teasing presents an opportunity to investigate key foundations of social and mental life. Developmental studies suggest that preverbal human infants already playfully tease their parents by performing 'the unexpected,' apparently deliberately violating the recipient's expectations to create a shared humorous experience. Teasing behaviour may be phylogenetically old and perhaps an evolutionary precursor to joking. In this review, we present preliminary evidence suggesting that non-human primates also exhibit playful teasing. In particular, we argue that great apes display three types of playful teasing described in preverbal human infants: teasing with offer and withdrawal, provocative non-compliance and disrupting others' activities. We highlight the potential of this behaviour to provide a window into complex socio-cognitive processes such as attribution of others' expectations and, finally, we propose directions for future research and call for systematic studies of teasing behaviour in non-human primates.

Beyond the motor account of amyotrophic lateral sclerosis: Verbal humour and its relationship with the cognitive and pragmatic profile

BACKGROUND

Amyotrophic Lateral Sclerosis (ALS) was traditionally described as a disease restricted to the motor system. However, recent findings suggested that it also affects cognition, especially executive functions, social cognition, language and pragmatics. A relevant issue in current research is thus the description of the cognitive phenotype of ALS and the identification of the most vulnerable aspects.

AIMS

The focus was on a communicative phenomenon placed at the crossroads of pragmatic and other cognitive domains, namely humour, which till now has been poorly explored in ALS. The first aim was to investigate whether ALS is associated with impairments in understanding and appreciating jokes. The second aim was to explore the predictors of humour comprehension and appreciation in patients, to confirm the involvement of pragmatic skills and to explore the role of other cognitive and clinical aspects.

METHODS & PROCEDURES

A total of 30 non-demented patients with ALS and 27 controls were assessed with a task of verbal humour comprehension and appreciation, including two types of jokes: phonological and mental. We also administered a battery of pragmatic and other language tasks, and cognitive and socio-cognitive tasks. Mixed-effects models were used to test differences in the humour task between the two groups. Multiple regressions determined the best predictors of humour comprehension and appreciation in patients.

OUTCOMES & RESULTS

Patients obtained lower comprehension accuracy scores than controls in the humour task, independently of the type of joke. Conversely, patients and controls did not differ in joke appreciation and both rated mental jokes as funnier than the phonological ones. Patients' comprehension accuracy was predicted by pragmatic skills and ALS severity, whereas appreciation was predicted by several clinical variables and, to a smaller extent, by language skills.

CONCLUSIONS & IMPLICATIONS

The findings suggest that humour is a very vulnerable aspect in ALS, and that impairment in humour comprehension might be part of the larger cognitive impairment, being linked to pragmatic impairment. Clinical variables were also important, especially in relation to humour appreciation. More generally, these data speak in favour of pragmatics as a relevant aspect to sketch the cognitive phenotype of ALS. On the practical level, these findings point to the need of supporting communication at large, not only motor-related aspects such as dysarthria but also social-pragmatic aspects such as understanding jokes, to increase well-being in ALS. What this paper adds What is already known on this subject The literature of the last decades has shown that ALS comes with impairment in several cognitive domains, affecting especially executive functions as well as language. There is also initial evidence that the pragmatics of communication and humour comprehension are impaired, although non-serious talk has been documented in conversational interaction among people with ALS. What this paper adds to existing knowledge This study offers compelling evidence of an impairment in the comprehension of jokes in ALS, whereas the appreciation of joke funniness seems to be spared. The study also highlights the interplay of cognitive factors (especially pragmatics) and clinical factors (related to disease severity) in predicting the patients' performance in the humour task. What are the potential or actual clinical implications of this work? The study's findings call for the need of increased awareness among scholars as well as practitioners and caregivers of the profile of humour comprehension and appreciation in ALS. On a practical level, we highlight the need of assessing humour comprehension and adapting the communicative style accordingly. Second, we recommend that intervention programmes targeting communication in ALS go beyond speech-related difficulties and include pragmatic aspects such as humour. Considering the important communicative and social function of humour, as well as its use as a coping strategy, humour interventions are key to improve the quality of life of individuals with ALS.

