Dès l'aube de la pensée philosophique en occident, l'Ecole d'Elèe souligne le caractère absolu de l'être. Découverte des plus importante, qui ne cessera d'exercer une profonde influence sur tout le cours de la réflexion philosophique. Platon s'attache à réhabiliter l'intelligibilité du multiple : il y a « des idées » subsistantes; et Aristote dégage l'intelligibilité du multiple matériel : il y a « des catégories » obtenues au moyen de l'abstraction. L'un et l'autre s'efforce d'y découvrir un ordre : rapports (...) de participation, selon Platon ; rapports de causalité, selon Aristote. Platon se dégage de la tenaille de Parménide, — ou l'être, ou l'absurde néant, — en distinguant deux néants : l'un, qui est le contraire de l'être, est absurde ; mais l'autre, qui est l'altérité, est parfaitement intelligible, une idée, un être véritable. Ce non-être relatif, à savoir l'altéritê, est aussi universel que l'être correspondant, à savoir ceci, cela, êtres corrélatifs. Pour autant, l'unité fondamentale du monde des idées est une unité d'ordre, une multiplicité, et non plus l'unicité à la manière de Parménide. Il est vrai que de toute son âme Platon aspire à une unité suprême et unique, mais il ne réussit pas à l'intégrer techniquement dans son système. Aristote, qui pose carrément en principe que l'être a des sens multiples et irréductibles, notamment les catégories, découvre, lui aussi, un ordre qui unit les catégories entre elles, de même qu'un ordre qui unit toutes les réalités substantielles en les reliant à un Premier Moteur : il est vrai que cette dernière influence ne peut pénétrer jusqu'au fond de la réalité, puisque celle-ci est autre chose que du mouvement, et que par conséquent cette réalité, fondamentalement non unifiée, demeure fondamentalement inintelligible. Il est intéressant de rapprocher de ces deux systèmes « essentialistes » celui de Hegel, dont le mouvement dialectique part de l'être et se porte immédiatement vers le non-être correspondant, considéré comme intelligible : l'être s'en trouve radicalement « relative » . Aussi bien, c'est dans l'élaboration ultérieure de l'être qualifié, quidditatif, que Hegel cherche, mais en vain, l'idée absolue. Plotin réussit à formuler nettement le problème du relatif et de l'absolu et à s'orienter vers une solution : il souligne le caractère radicalement relatif de la réalité relative, ce qui implique le caractère radicalement indépendant de la réalité absolue. Comme il continue à entendre l'être à la manière essentialiste de Platon et d'Aristote, il va de soi qu'il ne lui est pas possible d'identifier l'être et l'absolu : la réalité suprême, l'Un, est donc au delà de l'être, de même qu'il est au delà de l'intelligence, dont l'objet propre est l'être. En distinguant la quiddité et l'existence, Avicenne introduit, à côté de la quiddité, une nouvelle dimension où pourra se mouvoir l'intelligence. Néanmoins c'est sur la quiddité qu'il met l'accent : considérée en elle-même et indépendamment de toute rapport virtuel ou actuel avec l'existence, la quiddité à un sens complet ; au contraire, l'existence ne se conçoit que se rapportant à la quiddité. C'est du côté de la quiddité que se trouve l'absolu. S. Thomas reprend la distinction avicennienne, mais en la retournant : car c'est à l'esse qu'il accorde la primauté : l'esse est acte, la quiddité est puissance ; l'esse est la perfection fondamentale de tout, à laquelle toute réalité participe. C'est dans la ligne de l'esse que se trouve l'absolu. Heidegger fait observer que depuis Platon la philosophie se trouve sur une mauvaise voie : c'est toujours de l « étant » qu'elle s'est occupée, c'est-à-dire, de l'être qualifié, tandis qu'elle a négligé l'étude de l'être lui-même. Sans doute a-t-il raison pour une bonne part, mais il ignore que S. Thomas a élaboré une philosophie authentique de Yesse, que beaucoup sont trop enclins à ne pas considérer. Comment justifier le point de départ et le point de vue d'une philosophie de l'être ? Où les trouver ? Non pas dans quelque secteur particulier où Ion rencontrerait l'être pur, mais dans tout secteur, dans toute expérience. C'est sur le fait qu'il faut s'appuyer, sur le fait dont l'homme de science déclare qu'il est plus fort que le Lord Maire de Londres. L'homme de science se borne à noter les faits et à en chercher la régularité ; le philosophe s'attache à découvrir la raison de la solidité absolue des faits et à dégager ce que cela implique. Lorsqu'on a exposé tout ce qu'est une réalité donnée, tout ce que sa quiddité comporte, on n'a nullement fini de dire ce que cette réalité contient d'intelligible, puisqu'on n'a pas encore déclaré que cette réalité est, qu'elle existe. Sans doute, Kant est-il d'avis que l'intelligibilité de cent thalers existants ne dépasse en rien celle de cent thalers possibles, mais il est pourtant certain que le jugement d'existence, qui est un jugement, est affaire d'intelligence, d'intelligibilité : il manifeste d'emblée la solidité irréfragable de l'être ; rien ne pourra plus jamais effacer ce qui a été et, désormais, absolument tout doit en tenir compte. C'est cela même qui est à la base de la connaissance vraie, à savoir de celle qui saisit « ce qui est ». Ceci ne contredit en rien la relativité des faits : c'est précisément le fait qui nous révèle l'absolu, c'est le relatif qui se montre comme étant absolument relatif. Tout comme c'est de la situation dans laquelle je me trouve que j'ai conscience et que c'est donc en elle que je domine et transcende la relativité qui est propre à cette situation. L'absolu que je saisis est celui qui me révèle le relatif. Mon point de vue, qui n'est qu'humain, n'est jamais celui de Dieu : cependant il contient une valeur d'absolu. Et la donnée qui m'est présentée n'est pas l'être divin : cependant elle manifeste une signification d'absolu, à savoir la signification d'être. Dans cette signification, tout coïncide, car ce qui ne s'y trouverait pas, serait pur néant. Tout se rencontre dans une identité fondamentale. C'est à raison de l'être qu'il contient que la réalité parle à l'intelligence, comme aussi à la vie appetitive : c'est grâce à sa signification d'être, que la réalité peut m'être « présente ». Aussi bien, pour y répondre, pour résoudre les problèmes qu'elle pose, il n'est que de s'en approcher et de se laisser guider par elle. On peut montrer que la signification absolue d'être que manifeste toute donnée exige un principe réel unique qui fonde toute réalité. Ce principe ne peut se concevoir, ni sur le mode d'une substance, ni sur celui d'une cause particulière, car l'une et l'autre sont essentiellement relatives. Il ne peut s'entendre que comme l'Absolu, dégagé de tout rapport : si toutes choses sont intégralement dépendantes de cet Absolu, lui-même ne peut dépendre de rien et il garde nécessairement son indépendance totale. Il apparaît clairement qu'il ne sert à rien de se mouvoir, « horizontalement », le long d'une série de causes dans l'espoir d'en découvrir une, par exemple la première de la série, qui permettrait davantage de se porter, « verticalement », vers l'Absolu ; car du fini à l'Infini la distance demeure partout la même et la difficulté est toujours égale : le passage du fini à l'Infini est unique et il exige d'être examiné et justifié avec soin. L'argument en question est d'une nature spéciale : il s'agit d'atteindre l'Infini à partir du fini et, de plus, au moyen d'une intelligence finie. Aussi bien, n'atteignons-nous jamais immédiatement l'Infini en lui-même, mais uniquement dans le fini et tel que le fini nous le révèle. Donc c'est tout en pensant le fini qu'il nous faut penser l'Infini, à savoir comme exigence fondamentale de ce fini. C'est en ce sens qu'on dit que de l'Infini au fini il y a relation logique. Cependant, par là-même nous comprenons que nulle relation réelle ne peut lier l'Infini au fini. Ceci ne signifie nullement que l'Absolu divin serait entièrement isolé et loin de toute réalité finie ; mais tout au contraire, que Dieu est plus près de la créature qu'aucun terme relatif ne peut jamais l'être du terme qui lui correspond : l'Absolu créateur, souverainement indépendant et transcendant, est tout aussi parfaitement immanent, c'est-à-dire toujours intimement et activement présent à ce qu'il pose dans le réel. (shrink)

