Psychology has benefited from an enormous wealth of knowledge about processes of cognition in relation to how the brain organizes information. Within the categorization literature, this behavior is often explained through theories of memory construction called exemplar theory and prototype theory which are typically based on similarity or rule functions as explanations of how categories emerge. Although these theories work well at modeling highly controlled stimuli in laboratory settings, they often perform less well outside of these settings, such as explaining (...) the emergence of background knowledge processes. In order to explain background knowledge, we present a non-similarity-based post-Skinnerian theory of human language called Relational Frame Theory which is rooted in a philosophical world view called functional contextualism. This theory offers a very different interpretation of how categories emerge through the functions of behavior and through contextual cues, which may be of some benefit to existing categorization theories. Specifically, RFT may be able to offer a novel explanation of how background knowledge arises, and we provide some mathematical considerations in order to identify a formal model. Finally, we discuss much of this work within the broader context of general semantic knowledge and artificial intelligence research. (shrink)

Aristotle's Politics is widely recognized as one of the classics of the history of political philosophy, and like every other such masterpiece, it is a work about which there is deep division.

Research into people’s comprehension of novel noun-noun phrases has long neglected the possible influences of prosody during meaning construction. At the same time, work in conceptual combination has disagreed about whether different classes of interpretation emerge from single or multiple processes; for example, whether people use distinct mechanisms when they interpret octopus apartment as property-based (e.g., an apartment with eight rooms) or relation-based (e.g., an apartment where an octopus lives). In two studies, we manipulate the prosodic emphasis patterns of novel (...) noun-noun combinations (placing stress on the modifier noun, the head noun, or dual stress on both nouns) and ask participants to generate an interpretation for the novel phrase. Results show that people are faster to generate property-based interpretations when dual emphasis stresses both nouns equally, with prosody having little effect on the speed of relation-based interpretations. These findings highlight a role for prosody during meaning construction and underline important differences between relation- and property-based interpretations that are difficult to reconcile with unitary process views of conceptual combination. (shrink)

Bowler, Gardiner, and Grice have shown a small but significant impairment of autonoetic awareness or remembering involved in the episodic memory experiences of adults with Asperger’s syndrome. This was compensated by an increase in experiences of noetic awareness or knowing. The question remains as to whether the residual autonoetic awareness in Asperger individuals is qualitatively the same as that of typical comparison participants. Three experiments are presented in which manipulations that have shown differential effects on different kinds of conscious (...) awareness in memory in typical populations are employed with a sample of adults with Asperger’s syndrome. The results suggest that the experiences of remembering reported by such individuals, although reduced in quantity, are qualitatively similar to those seen in the typical population. The results are discussed in the context of current theories of awareness in episodic memory. (shrink)

In this article, I discuss the contribution of theoretical resources to the transformation in my thinking about professional development and accountability, within an action research self-study of practice as a civil servant, in the context of participation on the Doctor in Education programme at Dublin City University in the period 2008-2012. It is at the intersection of these subject positions, between theory and practice, that professional development was explored through the ‘leadership problem’ of encouraging trainer colleagues to investigate the educational (...) potential of information and communications technologies for the development of their practice. Ultimately, this constituted a critical space for sustained dialogue between the self and the social in exploring professional subjectivity. The resources discussed supported the interrogation of social, cultural and historical conditions influencing self-understanding and narrative reasoning and movement from strategic to communicative reasoning. It is claimed that this has significance for the development of a more educational training practice, which expresses a concern for subjectivity and agency in the face of a growing ‘performativity’ in professional life. (shrink)

In prevention and health promotion interventions, screening methods and risk profile assessments are often used as tools for establishing the interventions’ effectiveness, for the selection and determination of the health status of participants. The role these instruments fulfil in the creation of effectiveness and the effects these instruments have themselves remain unexplored. In this paper, we have analysed the role screening methods and risk profile assessments fulfil as part of prevention and health promotion programmes in the selection, enrolment and (...) participation of participants. Our analysis showed, that screening methods and health risk assessments create effects as they objectify health risks and/or the health status of individuals, i.e., they select the individuals ‘at risk’ and indicate the lifestyle modifications these people are required to make in order to improve their health. Yet, these instruments also reduce the group of participants thereby decreasing the possible effect of interventions, as they provide the legitimisation for people to make choices to whether they enrol or not and what lifestyle changes they incorporate into their lives. In other words, they present a space of interaction, in which agency is distributed across the practice nurses, the participants and the instruments. Decisions were not just made upon the projection of the outcomes of these instruments; decisions that were made by both the patients and practice nurses were the resultant of their opinions on these outcomes that were formed in interaction with the instruments. (shrink)

