You've developed a research question, conducted a preliminary search on your topic, identified some relevant search terms, and now you're ready to begin searching. Depending on your goals and your project, there are many different approaches that you can take to do just this. In this lecture, we'll look at a systematic approach that you can use in PubMed and other biomedical databases to find relevant articles on your topic. To learn how to use a combination of medical subject headings, mesh, and keywords in your search, incorporate search techniques such as Boolean operators, truncation, and field tags, and run your search in PubMed one concept at a time. This approach is best suited for developing a comprehensive search such as the one you might use for a literature review. Let's get started. In a previous lecture, we conducted a preliminary search for the following research question. How are mobile apps currently being used to help individuals with high blood pressure eat a low sodium diet? In this lecture, we're going to broaden the search to, how are mobile apps currently being used to help individuals with high blood pressure eat a healthier diet? We can use this question to develop the type of search strategy that we would use if we were conducting a comprehensive literature search. From our question, mobile apps, diet, and blood pressure are our key concepts. To build the search, I'm going to work in a Word document and I'll paste the final strategy in the PubMed when it's complete. As information is, we frequently use this technique because it allows us to think through all the terms and strategies that we want to use before we even get into a database. It also provides documentation of the search terms and strategy, which becomes vital if we want to rerun the search or let others know how we found our results. As a first step, we'll identify the relevant mesh for our search. As you might already know, mesh is a specialized subject headings or controlled vocabulary used in Medline. All Medline articles are indexed using this vocabulary. To better understand the value of mesh and why we include mesh in our searches, let's take a look at a common problem that occurs when searching. That is, that authors may refer to one concept using many different terms. For example, think about handwashing. If we want to find all of the articles available in PubMed on handwashing, just using the term could cause us to miss out on some key articles. This is because authors may refer to it as hand sanitation or surgical scrubbing. Sometimes they even write out handwashing using two words. If you just search for the term handwashing, your search won't retrieve citations where authors use these variations. To remedy this problem, databases such as Medline, M-Base, APA Psych Info and CINNL use a controlled vocabulary. In Medline, the control vocabulary is called MESH. Indexers who work for Medline read each article and tag it with the appropriate MESH. They use the most specific headings that are available and apply somewhere between 5 to 15 MESH to each article. For articles that address handwashing, they are tagged with the MESH hand disinfection. What this means for you is when you search using the appropriate MESH, such as hand disinfection, you'll retrieve articles regardless of the terminology used by the authors. There are several ways to identify relevant MESH for your research question. First, if you found an on-topic article in PubMed and it's indexed in Medline, such as this one titled Mobile Apps for the Dietary Approaches to Stop Hypertension, click on the citations title. Next, scroll to the right-hand side menu bar and click on MESH. This will take you to a listing of the article's MESH. If you see a heading that looks appropriate, click on the term and then the search in MESH link. You're now in the MESH database where you can look more closely at the heading. Below the term is a definition and the year it was introduced. Read through the definition and if everything looks good, click on the Add to Search Builder button on the right-hand side of the screen. Notice that PubMed puts the term in double quotes and adds the language bracket MESH bracket. This is the syntax that PubMed needs so that it knows to search the term as a MESH. Copy and paste exactly what you see in this box into your Word document. Alternatively, you can identify MESH by going directly to the MESH database from the PubMed homepage. Scroll down to the Explorer heading and click on the MESH database link. While it may look like you're still in PubMed, you're actually in a different database. You can tell this because you'll see the word MESH next to the search box. Now let's look up the corresponding MESH for our concept, Diet. I'll type Diet in the search box and click on the search button. The results show several pages of MESH to choose from. It's worth scrolling through this list as you might find more appropriate MESH to use than the first few results. For example, if we were focusing on low sodium diets, we could use diet, sodium restricted. Instead, let's click on the heading Diet Therapy. This heading is defined as adjusting the quantity and quality of food intake to improve health status for an individual, which makes it a good choice for our topic. Again, I'll click on the Add to Search Builder. If you want to see the articles tagged with this MESH, click on the Search PubMed button and go into PubMed to see your results. From here, you can also copy the heading with the added syntax and paste it into your Word document. Let's move on to our last concept, blood pressure. There is the broad heading blood pressure that we could use, but I don't want our search