Un système philosophique peut-il se maintenir à travers le temps ? Peut-il renaître après des siècles ? Oui, s'il peut faire l'objet d'une pensée vivante et, donc, personnelle.C'est pourquoi le cardinal Mercier estime que le thomisme authentique est appelé à se rajeunir sans cesse et à prendre la forme d'un néothomisme. Pour renouveller le thomisme, dit le Cardinal, « il ne peut s'agir simplement de retourner en arrière » ; il ne peut être question de considérer la doctrine thomiste comme (...) « une momie ensevelie dans un tombeau et autour duquel nous n'aurions qu'à monter la garde, mais comme un organisme toujours jeune, toujours en activité » ; en l'occurrence, ce qui importe avant tout, c'est esprit » dont la doctrine est animée. Pour saisir exactement l'idée du cardinal Mercier, il faut se référer à l'époque de son enseignement à l'Université de Louvain. En particulier, on doit se rappeler l'importance attachée à l'organisation universitaire de la recherche scientifique, au cours des dernières décades du dix-neuvième siècle, et il est nécessaire de se souvenir de la distinction introduite alors entre la « science faite » et la « science qui se fait » . Le cardinal Mercier n'a pas hésité à appliquer ces vues à la philosophie et dès lors au thomisme, qu'il considérait comme la philosophie vraie . Cependant il ne lui était guère possible, à cette époque, d'établir, à ce point de vue, une nette différence entre les sciences et la philosophie. Depuis lors, les résultats obtenus par la « critique des sciences », ainsi que certaines considérations de la philosophie d'aujourd'hui, sont venus jeter quelque lumière sur ce point capital. Au lieu d'étudier directement le problème, examinons le comportement du philosophe, pour savoir en quoi il diffère de celui de l'homme de science. Dans une étude philosophique se rencontrent régulièrement des références aux philosophes anciens, dont on discute les idées. On remarque que tout philosophe véritable garde indéfiniment son actualité : il ne se trouve jamais entièrement remplacé, annulé, par les penseurs qui le suivent. Assurément, personne ne songerait à prétendre, par exemple, qu'au vingtième siècle il n'y a plus aucun profit à étudier les classiques grecs ; et qui donc s'aviserait de nier que la disparition des œuvres de ces philosophes constituerait une perte irréparable ? A considérer l'histoire, il semble que tout se passe comme si un « colloque philosophique » se poursuivait depuis des siècles. Quelques dizaines de penseurs y prennant une part active. Or, il est remarquable qu'aucun des membres effectifs de ce Symposion ne s'efface jamais, ni ne cède la place à un autre. De fait, le groupe des penseurs déjà réunis voit, de temps à autre, de nouveaux se joindre à eux, mais toujours les derniers venus reconnaissent l'autorité des anciens et ils ne manquent pas de s'expliquer avec eux. Dans le secteur des sciences, il en va tout autrement. Pour s'y mettre au courant, c'est uniquement aux auteurs les plus récents qu'il convient de s'adresser. Les hommes de science du passé n'ont plus qu'une importance historique. Dès lors, on ne s'y réfère pas, on ne discute plus leurs opinions. A la lumière des résultats obtenus grâce à la critique des sciences, il est devenu possible de se faire une idée exacte de la valeur des sciences modernes, de définir la nature de leurs méthodes et la portée de leurs résultats. En conséquence, l'on peut poser le problème de la distinction entre les sciences et la philosophie avec quelque chance d'aboutir à une solution précise et dûment fondée. L'homme de science considère les données d'un point de vue objectif , du « point de vue de Sirius ». C'est notamment ce que fait le physicien lorsqu'il utilise des instruments pour enregistrer les faits et pour noter la régularité de leurs rapports spaciaux et temporels. Tout au contraire, le philosophe s'attache à « intelliger » ces mêmes réalités et à déceler les « significations » qu'elles comportent. Dès lors, en philosophie, un facteur personnel intervient immanquablement, tant en ce qui concerne la richesse des données d'expérience qu'en ce qui concerne la force du regard intellectuel qui les pénètre et les saisit. Ce qui n'autorise nullement de conclure au subjectivisme, bien au contraire. Dès lors, on comprend que tout système philosophique porte la marque de la personnalité « incommunicable » de son auteur et que, pour autant, il demeure irréductible à tout autre, — ce qui entraîne la condamnation de l'éclectisme. En effet, comme la personnalité humaine, tout en demeurant liée à la matière, est essentiellement fonction de l'esprit et, par conséquent de l'activité libre, on comprend que l'œuvre d'un philosophe ne puisse remplacer adéquatement celle d'un autre, même lorsqu'elle lui est de beaucoup supérieure : l'une et l'autre demeurera donc actuelle et chacune vaudra d'être entendue, discutée, fût-ce pour être réfutée. Par ailleurs, on ne voit pas le moyen de prévoir comment la pensée philosophique s'orientera dans la suite. A cet égard, il y a bien des traits communs à l'art et à la philosophie. Cependant la différence demeure profonde, car le propre de la philosophie est de tendre à découvrir la vérité dans sa valeur absolument universelle ; et en cela son activité de recherche rejoint celle de l'homme de science. C'est pourquoi, les différents systèmes ne présentent pas la même valeur philosophique ; et, comme il nous est donné de suivre les échange de vues du grand « colloque philosophique », nous sommes en droit de donner la palme à tel ou tel penseur, par exemple S. Thomas, s'il nous paraît être le meilleur. Il reste, que les autres penseurs se trouvent, eux aussi, d'une manière qui leur est propre, en possession de quelque vérité, même s'ils s'égarent sur les questions fondamentales ; ainsi qu'aimait à le répéter le cardinal Mercier : « dans toute erreur il y a une âme de vérité » Il en résulte que si l'on veut se faire le disciple de S. Thomas, c'est par un effort personnel qu'on doit poursuivre l'œuvre de celui-ci. Sans doute, le thomiste est-il supposé reprendre la structure essentielle du système, l'ensemble des thèses doctrinales, mais c'est pour les faire vivre, à savoir pour les rendre fécondes en les gardant enracinées dans une expérience de base, comme S. Thomas, sans aucun doute, a dû le faire lui-même. C'est à partir de pareille expérience que le Docteur Angélique a abstrait ses dées et qu'il a établi les catégories fondamentales de son système ; et c'est à ces données d'expérience qu'il n'a cessé de se référer, pour éclairer toujours davantage ses idées et en équilibrer le contenu, pour les compléter et, au besoin, les corriger. Il faudrait donc découvrir où se situe cette expérience chez S. Thomas, — par exemple, en rapport avec sa conception si personnelle de l'unité substantielle de l'homme et celle non moins personnelle de la signification de Y esse ; — travail difficile, car S. Thomas se retire modestement derrière l'exposé sincère de sa doctrine, sans fournir la description « phénoménologique » de son expérience personnelle, comme les auteurs actuels se plaisent à le faire ; travail ardu, qui suppose l'étude attentive et scrupuleuse du texte authentique, du milieu doctrinal, des sources littéraires et de la manière dont S. Thomas les utilise. Les résultats de pareille étude permettront de voir se profiler l'expérience qui fut la terre nourricière de la doctrine élaborée par le Docteur Angélique. Il faudra s'efforcer de faire soi-même une expérience analogue, tout aussi personnelle, c'est-à-dire liée étroitement au tempérament de la personne qui la fait, à la formation qu'elle a acquise, dès lors aux conditions de temps et d'espace dans lesquelles elle s'est développée, à l'atmosphère philosophique qu'elle respire, etc. : bref, une expérience réelle, vivante, donc « d'aujourd'hui ». C'est à partir de là que surgira la doctrine et que pourra se construire le système ; comme c'est à partir de là que l'idée thomiste pourra croître, se renouveller, garder sa perpétuelle jeunesse et sa fécondité. (shrink)

