Background: Pulsed dye laser is the gold standard for treatment of port-wine stain birthmarks but multiple treatments are required and complete resolution is often not achieved. Posttreatment vessel recurrence is thought to be a factor that limits efficacy of PDL treatment of PWS. Imiquimod 5% cream is an immunomodulator with antiangiogenic effects. Objective: We sought to determine if application of imiquimod 5% cream after PDL improves treatment outcome. Methods: Healthy individuals with PWS were treated with PDL and then randomized to (...) apply posttreatment placebo or imiquimod 5% cream for 8 weeks. Chromameter measurements for 57 PWS sites were taken at baseline and compared with measurements taken 8 weeks posttreatment. The Δa and ΔE were measured to quantify treatment outcome. Results: Two patients developed minor skin irritation. Other adverse effects were not noted. Average a was 0.43 for PDL + placebo sites and 1.27 for PDL + imiquimod sites indicating a greater reduction in erythema with imiquimod. Average E was 2.59 for PDL + placebo and 4.08 for PDL + imiquimod, again indicating a greater color improvement with imiquimod. Limitations: Effects were evaluated after a single treatment and duration of effect is unknown. Conclusion: Combined selective photothermolysis and antiangiogenic therapy may enhance PWS treatment efficacy. © 2011 by the American Academy of Dermatology, Inc. (shrink)

From co-authored publications to sponsored projects involving multiple partner institutions, collaborative practice is an expected part of work in the academy. As evaluators of a National Science Foundation Alliances for Graduate Education and the Professoriate grant awarded to four university partners in a large southern state, the authors recognized the increasing value of collaborative practice in the design, implementation, evaluation, and dissemination of findings in the partnership over time. When planning a program among partnering institutions, stakeholders may underestimate the need (...) for, and value of, collaborative practice in facilitating partnership functioning. This method paper outlines an evaluative model to increase the use of collaborative practice in funded academic partnership programs. The model highlights collaborative practice across multiple stakeholder groups in the academic ecology: Sponsors of funded programs, Program partners and participants, Assessment and evaluation professionals, academic researchers, and the national and global Community. The SPARC model emphasizes evidence-based benefits of collaborative practice across multiple outcome domains. Tools and frameworks for evaluating collaborative practice take a view of optimizing partnership operational performance in achieving stated goals. Collaborative practice can also be an integral element of program activities that support the academic success and scholarly productivity, psychosocial adjustment, and physical and psychological well-being of stakeholders participating in the program. Given the goal of our alliance to promote diversification of the professoriate, the model highlights the use of collaborative practice in supporting stakeholders from groups historically underrepresented in STEM fields across these outcome domains. Using data from a mixed-methods program evaluation of our AGEP alliance over 4 years, the authors provide concrete examples of collaborative practice and their measurement. Results discuss important themes regarding collaborative practice that emerged in each stakeholder group. Authors operationalize the SPARC model with a checklist to assist program stakeholders in designing for and assessing collaborative practice in support of project goals in funded academic partnership projects, emphasizing the contributions of collaborative practice in promoting diversification of the professoriate. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

The emergence of the “4th Industrial Revolution,” i.e. the convergence of artificial intelligence, the Internet of Things, advanced materials, and bioengineering technologies, could accelerate socioeconomic insecurities and anxieties or provide beneficial alternatives to the status quo. In the post-Covid-19 era, the entities that are best positioned to capitalize on these innovations are large firms, which use digital platforms and big data to orchestrate vast ecosystems of users and extract market share across industry sectors. Nonetheless, these technologies also have the potential (...) to democratize ownership, broaden political-economic participation, and reduce environmental harms. We articulate the potential sociotechnical pathways in this high-stakes crossroads by analyzing cellular agriculture, an exemplary 4th Industrial Revolution technology that synergizes computer science, biopharma, tissue engineering, and food science to grow cultured meat, dairy, and egg products from cultured cells and/or genetically modified yeast. Our exploration of this space involved multi-sited ethnographic research in both the cellular agriculture community and alternative economic organizations devoted to open source licensing, member-owned cooperatives, social financing, and platform business models. Upon discussing how these latter approaches could potentially facilitate alternative sociotechnical pathways in cellular agriculture, we reflect upon the broader implications of this work with respect to the 4th Industrial Revolution and the enduring need for public policy reform. (shrink)

