“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)

Explorations of a trust approach for nursing ethicsTrust has long been acknowledged as central to nurse–patient relationships. It, however, has not been fully explored nor‐matively. That is, trust must be examined from a perspective that encompasses not only reliability and competence, but also good will within nursing relationships. In this paper, we explore how a trust approach, based on Annette Baier’s work on trust in feminist ethics, could help inform future developments in nursing ethics. We discuss the limitations of other (...) approaches such as those based on contracts, paternalism, and care. By drawing out central features of Baier’s theory, we demonstrate how it can help overcome the problems of these previous models. In doing so, we emphasise the importance of combining the ethics of care and justice, acknowledging vulnerability and the potential for evil in nursing relationships, and politically situating the ethical concerns of nursing. (shrink)

Many of those teaching at the intersection of medicine and the humanities are siloed within institutional spaces. This essay recounts the teaching of Sarah Manguso’s The Two Kinds of Decay to students across different academic contexts and considers what we can learn when we put classrooms in conversation with each other. This essay argues for the value of texts like Manguso’s, which explicitly hold the narrating subject and form of illness narrative up for critical examination. The authors call for (...) more collaborative teaching, which has special resonance in the health humanities, where conversations already depend on bridging disciplines and listening to the stories others can tell. (shrink)

Internet recruitment methods for research are rapidly evolving as technology and participant preferences do as well. This brings data security concerns, balanced with respect to persons for research participants. Internet recruitment research strategies are still important given the importance of creating private and accessible pathways for potentially marginalized populations or people experiencing stigmatized mental health conditions to participate in research. This manuscript describes the case of social media recruitment for a mental health and racism study in Fall 2022 that was (...) infiltrated by bots. We contextualize it in the context of data quality literature, with considerations for future directions including strategies for study design and management, and further research questions. (shrink)

Graduates of doctoral programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete their studies in (...) one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study. (shrink)

The gaze cueing effect is characterized by faster attentional orienting to a gazed-at than a non-gazed-at target. This effect is often enhanced when the gazing face bears an emotional expression, though this finding is modulated by a number of factors. Here, we tested whether the type of task performed might be one such modulating factor. Target localization and target discrimination tasks are the two most commonly used gaze cueing tasks, and they arguably differ in cognitive resources, which could impact how (...) emotional expression and gaze cues are integrated to orient attention. In a within-subjects design, participants performed both target localization and discrimination gaze cueing tasks with neutral, happy, and fearful faces. The gaze cueing effect for neutral faces was greatly reduced in the discrimination task relative to the localization task, and the emotional enhancement of the gaze cueing effect was only present in the localization task and only when this task was performed first. These results suggest that cognitive resources are needed for gaze cueing and for the integration of emotional expressions and gaze cues. We propose that a shift toward local processing may be the mechanism by which the discrimination task interferes with the emotional modulation of gaze cueing. The results support the idea that gaze cueing can be greatly modulated by top-down influences and cognitive resources and thus taps into endogenous attention. Results are discussed within the context of the recently proposed EyeTune model of social attention. (shrink)

Any philosophy of science ought to have something to say about the nature of mathematics, especially an account like constructive empiricism in which mathematical concepts like model and isomorphism play a central role. This thesis is a contribution to the larger project of formulating a constructive empiricist account of mathematics. The philosophy of mathematics developed is fictionalist, with an anti-realist metaphysics. In the thesis, van Fraassen's constructive empiricism is defended and various accounts of mathematics are considered and rejected. Constructive empiricism (...) cannot be realist about abstract objects; it must reject even the realism advocated by otherwise ontologically restrained and epistemologically empiricist indispensability theorists. Indispensability arguments rely on the kind of inference to the best explanation the rejection of which is definitive of constructive empiricism. On the other hand, formalist and logicist anti-realist positions are also shown to be untenable. It is argued that a constructive empiricist philosophy of mathematics must be fictionalist. Borrowing and developing elements from both Philip Kitcher's constructive naturalism and Kendall Walton's theory of fiction, the account of mathematics advanced treats mathematics as a collection of stories told about an ideal agent and mathematical objects as fictions. The account explains what true portions of mathematics are about and why mathematics is useful, even while it is a story about an ideal agent operating in an ideal world; it connects theory and practice in mathematics with human experience of the phenomenal world. At the same time, the make-believe and game-playing aspects of the theory show how we can make sense of mathematics as fiction, as stories, without either undermining that explanation or being forced to accept abstract mathematical objects into our ontology. All of this occurs within the framework that constructive empiricism itself provides the epistemological limitations it mandates, the semantic view of theories, and an emphasis on the pragmatic dimension of our theories, our explanations, and of our relation to the language we use. (shrink)