L’enfant placé a souvent vécu des traumatismes qui ont impacté sa capacité à réguler ses émotions dans les relations interpersonnelles. Afin d’aider les assistants familiaux et les parents à mieux s’ajuster à l’enfant ont été instaurés des temps d’observation dans les conditions naturelles des interactions adulte-enfant qui ont été enregistrés en vidéo. Le vidéo-feedback a ensuite été utilisé avec chacun des adultes. L’exemple de Matthias montre comment ce dispositif a permis aux parents d’identifier les conséquences de leur comportement sur leur (...) enfant. L’exercice a été plus difficile pour l’assistante familiale davantage centrée sur ses besoins. (shrink)

La théorie de l’attachement offre un cadre conceptuel fécond pour comprendre la dynamique de l’adolescence et ses aléas. De plus elle donne des repères précieux pour orienter le traitement en complément d’autres approches. Au cours de cette période l’équilibre entre attachement et exploration est crucial. Si les expériences précoces et les modèles internes opérant qui en émergent jouent un rôle important, il faut insister sur le fait que la relation actuelle avec les parents reste déterminante. Un état d’esprit insécure (...) n’est pas une pathologie en soi mais constitue par contre un facteur de risque majeur de survenue d’un trouble. Les adolescents détachés développent plus souvent des troubles dits « externalisés », tandis que les « préoccupés » décompensent plutôt avec des troubles dits « internalisés ». Si l’on se réfère à la théorie de l’attachement l’un des principaux objectifs du dispositif de soin est d’offrir une base de sécurité, à l’adolescent mais aussi à ses parent, pour leur permettre une reprise de l’exploration d’eux-mêmes et des relations. (shrink)

Cet article présente un bref historique de la théorie de l’attachement, une définition des concepts, et les développements ultérieurs, tant sur le plan de la recherche que sur le plan plus actuel de la pratique, des liens avec la psychopathologie et des répercussions sur le cadre thérapeutique. Il s’agit de mettre en évidence les bases théoriques et de comprendre leur place dans le champ clinique.

Au Québec, la formation des professionnels qui travaillent en protection de l’enfance s’appuie fortement sur la théorie et la clinique de l’attachement. Le but général de cette formation est d’éviter que les enfants concernés évoluent à l’âge adulte vers une situation d’exclusion sociale, d’errance, d’internement psychiatrique, ou de violence. Les outils utilisés pour l’évaluation initiale et l’intervention qui peut s’en suivre, reposent sur la même théorie. Une comparaison est effectuée avec le dispositif français.

Measurement outcomes are frequently used as evidence in favor of or against medical and surgical interventions, health policies, and system designs. Indeed, in the medical and health services research literature, outcomes are the currency of policy debate and decision making. Yet in the philosophy of science and philosophy of medicine, the measures used in evidence-based medicine (EBM) are rarely discussed. Rather, the focus here is almost exclusively on study design and hierarchies of evidence. This concentration on the methodology of study (...) design has meant that for practical purposes the measures used in randomized controlled trials, observational studies, audits, and so forth, appear as a “black box.” Yet as I argue in the first part of this article, an engagement with measurement can improve our understanding of EBM and the quality of our evidence. In the second part of the article, I develop such an engagement with one aspect of measurement, namely, the validity of patient-reported outcome measures. Here, I illustrate some of the complexity that is required to improve the validity of these measures and hence the validity of our study outcomes, that is, evidence. The concentration in philosophy of science on study design over measurement methodology perhaps reveals the interest that many philosophers of medicine have in causation, but there is more to the production of high-quality scientific evidence than securing the causal inference. (shrink)

The management of ethics within organisations typically occurs within a problem-solving frame of reference. This often results in a reactive, problem-based and externally induced approach to managing ethics. Although basing ethics management interventions on dealing with and preventing current and possible future unethical behaviour are often effective in that it ensures compliance with rules and regulations, the approach is not necessarily conducive to the creation of sustained ethical cultures. Nor does the approach afford (mainly internal) stakeholders the opportunity to be (...) co-designers of the organisation's ethical future. The aim of this paper is to present Appreciative Inquiry (AI) as an alternative approach for developing a shared meaning of ethics within an organisation with a view to embrace and entrench ethics, thereby creating a foundation for the development of an ethical culture over time. A descriptive case study based on an application of AI is used to illustrate the utility of AI as a way of thinking and doing to precede and complement problem-based ethics management systems and interventions. (shrink)

