POHLMAN S, CIBULKA NJ, PALMER JL, LORENZ RA and SMITHBATTLE L. Nursing Inquiry 2013; 20: 71–81 The placebo puzzle: examining the discordant space between biomedical science and illness/healingThe placebo response presents an enigma to biomedical science: how can ‘inert’ or ‘sham’ procedures reduce symptoms and produce physiological changes that are comparable to prescribed treatments? In this study, we examine this puzzle by explicating the discordant space between the prevailing biomedical paradigm, which focuses on a technical understanding of diagnosis and (...) treatment, and a broader understanding of illness and healing as relational and embodied. Although biomedical achievements are impressive, the knowledge resulting from this paradigm is limited by its ontological and epistemological assumptions. When the body and world are objectified, illness meanings, therapeutic relationships, and healing practices are dismissed or distorted. In spite of a robust critique of the tenets of biomedicine for guiding practice, the biomedical paradigm retains a tenacious hold on evidence-based medicine and nursing, downplaying our clinical understanding of the sentient body, patients’ life-worlds, and illness and healing. In reality, skilled nurses rely on multiple forms of knowledge in providing high-quality care to particular patients. Clinically wise nurses integrate their experience and knowledge of patients’ priorities, fears, and illness trajectories along with biomedical findings to make astute judgments and promote health and healing. (shrink)

Over the last decade, empirical research on compassion has burgeoned in the biomedical, clinical, translational, and foundational sciences. Increasingly sophisticated understandings and measures of compassion continue to emerge from the abundance of multi- and cross-disciplinary studies. Naturally, the diversity of research methods and theoretical frameworks employed presents a significant challenge to consensus and synthesis of this knowledge. To bring the empirical findings of separate and sometimes siloed disciplines into conversation with one another requires an examination of their disparate assumptions about (...) what compassion is and how it can be known. Here, we present an integrated theoretical review of methodologies used in the empirical study of compassion. Our goal is to highlight the distinguishing features of each of these ways of knowing compassion, as well as the strengths and limitations of applying them to specific research questions. We hope this will provide useful tools for selecting methods that are tailored to explicit objectives (methods matching), taking advantage of methodological complementarity across disciplines (methods-mixing), and incorporating the empirical study of compassion into fields in which it may be missing. (shrink)

A call to advance integrative teaching and learning in higher education. From Parker Palmer, best-selling author of The Courage to Teach, and Arthur Zajonc, professor of physics at Amherst College and director of the academic program of the Center for Contemplative Mind in Society, comes this call to revisit the roots and reclaim the vision of higher education. The Heart of Higher Education proposes an approach to teaching and learning that honors the whole human being--mind, heart, and spirit--an essential (...) integration if we hope to address the complex issues of our time. The book offers a rich interplay of analysis, theory, and proposals for action from two educators and writers who have contributed to developing the field of integrative education over the past few decades. Presents Parker Palmer's powerful response to critics of holistic learning and Arthur Zajonc's elucidation of the relationship between science, the humanities, and the contemplative traditions. Explores ways to take steps toward making colleges and universities places that awaken the deepest potential in students, faculty, and staff. Offers a practical approach to fostering renewal in higher education through collegiality and conversation. The Heart of Higher Education is for all who are new to the field of holistic education, all who want to deepen their understanding of its challenges, and all who want to practice and promote this vital approach to teaching and learning on their campuses. (shrink)

Over the last decade, numerous interventions and techniques that aim to engender, strengthen, and expand compassion have been created, proliferating an evidence base for the benefits of compassion meditation training. However, to date, little research has been conducted to examine individual variation in the learning, beliefs, practices, and subjective experiences of compassion meditation. This mixed-method study examines changes in novice meditators’ knowledge and contemplative experiences before, during, and after taking an intensive course in CBCT®, a contemplative intervention that is increasingly (...) used for both inter- and intrapersonal flourishing. The participants in this study were Christian healthcare chaplains completing a 1-year residency in Clinical Pastoral Education who learned CBCT as part of their professional chaplaincy training curriculum. Prior to and upon completion of training, we surveyed participants to assess their beliefs about the malleability of compassion, types of engagement in compassion meditation, and perceptions of the impact of taking CBCT. We also conducted in-depth interviews with a subset of participants to gain a qualitative understanding of their subjective experiences of learning and practicing compassion meditation, a key component of CBCT. We found that participants reported increases in the extent to which they believed compassion to be malleable after studying CBCT. We also found high levels of variability of individual ways of practicing and considered the implications of this for the study of contemplative learning processes. This multi-methodological approach yielded novel insights into how compassion practice and compassion-related outcomes interrelate, insights that can inform the basic scientific understanding of the experience of learning and enacting compassion meditation as a means of strengthening compassion itself. (shrink)