Through publicness we offer a reconceptualization of marginality in the city, one that makes apparent the “inherent porosity” of the boundaries that organize urban life (Harvey 2006, 19). Our analysis attends to moments of publicness during fieldwork spent in various spaces within the city of Ottawa, Ontario, with individuals who use drugs and/or panhandle. Much of this research took place in central neighborhoods of Ottawa, which serve as the public image of the nation’s capital: Lowertown to the East of Parliament (...) Hill, and Centretown to the South. These neighborhoods hold the largest concentration of national and historical monuments in the city. They also contain the largest concentration of public marginality, including a cluster of homeless shelters and harm reduction services. In this article we examine this paradox of urban marginality and the limits of exclusion for conceptualizing it. While marginal individuals are deemed invisible, unimportant, and apart from “normal” city life, they are present and visible, perhaps more visible than anyone else. Even from marginal positions individuals remain affective participants in the space of the city, and constitutive of the urban experience. (shrink)

Terrorism, ethnocentrism, religious tension, competition over limited resources, war - these are just a few of the problems and challenges that have emerged in today's global economy. Globalization both implies and requires economic interdependence; and this should bring with it a heightened sense of the interconnectedness of the participating societies. But unfortunately, as recent events indicate, rather than our having formed a global community, today's society is more fragmented than ever. In light of this, education faces some formidable new challenges. (...) How do we prepare future citizens for the world they will live in? How do we teach future generations to embrace the paradox of accepting the value of multiculturalism despite the conflicts it has produced? How do we instill religious tolerance in a time when fundamentalism has become inextricably tied with terrorism? How do we promote economic growth in the face of overpopulation and its depletion of resources? The authors of this collection of essays explore these and related challenges, and they suggest some novel ways of dealing with them. (shrink)

Violations of ethical conductThis article is about torture, power and the breach of ethical conduct among military doctors, nurses and medics in the “War on Terror”. Violations of ethical conduct have been widely recounted in academic and non-academic journals and reports.1 This paper is also a call to international boards of doctors and nurses to intervene directly to stop abuses undertaken by US military healthcare providers under the guise of the War on Terror. With evidence growing that US military and (...) security services are actively engaged in the ill treatment, torture and deaths of suspects, details about the participation of healthcare professionals in such unlawful and unethical activities remain for the most part timidly accounted for. But according to current literature on this topic, there is increasing evidence that US doctors, nurses and medics have been complicit in torture and other unethical activities in Afghanistan, Iraq and Guantanamo Bay .2–4The US government has inadequately dealt with these facts. Senior officials in the Bush administration who have played a major part in conducting the War on Terror have been either promoted or asked to remain in their posts. More seriously, despite worldwide condemnation of the reality behind the photos, allegations of torture continue at Guantanamo Bay, Cuba.5 The graphic and appalling nature of several photographs are by no means the only evidence of abuses conducted by the US on its own territory and abroad. But the complicity of healthcare professionals in many venues , such as in capital punishment procedures in the US, exacerbates the already disturbing extent of bio-political abuses by the US government.Doctors and nurses often top the polls as caring and trustworthy professionals.6 Indeed, so strong …. (shrink)

Environmental Ethics is a systematic account of values carried by the natural world, coupled with an inquiry into duties toward animals, plants, species, and ecosystems. A comprehensive philosophy of nature is illustrated by and integrated with numerous actual examples of ethical decisions made in encounters with fauna and flora, endangered species, and threatened ecosystems. The ethics developed is informed throughout by ecological science and evolutionary biology, with attention to the logic of moving from what is in nature to what ought (...) to be. The ethical theory is applied in detail to social, public, and business policy. Written in an engaging style, using diagrams and figures as well as numerous case studies, Environmental Ethics prods the reader into concrete application and invites reader participation in the ethical discussions. The ethics concludes by exploring the historical experiences of personal residence in a surrounding environment. Here is an adventure into what it means to live as responsible human beings in the community of life on Earth. In the series Ethics and Action, edited by Tom Regan. (shrink)