Social norms – rules governing which behaviours are deemed appropriate or inappropriate within a given community – are typically taken to be uniquely human. Recently, this position has been challenged by a number of philosophers, cognitive scientists, and ethologists, who have suggested that social norms may also be found in certain non-human animal communities. Such claims have elicited considerable scepticism from norm cognition researchers, who doubt that any non-human animals possess the psychological capacities necessary for normative cognition. However, there is (...) little agreement among these researchers about what these psychological prerequisites are. This makes empirical study of animal social norms difficult, since it is not clear what we are looking for and thus what should count as behavioural evidence for the presence (or absence) of social norms in animals. To break this impasse, we offer an approach that moves beyond contested psychological criteria for social norms. This approach is inspired by the animal culture research program, which has made a similar shift away from heavily psychological definitions of ‘culture’ and to become organized around a cluster of more empirically tractable concepts of culture. Here, we propose an analogous set of constructs built around the core notion of a normative regularity, which we define as a socially maintained pattern of behavioural conformity within a community. We suggest methods for studying potential normative regularities in wild and captive primates. We also discuss the broader scientific and philosophical implications of this research program with respect to questions of human uniqueness, animal welfare and conservation. (shrink)

The proto-code of ethics and conduct for European nurse directors was developed as a strategic and dynamic document for nurse managers in Europe. It invites critical dialogue, reflective thinking about different situations, and the development of specific codes of ethics and conduct by nursing associations in different countries. The term proto-code is used for this document so that specifically country-orientated or organization-based and practical codes can be developed from it to guide professionals in more particular or situation-explicit reflection and values. (...) The proto-code of ethics and conduct for European nurse directors was designed and developed by the European Nurse Directors Association’s (ENDA) advisory team. This article gives short explanations of the code’ s preamble and two main parts: Nurse directors' ethical basis, and Principles of professional practice, which is divided into six specific points: competence, care, safety, staff, life-long learning and multi-sectorial working. (shrink)

Action research is increasingly used as a means for teachers to improve their instruction, yet for many the idea of doing "research" can be somewhat intimidating. _Using Action Research to Improve Instruction_ offers a comprehensive, easy-to-understand approach to action research in classroom settings. This engaging and accessible guide is grounded in sources of data readily available to teachers, such as classroom observations, student writing, surveys, interviews, and tests. Organized to mirror the action research process, the highly interactive format prompts readers (...) to discover a focus, create research questions, address design and methodology, collect information, conduct data analysis, communicate the results, and to generate evidence-based teaching strategies. Engaging in these decision-making processes builds the skills essential to action research and promotes a deeper understanding of teaching practice. Special Features Include: -An Interactive Text -Reflection Questions and Activity Prompts -A Sample Action Research Report -Numerous Examples and Practice Examples -Numbered Sections for Cross Referencing This original text is a must-read for teachers interested in how they can use their current knowledge of instruction and assessment to meaningfully engage in action research. (shrink)

The moral/conventional task has been widely used to study the emergence of moral understanding in children and to explore the deficits in moral understanding in clinical populations. Previous studies have indicated that moral transgressions, particularly those in which a victim is harmed, evoke a signature pattern of responses in the moral/conventional task: they are judged to be serious, generalizable and not authority dependent. Moreover, this signature pattern is held to be pan‐cultural and to emerge early in development. However, almost all (...) the evidence for these claims comes from studies using harmful transgressions of the sort that primary school children might commit in the schoolyard. In a study conducted on the Internet, we used a much wider range of harm transgressions, and found that they do not evoke the signature pattern of responses found in studies using only schoolyard transgressions. Paralleling other recent work, our study provides preliminary grounds for skepticism regarding many conclusions drawn from earlier research using the moral/conventional task. (shrink)

In their target article, Conley et al. (2023) appropriately highlight the ongoing conceptual and practical opacity of public engagement (PE) in the translation of human gene editing (HGE) (Conley e...