The central role played by Darwin's analogy between selection under domestication and that under nature has been adequately appreciated, but I have indicated how important the domesticated organisms also were to other elements of Darwin's theory of evolution-his recognition of “the constant principle of change,” for instance, of the imperfection of adaptation, and of the extent of variation in nature. The further development of his theory and its presentation to the public likewise hinged on frequent reference to domesticates.We have seen (...) that Darwin's reliance on the analogy between domesticated varieties and wild species was a bold and original step, in light of contemporary views on the nature of domesticates. However, as Darwin undoubtedly foresaw, his reliance on the analogy created difficulties as well as solving problems, and these began with his Malthusian codiscoverer of the principle of natural selection, Alfred Russel Wallace. Wallace's paper “On the Tendency of Varieties to Depart Indefinitely from the Original Type,” presented to the Linnean Scoiety along with the first public unveiling of Darwin's theory, states: We see, then, that no inferences as to varieties in a state of nature can be deduced from the observation of those occurring among domestic animals. The two are so much opposed to each other in every circumstance of their existence, that what applies to the one is almost sure not to apply to the other. Domestic animals are abnormal, irregular, artificial; they are subject to varieties which never occur and never can occur in a state of nature.62Much has been made of the similarity of views of Darwin and Wallace, but this quotation surely reveals how utterly different their views were on what to Darwin was an important matter. Several critics of the Origin saw Darwin's reliance on the domesticates as his Achilles heel. As Young has pointed out, Samuel Wilberforce included the following passage in his attack on the Origin: Nor must we pass over unnoticed the transference of the argument from the domesticated to the untamed animals. Assuming that man as the selector can do much in a limited time, Mr. Darwin argues that Nature, a more powerful, a more continuous power, working over vastly extended ranges of time, can do more. But why should Nature, so uniform and persistent in all her operations, tend in this instance to change? Why should she become a selector of varieties?63Another critic, Fleeming Jenkin, found the analogy a weakness in Darwin's theory because of the limited extent of variation in any one direction in domestic animals and plants.64 We have already seen that Darwin had confided a similar view to his notebook thirty years earlier, but changed his mind as a result of his profound study of domesticates. De Beer's reference to “an English country gentleman's knowledge of domestic plants and animals and their breeding”65 fails totally to recognize the originality and depth of Darwin's knowledge of domesticates.Why did Darwin, against the currents of his time, rely so heavily on mankind's experience with domesticated organisms to shape his theory about species in nature? On reason is that only with domesticates was an approach that came close to experimental verification possible. Darwin fully realized the inadequacies of the experiment, as is emphasized by his repeated contrasting of selection under nature and selection by man. Yet the extensive experience and data of plant and animal breeders offered the only reliable base against which Darwin could continually challenge his views. As he wrote in the introduction to Variation, with domestication, “man ... may be said to have been trying an experiment on a gigantic scale.”66 Given Darwin's high opinion of the quantitative work of Malthus and Quetelet (as emphasized by Schweber),67 and his unremitting efforts to secure data by which to test his theories, it was inevitable that he should attach high significance to domesticated varieties. John Tyndall, in his Belfast address of 1874, said: “The strength of the doctrine of Evolution consists, not in experimental demonstration (for the subject is hardly accessible to this mode of proof), but in its general harmony with scientific thought.”68 Darwin would have agreed with the latter thought, but I think he would have challenged the preceding one on the grounds that long experience with domesticated varieties did provide an element of experimental demonstration. It gave him confidence in his theory, and he used his vast knowledge of artificial selection boldly and creatively. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In this systematic review, we summarized and evaluated the evidence for effects of, and associations between, immersive nature-experience on mental, physical and social health promotion outcomes. Immersive nature-experience was operationalized as non-competitive activities, both sedentary and active, occurring in natural environments removed from everyday environments. We defined health according to the World Health Organization’s holistic and positive definition of health and included steady-state, intermediate, and health promotion outcomes. An electronic search was performed for Danish, English, German, Norwegian, and Swedish articles (...) published between January 2004 and May 2017. Manual approaches, e.g., bibliographies from experts, supplemented the literature search. Data were extracted from 461 publications that met the inclusion criteria. To assess the status and quality of the evidence for health promotion effects of immersive nature-experience, we focused on the subset of studies based on controlled designs (n = 133). Outcome level quality of the evidence was assessed narratively. Interventions most often involved adventure-based activities, short-termed walking, and seated relaxation in natural environments. We found positive effects on a range of health promotion outcomes grouped under psychological wellbeing (n = 97; ≈55% positive; ≈13% mixed; ≈29% non-significant; 2% negative); psychosocial function (n = 67; ≈61% positive; ≈9% mixed; ≈30% non-significant); psychophysiological stress response (n = 50; ≈58% positive; ≈18% mixed; ≈24% non-significant), and cognitive performance (n = 36; ≈58% positive; ≈6% mixed; ≈33% non-significant; 3% negative); and social skills and relationships (n = 34; ≈70% positive; ≈7% mixed; ≈22% non-significant). Findings related to outcomes categorized under physical health, e.g., risk of cardiovascular disease, were less consistent (n = 51; ≈37% positive; ≈28% mixed; ≈35% non-significant). Across the types of interventions and outcomes, the quality of the evidence was deemed low and occasionally moderate. In the review, we identify, discuss, and present possible solutions to four core methodological challenges associated with investigating immersive nature-experience and health outcomes: 1) intervention and program complexity; 2) feasibility and desirability of randomization; 3) blinding of participants and researchers; and 4) transferability and generalizability. The results of the review have been published as a popular-scientific report and a scientific research overview, both in Danish language. (shrink)

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural pride. Circumcision (...) is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants. Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

Je lui ai associÉ un court extrait d'une revue de questions portant sur le même thème. Implicit memory is revealed when previous experiences facilitate perf on a task that does not require conscious or intentional recollection of those expces. Explicit memory is revealed when perf on a task requires conscious recolelction of previous expces. Il s'agit de defs descriptives qui n'impliquent pas l'existence de deux systs de mÉmo sÉparÉs. Historiquement Descartes est le premier ˆ faire mention de phÉnomènes de mÉmo (...) implicites, Leibniz, Maine de Biran, Bergson en ont Également parlÉ. Korsakoff (1889) avec ses travaux sur les amnÉsiques montre qu'ils sont capables d'utiliser de l'info qu'ils ont acquises dans des Épisodes rÉcents sans pour autant manifester le moindre souvenir de l'Épisode. L'interprÉtation de ces phÉnomènes Était alors que ça renvoyait ˆ des traces en mÉmoire trop tÉnues pour accèder jusqu'au champ de la conscience. Cette interprÉtation va pouvoir être ÉcartÉe par les travaux rÉcents. Thorndike a Également conduit un nbre important de travaux sur MI. Les trauvaux un peu plus rÉcents ont montrÉ qu'un apprentissage antÉrieur pouvait faciliter une perfce sans qu'il y ait ref explicite à l'Épisode d'apprentissage. On a montrÉ aussi l'effet de stimuli subliminaux, qui en tant que tels ne peuvent pas être rappelÉs consciemment, mais qui influencent la conduite ou les jugts ultÉrieurs. Par ex, la prÉsentation de formes sur des temps très courts qui excluent la possibilitÉ d'une perception consciente influence significativement lechoix de formes dans une pÉreuve ultÉrieure de choix forcÉs où les sjts doivent indiquer la forme qu'il prÉfère entre deux. Ils choisissent prÉfÉrentiellement celles qui leur ont ÉtÉ prÉsentÉes de manière subliminale. De même Bargh et al. ont montrÉ que des sjts soumis de manière subliminale ˆ des mots hostiles portent ultÉrieurement des jugts plus nÉgatifs sur une personne target. Il ya Également eu des travaux sur l'apprsge ou le condt without awareness en particulier apprsge implicite de règles de grammaire (ie le sjt peut construire de nouvelles phrases conformes ˆ la syntaxe de celles qui lui ont ÉtÉ prÉsentÉes sans pour autant petre capables d'noncer les règles de grammaire qu'il utilise) Rem: N'est ce pas un pbe de typemÉtacognition??? Enfin, tous les travaux sur le priming sont des elts en faveur de MI: Facilitation in the processing of a stimulus as a function of a recent encounter with the same stimulus. Type de perfce sur lesquels les effets de priming ont ÉtÉ dÉmontrÉs: -T‰ches de dÉcision lexicale: Le sjt doit dire si la cha"ne de caractères qu'on lui prÉsente est un mot ou pas: Le temps de latence est beaucoup plus court si la cha"ne a dÉjˆ ÉtÉ prÉsentÉe une première fois. -Mesures de temps d'identification de mots en rpÉsentation tachitoscopiques -ComplÉmentation de mots: les sjts ont tendance ˆ complÉter pour crÉer les mots qui leur ont ÉtÉ prÉsentÉs antÉrieurement. L'intÉrêt pour le paradigme de priming se retouve chez les gens qui s'intÉressent ˆ: -reconnaissance de mots et organisation lexicale. les effets de priming permettent de faire des hyps sur l'accès lexical et la reprÉsentation. -M. Épisodique: travux sur les amnÉsiques qui ne se souviennent pas qu'on vient de leur prÉsenter des mots mais qui manifestent une mÉmoire implicite lorsqu'on leur fait faire de la complÉmentation de mots. DISSOCIATION ENTRE M.I. ET M EXPLICITE 1-Si de nombreux travaux montrent que la M explicite est influencÉe par le travail d'Élaboration (profondeur de traitement) en jeu pendant la première phase d'Étude des stimuli, il semble que la MI ne le soit pas. 2-Le changt de modalitÉ (par ex auditif -> visuel) entre la phase d'Étude et la phase de test provoque une attÉnuation importante de l'effet de priming si le test est un test de MI mais pas si c'est un test de ME. 3-Les effets de primings persistent assez largement sur plusieurs jours ce qui n'est pas le cas des perfces ˆ une Épreuve de reconnaissance. 4-Les perfces sur des tests de MI ne semblent pas influencÉes par des manipulations d'interfÉrences proactives ou rÉtroactives dont on sait qu'elles influencent les perfces en ME. 5-Absce de corrÉlation entre perfces ˆ des tests de reconnaissance et perfces ˆ une Épreuve de complÉmentation de mots. SIMILARITES ENTRE PRIMING ET REMEMBERING 1- A certaines conditions les durÉes de rÉtention on des effets parallèles sur les effets de priming et les mesures de ME (REm: en partie contradictoire avec 3 ci dessus) 2-La manipulation du contexte de la liste lors de la phase d'Étude affecte ˆ la fois les perfces en reconnaissance et en identification de mots. 3- ME et MI sont influencÉes par des associations nouvellement acquises entre des paires de mots non reliÉes (Rem: contradictoires avec 4 ci dessus ??) 4- Rem: Le contraire de 1 du pt "dissociation" !!!! dans une manip particulière 5-Johnston et al. ont montrÉ que des mots identifÉs plus rapidement Étaient plus svt jugÉs comme 'old' dans une t‰che de reconnaissance que les mots identifiÉs plus lentement. Il n'est pas exclu que les phÉnomènes que l'on interprètent comme relevant de MI soient parfois de la ME involontaire cad des cas o les cues fournis dans le test conduisent ˆ un souvenir involontaire mais totalement conscient. LES INTERPRETATIONS THEORIQUES DE MI 1-Les effets de priming sur des test de MI sont attribuables ˆ l'activation temporaires de reprÉsentations ou structures de K prÉ-existantes . Cette activation est supposÉe avoir lieu de manière automatique, indÉpendamment des processus d'Élaboration nÉcessaires pour Établir de nouvelles traces Épisodiques. 2- les difÉrences entre ME et MI sont dues ˆ la nature et aux relations entre les processus d'encodage et de rÉcupÉration. Une version de cette approche est celle qui s'appuie sur la distinction entre processus dirigÉs par les donnÉes et processus dirigÉs par les concepts. Ces derniers reflètent des activitÉs initiÉes par le sjt comme l'Élaboration, l'organisation et la reconstruction, c'est sur ce type de processus que reposerait la ME alors que la MI reposerait sur des processus data-driven. 3-ME et MI renvoient ˆ des systs sous jacents diffÉrents. Pour Cohen & Squire (1984), la ME est supportÉe par une M DECLARATIVE , syst qui est en jeu dans la formation de nouvelles reprÉsentations. La MI repose sur un syst PROCEDURAL dans lequel la M se manifeste par des modifications on line de procÉdures ou opÉrations de traitement. Le syst de M Épisodique est vu comme la base pour le souvenir explicite d'evts rÉcents tandis que la M sÉmantique est responsable des perfces sur des tests de MI. Chacune de ces approches est conforme ˆ certaines des donnÉes recueillies mais pas ˆ d'autres. (shrink)