A call to advance integrative teaching and learning in higher education. From Parker Palmer, best-selling author of The Courage to Teach, and Arthur Zajonc, professor of physics at Amherst College and director of the academic program of the Center for Contemplative Mind in Society, comes this call to revisit the roots and reclaim the vision of higher education. The Heart of Higher Education proposes an approach to teaching and learning that honors the whole human being--mind, heart, and spirit--an essential (...) integration if we hope to address the complex issues of our time. The book offers a rich interplay of analysis, theory, and proposals for action from two educators and writers who have contributed to developing the field of integrative education over the past few decades. Presents Parker Palmer's powerful response to critics of holistic learning and Arthur Zajonc's elucidation of the relationship between science, the humanities, and the contemplative traditions. Explores ways to take steps toward making colleges and universities places that awaken the deepest potential in students, faculty, and staff. Offers a practical approach to fostering renewal in higher education through collegiality and conversation. The Heart of Higher Education is for all who are new to the field of holistic education, all who want to deepen their understanding of its challenges, and all who want to practice and promote this vital approach to teaching and learning on their campuses. (shrink)

The structure of Au layers deposited by sputtering on oxidized p-type Si substrates is investigated by a combination of scanning electron microscopy and scanning probe microscopy. The effect of the temperature on the grain structure of the layers has been determined, revealing that an annealing temperature of 300° C results in a larger grain size and smoother surfaces but generates some cracks in the film surface. At an annealing temperature of 500° C, further grain growth is observed, but a high (...) density of cracks and voids also results while there is little enhancement regarding the smoothness of the grain surfaces. (shrink)

This collection gathers classic, influential, and important papers in environmental philosophy ranging from the late 1960s and early 1970s to the present. The volumes explore environmental ethics, epistemological, metaphysical, and comparative worldview questions raised by environmental concerns. The set also represents a genuinely global and international focus, and includes a full index and new introductions by the editors.

A hybrid theory is any moral theory according to which different classes of individuals ought to be treated according to different principles. We argue that some hybrid theories are able to meet standards of psychological plausibility, by which we mean that it’s feasible for ordinary human beings to understand and act in accord with them. Insofar as psychological plausibility is a theoretical virtue, then, such hybrid theories deserve more serious consideration. To make the case for this view, we explain what (...) psychological plausibility is and why we might value it, why the human/animal divide appears to be an entrenched feature of human psychology, and why Robert Nozick’s hybrid theory doesn’t go far enough. Finally, we make the case that a more promising psychologically plausible hybrid theory, with respect to humans and animals, will be (at least) at tribrid theory—that is, positing three domains rather than two. (shrink)

Social and structural inequities shape health and illness; they are an everyday presence within the doctor-patient encounter yet, there is limited ethical guidance on what individual physicians should do. This paper draws on a study that explored how doctors and their professional associations ought to respond to the issue of social health inequities.

Advance care directives for health care have been promoted as a way to improve end-of-life decision making. These documents allow a patient to state, in advance of incapacity, the types of medical treatments they would like to receive, to name a surrogate to make those decisions, or to do both. Although studies have shown that both physicians and patients generally have positive attitudes about the use of these documents, relatively few individuals have actually completed one.What underlies this discrepancy between attitudes (...) and behavior with regard to advance care directives? One obvious explanation is lack of access. Emanuel et al. estimated that approximately 90 percent of the population desire an advance care directive, and they pointed to access as the major barrier. Yet interventions that increase accessibility have typically failed to yield more than a 20 percent completion rate. Thus, it appears that access is not the sole determinant of advance care directive completion. (shrink)

This primer on authentic education explores how mind and heart can work together in the learning process. Moving beyond the bankruptcy of our current model of education, Parker Palmer finds the soul of education through a lifelong cultivation of the wisdom each of us possesses and can share to benefit others.