To examine the influence of hypnotic suggestibility testing as a source of individual differences in hypnotic responsiveness, we compared behavioral and subjective responses on three scales of hypnotic suggestibility: The Harvard Group Scale of Hypnotic Susceptibility, Form A . Harvard Group Scale of Hypnotic Susceptibility. Berlin: Consulting Psychologists Press); the Carleton University Responsiveness to Suggestion Scale . The Carleton University Responsiveness to Suggestion Scale: Normative data and psychometric properties. Psychological Reports, 53, 523–535); and the Group Scale of Hypnotic Ability . (...) The Group Scale of Hypnotic Ability and response booklet. Australian Journal of Clinical and Experimental Hypnosis, 27, 20–31). Behavioral and subjective responses to the CURSS were significantly different than those on the HGSHS: A and GSHA. More participants were classified as “low suggestible” on the CURSS and they reported subjective experiences more similar to everyday mentation. Attitudes and expectancies of participants who received the GSHA were less predictive of responding, but rates of responding and subjective experiences were similar on the GSHA and the HGSHS: A. Discussion focuses on implications for the use of group hypnotic suggestibility scales. (shrink)

Philosophers should be wary of using the methods they use in philosophy when engaging in discussions about policy makingThe beginning of November last year was a busy time in the bioethics calendar with four conferences taking place in New Zealand and Australia. The Fifth International Conference on Priorities in Health Care took place in Wellington; the Fifth Feminist Approaches to Bioethics congress, the Seventh World Congress of Bioethics, and the meeting of the Australasian Bioethics Association were all in Sydney.One of (...) the interesting features of these meetings was a move to a deeper exploration of the relations between ethics and political theory and political philosophy. The factors that drive this exploration are manifold but the four most important seem to be: 1) that ethicists often comment on, or propose political action and regulation; 2) that there is a growing awareness that the basic national and international societal and legal structures profoundly influences ethical issues; 3) the growing interest in global and third world issues, and 4) the move in many countries toward greater public participation in decision making concerning ethically contentious issues. All of these developments move the focus from the traditional subject matter of medical ethics—that is, the individual ethically charged action, to the question of how ethics should influence political action and regulation.To …. (shrink)

Theories of embodied cognition hold that the conceptual system uses perceptual simulations for the purposes of representation. A strong prediction is that perceptual phenomena should emerge in conceptual processing, and, in support, previous research has shown that switching modalities from one trial to the next incurs a processing cost during conceptual tasks. However, to date, such research has been limited by its reliance on the retrieval of familiar concepts. We therefore examined concept creation by asking participants to interpret modality-specific (...) compound phrases (i.e., conceptual combinations). Results show that modality switching costs emerge during the creation of new conceptual entities: People are slower to simulate a novel concept (e.g., auditory jingling onion) when their attention has already been engaged by a different modality in simulating a familiar concept (e.g., visual shiny penny). Furthermore, these costs cannot be accounted for by linguistic factors alone. Rather, our findings support the embodied view that concept creation, as well as retrieval, requires situated perceptual simulation. (shrink)

Do experiences with nature –– from wilderness backpacking to plants in a preschool to a wetland lesson on frogs, promote learning? Until recently, claims outstripped evidence on this question. But the field has matured, not only substantiating previously unwarranted claims but deepening our understanding of the cause-and-effect relationship between nature and learning. Hundreds of studies now bear on this question, and converging evidence strongly suggests that experiences of nature boost academic learning, personal development, and environmental stewardship. This brief integrative review (...) summarizes recent advances and the current state of our understanding. The research on personal development and environmental stewardship is compelling although not quantitative. Report after report –– from independent observers as well as participants themselves –– indicate shifts in perseverance, problem-solving, critical thinking, leadership, teamwork, and resilience. Similarly, over fifty studies point to nature playing a key role in the development of pro-environmental behavior, particularly by fostering an emotional connection to nature. In academic contexts, nature-based instruction outperforms traditional instruction. The evidence here is particularly strong, including experimental evidence; evidence across a wide range of samples and instructional approaches; outcomes such as standardized test scores and graduation rates; and evidence for specific explanatory mechanisms and active ingredients. Nature may promote learning by improving learners’ attention, levels of stress, self-discipline, interest, and enjoyment in learning, and physical activity and fitness. Nature also appears to provide a calmer, quieter, safer context for learning; a warmer, more cooperative context for learning; and a combination of “loose parts” and autonomy that fosters developmentally beneficial forms of play. It is time to take nature seriously as a resource for learning — particularly for students not effectively reached by traditional instruction. (shrink)