The Hooks et al. review of microbiota-gut-brain literature provides a constructive criticism of the general approaches encompassing MGB research. This commentary extends their review by: highlighting capabilities of advanced systems-biology “-omics” techniques for microbiome research and recommending that combining these high-resolution techniques with intervention-based experimental design may be the path forward for future MGB research.

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain (...) neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries’ national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited (...) from KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

There is growing interest in nature-based interventions to improve human health and wellbeing. An important nascent area is exploring the potential of outdoor therapies to treat and prevent common mental health problems like depression. In this conceptual analysis on the nature–depression nexus, we distil some of the main issues for consideration when NBIs for depression are being developed. We argue that understanding the mechanisms, or ‘active ingredients’ in NBIs is crucial to understand what works and for whom. Successfully identifying modifiable (...) mediating intervention targets will pave the way for interventions with increased efficacy. We highlight a non-exhaustive list of five clinically relevant putative, candidate mechanisms which may underly the beneficial effects of NBIs on depression: stress, rumination, mindfulness, sleep and exercise. We also make the case that when developing NBIs it is important to not neglect young people, explore personalised approaches and focus on both treatment and prevention approaches. To achieve these aims methodologically rigorous programmes of clinical research are needed that include well-powered and controlled experimental designs including randomised controlled trials, qualitative research, longitudinal studies and large prospective cohorts. (shrink)

This article describes the spiritual formation training program for counseling students at Richmont Graduate University, an evangelical institution providing Master’s-level instruction for counselors and ministers. This model of spiritual formation has a dual foundation which includes the centrality of love to the Christian life and the importance of attachment to the development of persons. The training is intentionally designed to invite students to pursue a more secure attachment to God, healthier relationships with others, and a more grace-based self-awareness. Integrative and (...) clinical instruction, and experiences that foster establishment of secure attachment are described. Co-curricular efforts in research and student advisement focus on grace and wellness, as well as opportunities for service, and these serve to further contribute to a supportive environment for spiritual formation. (shrink)

Innovative therapy is the name we give to novel medical interventions, radically different from the standard of care, provided in order to benefit a patient, rather than to acquire new knowledge. They are paradigmshifting, not incremental, responses to serious patient problems that standard medical care inadequately addresses. Innovative therapies are often devised by clinicians, not basic science researchers; they do not follow the linear model of basic research, to translation, to clinical research, to application. Instead, they come from thinking backwards (...) from the patient’s circumstances, and forward from deep knowledge of how the body functions, to challenge the limits of current mechanisms for effecting cures. (shrink)

We report on the performative score “Sharing Perspectives” from the art/science research collaboration, Experimenting, Experiencing, Reflecting. Sharing Perspectives is developed as a score, inspired by choreography and the postmodern dance form Contact Improvisation, to stage exploration and improvisation, exploring uncertainty, creativity, togetherness, and the relationship between bodies and between bodies and space and artworks. The SP score acts as an experiment in how a brief intervention may affect the way art exhibitions are experienced, exploring how deeper and more sensorial (...) engagement with art may be facilitated, for the benefit of visitors, galleries and artists. Based on questionnaires and qualitative interviews with participants during the Olafur Eliasson exhibition “In Real Life” at the Tate Modern in London in November 2019, we explore how the SP score modulates a playful mode of being, enhancing the experience of a museum art exhibition as a space of transformation and reflection. We find that the SP score encourages curiosity, which allows participants to recognize their habits for art and instead experience art slowly, recognize their comfort zones and move past them. As the score enacts a sensorial and playful approach to the exploration of the exhibition, participants experience a breaking of boundaries between each other, toward the other visitors, as well as to the artworks and the space itself, prompting an experience of being part of the exhibit as a whole. We discuss how the SP score invites a slowness and curiosity that takes on characteristics of play, which can change the participants’ appreciation of an art space. (shrink)

This paper recasts the normative shape of Fear and Trembling by presenting an ‘ethical reading’ based on an ethic of care. It will be argued that Abraham's response represents a commitment to sustain and deepen his fundamental relationship with God, to make absolute his relation to the Absolute. Since most readers tend to focus myopically on ‘the trial’ itself, apart from the context and history of the God-relationship, the proffered interpretations tend inevitably to distort the nature and significance of Abraham's (...) form of life. By remembering the pattern of attachment between God and Abraham, I think that a different normative picture will emerge, one which can be expressed in the grammar of care. (shrink)