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

We demonstrate that the key components of cognitive architectures (declarative and procedural memory) and their key capabilities (learning, memory retrieval, probability judgment, and utility estimation) can be implemented as algebraic operations on vectors and tensors in a high‐dimensional space using a distributional semantics model. High‐dimensional vector spaces underlie the success of modern machine learning techniques based on deep learning. However, while neural networks have an impressive ability to process data to find patterns, they do not typically model high‐level cognition, and (...) it is often unclear how they work. Symbolic cognitive architectures can capture the complexities of high‐level cognition and provide human‐readable, explainable models, but scale poorly to naturalistic, non‐symbolic, or big data. Vector‐symbolic architectures, where symbols are represented as vectors, bridge the gap between the two approaches. We posit that cognitive architectures, if implemented in a vector‐space model, represent a useful, explanatory model of the internal representations of otherwise opaque neural architectures. Our proposed model, Holographic Declarative Memory (HDM), is a vector‐space model based on distributional semantics. HDM accounts for primacy and recency effects in free recall, the fan effect in recognition, probability judgments, and human performance on an iterated decision task. HDM provides a flexible, scalable alternative to symbolic cognitive architectures at a level of description that bridges symbolic, quantum, and neural models of cognition. (shrink)

Meaning holism says that the meaning of an expression depends on all of its inferential connections. This dissertation defends this view from the objections that its grounds are infirm and that any theory of meaning holism faces insuperable difficulties. I argue that there are indeed compelling Quinean grounds for holism . I explicate the debate between Quine and Carnap over the status of analyticity, concluding that Quine is right to deny the distinction between inferences that are constitutive of expression meanings (...) and inferences that are merely empirical. The upshot is that all inferences are constitutive of meaning. Coupled with confirmation holism---the claim that all statements in a system of beliefs are holistically inferentially connected---meaning holism follows. I then argue that holism allows for communication even though it entails that communicants do not share the meanings of their expressions . In Chapter 5, I demonstrate how holism is reconcilable with the compositionality of language, thus denying the criticism that their incompatibility presents a prima facie case against holism. After responding to criticisms of holism, I provide a model of the interdependent structure of meaning constituting inferential relations among sentences in terms of conditional subjective probabilities, and I explain how the theory accounts for the normativity of meaning . I then defend a crucial assumption that underlies the entire dissertation, namely, that the meaning of an expression is in fact constituted by the inferences in which it figures . I argue that transparent self-knowledge is an essential feature of meaning, and show how self-knowledge lends itself to inferential role semantics. Chapter 8 takes a critical look at other meaning theories. I argue that denotational views either neglect the significance of behavior explanation in the theory of meaning, or they face the same difficulties that holism encounters, in which case they offer no advantage over holism. Internalist accounts of meaning, on the other hand, unjustifiably invoke ordinary external objects as semantic values. But without this illicit appeal to external objects, they tell us little about the meanings of expressions. (shrink)

Emotion dysregulation (ED) is a vulnerability factor for affective disorders that may originate from deficits in cognitive control (CC). Although measures of ED are often designed to assess trait-like tendencies, the extent to which such measures capture a time-varying (TV) or state-like construct versus a time-invariant (TI) or trait-like personality characteristic is unclear. The link between the TV and TI components of ED and CC is also unclear. In a 6-wave, 5-month longitudinal study, community participants (n = 1281) completed the (...) Difficulties in Emotion Regulation Scale (DERS-16), a commonly used measure of ED and measures of CC. A latent variable (trait-state-occasion) model showed that the proportion of TI factor variance (.80) was greater than the TV factor variance (.19). Although TV factor stability was significant, the coefficients were small in magnitude. Furthermore, regression weights for the ED TI factor (average β = −.62) were significant and larger than those for the TV factor (average β = −.10) in predicting latent CC at each of the six-time points. These findings suggest that ED, as assessed by the DERS-16, is largely TI and this TI component is more strongly linked to CC than the TV component. (shrink)