Background Middle managers play a key role in promoting a caring culture in nursing homes. However, there is limited knowledge about middle managers’ inner motives and their experiences of their responsibility in developing a caring culture. Research aim The aim of the study is to get a deeper understanding of middle managers’ motives and their experiences of their responsibility to develop a caring culture in nursing homes. Research design A qualitative design with a hermeneutic approach inspired by Gadamer was chosen (...) which guided the interpretation of data. Qualitative semi-structured interviews were conducted. Participants and research context Data were collected from thirteen middle managers in nursing homes, in six municipalities in northern Norway in September and October 2021. Ethical considerations The study was approved by the Norwegian Centre for Research Data. Oral and written informed consent was obtained from participants. Findings The findings show that the middle managers had non- egoistic motives to promote a caring culture as expressed in their attitudes and actions. They felt responsible to promote a caring culture where both patients and staff experienced care and were respected and recognized as unique individuals. Middle managers as good role models are responsible for being present and raising awareness of the importance of care in the nursing home culture by systematically reflecting on care values. However, a strong focus on the financial and administrative demands limits the middle managers’ possibilities to promote a caring culture and prevented them from always acting as they wanted to act, which often causes moral distress. Conclusion Being in contact with inner motives, enables the leader to promote a homelike and caring culture where both patients and staff feels respected and recognized as unique individuals. This study highlights the importance of systematic reflection on caring values in nursing homes which leads to value awareness among all actors. (shrink)

The legalization of cannabis in Canada instantiates principles of harm-reduction and safe supply. However, in-depth understanding of values at stake and attitudes toward legalization were not part of extensive democratic deliberation. Through a qualitative exploratory study, we undertook 48 semi-structured interviews with three Canadian stakeholder groups to explore opinions and values with respect to the legalization of cannabis: (1) members of the general public, (2) people with lived experience of addiction and (3) clinicians with experience treating patients with addiction. Across (...) all groups, participants tended to be in favor of legalization, but particular opinions rested on their viewpoint as stakeholders. Clinicians considered the way legalization would affect an individual’s health and its potential for increasing rates of addiction on a larger scale. People with lived experience of addiction cited personal autonomy more than other groups and stressed the need to have access to quality information to make truly informed decisions. Alternatively, members of the public considered legalization positive or negative in light of whether one’s addiction affected others. We elaborate on and discuss how scientific evidence about drug use impact values relates and how can different arguments play in democratic debates about legalization. (shrink)

The goal of the study was to determine which aspects of interpersonal touch interactions lead to a positive or negative experience. Previous research has focused primarily on physical characteristics. We suggest that this may not be sufficient to fully capture the complexity of the experience. Specifically, we examined how fulfilment of psychological needs influences touch experiences and how this relates to physical touch characteristics and situational factors.In two mixed-method studies, participants described their most positive and most negative interpersonal touch (...) experience within a specific time frame. They reported fulfilment of nine needs, affect, intention, and reason for positivity/negativity, as well as the body part(s) touched, location, type of touch, interaction partner, and particular touch characteristics (e.g. humidity).Positive and negative touch experiences shared similar touch types, locations, and body parts touched, but differed in intended purpose and reasons. Overall, the valence of a touch experience could be predicted from fulfilment of relatedness, the interaction partner and initiator, and physical touch characteristics. Positive affect increased with need fulfilment, and negative affect decreased.The results highlight the importance of relatedness and reciprocity for the valence of touch, and emphasise the need to incorporate psychological needs in touch research. (shrink)

We do lots of things together in a shared manner. From the phenomenological point of view, does joint or shared agency need a conscious sense of shared agency? Yet there are many processes where we seem to just go along with the group without conscious intent. Building on the classic phenomenological accounts of Edmund Husserl, Alfred Schutz, Martin Heidegger (and the synthetic account of Berger & Luckmann), I want to emphasize the thick horizon of the life-world as a fundamental condition (...) for intentional shared agency. Joint agency has divergent forms with their own peculiar intentionality, attentivity, anticipations and expectations, and embeddedness in a pre-predicative tacit knowledge in the overall live-world. Phenomenology recognizes that even ego-centered activities that appear to be fully ‘agential’ can be carried out in an anonymous un-owned manner, in the manner which Heidegger calls ‘das Man’, or ‘the one’. This suggests that tacit belonging to the collective ‘we’ undergirds individual agency. Husserl, Heidegger, and Schutz all have accounts of this ‘anonymous’, pre-predicative kind of group participation. Phenomenology has rich accounts of anonymous, voluntary, shared, social participation that demand a new concept of agency, one neglected in the current literature in philosophy of action. (shrink)