Over the last several decades there has been an increase in the amount of research conducted concerning academically dishonest behaviors at the undergraduate level. However, this research and subsequent interventions are based on the assumptions that there exists a clear understanding of what constitutes academic dishonesty. In an attempt to address this gap in the current literature, a concept synthesis of students’ perceptions of academic behavior was completed. The end result was 18 categories of potentially dishonest academic behaviors. Definitions and (...) examples are explored. Inter-rater reliability was completed and Kappa values are reported as well as implications for teaching and future research. (shrink)

The harvest and the pigeons. A note on the summit course of the pillar of Prusias at Delphi The remains of the pillar of Prusias, next to the temple of Apollon at Delphi, have generated much comment. Indeed, the course that supported the equestrian statue of the king of Bithynia presents 112 mortises, above and beyond the attachment holes of the statue itself. Until the present, it has been thought that these cavities served to attach vegetal elements, ears of corn (...) reaped by a laborer or, after the identification of the base as belonging to the pillar of Prusias, a field of corn signifying the beneficence of the king. A trail of textual and archaeological indications prompts a different interpretation for this enigmatic arrangement. The mortises would have served the insertion of bronze points (obeloi or meniskoi) forming a system of protection against defacement by birds, as is occasionally the case in sculpture and in temple architecture. (shrink)

La question platonicienne est traversée par une énigme qui défie les interprètes depuis les travaux de Léon Robin, qui datent de plus d'un siècle. Platon a-t-il élaboré une doctrine, ou sa pensée est-elle tout entière contenue dans les dialogues? Autrement dit, y a-t-il un enseignement secret de Platon qui n'apparaîtrait pas dans son oeuvre écrite? Le témoignage des doxographes, à commencer par Aristote, laisse entendre que Platon a bien enseigné une doctrine, mais comment expliquer le silence des dialogues? Analysant l'étrange (...) passage du Timée qui s'articule sur la gamme pythagoricienne, J.-J. Duhot, qui a aussi été musicien professionnel, en a décrypté la clef, qui avait échappé aux interprètes : le Même code l'octave, soit le rapport 2, et l'Autre code la quinte, soit le rapport 3/2. Cette clef, indiscutable en elle-même, comme le démontre J.-J. Duhot, permet d'établir la grille de lecture qui éclaire toutes les obscurités du passage. On a donc là une double équivalence, entre métaphysique (Un/Multiple), acoustique (octave et quinte), et mathématiques (construction arithmétique de la gamme). J.-J. Duhot montre que c'est la matrice sur laquelle Platon construit son oeuvre et met en place le postulat de mathématicité du monde, qui sera la base de toute la science moderne, à partir de Galilée. La gamme du Timée offre un modèle mathématique, la division de 2 en produits de facteurs dans un système logarithmique, qui résout (métaphoriquement) les problèmes de l'Un et du Multiple. On voit ainsi apparaître un "cycle éléatique" dans lequel, au fil des dialogues, Parménide, Théétète, Sophiste et Politique, se met en place une véritable doctrine platonicienne. Doctrine secrète qui s'offre au lecteur qui sait en décrypter le code. (shrink)

Background and ObjectivesUp to 10% of fathers experience perinatal depression, often accompanied by anxiety, with a detrimental impact on the emotional and behavioural development of infants. Yet, few evidence-based interventions specifically for paternal perinatal depression or anxiety exist, and few depressed or anxious fathers engage with support. This mini-review aims to build on the evidence base set by other recent systematic reviews by synthesising more recently available studies on interventions for paternal perinatal depression and anxiety. Secondarily, we also aimed to (...) identify useful information on key implementation strategies, if any, that increase the engagement of men.MethodsWe drew upon three major previous systematic reviews and performed an updated search of PubMed/Medline; Psycinfo; Cochrane Database; Embase and Cinahl. The search was limited to trials, feasibility studies or pilot studies of interventions published between 2015 and 2020 that reported on fathers' perinatal mental health. We included psychological, educational, psychosocial, paternal, couple-focused, or group therapies, delivered face-to-face, via telephone and/or online that reported on either paternal depression, anxiety or both.ResultsEleven studies satisfied search criteria. The majority were randomised controlled trials. Most interventions incorporated counselling, therapy or psychoeducation and took an indirect approach to perinatal mental health through antenatal or postnatal education and were couple-focused. No studies reported a presence of diagnosed depression or anxiety at baseline, although five studies reported a positive effect on sub-threshold symptoms.DiscussionThere was some evidence that these approaches may be useful in the initial engagement of fathers with perinatal supports and improve depression and anxiety scores. No studies targeted the explicit treatment of clinically depressed or anxious men, and this remains the most substantial gap in the peer-reviewed evidence base. Our results highlight the need to deliver perinatal interventions specifically designed for men and evaluate them in populations with clinical levels of depressive and anxious symptomatology. (shrink)

This paper examines the attitudes of circumcised women towards female circumcision in a community where the practice is in vogue. Also described are the type of circumcision performed, who usually performs the circumcision and complications. One hundred volunteers across the social strata were interviewed by means of a structured questionnaire. Data were analysed using frequency tables. The study revealed that 62% of respondents favoured the practice as an instrument for the control of female sexuality and maintenance of cultural pride. Circumcision (...) is mainly by excision of the clitoris and the labia minora performed mainly by traditional birth attendants (TBAs). Complications include severe pain, difficulty with urination and excessive bleeding. Based on the findings, it is suggested that communities where femal genital mutilation (FGM) is practised as a social norm should be involved in any eradication campaign, with the support of national and international organisations. Research is also essential to understand FGM in order to design effective reforms. (shrink)

BACKGROUND -/- The importance of ontologies in the biomedical domain is generally recognized. However, their quality is often too poor for large-scale use in critical applications, at least partially due to insufficient training of ontology developers. -/- OBJECTIVE -/- To show the efficacy of guideline-based ontology development training on the performance of ontology developers. The hypothesis was that students who received training on top-level ontologies and design patterns perform better than those who only received training in the basic principles of (...) formal ontology engineering. -/- METHODS -/- A curriculum was implemented based on a guideline for ontology design. A randomized controlled trial on the efficacy of this curriculum was performed with 24 students from bioinformatics and related fields. After joint training on the fundamentals of ontology development the students were randomly allocated to two groups. During the intervention, each group received training on different topics in ontology development. In the assessment phase, all students were asked to solve modeling problems on topics taught differentially in the intervention phase. Primary outcome was the similarity of the students’ ontology artefacts compared with gold standard ontologies developed by the authors before the experiment; secondary outcome was the intra-group similarity of group members’ ontologies. -/- RESULTS -/- The experiment showed no significant effect of the guideline-based training on the performance of ontology developers (a) the ontologies developed after specific training were only slightly but not significantly closer to the gold standard ontologies than the ontologies developed without prior specific training; (b) although significant differences for certain ontologies were detected, the intra-group similarity was not consistently influenced in one direction by the differential training. -/- CONCLUSION -/- Methodologically limited, this study cannot be interpreted as a general failure of a guideline-based approach to ontology development. Further research is needed to increase insight into whether specific development guidelines and practices in ontology design are effective. (shrink)