[Reflection on the use of humour in care]

The hospital is a healthcare setting in which staff often manage acute health situations. Patients, families and healthcare professionals constantly interact, often against a background of emergencies and anxiety. In such contexts, communication plays an important role in establishing a compassionate relationship. Does humour have a place in this relationship? If so, in what form and what are the benefits for the teams and the patients?

Accommodating to a troubled life - chronic obstructive pulmonary disease patients' experiences and perceptions of self-image during the course of rehabilitation

Background: To tailor future rehabilitation programmes for patients with chronic pulmonary obstructive disease, there is a need for more in-depth knowledge about what is essential to these patients and how they perceive their self-image while participating in rehabilitation. Therefore, this study aims to explore patients' experiences and perception of self-image during pulmonary rehabilitation.Methods: Twenty-one patients were followed by participant observations during standard rehabilitation complicity supplemented with final individual interviews. Phenomenological-hermeneutic analysis and interpretation were applied.Results: Through a rewarding peer fellowship, patients became engaged in rehabilitation and improved their capacity to embrace and manage their illness. Through a humorous interplay, encouragement to live with the life-threating disease developed. While understanding themselves in a wider perspective, patients enhanced enablement to shape life according to personal satisfaction. Although participating in the group-based programme was mostly invigorating, it was, however, sometimes perceived as a stressful overload. More individualized support from healthcare professionals was warrented.Conclusions: Group-based pulmonary rehabilitation can support chronic pulmonary obstructive disease patients towards significant change in self-image and health behaviour, leading to improved illness management. Enlarged opportunities to benefit from peer-fellowship and enhanced focus on what is essential to the participants might expand the rehabilitation yields.

'H, I, J, K, L, M, N, O, PEE! Get it? Pee!': Siblings' shared humour in childhood

Humour is a central feature of social interactions in childhood that has received little attention. In a sample of 86 7-year-old children (M age = 7.82 years, SD = 0.80), we investigated patterns and individual differences in spontaneous humour observed during free play with their older (M age = 9.55 years, SD = 0.88) or their younger sibling (M age = 5.87 years, SD = 0.96). We coded children's instances, categories, and responses to humour. We investigated the nature of children's humour on the dyadic and individual level. Humour was common, and siblings' production of humour was highly interdependent between play partners. Dyadic humour differed according to structural features of the sibling relationship (age, gender composition), and 7-year-old focal children's humour varied according to gender. This study contributes to knowledge regarding the dyadic nature of children's humour and individual patterns of humour beyond the preschool years. Statement of contribution What is already known on this subject? Humour is an integral part of children's close and intimate interactions. Children produce humour from an early age and increasingly produce more complex humour as they develop. Few studies examine children's humour with siblings and beyond the fourth year of life. What does this study add? Children's humour during free play with siblings was common and highly dyadic. Sibling dyads' humour differed according to age and gender composition. Seven-year-old boys produced more humour than girls.

Longitudinal associations between younger children's humour styles and psychosocial adjustment

Whilst a multitude of studies have examined links between different styles of humour and aspects of adjustment, longitudinal research is noticeably lacking. Following a study which identified bidirectional associations between humour styles and psychosocial adjustment in older children, the current research aimed to investigate these associations in younger children. In total, 413 children aged 8-11 years completed the humour styles questionnaire for younger children (HSQ-Y) alongside measures of psychosocial adjustment in both the autumn and the summer over the course of a school year. Findings across the school year suggested that children's adjustment may impact significantly on their use of different styles of humour. Further longitudinal research over a longer time period would now be beneficial to further increase our understanding of the associations between humour styles and adjustment throughout development. Statement of contribution What is already known on this subject? Research has identified associations between children's humour styles and psychosocial adjustment. Research with older children has also identified longitudinal associations. What does this study add? This is the first study to identify longitudinal associations between humour styles and adjustment in younger children. This allows for stronger statements to be made about causal relationships.