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

Investigation of neural and cognitive processes underlying individual variation in moral preferences is underway, with notable similarities emerging between moral- and risk-based decision-making. Here we specifically assessed moral distributive justice preferences and non-moral financial gambling preferences in the same individuals, and report an association between these seemingly disparate forms of decision-making. Moreover, we find this association between distributive justice and risky decision-making exists primarily when the latter is assessed with the Iowa Gambling Task. These findings are consistent with neuroimaging studies (...) of brain function during moral and risky decision-making. This research also constitutes the first replication of a novel experimental measure of distributive justice decision-making, for which individual variation in performance was found. Further examination of decision-making processes across different contexts may lead to an improved understanding of the factors affecting moral behaviour. (shrink)

This volume consists of fourteen chapters selected from papers presented at the conference 'Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics treated (...) are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines. (shrink)

Ecological sciences have informed environmental ethics from its inception as a scholarly pursuit in the 1970s-so much so that we now have ecological ethics, Deep Ecology, and ecofeminism. Throughout the 20th century, however, most ecologists remained enthralled by the myth that science is value-free. Closer study of science by philosophers reveals that metaphors are inescapable and cognitively indispensable to science, but that metaphors are value-laden. As we confront the enormous challenges of the 21st century-the prospect of a 6th mass extinction, (...) acidifying oceans, rising sea level, and global warming-ecologists can no longer remain aloof from public discourse about what actions to take to address these problems. And that means that 21st century ecologists understand that right action is guided by ethics. However, integration of ethical ideas into academic curricula and ecologists' research agendas is still meager. Aldo Leopold, 1947 President of the Ecological Society of America, keenly understood that latent in ecological sciences is an organizing worldview, with implications for reordering societal values and expanding ethics to embrace "soils, waters, plants, and animals, or collectively: the land." Going beyond Leopold's land ethic, contemporary environmental ethics includes eco-social justice and the realization that as important as biodiversity is cultural diversity, inter-cultural, inter-institutional, and international collaboration requiring a novel approach known as biocultural conservation. Right action in confronting the challenges of the 21st century requires science and ethics to be seamlessly integrated. Contemporary science proposes the concept of the inclusive ecosystem that recognizes humans as components. In this book, this "inclusive conviction is endorsed, fortunately, by over forty contributors sharing their accounts, of living well in place, combining nature and culture, residing on landscapes: biocultural ethics" (Holmes Rolston, III). (shrink)

Distributive justice decision making tends to require a trade off between different valued outcomes. The present study tracked computer mouse cursor movements in a forced-choice paradigm to examine for tension between different parameters of distributive justice during the decision-making process. Participants chose between set meal distributions, to third parties, that maximised either equality (the evenness of the distribution) or efficiency (the total number of meals distributed). Across different formulations of these dilemmas, responding was consistent with the notion that individuals tend (...) to base decisions in part on the magnitude of these parameters. In addition, dilemmas associated with inconsistent responding across the sample tended to elicit the greatest spatial deviation of the cursor, potentially reflecting dilemma difficulty. One interpretation of these results is that individuals value equality and efficiency in such a way that moral dilemmas are resolved by comparing the perceived value of these qualitatively different parameters, consistent with a value pluralistic framework of decision making. A post-hoc analysis indicated that individuals also incorporated sufficiency concerns during distributive justice decision making. The results are discussed in relation to political philosophy. (shrink)

In this paper, we argue that in order for the study of arts education to continue to advance, we must delineate the effects of particular forms of arts education, offered in certain contexts, on specific domains of children’s socioemotional development. We explain why formulating precise hypotheses about the effects of arts education on children’s socioemotional development requires a differentiated definition of each arts education program or activity in question, as well as a consideration of both the immediate and broader contexts (...) in which that program or activity occurs. We then offer the New Victory Theater’s Schools with Performing Arts Reach Kids program as an illustrative example of how these considerations allow for the refinement of hypotheses about the impact of arts education on children’s socioemotional development. (shrink)