to veer too far off the original question. So instead, I'm going to select hypertension. Let's click on this heading and scroll down to the hierarchy. Here you'll see all the narrow or MESH that fall below hypertension. These headings are automatically included when you search the broader term hypertension. The technical term for this is exploding. But if you want to exclude these narrower terms, you can click on the button next to do not include MESH terms found below this term in the MESH hierarchy. Now, when I add the term to the search builder in brackets, you'll see MESH colon no EXP. Essentially, we're telling PubMed not to explode this heading. But in our case, I'm going to uncheck this box and just search with the MESH hypertension. I'll copy and paste this into my Word document. Now we have three MESH for our research question. It's not uncommon to identify and use several relevant MESH for each concept. So we could keep looking through the MESH database. But for the sake of time, let's move on to the next step. In an ideal world, searching by MESH should be good enough to retrieve relevant citations on the topic. Unfortunately, this is not always the case. Sometimes there isn't a MESH for the concept you're searching. This is particularly true for terms related to technology and rare diseases. For example, there is no MESH for sporadic porencephaly. Also, new MESH gets added every year. If you're using one of these newer headings, like augmented reality, which was added to the MESH database in 2019, you'll miss older articles that were indexed under another heading. Furthermore, it can take several months for Medline to index new articles. If you only search with MESH, you might miss the most recent literature on your topic. For these three reasons, if your goal is to be thorough, you'll want to search using a combination of MESH and keywords. Once you've identified keywords that you'll use in your search, you can begin applying search techniques such as bullion operators, truncation, nesting, quotes, and field tags to these terms. For our example, in my Word document, I've already identified two to five keywords for each term. Depending on the topic and the scope of your project, you may keep going until you've identified every possible keyword for your topic. But what we have here is enough to get started. Looking at our first concept, mobile applications, I'll use an OR in between the synonyms. Remember, we want articles that address any of these terms, so OR is the correct bullion operator to use. I'll type mobile applications, or mobile technologies, or mobile healthcare, or mHealth. Then I'll go through this list and look for terms that I can truncate. Mobile applications might seem like an obvious phrase to truncate in order to find the terms mobile application, mobile applications, mobile app, and mobile apps. But currently PubMed only allows truncation with stems that are four letters or longer. So while we can use an asterisk at the end of the N to get application or applications, we'll need to write out mobile app or mobile apps. I'll also take the IES off of technologies and use an asterisk to find technology and technologies. Next, I'll put double quotes around any multi-word phrases. So I'll put double quotes around mobile application, mobile app, mobile apps, mobile technology, and mobile healthcare. I won't use double quotes around mHealth because it's a single word. Notice in PubMed I can now use truncation and double quotes at the same time. This is a recent change. Just make sure that the asterisk is inside the quotes. Last, I'll add field tags to my terms. Remember for a comprehensive literature review, the TW or TIAB field tags are most frequently used. Test your search both ways to see which provide the best results. I'll start with the TW field tag for this search. So I'll put bracket TW bracket at the end of each term, making sure that I type it after the double quotes for my phrases. Before moving on to the next concept, double check to make sure the syntax is correct and that Boolean operators are in all caps. Even the smallest mistake like missing an end quote around this phrase mobile technology can throw off the results when you go into PubMed. I'll go through my other two concepts and apply the same treatment to them, adding ORs in between the terms and then incorporating truncation, double quotes and field tags. Finally, double checking for typos and errors. As a last step, I'll use an OR and include my mesh into the searches. So the final search will look like this. Once you have the search the way you want it, you can go into PubMed and start to run your search. The method we're going to use is frequently referred to as the building block approach. That is, we'll build the search one block or concept at a time and then connect these pieces together at the end to see our final list of results. Start with your first concept. In our case, I'll copy the search for mobile applications and paste it into the PubMed search box. One of the benefits of searching one concept at a time is that you can catch any mistakes in these smaller blocks before you put everything together. You can see that I misspelled health in mHealth. PubMed notified me of this underneath the results. I'll go back to my Word document and fix this mistake. Then I'll run the search again. Don't be nervous about the large number of results. Remember each time we end in another concept the results will get smaller. Now I'll paste the search strategy for diet. In addition to looking for spelling mistakes, it's also a good idea to look at the search details for each concept to make sure PubMed is searching exactly how you want it