Developing successful social support: An interpretative phenomenological analysis of mechanisms and processes in a chronic pain support group

OBJECTIVE

The experience of long-term membership of a successful chronic pain support group (CPSG) was explored to identify; (i) factors associated with social support, and; (ii) ways that health care professionals (HCPs) could help CPSGs become more effective and supportive.

DESIGN

Interpretative Phenomenological Analysis enabled exploration of participants' experiences of membership and rationales for continued attendance.

MAIN OUTCOME MEASURES

Twelve participants (four males, eight females), recruited from a regional CPSG, completed semi-structured interviews lasting from 45 to 120 minutes. Following verbatim transcription, idiographic then cross-case analyses were undertaken.

RESULTS

Three superordinate themes emerged: (1) Investing in the new normal; (2) The nurturing environment; (3) Growth facilitation through social evolution. Increased investment and identification with membership, generated snowballing social engagement, enhancing pain management/well-being through collective humour and peer-to-peer support. Explicit guidance by HCPs in early stages of group formation/development, and subsequent implicit influences on group attitudes and actions, promoted the group's development into its current healthy, supportive state.

CONCLUSION

Contrary to stereotypes, membership offered positive respite from chronic pain through collective coping. Successful CPSGs forge an independent identity, fostering strong group investment and an ability to live well with chronic pain. HCPs can provide a stabilising foundation for CPSGs to develop positively and supportively.

The 'who' and 'what' of #diabetes on Twitter

Social media are being increasingly used for health promotion, yet the landscape of users, messages and interactions in such fora is poorly understood. Studies of social media and diabetes have focused mostly on patients, or public agencies addressing it, but have not looked broadly at all of the participants or the diversity of content they contribute. We study Twitter conversations about diabetes through the systematic analysis of 2.5 million tweets collected over 8 months and the interactions between their authors. We address three questions. (1) What themes arise in these tweets? (2) Who are the most influential users? (3) Which type of users contribute to which themes? We answer these questions using a mixed-methods approach, integrating techniques from anthropology, network science and information retrieval such as thematic coding, temporal network analysis and community and topic detection. Diabetes-related tweets fall within broad thematic groups: health information, news, social interaction and commercial. At the same time, humorous messages and references to popular culture appear consistently, more than any other type of tweet. We classify authors according to their temporal 'hub' and 'authority' scores. Whereas the hub landscape is diffuse and fluid over time, top authorities are highly persistent across time and comprise bloggers, advocacy groups and NGOs related to diabetes, as well as for-profit entities without specific diabetes expertise. Top authorities fall into seven interest communities as derived from their Twitter follower network. Our findings have implications for public health professionals and policy makers who seek to use social media as an engagement tool and to inform policy design.

Doing comic geographies

This article reflects on how notions of 'the comic' may be of added value to geographers' research. It is formed around the idea that there are aspects of space and society that are by nature incongruous and unsuitable to be understood through frameworks of scholarship that privilege 'reason' and objectivity above all else. The author thus reflects on how these notions of 'the comic' as a mode of thought can be applied to understanding different fields of research. Ultimately, the article draws out how using this comic mode also forms an 'inward' reflective process which can help to understand the often complicated positions that researchers hold. This article thus calls for an inclusion of the often otherwise ignored comic aspects of the world into scholarship so that we, as geographers, may provide fuller and more human critical analyses of space, culture and society.

Presence redefined: The reciprocal nature of engagement between elder-clowns and persons with dementia

Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. We examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.

Perceptions of nurses about potential barriers to the use of humour in practice: a literature review of qualitative research

AIM

To identify the perceptions of nurses (working with adult patients) about potential barriers to the use of humour in practice.

DESIGN/METHODS

A literature review of qualitative research and thematic synthesis were undertaken. Four key databases were systematically searched and manual search conducted.

RESULTS

The review and thematic analysis identified five key themes from the included studies: (1) inappropriate situations, (2) being a new or junior nurse, (3) the impact on nurse professionalism, (4) differences in personality, and (5) environmental factors.

CONCLUSION

Results from this thematic synthesis identified perceptions of nurses about potential barriers that prevent the use of humour in practice. The extent to which nurses use humour is related to personality factors, but is also affected by external and social factors. Reluctance in its use in practice is influenced by views that humour is unprofessional; with senior nurses found to have a pertinent role in influencing its use.