Growth mindset is an important aspect of children’s socioemotional development and is subject to change due to environmental influence. Orchestral music education may function as a fertile context in which to promote growth mindset; however, this education is not widely available to children facing economic hardship. This study examined whether participation in a program of orchestral music education was associated with higher levels of overall growth mindset and greater change in levels of musical growth mindset among children placed at risk (...) by poverty. After at least 2 years of orchestral participation, students reported significantly higher levels of overall growth mindset than their peers; participating students also reported statistically significant increases in musical growth mindset regardless of the number of years that they were enrolled in orchestral music education. These findings have implications for future research into specific pedagogical practices that may promote growth mindset in the context of orchestral music education and more generally for future studies of the extra-musical benefits of high-quality music education. (shrink)

Spirituality and religion are not synonymous and, in fact, require not only different definitions but also appropriate vocabulary. A deeper discussion of the issues concerning spirituality ensues in several sections: 1) fundamental differences between spirituality and religion; 2) brain operations relative to transcendent states; 3) a definition of consciousness; 4) music, culture, and transcendence; 5) transcendence; 6) transcendence through music, and 7) spirituality in music education. The last section contains several recommendations on how spirituality can be embraced by music educators (...) and included in the curriculum to enhance the worldview of students. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Charm and Speed: Virtuosity in the Performing ArtsAnthony J. PalmerV. A. Howard, Charm and Speed: Virtuosity in the Performing Arts (New York: Peter Lang, 2008)There may be one other book on virtuosity, but nothing that approaches the depth of argument put forth by V. A. Howard in Charm and Speed. As the author states, “[t]his book offers an interpretation, analysis, and reconstruction of the concept of virtuosity which (...) plays so prominent a role in historical, critical, and theoretical discussions of artistic performance.”1 The book is not an easy read, however, because of Howard’s customarily esoteric vocabulary. While the writing is in fine style, there are too many occasions where the reader may be hampered by having to pause to reconsider what was stated, especially in some of the longer sentences, or because a dictionary consultation is warranted.Nevertheless, this is a must-read for voice and instrumental students and their teachers, coaches, and accompanists. Moreover, this book is a must-read for anyone working with performing artists; Howard covers the performance arts broadly, including theatre and dance as well. If you only surmise what virtuosity is, you will become intimately aware of its meaning and all its ramifications.Its casual use suggests that virtuosity can be found everywhere, from auto mechanics to baristas and even include, as Howard describes, cheetahs on the hunt and the kill. And although the cheetah is perfectly suited to find food to feed her [End Page 101] cubs, the intentional development of techniques and a conscious plan to attack her prey is questionable; she acts out of instinct. We can admire various manifestations of excellence, but their qualities do not measure up to the characteristics of virtuosity. Excellence in execution is not by such virtue virtuosic.The fact is performance in the arts requires a special understanding of virtuosity that must be narrowly applied under appropriate conditions. The ten chapters comprising the book deal with every facet of virtuosity in performance and clarify the issues forcefully and accurately. Charm and Speed is a brief treatise of only 134 pages, plus notes and a 3-page appendix. But in those chapters lie explanations to which most professional performers, teachers, and subsidiary personnel may need to give serious consideration. On the other end of the spectrum, for those who may require a less than keenly argued thesis, how much does one really need to know about virtuosity to enjoy fine, but lesser, performance? Some differences do need to be noted, however, and confusing virtuosity with other artistic appellations could be eliminated.At the outset, virtuosity can easily be confused with creativity, but the latter is more general while “a judgment of virtuosity is necessarily grounded in the observables of execution.”2 Howard’s outline of the conditions of virtuosity is carried throughout the discussion. Three parts comprise any consideration: 1) the performing individual or group “inclusive of training and manifest talent,” judged by experts; 2) the domain of the performance—acting, dancing, and playing the violin—must be specified; and 3) the audience comprised of a general audience and “critics, colleagues, and institutions” must render appropriate judgment.3 Virtuosity is not a single state but requires both process and achievement.Howard narrows his discussion on virtuosity to those in the performing arts, “to