to. Click on the advanced link and scroll down to the history and search details. Then click on the arrow next to details. Everything looks good here, so I can go back to the PubMed search box and paste in my third concept, hypertension. If you're on the advanced search page, you can also paste in your search strategy in the query box and click on the search button. Again, check the results for spelling and the search details to make sure each concept was searched correctly. Once you search your three concepts, it's time to combine them and see your final results. In the history and search details box, you'll see all of the searches that we've conducted so far. I'm going to delete this first search with our spelling mistake so it doesn't cause confusion. Click on the three dots under the action heading and then click on the delete link. Now I'm looking at the final searches for my three concepts. There are several ways to combine these searches. What I do most often is use the set numbers. You can see our first concept mobile applications is number two, our second concept diet is number three, and our third concept type retention is number four. In the query box, I can simply type number two and number three and number four. Remember, I'm using an and between the sets because I want articles that address all three concepts. Once the query box is how you want it, click the search button. As you look through the results, you should see your terms appear in the titles and abstracts. This is the first indication that your search is working correctly. Again, if you're in doubt, you can go back to the search details and take a look at how PubMed searched. If you don't like using the set numbers, you can click on the three dots next to each set and click on the add query link for your first concept. Then for each set afterwards, you'll click on the add with and link. If you make any changes in PubMed, make sure to make all of these changes in your word document. It's important to keep your word document current so that you can report your search strategy and replicate it when needed. I often put my search strategy in a chart using the same number sets that I used in PubMed. This provides a clean and organized way to share exactly how the search was conducted. An important idea to remember when searching biomedical databases is that searching is an iterative process. Oftentimes, you need to make major and minor adjustments along the way. For example, after you review your results, you may see more terms that you want to add or remove from your search. Or you may decide to change your field tags or use of truncation after you see what these are doing to the search. While this may feel like extra work, remember that each change you make is bringing your search one step closer to generating relevant results. In closing with a little bit of legwork and patience, you will be well on your way to developing an effective search strategy following a systematic approach that uses a combination of mesh and keywords integrated with Boolean operators, truncation, quotes, and field tags. Is a key factor in building comprehensive searches that can be used for literature reviews and other research projects.


I'm Sam Vaknin and I'm the author of Malignant Self-Love, Narcissism Revisited. Do narcissists have emotions? Of course they do. Everybody has emotions. It is how we choose to relate to our emotions that matters. The narcissist tends to repress emotions so deeply that for all practical purposes they play no conscious role in his life or in his conduct. But his emotions play an inordinately and extraordinarily large unconscious role. The narcissist's positive emotions come bundled with very negative ones. This is the outcome of frustration and the consequent transformations of aggressions that the narcissist experiences in early childhood. This frustration is connected to the parents and caregivers of the narcissist. Instead of being provided with the unconditional love that he craved, the narcissist was subjected to totally unpredictable and inexplicable bouts of temper, rage, searing sentimentality, envy, prodding, infusion of guilt, and other unhealthy parental emotions, control and behavior patterns. The narcissist reacted by retreating into his private world where he deemed himself omnipotent and omniscient and therefore immune to such vicious vicissitudes. The narcissist stashed his vulnerable true self in a deep mental cellar and outwardly presented to the world a false self, omnipotent and omniscient. But bundling positive and negative emotions is far easier than unbundling them. The narcissist is unable to evoke positive feelings without provoking negative ones. Gradually he becomes phobic, he is afraid to feel anything, lest he be accompanied by some fearsome, guilt-inducing, anxiety-provoking, out-of-control emotional compliments. The narcissist is reduced to experiencing dull stirrings in his soul that he identifies to himself and to others as emotions. Even these are felt only in the presence of someone or something capable of providing the narcissist with his badly needed drug, narcissistic supply. Only when the narcissist is in the overvaluation, the idealization phase of his relationships, does he experience the convulsions that he prefers to call feelings. These are so transient and fake that they are easily replaced and substituted for by rage, envy and devaluation. The narcissist really recreates the behavior patterns of his less than ideal parents. Deep inside, the narcissist knows that something is amiss. He does not empathize with other people's feelings, he holds them in contempt and ridicule. He cannot understand how people are so