The precautionary principle brings a special challenge to the practice of evidence-based public health decision-making, suggesting changes in the interpretative methods of public health used to identify causes of disease. In this paper, precautionary changes to these methods are examined: including discounting contrary evidence, reducing the number of causal criteria, weakening the rules of evidence assigned to the criteria, and altering thresholds for statistical significance. All such changes reflect the precautionary goal of earlier primary preventive intervention, i.e. acting on (...) insufficient evidence, the least amount, or minimum level, of evidence for causation. Evaluating the impact of these changes will be difficult without a careful study of how well the current methods of causal inference work, their theoretical foundations, and the ethical implications of their applications. That research program will be most productive if it is jointly developed by public health professionals trained in the ethics and philosophy and by bioethicists and philosophers trained in the theories, methods, and practice of public health. (shrink)

Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice (...) behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five (...) school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

Sans prétendre à l’exhaustivité, les éléments de base de la notion d’existence – dans la falsafa, principalement chez Alfarabi et Avicenne, sont ici examinés. En commençant par les questions terminologiques, on considère ensuite quelques questions concernant la conception de l’existence dans la philosophie arabe jusqu’à Avicenne. Puis, on analyse la notion d’existence chez Avicenne en prenant en considération les dernières recherches sur ce sujet.

Surveillance is essential for communicable disease prevention and control. Traditional notification of demographic and clinical information, about individuals with selected infectious diseases, allows appropriate public health action and is protected by public health and privacy legislation, but is slow and insensitive. Big data–based electronic surveillance, by commercial bodies and government agencies, which draws on a plethora of internet- and mobile device–based sources, has been widely accepted, if not universally welcomed. Similar anonymous digital sources also contain syndromic information, which can be (...) analysed, using customised algorithms, to rapidly predict infectious disease outbreaks, but the data are nonspecific and predictions sometimes misleading. However, public health authorities could use these online sources, in combination with de-identified personal health data, to provide more accurate and earlier warning of infectious disease events—including exotic or emerging infections—even before the cause is confirmed, and allow more timely public health intervention. Achieving optimal benefits would require access to selected data from personal electronic health and laboratory records and the potential to re-identify individuals found to be involved in outbreaks, to ensure appropriate care and infection control. Despite existing widespread digital surveillance and major potential community benefits of extending its use to communicable disease control, there is considerable public disquiet about allowing public health authorities access to personal health data. Informed public discussion, greater transparency and an ethical framework will be essential to build public trust in the use of new technology for communicable disease control. (shrink)

Background: People with traumatic brain injury face a range of mental health challenges during the adjustment process post-injury, but access to treatment can be difficult, particularly for those who live in regional and remote regions. eHealth provides the potential to improve access to evidence-based psychological therapy for people with a severe TBI. The aim of the current study is to assess the efficacy of a psychological intervention delivered via video consulting to reduce psychological distress in people with TBI.Methods: This (...) paper outlines the protocol for a multi-center, three-arm, parallel, non-inferiority randomized controlled trial of an evidence-based manualized psychological intervention, ACT-Adjust. ACT-Adjust provides nine sessions for adults with a moderate to severe TBI experiencing clinical levels of psychological distress. Fifty-six participants referred from Brain Injury Rehabilitation Units across New South Wales and the NSW icare scheme will be randomly allocated to three conditions; video consulting, face-to-face and, a waitlist control.Discussion: This is the first RCT to evaluate the efficacy of a psychological therapy delivered via video consulting for individuals with a moderate to severe TBI.Trial Registration:www.anzctr.org.au, Australian New Zealand Clinical Trials Registry ANZCTRN2619001602112. (shrink)

There are two parts to this present article. First, I consider the applied problem of assessing changes in a congregation—how often to assess, why assess, what changes are looked for, what interventions are assessed, why look to the components of interventions, and how to avoid problems interpreting your data. Brief assessments are mandatory. Pastors and lay leaders can make simple but sound assessments of their spiritual formation programs using item response theory, goal attainment scales, single items, parceling single items, or (...) narrative responses as five alternatives. I describe dangers in interpreting the findings such as not knowing the base rate of change and mistaking the assessment for the mission. In the second part of the article, I briefly describe a program labeled a deep dive into humility. I summarize the assessments that were done, which gives a practical example of the technical recommendations I made earlier in the article. (shrink)

Background:The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy.Objectives:To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory and kinaesthetic model, (...) three strategies were developed for determining the programme components and corresponding learning styles.Research design:This was a quasi-experimental study.Participants:A total of 234 junior-college student nurses participated in this study. All participants were aged 18–19 years.Ethical considerations:The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score.Results:The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies. Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning.Conclusion:This strategy was consistent with the student nurses’ preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge. (shrink)

Devant des enjeux économiques et écologiques majeurs, les sociétés comme le Québec font face aujourd’hui à une exigence forte de transition écolo­gique de leurs structures économiques et énergétiques. Parmi l’ensemble des ques­tions d’ordre pratique soulevées par cette transition, celle qui a trait à son financement est l’une des plus épineuses. Dans le contexte actuel, où les finances publiques sont exsangues et où les fonctions économiques de l’État sont en redé­finition, des innovations permettant de mobiliser l’épargne capitalisée dans les fonds privés (...) seront vraisemblablement appelées à contribuer à la transition qui s’amorce. Ces innovations, qui peuvent tirer profit des apports de la finance res­ponsable, sont basées sur un élargissement de l’horizon d’investissement, tant sur la durée que sur le processus d’analyse des choix de placement. Cet élargissement des perspectives permet aux épargnants et aux gestionnaires de fonds de reconsi­dérer les externalités importantes d’un modèle de croissance à haute intensité carbonique et de soutenir la transition écologique. (shrink)

Cosmetic dentistry is a divisive discipline. Within discourses that raise questions of the purpose of the dental profession, cosmetic dentistry is frequently criticised on the basis of it being classified as a non‐therapeutic intervention. This article re‐evaluates this assertion through examination of ethics of care of the self, healthcare definitions and the social purpose of dentistry, finding the traditional position to be wanting in its conclusions. The slide of dentistry from a healthcare vocation towards being a predominantly business‐focused interaction (...) between clinician and consumer conflicts with traditional notions of dentistry as a profession. Whilst it is undeniable that cosmetic dental treatment particularly lends itself to the commercial paradigm, this is not exclusive to this area of professional practice. The cultural basis of dental appearance and the potential of the dental profession to exert coercive pressure upon the public to undergo treatment that is based upon social norms is discussed. This essay concludes that cosmetic dentistry is undeniably part of the professional purpose of 21st Century dentistry. However, the caveat that may be placed upon this, is that this status is conditional upon the professional conduct of dental practitioners remaining resilient to commercial practices not compatible with professional obligations. (shrink)

European animal disease policy seems to find its justification in a “harm to other” principle. Limiting the freedom of animal keepers—e.g., by culling their animals—is justified by the aim to prevent harm, i.e., the spreading of the disease. The picture, however, is more complicated. Both during the control of outbreaks and in the prevention of notifiable, animal diseases the government is confronted with conflicting claims of stakeholders who anticipate running a risk to be harmed by each other, and who ask (...) for government intervention. In this paper, we first argue that in a policy that aims to prevent animal diseases, the focus shifts from limiting “harm” to weighing conflicting claims with respect to “risks of harm.” Therefore, we claim that the harm principle is no longer a sufficient justification for governmental intervention in animal disease prevention. A policy that has to deal with and distribute conflicting risks of harm needs additional value assumptions that guide this process of assessment and distribution. We show that currently, policies are based on assumptions that are mainly economic considerations. In order to show the limitations of these considerations, we use the interests and position of keepers of backyard animals as an example. Based on the problems they faced during and after the recent outbreaks, we defend the thesis that in order to develop a sustainable animal disease policy other than economic assumptions need to be taken into account. (shrink)