Addiction theorists have often utilized the metaphor of the blind men and the elephant to illustrate the complex nature of addiction and the varied methodological approaches to studying it. A common purported upshot is skeptical in nature: due to these complexities, it is not possible to offer a unifying account of addiction. I think that this is a mistake. The elephant is real–there is a _there_ there. Here, I defend a dispositionalist account of addiction as _the systematic disposition to fail (...) to control one’s desires to engage in certain types of behaviors_. I explain this position, defend the inclusion of desires and impaired control, and flesh out the notion of _systematicity_ central to my account. I then illustrate how my dispositionalist framework can unify the disparate and seemingly incompatible accounts of addiction (and their respective methodological approaches). I close with a brief plan to extend and implement my account. (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

In this open peer commentary, we categorize the possible “neuroscience in national security” definitions of misuse of science and identify which, if any, are uniquely presented by advances in neuroscience. To define misuse, we first define what we would consider appropriate use: the application of reasonably safe and effective technology, based on valid and reliable scientific research, to serve a legitimate end. This definition presents distinct opportunities for assessing misuse: misuse is the application of invalid or unreliable science, or is (...) the use of reliable scientific methods to serve illegitimate ends. Ultimately, we conclude that while national security is often a politicized issue, assessing the state of scientific progress should not be. (shrink)

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

Media use is a pervasive aspect of children’s home experiences but is often not considered in studies of the home learning environment. Media use could be detrimental to children’s language and literacy skills because it may displace other literacy-enhancing activities like shared reading and decrease the quantity and quality of caregiver-child interaction. Thus, the current study asked whether media use is associated with gains in children’s language and literacy skills both at a single time point and across a school year (...) and whether age moderates any association. Children (N = 1583) were from preschool through third grade classrooms and language and literacy skills were measured in the fall and spring of the school year. Parents reported how much time their child spends using media on a typical school day. Regression analyses showed that using 4 hours or more of media was related to lower literacy gains, but not to language gains. Multilevel models conducted as a robustness check showed that this effect did not hold when accounting for classroom. In neither set of models was there an interaction between age and media use. Single-time-point models did show some associations that did not manifest in more stringent models, highlighting the limitations of correlational designs that do not have measures of children’s skills over time. Given the concern and popular press coverage around children’s media use, it is important to acknowledge nonsignificant effects in this domain. These nonsignificant associations suggest that societal fears around children’s media use may be exaggerated. Notably, however, characteristics of children’s media use, like educational content or adult co-use, may moderate any effects. The relation between media use and language and literacy growth did not differ across the age range investigated suggesting that, within this range, younger children are not more vulnerable to detrimental effects. (shrink)

In amblyopia, abnormal visual experience during development leads to an enduring loss of visual acuity in adulthood. Physiological studies in animal models suggest that intracortical GABAergic inhibition may mediate visual deficits in amblyopia. To better understand the relationship between visual cortical γ-aminobutyric acid (GABA) and perceptual suppression in persons with amblyopia (PWA), we employed magnetic resonance spectroscopy (MRS) to quantify GABA levels in both PWA and normally-sighted persons (NSP). In the same individuals, we obtained psychophysical measures of perceptual suppression for (...) a variety of ocular configurations. In PWA, we found a robust negative correlation between the depth of amblyopia (the difference in visual acuity between the amblyopic and non-amblyopic eyes) and GABA concentration that was specific to visual cortex and was not observed in a sensorimotor cortical control region. Moreover, lower levels of visual cortical GABA were associated with weaker perceptual suppression of the fellow eye by the amblyopic eye and stronger suppression of the amblyopic eye by the fellow eye. Taken together, our findings provide evidence that intracortical GABAergic inhibition is an important component of the pathology of human amblyopia and suggest possible therapeutic interventions to restore vision in the amblyopic eye through enhancement of visual cortical GABAergic signaling in PWA. (shrink)