sentimental, so irrational. He identifies being rational with being cool-headed and cold-blooded. Even the narcissist believes that other people are faking it, merely aiming by displaying emotion to achieve a goal. He is convinced that their feelings are grounded in ulterior, non-emotional motives. He becomes suspicious, paranoid, embarrassed, feels compelled to avoid emotional situations or worse experiences surges of almost uncontrollable aggression in the presence of genuinely expressed emotions and sentiments. These emotions and sentiments remind him of how imperfect and poorly equipped he is to deal with life. The weaker variety of narcissists tries to emulate and simulate emotions, or at least their external facet, their expression, their appearance, what we call affect. These narcissists mimic and replicate the intricate pantomime that they learn to associate with the existence of feelings in others. But there are no real emotions there, no emotional correlate inside the narcissist. This is empty effect, devoid of emotion. This being so, the narcissist quickly tires of it. He becomes impassive and begins to produce inappropriate effect. For instance, he remains indifferent when grief is the normal reaction. The narcissist subjects his feigned emotions to his cognition. He decides that it is appropriate to feel this way or that. His emotions are invariably the result of analysis, goal-setting and planning. He substitutes remembering for sensing. He relegates his bodily sensations, feelings and emotions to a kind of memory vault. The short and medium-term memory is exclusively used to store his reactions to his actual and potential narcissistic supply sources. The narcissist reacts in general only to such sources. The narcissist finds it hard to remember or recreate what he ostensibly though ostentatiously felt even a short while back towards the narcissistic source of supply once it has ceased to be a source of supply. In his attempts to recall his feelings, the narcissist draws a mental blank. It is not that narcissists are incapable of expressing what we would tend to classify as extreme emotional reactions. They mourn, they grieve, they rage, they smile, they excessively love and care. But this is precisely what sets them apart, this rapid movement oscillation from one emotional extreme to another and the fact that they never occupy the emotional middle ground. The narcissist is especially emotional when weaned off his drug of narcissistic supply. Breaking a habit is always difficult, especially one that defines and generates oneself. Getting rid of an addiction is doubly taxing. The narcissist misidentifies this crisis, this cold turkey phase, with an emotional depth and his self-conviction is so immense that he mostly succeeds to delude other people as well. But the narcissistic crisis, losing a source of narcissistic supply, obtaining an alternative one, moving from one narcissistic pathological space to another, all these crises must never be confused with the real thing, which the narcissist never experiences, true emotions. Many narcissists have emotional resonance tables. They use words as others use algebraic signs, with meticulousness, with caution, with the precision of the artisan. The narcissist sculpts in words the fine-tuned reverberations of pain, love and fear. It is a mathematics of emotional grammar, the geometry of the syntax of passions. Devoid of all true emotions, narcissists closely monitor people's reactions, and they adjust their verbal choices accordingly, until their vocabulary resembles that of their interlocutors and listeners. This is as close as the narcissist gets to empathy. To summarize, the emotional life of the narcissist is colorless and eventless, as rigidly blind and as his disorder, as dead as the narcissist is. He does feel rage and hurt, envy and emotional and inordinate humiliation and fear. These negative feelings are very dominant, prevalent and recurrent use in the converse of his emotional existence. But there is nothing there except these autovistic gut reactions. Whatever it is that the narcissist experiences as emotions, he experiences in reaction to slight syringes, real and imagined. His emotions are all reactive, not proactive.  The narcissist can appreciate beauty but in a cerebral, cold and mathematical way.  Their emotional landscape is dim and gray, as though looking through a glass darkly. Many narcissists can intelligently discuss those emotions never experienced by them, like empathy or love, because they make it a point to read a lot and to communicate with people who claim to be experiencing these emotions. Thus, they gradually construct working hypotheses as to what people feel and how they feel. As far as the narcissist is concerned, it is pointless to try to really understand emotions, but at least these models, it does form, allow him to better predict people's behavior and to adjust to them. Narcissists are not envious of others for having emotions, they disdain feelings and sentimental people, because they find them to be weak and vulnerable, and they deride human frailties and vulnerabilities. Such derision makes the narcissist feel superior, and is probably the ossified remains of a defense mechanism, gun or eye. Narcissists are afraid of pain. It is the pabo in their indra's net, lifted at the whole net and rattles. Their pains do not come isolated. They constitute families of anguish, tribes of hurt, whole races of agony. The narcissist cannot experience each and every emotion separately, only collectively. Narcissism in effect is an attempt to contain the ominous onslaught of stale, negative emotions, repressed rage in a child's deep set of irretractable injuries.