One important aspect of the nurse-patient relationship is nurses’ attitudes towards their patients. Nurses’ attitudes towards people with dementia have been studied from a wide range of approaches, but few authors have focused on the structure of these attitudes. This study aimed to identify a structure in licensed practical nurses’ attitudes towards people with dementia. Twenty-one group dwelling units for people with dementia at 11 nursing homes participated in the study. A total of 1 577 assessments of 178 patients were (...) sent out to 181 respondents and 1 237 answers were returned. The semantic differential technique was used. The scale had 57 bipolar pairs of adjectives that estimate an unknown number of dimensions of nurses’ attitudes towards an identified patient. The assessments were analysed using entropy-based measures of association combined with structural plots. The analysis revealed four dimensions, which related to licensed practical nurses’ opinions of the patients: an ethical and aesthetic dimension; an ability to understand; an ability to experience; and an ability for social interaction. The results of the study indicated that, on the positive to negative attitude continuum, the nurses’ attitudes fell at the positive to neutral end. This is an important finding owing to the personhood perspective, from which it is reasonable to assume that, with a more positive attitude to people with dementia, the prerequisites for person-centred care will improve. (shrink)

Imaginative resistance refers to a perceived inability or unwillingness to enter into fictional worlds that portray deviant moralities (Gendler, 2000): we can all easily imagine that dragons exist, but many people feel incapable of imagining fictional worlds in which morality works differently. Although this phenomenon has received much attention from philosophers, no one has attempted to operationalize the construct in a self-report scale. In Study 1, we developed the Imaginative Resistance Scale (IRS), investigated its relationship to theoretically related constructs, and (...) confirmed its structure and reliability (rα = 0.92) in a large sample. In Study 2, we asked participants to rate scenarios expected to provoke imaginative resistance and predicted these ratings from the IRS and its validity measures. IRS scores accounted for variability in ease of imagining these scenarios over and above gender, political orientation, and three related measures. The results are discussed in terms of theories of imaginative resistance and directions for future research. (shrink)

How to embed reflexivity in public participation in techno-science and to open it up to the agency of publics are key concerns in current debates. There is a risk that engagements become limited to “laboratory experiments,” highly controlled and foreclosed by participation experts, particularly in upstream techno-sciences. In this paper, we propose a way to open up the “participation laboratory” by engaging localized, self-assembling publics in ways that respect and mobilize their ecologies of participation. Our innovative reflexive methodology introduced participatory (...) methods to public engagement with upstream techno-science, with the public contributing to both the content and format of the project. Reflecting on the project, we draw attention to the largely overlooked issue of temporalities of participation, and the co-production of futures and publics in participation methodologies. We argue that many public participation methodologies are underpinned by the open futures model, which imagines the future as a space of unrestrained creativity. We contrast that model with the lived futures model typical of localized publics, which respects latency of materials and processes but imposes limits on creativity. We argue that to continue being societally relevant and scientifically important, public participation methods should reconcile the open future of research with the lived futures of localized publics. (shrink)

The attitudes of women patients with cancer were explored when they were invited to participate in one of three randomised trials that included chemotherapy at two university centres and a satellite centre. Fourteen patients participating in and 15 patients declining trials were interviewed. Analysis was based on the constant comparative method. Most patients voiced positive attitudes towards clinical research, believing that trials are necessary for further medical development, and most spontaneously argued that participation is a moral obligation. Most trial decliners, (...) however, described a radical change in focus as they faced the actual personal choice. Almost no one got an impression of clinical equipoise between treatments in the trials, and most patients expressed discomfort with randomisation. A patient’s choice to participate was mainly determined by whether the primary focus was on treatment effect or on adverse effects. Both knowledge about and feelings towards trials originated mostly from the media, although paradoxically the media were largely seen as untrustworthy. Mistrust was shown towards the pharmaceutical industry, and although most patients originally trusted that doctors primarily pursued the interest of patients, they did not trust the adequacy of doctors or industry in maintaining self-regulation. Thus, public control measures were judged to be essential. (shrink)

This paper seeks to analyze the construction of ethics in sexuality research in which qualitative methods are employed in the field of social sciences. Analyses are based on a bibliographic review of current discussions on research methods of queer theory and on the authors' own experiences of past research on sexuality. The article offers a theoretical perspective on the ways ethnography and in‐depth interviews become methods that can rely on a consensual method and create a politics of intimacy between the (...) researchers and research participants. The politics of intimacy may contribute to the production of a politically engaged knowledge while escaping from the moral matrix that usually governs the relationship between researchers and research participants. It is argued here that the researcher's sexed and gendered body matters for fieldwork; that the consensual method among participants may be employed in sexuality research as a fruitful tool; and that the relationships created among researchers and participants can pose a challenge to predetermined ethical guidelines in research. As a result, discussions problematize the existence of a politics of intimacy in sexuality research that is characterized by ethical relations among research participants. (shrink)