The literature on transnational civil society encompasses a number of conflicting views regarding civil society organizations’ (CSOs) behavior and impacts and the desirability of civil society involvement in international policymaking. This piece suggests that this lack of consensus arises from the diverse range of contexts in which CSOs operate and the wide variety of activities in which it engages. This article seeks to organize and analyze the disparate data on civil society by developing a context-based standard of democratic legitimacy for (...) CSOs. The article disaggregates democracy into input, throughput, and output components, and shows how CSOs must support or manifest different aspects of democracy in order to be democratically legitimate in a given context. Applying this standard to existing works, the article identifies several problems in current research, including a failure to recognize ways the democratic imperatives of transnational advocacy differ from national advocacy, and the potential for international civil society interventions to undermine local democratic processes. Keywords: transnational civil society; democracy; global governance; NGOs; international policymaking (Published: 1 September 2010) Citation: Ethics & Global Politics, Vol. 3, No. 3, 2010, pp. 217-238. DOI: 10.3402/egp.v3i3.4882. (shrink)

Chemists take mechanisms to be an important way of explaining chemical change. I examine the usefulness of the mechanism approach in the recent philosophical literature in explicating the explanatory use of mechanisms by organic chemists. I argue that chemists consider a mechanism to be explanatory because it accounts for the “dynamic process of bringing about” (Tabery 2004 , 10) chemical change. For chemists, mechanisms are causal explanations based on interventions that show “how some possibilities depend on others” (Woodward 2003 , (...) 375). Only possibilities are achievable because chemists face a number of challenges when they explain by means of a mechanism. †To contact the author, please write to: Department of Philosophy, Smith College, Northampton, MA 01063; e‐mail: [email protected]. (shrink)

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and (...) English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one’s training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a “professional.” Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth. The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and address patients’ concerns about excessive interventions. Creating a sustained culture of comprehensive safety, which cannot be achieved in planned home birth, informed by compassionate and respectful treatment of pregnant women, should be a primary focus of professional obstetric responsibility. (shrink)

Research involving transgender and gender diverse people (TGD) increased in the last years, mostly concerning healthcare associated to this population. Few studies dedicated their analysis to the impact of parental support on transgender people, even though this is an important aspect in creating a safe environment on which these individuals can build their identity. In addition, the link between family support, TGD identity and homelessness is not completely established. Thus, due to the specificities of the family context of TGD individuals, (...) the aim of this study is to investigate the association between family support and TGD in different moments of the process of gender affirmation. In addition, this study also aims to explore the relationship between a lack of social support and low self-esteem, home abandonment, and dwelling in the street. The survey was designed based on the TransPULSE project and was made available in electronic format. The sample was constituted of 423 TGD residents in two Brazilian states. A Structural Equation Model analysis suggested that the impact of gender affirmation status on homelessness was mediated by parental support, through self-esteem, and the need to move from home. The association between the status of the gender affirmation procedures, family support and self-esteem was significant and indicated that the further TGD individuals advanced in gender affirmation, the more self-esteem and family support they would have. The association between family support and self-esteem indicated that family support was associated with higher self-esteem. Low family support was associated with the willingness to move from home due to one’s TGD status and there was also a significant correlation between low self-esteem and the willingness to move from home due to one’s TGD status. Finally, homelessness was associated with the willingness to move with a large effect size. Limitations include the sample that was constituted by individuals with Internet access and who had more contact with TGD communities. The findings indicate directions for interventions involving TGD people and their families, considering the parental relationship as a critical variable to improve TGD quality of life in the process of gender affirmation. (shrink)

Medical, scientific and societal progress has been such that, in a universalist humanist perspective such as the WHO’s, it has become an ethical imperative for the primary endpoints in evidence based health care research to be expressed in e.g. Quality Adjusted Life Years (QALYs). The classical endpoints of discrete health‐related functions and duration of survival are increasingly perceived as unacceptably reductionistic. The major problem in ‘felicitometrics’ is the measurement of the ‘quality’ term in QALYs. That the mental, physical and social (...) domains, each containing many dimensions and items, all contribute to QOL is uncontroversial. What is controversial, is the weight of the different dimensions in overall QOL. It has been shown to be very different between different patient populations. In human individuals, assuredly complex systems, the many dimensions and items of QOL observably interact, probably sometimes also in chaotic ways. In these conditions, the weights of isolated items in individuals become for all practical purposes meaningless. Therefore, the much used multi‐item questionnaires at best describe, but do not evaluate QOL, neither in individuals, nor in populations. For example, allergic patients treated with cetirizine scored better than those a placebo on all dimensions of the SF‐36, a standard QOL questionnaire. Here there is no serious doubt that the treatment improved QOL, because it is highly unlikely that any important dimension on which the patient groups would have scored otherwise is missing in the SF‐36. However, whether piracetam treatment of acute stroke, which improved the surrogate endpoints neurological and functional scores, also improved QOL is plausible, but will be proven only when comprehensive QOL measurement will have been done. And suppose in randomised populations of end‐stage metastatic solid cancer patients, one would compare palliative last‐line chemotherapy with only palliative care, and one would, as can be expected, find no significant differences in average survival, and chemotherapy superior for the mental domain, but inferior for the physical comfort domain: we would not know which treatment, on aggregate, would be the better. The problem is that QOL is an individual and emergent construct, the resultant of a great many intractions, and of a different order than its contributing components. Overall QOL can therefore best be captured only as the Gestalt of a global self‐assessment. Just as people in everyday life, while acting under uncertainty, make global assessments all the time, so they can seriously answer the serious question: ‘How have you been?’ A solemn, practical, non peer‐relativistic, non‐cultural, experiential, and well tolerated way to obtain such responses is Anamnestic Comparative Self Assessment (ACSA), in which the subjects' memories of the best and the worst times in their life experience define their individual scale of QOL. ACSA is thus both exquisitely idiosyncratic, and yet can in a universalist humanistic perspective be considered generic. Using both a multi‐item questionnaire and a global assessment allows by one logistic regression, to estimate the weights of the dimensions and items in populations, and thus identify those whose improvement would most contribute to the QOL of the greatest number. A combined approach to measurement of QOL is necessary to maximise the utility of QOL interventions. (shrink)

Dès 1935 Heidegger retrouve le sens originel de la métaphysique dans la conception présocratique de l'être comme "phusis". Sur cette base il va interpréter la métaphysique traditionnelle qui apparaît avec Platon pour culminer chez Nietzsche dans une ontologie de la vie et qui prépare le règne moderne de la technique planétaire, comme un "déni" radical de ce sens originel. L'un des interêts de cette interprétation de la métaphysique, et non des moindres, est ainsi de rendre compte de la signification de (...) la vogue actuelle des philosophies de la vie. (shrink)

Abstract:Implementing creative and sustainable urban planning initiates is rather challenging. This article argues that universities can become more relevant to underserved communities in their hinterlands by conducting town-gown citizen-science programs. Central to the article is a review of the most pertinent literature on public engagement, citizen-science, and other community based participatory methods utilized in the resolution of very complex health, social, environmental, and consumption problems. The research’s analytical mechanism is centered on the triad of Placeless, Place and Non-Place genius loci (...) of socio-spatial town-gown interventions. The curricular and pedagogical innovations identified entail the strengthening of citizen-science and design thinking in both high school and university education. (shrink)