I would like to thank the organizers for giving me the opportunity to be here today. In my presentation, I will talk about the elements that we can relate to the social processes developed in the cave of Umbria de Sanctiite during the last centuries of the first millennium BC. This will be the way to approach ritual practices and social processes. The study of this sanctuary has always been very focused on a well-known and striking potterysert which has perhaps monopolized the attention. Taking this into account, my approach, wants to be careful with the diversity of social practices, maybe ritualized at times, developed in rock caves. I try to understand rock caves as part of a landscape that I understand as a synthesis of social processes, a landscape which is endowed with meaning and that is formed by notes that are culturally meaningful. Rock caves could have been part of these notes. They are therefore flexible and changing, depending on social relationships. For me, it is a priority to try to understand the ways in which rock caves could have been part of cognitive geographies of arts and societies. I believe that the scholarship on performance is particularly interesting as it has built a strong consensus on the fact that performance is a crucial aspect of ritual. The notion that ritual and ritualization include a range of activities from daily life to episodic or unique spectacles. In the case of lambria, I think it is essential to expand the discussion to a more representative archaeological record and to carry out a multi-scale and multi-disciplinary analysis in line with the objectives of this session. I will quickly mention the most important elements of lambria de Salchite that can bring us closer to the social practices, to later integrate this case study into time and in this territory that we can see in this image. The sanctuary is in an imposing mountain of limestone located in Campo de San Juan, a high plateau in Southeastern Iberia. In this mountain, the place of the sanctuary is characterized by a very peculiar morphology stated most of the time. Morphologically, umbria is therefore a benchmark on a valley scale. It is a place with wide visibility. It has a difficult access.  I mean light, shadow, heat, cold, dryness, humidity, water, flow, silence. It has therefore a natural multi-sensorial architecture with specific characteristics regarding temperature, humidity, or distorted sonority. It is a well-known place since at least the Bronze Age. It is therefore what I would call a persistent place. Among the archaeological contests, I will highlight several groups. Small, globular vessels, they seem to have been representative of at least part of the social practices carried out in the sanctuary. Storage bases, some of them carry complex figurative iconographies, open serving words, less abundant. Personal, adornment items, rings, weapons. Finally, I will highlight two groups that I will relate to transformation practices. Lead clamps and lead metallurgy waste, they are an indication of either repairs or the participation of repaired vessels in the ritual. Artified refitting could be related to performance as has been underlined in other ritual contests linked to an idea of renewal and fertility that I will come back to later. In this sense, stone mills are also related with food transformation. When globally considered, this archaeological contest is compatible with libations and periodic mills that could have been celebrated in the sanctuary always with the importance presence of water and fire as the main elements for libations and transformation. Let's focus now on complex figurative iconographies. In the best known search, we can identify a female figure linked to fire and birds, carnivores and plants. In 2014, we proposed a territorial reading linking the sanctuary to the settlements of the Plain of Morataya to the east. This proposal is based on the identification of an iconographical and territorial relationship between both geographical units, the Plain of Morataya and the High Plateau of Campo de San Juan. On one hand, the iconographic relationship consists on the presence in both areas of the representation of a veil figure dressed in a long robe with his head covered and his arms raised. In Molinikos, we find a very similar representation in two fire dogs. On the other hand, the territorial relationship is based on the sharing of the basin of the Alarabe River here in the immense and also on a visual connection since the visual horizon of the communities that inhabited Molinikos was the mountain of Lambria de San Chita. Although Molinikos is abandoned in the 4th century BC, settlement in the area continues for instance in Morataya la Vieja, which also maintains the visual connection with Lambria Mountain, which would have been a constant visual reference for the communities of Llano de Morataya, either Molinikos or Morataya la Vieja. In summary, the proposal for these two geographical units is that they could have served a story with possible variations in time, but sharing a feminine representation using fire as a transformational element and the cooking in the fire dog. Other elements appear only in the representation of Lambria, the birds, the carnivores and the plants, which are often present in other ritual images of the Iberian Iron Age. Our current work in the nearby Tiberia River Basin has allowed us to document a settlement, Mora de los Castillejos, where we have identified bases with complex figurative iconographies. It is contemporary to the period of greatest frequentation of Lambria. These bases are sometimes repaired. In Mora de los Castillejos, we have also note clamp making. This