A deep investigation of proprioceptive processes is necessary to understand the relationship between sensory afferent inputs and motor outcomes. In this work, we investigate whether and how perception of wrist position is influenced by the direction along which the movement occurs. Most previous studies have tested Joint Position Sense through 1 degree of freedom wrist movements, such as flexion/extension or radial/ulnar deviation. However, the wrist joint has 3-DoF and many activities of daily living produce combined movements, requiring at least 2-DoF (...) wrist coordination. For this reason, in this study, target positions involved movement directions that combined wrist flexion or extension with radial or ulnar deviation. The chosen task was a robot-aided Joint Position Matching, in which blindfolded participants actively reproduced a previously passively assumed target joint configuration. The JPM performance of 20 healthy participants was quantified through measures of accuracy and precision, in terms of both perceived target direction and distance along each direction of movement. Twelve different directions of movement were selected and both hands tested. The left and right hand led to comparable results, both target extents and directions were differently perceived according to the target direction on the FE/RUD space. Moreover, during 2-DoF combined movements, subjects’ perception of directions was impaired when compared to 1-DoF target movements. In summary, our results showed that human perception of wrist position on the FE/RUD space is symmetric between hands but not isotropic among movement directions. (shrink)

The increasing popularity of local food consumption can be attributed to the heightened awareness of food safety concerns, carbon emissions produced from food transportation, and an understanding of how large corporations’ obtain their food supplies. Although there is increasing discussion on both the local and organic food movement independently, there is not a wide availability of literature examining the motivations and perceptions of consumers with regard to farmers’ markets. Issues such as perceptions about what type of food consumers are purchasing (...) at markets, nor the main motivations for frequenting such establishments are discussed. Therefore the purpose of this study was to determine consumer motivations, benefits, and perceptions of farmers’ markets. Using the case study location of Toronto, Canada, this study surveyed 300 participants during the fall of 2011. Findings indicated that the main purpose for visiting famers’ markets is not solely to fulfill grocery needs. Quality of products offered and the ability to support the local community were the primary motivators to visit the markets. (shrink)

The question of if, and under what conditions transsexuals should be allowed to participate in sports in their acquired sex is becoming increasingly relevant partly because the number of transsexuals is increasing partly because many countries now provide mechanisms for achieving legal recognition as belonging to the new acquired sex. This paper develops (1) an analysis of the justification for maintaining sex segregation in some sports and (2) an account of the rights of transsexuals to be recognised in their new (...) sex. On the basis of these two analyses it critically evaluates two set of rules for the participation of transsexuals in elite sports: the UK guidelines issued in pursuance of the Gender Recognition Act 2004 and the International Olympic Committee's guidelines. It is argued that these guidelines are conflicting and that a modified set of criteria is more justifiable. (shrink)

BackgroundGeneral practitioners often act as gatekeeper, authorizing patients’ access to hospital care. This gatekeeping role became even more important during the current COVID-19 crisis as uncertainties regarding COVID-19 made estimating the desirability of hospital referrals (for outpatient or inpatient hospitalization) complex, both for COVID and non-COVID suspected patients. This study explored Dutch general practitioners’ experiences and ethical dilemmas faced in decision making about hospital referrals in times of the COVID-19 pandemic.MethodsSemi-structured interviews with Dutch general practitioners working in the Netherlands were (...) conducted. Participants were recruited via purposive sampling. Thematic analysis was conducted using content coding.ResultsFifteen interviews were conducted, identifying four themes: one overarching regarding (1) COVID-19 uncertainties, and three themes about experienced ethical dilemmas: (2) the patients’ self-determination vs. the general practitioners’ paternalism, (3) the general practitioners’ duty of care vs. the general practitioners’ autonomy rights, (4) the general practitioners’ duty of care vs. adequate care provision.ConclusionsLack of knowledge about COVID-19, risks to infect loved ones, scarcity of hospital beds and loneliness of patients during hospital admission were central in dilemmas experienced. When developing guidelines for future crises, this should be taken into account. (shrink)

Communication is an important component in the construction of workplace identities, including leader and group identities. Micro-level analysis of everyday workplace discourse provides valuable insights into the way leadership is constructed and how workplace culture is created, maintained, and changed. In this context, leaders and managers are inevitably significant and influential participants, with a crucial impact on workplace culture. Drawing on audio and video data collected in 12 meetings of an IT department, the analysis demonstrates ways in which two (...) leaders, who succeed each other in the role of Director, reinforce and shape the culture of the workplace in which they operate. While both leaders claim teamwork as an important cultural value for their teams, their respective instantiations of teamwork are rather different. To explore the leaders' effect on the culture of their department, this investigation of leadership change examines ways in which the leaders manage regular workplace meetings and how they contribute to workplace humour. The analysis provides detailed evidence of the ways in which a change in leadership style can create the conditions for a change in the culture of a community of practice. (shrink)