WQ.1 “Independent men and women, in independent homes, leading separate and independent lives, with full freedom to form and dissolve relations, and with perfectly equal opportunities to happiness, development, and love.” I leave out the word “rights,” doubtful I can use it without being misunderstood. Perhaps I can succeed in dispensing with its use altogether. This ideal, so stated, is attractive to me and completely in harmony with my idea of the course in life which will best further human happiness. (...) WQ.2 I am not sure that I quite understand Victor’s position in regard to the number of.. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

This article focuses on Guyanese efforts in the ​postcolonial present to address environmental issues that have become increasingly complex in the face of an awareness of climate change. It opens with an account of how the preservation of Indigenous forests contributes to international efforts to reduce carbon, while making visible the instability that the discovery of oil and gas reserves in the seabed might portend for the Guyanese economy. Specifically, the article examines how engineers have historically confronted settler-colonial discourses about (...) terra nullius unfold as they invest in sea defense. In doing so, the article foregrounds what engineers call slips—the slow or sudden displacement of a sea defense’s structural foundation. Slips are phenomena of energy conversion between land and sea. Rather than arguing for the claims of the pre-Anthropocene earth, the article suggests how many factors are in play in developing policy in the present, in an era of heightened awareness of the different forces in a changing climate. (shrink)

This article sets my own acquaintance with Asphodel in the context of her academic and life achievements. In this long life, she has both seen and influenced changes in the work of theology and social attitudes. Her own work has been seminal and inspiring. Her life has been as radical as her writing. The article draws on conversations with others of her acquaintance, as well as her writings. I end by honouring Asphodel as a gevirah, in scriptural terms.

In a pioneering book, Philosophy of Microbiology, Maureen O’Malley argues for the philosophical importance of microbes through an examination of their impact on ecosystems, evolution, biological classification, collaborative behavior, and multicellular organisms. She identifies many understudied conceptual issues in the study of microbes. If philosophers follow her lead, the philosophy of biology will be expanded and enriched.

Venturing into novel terrain poses physical risks to a female and her offspring. Females have a greater tendency to avoid physical harm, while males tend to have larger range sizes and often outperform females in navigation-related tasks. Given this backdrop, we expected that females would explore a novel environment with more caution than males, and that more-cautious exploration would negatively affect navigation performance. Participants explored a novel, large-scale, virtual environment in search of five objects, pointed in the direction of each (...) object from the origin, and then navigated back to the objects. We found that females demonstrated more caution while exploring as reflected in the increased amounts of pausing and revisiting of previously traversed locations. In addition, more pausing and revisiting behaviors led to degradation in navigation performance. Finally, individual levels of trait harm avoidance were positively associated with the amount of revisiting behavior during exploration. These findings support the idea that the fitness costs associated with long-distance travel may encourage females to take a more cautious approach to spatial exploration, and that this caution may partially explain the sex differences in navigation performance. (shrink)

Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long‐term care (LTC). Nurses from an older persons’ mental health and dementia LTC unit in Australia participated in this study. Forty‐one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty‐nine nurses participated in individual interviews to (...) further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well‐being of people in LTC. (shrink)

To understand why autistic people are misperceived in the way Jaswal & Akhtar suggest, we should embrace concepts like the “double empathy problem” and camouflaging and recognize the negative consequences these have for mental health in autism. Moreover, we need to value expertise from experience so that autistic people have a voice and indeed a stake in research into autism.

Background While it is generally acknowledged that self-prescribing among physicians poses some risk, research finds such behaviour to be common and in certain cases accepted by the medical community. Largely absent from the literature is knowledge about other activities doctors perform for their own medical care or for the informal treatment of family and friends. This study examined the variety, frequency and association of behaviours doctors report providing informally. Informal care included prescriptions, as well as any other type of personal (...) medical treatment (eg, monitoring chronic or serious conditions). Method A survey was sent to 2500 randomly-selected physicians in Colorado, 600 individuals returned questionnaires with usable data. The authors hypothesised: (1) physicians would prescribe the same types of treatment at home as they prescribed professionally; and (2) physicians who informally prescribed addictive medications would be more likely to engage in other types of informal medical care. Results Physicians who wrote prescriptions for antibiotics, psychotropics and opioids at work were more likely to prescribe these medications at home. Those prescribing addictive drugs outside of the office treated more serious illnesses in emergency situations, more chronic conditions and more major medical/surgical conditions informally than did those not routinely prescribing addictive medications. Physicians reported a variety of informal care behaviour and high frequency of informal care to family and friends. Discussion The frequency and variety of informal care reported in this study strongly argues for profession-wide discussion about ethical and guideline considerations for such behaviour. These areas are discussed in the paper. (shrink)

ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)

There is increasing interest today in how the arts contribute to individual and community wellbeing. This scoping review identified and examined ways in which the arts have been used to address wellbeing in communities in the United States. The review examined 44 publications, with combined study populations representing a total of 5,080 research participants, including marginalized populations. It identified the types of artistic practices and interventions being conducted, research methods, and outcomes measured. It highlights positive associations found across a broad (...) spectrum of psychological, physical, and social outcomes, including improvements in self-esteem and identity formation, cognition, physical balance, and physical conditioning. It also reports negative outcomes of arts interventions that may be underreported. The study identifies the need for core outcomes sets and reporting guidelines for advancing evidence synthesis in this area. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and DanceSarah H. WattsElizabeth Mackinlay. Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and Dance (Bern: Peter Lang, 2007).Elizabeth Mackinlay, a lecturer in the Aboriginal and Torres Strait Islander Studies Unit at the University of Queensland, documents her unique pedagogical approaches and ways of thinking about the teaching and (...) learning of music and dance in her book, Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Indigenous Australian Women’s Music and Dance. A university-level anthropology course dealing with the music and dance traditions of Australia’s Yanyuwa women was the setting for this “ethnographic case study” (p. 17). Through this course, Mackinlay sought to help students connect Indigenous Australian performance practices to social and political issues while fostering awareness of gender issues and learning processes within Indigenous Australian music and dance performance contexts. These objectives were met through a distinctive approach—by disposing of the strict lecture class format and bringing the field into the classroom. Disturbances and Dislocations documents the experiences of Mackinlay, her students, and several Yanyuwa women who come together as part of the course to engage in hands-on, authentic music and dance exchanges that bring the Yanyuwa women’s voices to the fore. [End Page 90]From the very beginning of the book, Mackinlay highlights her unique point of view as author of this work. She is a “white, middle class, educated woman” (p. 15) researching the experiences of and teaching university-level courses relating to Indigenous Australian and Torres Strait Islander peoples, a cultural background that is not her own. She is a political, educational, and ethnic outsider to the groups of peoples she studies. The wife of an Aboriginal man and mother to Aboriginal children, she is afforded links to the Yanyuwa people that provide her with a measure of status as a family member within the community. The dichotomy of being at once an insider and an outsider in the Yanyuwa community lends a fascinating level of complexity to Mackinlay’s exploration and analysis of the presence and impact of Yanyuwa culture-bearers in her classroom. The warmth, honesty, and openness with which she addresses her unique role in this learning exchange is engaging to the reader, and allows her personal situation to add humanity and life to the words on the page.The eight-chapter book commences with an introductory section that reflects upon her personal experiences in engaging in scholarship relating to Indigenous Australian issues. Additionally, the reader is introduced to the site of the ethnography, her classroom, in which her personal and professional lives intertwine. The next chapter further establishes the context of the ethnography by discussing a pilot project that laid foundations for the main study presented in the book. In this 1999 pilot project, a group of Mackinlay’s students, largely white women, participated in hands-on music and dance workshops under the guidance of Mackinlay and several Yanyuwa women. Student responses from this pilot project indicated that they felt awkward at times, but valued the time spent with the Yanyuwa guests and wished for more of these types of class sessions. Mackinlay determined that this cultural exchange could be even richer if more class time could be dedicated to it, an important observation for her own work, and also for others who seek to furnish cultural encounters for students.The fourth chapter delves into a theoretical discussion of the meanings of the inclusion of the study of Aboriginal and Torres Strait Islander peoples in contemporary classroom settings. Issues of political positioning, representation of Indigenous voices, identity, and “speaking from and of in-between spaces” (p. 64) as one with a foothold in both white and Indigenous worlds are all addressed, engaging the reader in Mackinaly’s own complex journey of coming to terms with her own teaching and scholarly pursuits. It is refreshing to the reader that Mackinlay acknowledges her unique viewpoint as facilitator of this course and this research study. While she is an authority in this realm, she highlights her own backgrounds and biases, her individual lens... (shrink)