contest of Mora seems to corroborate a long use and repair of certain pottery vessels carrying iconographies and complex stories, which seem related to Lambria ritual practices. This is a current line of work, but I will outline some ideas. Although Lambria could have had a previous frequentation, most of its materials point to the period between the end of the 1st century BC and until the 1st century BC, which is coincident with that of Mora de los Castillejos. This allowed us to establish the relationship of Lambria de Saccita, not only with the Basin of Al Arabi River, but also with the Tiberia River to the west. These practices in the cave of Lambria take place in a contest of deep changes, the Second Pony War and the Roman Conquest, which alter the territorial organization and the social structure of the Iberian Iron Age communities. Our territory was part of these changes. In Roman times, there seems to be an increase in settlement in a high plateau where Lambria is located, something chronologically coincident with most of the archeological record of this cave. The height of this plateau suggests a complementarity in its use with respect to other surrounding lands, such as those of the Plain of Moratalla, which are lower. Lambria area has important additional resources, such as the Stacatin Salt March. This possible greater occupation will have required to know and control the Arrayan calendar and surrender the fecundity of land. With all this in mind, which practices can Lambria's archeological record be pointing to? I will hypothesize that those who went to Lambria transformed food possibly including its cooking, its consumption, and perhaps its suffering in a small basis. The celebration could include the remembrance of stories, some of them represented in the pottery vessels. They were repaired vessels used many times with representations possibly linked to the memory of the community. Fire, water, and bell sounds would accompany these practices. My proposal is that these practices could have been related to commemorative or calendrical rituals, perhaps related to the fertility and renewal of pastures and harvests every year. Rituals probably celebrated on key dates of the agricultural calendar. Future lines of research include a more detailed documentation of archeological evidence of what I will preliminarily call cyclic communal rites. This more detailed documentation could reveal aspects of performance, including food preparation and cooking, item refitting, and the position of material culture in what I think Lambria was above all, a persistent place. At this point, I think it is important to remember how Catherine Bell pointed out that the appropriation of calendrical festivals is a very common and highly effective strategy in places where one set of religious practices encounters and tries to dominate another set. In this line, my hypothesis is that in the context of the Roman conquest, the painted pottery Lambria could have reinvented the tradition of a previous story that I have mentioned from the Molinikos area, a story related to fire, water, to a feminine figure and to the transformation and sharing of food. The vessels could have brought to the sanctuary an old myth about the goddess that favored the renewal and fecundity of the territory. They were repaired vessels and they appreciated used over and over again. If this hypothesis of a process of reinvention of tradition is correct, it would show us once more how the images of tradition were probably the best way to establish change. Comparing this case with the nearby monumental sanctuaries of Caraba Cancero de los Santos allow us to emphasize once again the great variety of formulations that the Roman conquests entailed. Given the greater visibility and attention traditionally received by the monumental sanctuaries, this case study allows us to underline the importance of other practices such as those located in caves or the rural ones. They were less visible but certainly play an important role on how some social groups express and experience the boundaries between the social and the supernatural defining their social identity at every moment. Thank you very much.


State socialism, state socialism is a classification for any socialist political and economic perspective advocating state ownership of the means of production either as a temporary measure in the transition from capitalism to socialism, or as characteristic of socialism itself. It is often used interchangeably with state capitalism in reference to the economic systems of Marxist-Leninist states such as the Soviet Union to highlight a role of state planning in these economies, with the critics of said system referring to it more commonly as state capitalism. Libertarian and Democratic Socialists claimed that these states had only a limited number of socialist characteristics. However, Marxist-Leninists maintained that workers in the Soviet Union and other Marxist-Leninist states had genuine control over the means of production through institutions such as trade unions. State socialism is held in contrast with libertarian socialism, which rejects the view that socialism can be constructed by using existing state institutions or by governmental policies. By contrast, proponents of state socialism claimed that the state through practical considerations of governing must play at least a temporary part in building socialism. It is possible to conceive of a democratic state that owns the means of production, but it is internally organized in a participatory, cooperative fashion, thereby achieving both social ownership of productive property and workplace democracy in day-to-day operations.