Before COVID-19, dementia singing groups and choirs flourished, providing activity, cognitive stimulation, and social support for thousands of people with dementia in the UK. Interactive music provides one of the most effective psychosocial interventions for people with dementia; it can allay agitation and promote wellbeing. Since COVID-19 has halted the delivery of in-person musical activities, it is important for the welfare of people with dementia and their carers to investigate what alternatives to live music making exist, how these alternatives are (...) delivered and how their accessibility can be expanded. This community case study examines recent practice in online music-making in response to COVID-19 restrictions for people with dementia and their supporters, focusing on a UK context. It documents current opportunities for digital music making, and assesses the barriers and facilitators to their delivery and accessibility. Online searches of video streaming sites and social media documented what music activities were available. Expert practitioners and providers collaborated on this study and supplied input about the sessions they had been delivering, the technological challenges and solutions they had found, and the responses of the participants. Recommendations for best practice were developed and refined in consultation with these collaborators. Over 50 examples of online music activities were identified. In addition to the challenges of digital inclusion and accessibility for some older people, delivering live music online has unique challenges due to audio latency and sound quality. It is necessary to adapt the session to the technology's limitations rather than expect to overcome these challenges. The recommendations highlight the importance of accessibility, digital safety and wellbeing of participants. They also suggest ways to optimize the quality of their musical experience. The pandemic has prompted innovative approaches to deliver activities and interventions in a digital format, and people with dementia and their carers have adapted rapidly. While online music is meeting a clear current need for social connection and cognitive stimulation, it also offers some advantages which remain relevant after COVID-19 restrictions are relaxed. The recommendations of this study are intended to be useful to musicians, dementia care practitioners, and researchers during the pandemic and beyond. (shrink)

Research ethics committees and institutional review boards spend considerable time developing, scrutinising, and revising specific consent processes and materials for survey-based studies conducted on crowdsourcing and online recruitment platforms such as MTurk and Prolific. However, there is evidence to suggest that many users of ICT services do not read the information provided as part of the consent process and they habitually provide or refuse their consent without adequate reflection. In principle, these practices call into question the validity of their consent. (...) In this paper we argue that although the ‘no read problem’ and the routinisation of consent may apply to research participants’ consent practices for studies on crowdsourcing platforms, this is not a serious problem. Furthermore, given that the informational requirements for informed consent in these contexts are minimal, we argue that these participants are, nevertheless, sufficiently informed to give valid consent. We conclude that research ethics committees and institutional review boards should only agonise over the precise details of the informed consent process and materials in those rare cases where appreciable risks to research participants need to be managed. (shrink)

Addiction is a common condition affecting millions of people worldwide of which only a small proportion receives treatment. The development and use of healthcare services is influenced by how addiction is understood (e.g., a condition to treat, a shameful condition to stigmatize), notably with respect to how volition is impacted (e.g., addiction as a choice or a disease beyond one’s control). Through semi-structured qualitative interviews, we explore the implicit views and understandings of addiction and volition across three stakeholder groups: people (...) with lived experience of addiction, clinicians with experience treating addiction, and members of the public without lived experience of addiction. We notably examine whether three paradigms, i.e., three philosophical sets of understandings about the nature of reality and knowledge (realism, relativism, pragmatism) reflect how stakeholders envision addiction and volition in the context of addiction. The use of these paradigms allows for the characterization of different stances on addiction and volition and an assessment of the coherence of beliefs about these matters. Our findings demonstrate that few participants relied on a single epistemic paradigm when describing their views. Furthermore, there were notable differences in understandings of volition between the clinician group, who were more oriented toward pragmatism, and people with lived experience of addiction, who were less oriented toward realism. Despite its limitations, our study suggests that a greater appreciation for the complexity of views held by different stakeholders about addiction and volition could help critically assess the search for coherence expressed in academic and policy debates. (shrink)

BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be communicated (...) to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

Adolescent populations have become increasingly accessible through online data collection methods. Online surveys are advantageous in recruiting adolescent participants and can be designed for adol...