Why did the proton cross the road? Humour and science communication

The use of humour in public discourse about science has grown remarkably over the past few years, and when used in science communication activities is being seen as a great way to bring science to the public through laughter. However, barely any research has been published either on the often-assumed beneficial learning effects of humour in informal science education, or on the wider social functions and effects of humour about science and how humorous public discourse about science can influence the public understanding of science and the science-society relationship. This research note reviews some of the literature on the psychology and sociology of humour and comedy and tries to apply some of its insights to the effects humour might have when used in science communication. Although not intended to be anti-humour, this note attempts at least to start a more critical conversation on the value of humour in the communication of science.

Communicating through humour: A project of stand-up comedy about science

A study of a project on science stand-up comedy developed in Portugal between 2009 and 2013 is presented, in which thirteen scientists, coordinated by a science communicator and a professional actor, created and presented comedy acts. Eleven of these scientists were asked about their motivations to participate, the process of performance development and the perceived value of the project. Personal motivations were highly important, but professional reasons were also mentioned. Working in a group with the guidance of coordinators, testing and re-writing the texts and gradually gaining confidence on stage were considered fundamental in the development of the shows. Additionally, a questionnaire revealed that the audience, most of whom were young adults, and held a higher education degree, were satisfied with the show. Overall, both participating scientists and audience members considered that stand-up comedy has potential for science communication.

More than just clowns--Clown doctor rounds and their impact for children, families and staff

Admission to hospital is recognised as a difficult time for children and families. This study explored clown doctor activities in an acute paediatric setting and the impact their activities have on children, their families, other health professionals and clown doctors themselves. We used observation, semi-structured interviews and focus groups with children and parents and staff and clown doctors and results provide a rich description of the work of clown doctors. The major themes were 'the encounter - in the moment' of the interaction of the child and the clown doctor and 'beyond the encounter'. The findings show that the impact of clown doctor visits is experienced beyond the immediate interaction, and this has not been clearly articulated in previous studies. This study highlights the multifaceted and complex nature of the work of the clown doctors and the high level of skill required as they modify and interpret play, activities and environment based on individual need and response.

The use of cognitive reappraisal and humour as coping strategies for bullied nurses

This article explores the repercussions of workplace bullying on nurses and the health-care profession as a whole. I discuss the nature of workplace bullying and draw upon prior studies to explore some of the barriers that prevent witnesses to bullying from intervening, as well as barriers faced by targets in taking action to stop the bullying. As overt forms of resistance are often not feasible in situations where nurses occupy subordinate positions to their bullies, I propose that cognitive reappraisal can be an effective coping strategy, and situate this perspective within the research on humour, hope and optimism.

Humour in adult cancer care: a concept analysis

AIMS

To report an analysis of the concept of humour in adult cancer care.

BACKGROUND

Humour is a form of communication which is present in the adult cancer setting. Numerous studies show the multi-dimensional value of humour in cancer care. A clear conceptual understanding, however, of what it represents is lacking.

DESIGN

Walker and Avant's framework was used to guide this concept analysis.

DATA SOURCES

Literature searches included bibliographic databases, internet, and manual searches.

REVIEW METHODS

Literature published from 1990 to the present was reviewed. Thematic analysis was carried out to identify critical attributes and antecedents.

RESULTS

Based on the analysis, a definition of humour in adult cancer nursing is proposed. Humour is a subjective emotional response, resulting from the recognition and expression of incongruities of a comic, absurd and impulsive situation, remark, character, or action, which enhances feelings of closeness or togetherness when shared in the context of trust between the patient and nurse and may be used as a coping mechanism in a stressful situation such as the adult cancer care setting.

CONCLUSION

The analysis provides an understanding of the concept of humour in the adult cancer setting and includes a theoretical illustration of its critical attributes. This concept analysis provides a forum for discussion with reference to the use of humour in adult cancer nursing care. Further exploration is recommended to determine the meaning of humour and its nature across different care settings.