those who play instruments, or sing or act, dance or conduct,”4 with no other reason or intention but to render the artwork with unique interpretations at the highest level possible. Howard restricts discourse to allographic5 works in the Western tradition, an important distinction that I had considered questionable at first, but came to realize that virtuosity considered on a wider scale could be overly complicated. My experience with Japanese performing art, for example, would have to examine, Nô, Bunraku, Kabuki theatre, and traditional vocal and instrumental performance, among other things, all quite complex in their own right. Can a puppet in Bunraku be a virtuoso, or would it be the puppeteer? Further, Korean art forms such as pansori and African arts, where some cultures are communal rather than performed by superb practitioners, would all have to be considered. When the whole world is examined... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Charm and Speed: Virtuosity in the Performing ArtsAnthony J. PalmerV. A. Howard, Charm and Speed: Virtuosity in the Performing Arts (New York: Peter Lang, 2008)There may be one other book on virtuosity, but nothing that approaches the depth of argument put forth by V. A. Howard in Charm and Speed. As the author states, “[t]his book offers an interpretation, analysis, and reconstruction of the concept of virtuosity which (...) plays so prominent a role in historical, critical, and theoretical discussions of artistic performance.”1 The book is not an easy read, however, because of Howard’s customarily esoteric vocabulary. While the writing is in fine style, there are too many occasions where the reader may be hampered by having to pause to reconsider what was stated, especially in some of the longer sentences, or because a dictionary consultation is warranted.Nevertheless, this is a must-read for voice and instrumental students and their teachers, coaches, and accompanists. Moreover, this book is a must-read for anyone working with performing artists; Howard covers the performance arts broadly, including theatre and dance as well. If you only surmise what virtuosity is, you will become intimately aware of its meaning and all its ramifications.Its casual use suggests that virtuosity can be found everywhere, from auto mechanics to baristas and even include, as Howard describes, cheetahs on the hunt and the kill. And although the cheetah is perfectly suited to find food to feed her [End Page 101] cubs, the intentional development of techniques and a conscious plan to attack her prey is questionable; she acts out of instinct. We can admire various manifestations of excellence, but their qualities do not measure up to the characteristics of virtuosity. Excellence in execution is not by such virtue virtuosic.The fact is performance in the arts requires a special understanding of virtuosity that must be narrowly applied under appropriate conditions. The ten chapters comprising the book deal with every facet of virtuosity in performance and clarify the issues forcefully and accurately. Charm and Speed is a brief treatise of only 134 pages, plus notes and a 3-page appendix. But in those chapters lie explanations to which most professional performers, teachers, and subsidiary personnel may need to give serious consideration. On the other end of the spectrum, for those who may require a less than keenly argued thesis, how much does one really need to know about virtuosity to enjoy fine, but lesser, performance? Some differences do need to be noted, however, and confusing virtuosity with other artistic appellations could be eliminated.At the outset, virtuosity can easily be confused with creativity, but the latter is more general while “a judgment of virtuosity is necessarily grounded in the observables of execution.”2 Howard’s outline of the conditions of virtuosity is carried throughout the discussion. Three parts comprise any consideration: 1) the performing individual or group “inclusive of training and manifest talent,” judged by experts; 2) the domain of the performance—acting, dancing, and playing the violin—must be specified; and 3) the audience comprised of a general audience and “critics, colleagues, and institutions” must render appropriate judgment.3 Virtuosity is not a single state but requires both process and achievement.Howard narrows his discussion on virtuosity to those in the performing arts, “to those who play instruments, or sing or act, dance or conduct,”4 with no other reason or intention but to render the artwork with unique interpretations at the highest level possible. Howard restricts discourse to allographic5 works in the Western tradition, an important distinction that I had considered questionable at first, but came to realize that virtuosity considered on a wider scale could be overly complicated. My experience with Japanese performing art, for example, would have to examine, Nô, Bunraku, Kabuki theatre, and traditional vocal and instrumental performance, among other things, all quite complex in their own right. Can a puppet in Bunraku be a virtuoso, or would it be the puppeteer? Further, Korean art forms such as pansori and African arts, where some cultures are communal rather than performed by superb practitioners, would all have to be considered. When the whole world is examined... (shrink)