The concept of benefit sharing pertains to the act of giving something in return to the participants, communities, and the country that have participated in global health research or bioprospecting activities. One of the key concerns of benefit sharing is the ethical justifications or reasons to support the practice of the concept in global health research and bioprospecting. This article evaluates one of such ethical justifications and its meaning to benefit sharing, namely justice. We conducted a systematic review to (...) map the various principles of justice that are linked to benefit sharing and analysed their meaning to the concept of benefit sharing. Five principles of justice have been shown to be relevant in the nuances of benefit sharing in both global health research and bioprospecting. The review findings indicate that each of these principles of justice provides a different perspective for a different benefit sharing rationale. For example, commutative justice provides a benefit sharing rationale that is focused on fair exchange of benefits between research sponsors and communities. Distributive justice produces a benefit sharing rationale that is focused on improving the health needs of the vulnerable research communities. We have suggested that a good benefit sharing framework particularly in global health research would be more beneficial if it combines all the principles of justice in its formulation. Nonetheless, there is a need for empirical studies to examine the various principles of justice and their nuances in benefit sharing among stakeholders in global health research. (shrink)

OBJECTIVES: To study whether linguistic analysis and changes in information leaflets can improve readability and understanding. DESIGN: Randomised, controlled study. Two information leaflets concerned with trials of drugs for conditions/diseases which are commonly known were modified, and the original was tested against the revised version. SETTING: Denmark. PARTICIPANTS: 235 persons in the relevant age groups. MAIN MEASURES: Readability and understanding of contents. RESULTS: Both readability and understanding of contents was improved: readability with regard to both information leaflets and understanding (...) with regard to one of the leaflets. CONCLUSION: The results show that both readability and understanding can be improved by increased attention to the linguistic features of the information. (shrink)

Inspirée d’un cadre poststructuraliste, cette étude qualitative de « réception d’un médium » nous a permis de mettre en lumière les « lectures » que font une vingtaine de consommateurs de pornographie des notions de masculinité, de race et ethnicité, du milieu gai et du genre en lien avec la pornographie qu’ils consomment. Les résultats qui émergent de notre analyse critique de discours sont à l’effet que les lectures des consommateurs sont majoritairement dominantes, reproduisant ainsi les stéréotypes présents en société (...) et qui sont re/produits et véhiculés dans la pornographie qu’ils consomment. Les récits des participants attestent du fait que ces derniers remettent peu en question ce qu’ils voient dans le matériel pornographique ; matériel pouvant avoir certaines répercussions sur des indicateurs de santé mentale en accentuant et perpétuant certaines formes de stigmatisation chez certains groupes sociaux. Inspired by a poststructuralist perspective, our qualitative exploratory media reception study offers a critical discourse analysis of 20 male pornography consumers, focusing on their readings of masculinity, race/ethnicity, the gay world, and gender in relation to the pornography they consume. For the most part, results show dominant readings of these categories, which suggests that social stereotypes are produced, reproduced, and transmitted through the medium of pornography. Participant narratives reveal individuals who rarely question what is shown in pornographic material; the latter having potential implications for certain mental health indicators, as well as perpetuating and accentuating forms of stigmatization among specific social groups. (shrink)

Voluntary participation is connected to cultural, political, religious and social contexts. Social and societal factors can provide opportunities, expectations and requirements for voluntary activity, as well as influence the values and norms promoting this. These contexts are especially central in the case of voluntary participation among students as they are often responding to the societal demands for building a career and qualifying for future assignments and/or government requirements for completing community service. This article questions how cultural values affect attitudes towards (...) volunteerism, using data from an empirical research project on student volunteering activity in 13 countries in North America, Europe, the Middle East, and the Asia Pacific region. The findings indicate that there are differences in motivation between countries which represent different cultural values. This article sets these findings in context by comparing structural and cultural factors which may influence volunteerism within each country. (shrink)

In a recent article in the Journal of Medical Ethics, Neil Manson sets out to show that the meta-consent model of informed consent is not the solution to perennial debate on the ethics of biobank participation. In this response, we shall argue that Manson’s considerations on the costs of a meta-consent model are incomplete and therefore misleading; his view that a model of broad consent passes a threshold of moral acceptability rests on an analogy that misconstrues how biobank research is (...) actually conducted and a model of meta-consent is more in tune with the nature of biobank research and enables autonomous choice. (shrink)

Anhedonia is a risk factor for suicide and poor treatment response in depressed individuals. Most evidence-based psychological therapies target symptoms of heightened negative affect instead of deficits in positive affect and typically show little benefit for anhedonia. Viewing positive scenes through virtual reality has been shown to increase positive affect and holds great promise for addressing anhedonic symptoms. In this pilot study, six participants with clinically significant depression completed 13 sessions of exposure to positive scenes in a controlled VR (...) environment. Significant decreases were found in self-reported anhedonia, depression, anxiety, and impairments in functioning from baseline to 1-month follow-up. Negative affect decreased over all 13 sessions, and positive affect increased over sessions 8–13. Results suggest that positive experiences in VR may be a novel avenue for the treatment of anhedonia in depressed individuals. (shrink)