This chapter describes the development of a workshop series focused on helping students develop research lab ethics guidelines. The workshop was developed through a National Science Foundation-funded project that situates ethics education within the research environment. Students in four departments at a private research university were recruited to join a Student Ethics Committee that collaboratively developed context-specific codes-of-ethics-based guidelines for their departments. These bottom-up developed guidelines were revised in an iterative process, including feedback from faculty, other graduate students, and the (...) original Student Ethics Committee. The goal of the workshops was to promote the cultivation of an ethical culture in experimental laboratories by integrating research stakeholders in a bottom-up approach to developing context-specific guidelines and to identify factors that students consider relevant to the ethical conduct of research. After describing the workshop series, this chapter presents a qualitative content analysis of the guidelines. The guidelines developed by the Student Ethics Committees reflect the current culture of experimental labs in these departments and the ethical issues that students think are important. The content of these guidelines and the ethical issues the students focused on contrast in some key ways with what ethical issues faculty who head research groups saw as paramount. The chapter describes the first two iterations of the ethics education workshop module, a qualitative analysis of the first draft of these guidelines, and finally reflects on future work in this area of in situ ethics education. (shrink)

This important new book explores the contemporary refugee crisis and the untold realities and experiences of refugees themselves. A team of top scholars offer a critical and necessary diagnosis of the challenges, complexities, and contradictions impacting our philosophical approaches to the contemporary figure of the refugee.

Curiously, while the efficacy of the arts for the development of multicultural understandings has long been theorized, empirical studies of this effect have been lacking. This essay recounts our combined empirical and philosophical study of this issue. We explicate the philosophical considerations that shaped the development of the arts course we studied, which was grounded in rather traditional humanist educational thought, informed by Deweyan considerations for pedagogy and multiculturalism. We also provide an overview of the course and of the study (...) design: the ways in which the course worked to teach aesthetic theory through a combination of popular and canonical works, and the ways in which it sought to instill a sense of cross-cultural appreciation and solidarity among students through the inclusion of art from different cultures and generations. We then share our research findings and our return to the realm of philosophy to interpret them. Our postcolonial analysis incorporates emerging discussions of the arts as a tool for resistance and dialogue within the system of public education, and revisit and reconsider the very concept of education for pluralistic democracy. This approach problematizes traditional conceptions of pluralism, in which an attempt is made to dissolve difference in a common understanding, and instead advocates that works from among the contemporary popular arts and works drawn from the artistic “canon” alike must be considered and employed for their instrumental value to the educational process—especially for their ability to prompt an intersubjectivity that is accompanied by a heightened awareness of difference. (shrink)

G. W. F. Hegel’s Elements of Philosophy of Right analogizes the unfolding of a people’s political self-consciousness to the unfolding of an education. Yet Hegel is somewhat unsystematic in accounting for how the process of political education unfolds in its differentiated moments. This paper pieces together a more systematic account of political education from Hegel’s scattered remarks on the subject in Philosophy of Right. I argue that, once we understand how political education fits into the holistic picture of Hegel’s Rechtsphilosophie, (...) we see that it exercises both a fortifying and a threatening influence on the state: fortifying the state insofar as it habituates individuality to universality in the form of ethical dispositions such as patriotism, threatening the state insofar as it represents a destabilizing tendency toward democratic judgment in the emergence of public opinion. I conclude by raising the possibility that political education poses an entropic, “democratic” threat to the modern state. (shrink)

G. W. F. Hegel’s Elements of Philosophy of Right analogizes the unfolding of a people’s political self-consciousness to the unfolding of an education. Yet Hegel is somewhat unsystematic in accounting for how the process of political education unfolds in its differentiated moments. This paper pieces together a more systematic account of political education from Hegel’s scattered remarks on the subject in Philosophy of Right. I argue that, once we understand how political education fits into the holistic picture of Hegel’s Rechtsphilosophie, (...) we see that it exercises both a fortifying and a threatening influence on the state: fortifying the state insofar as it habituates individuality to universality in the form of ethical dispositions such as patriotism, threatening the state insofar as it represents a destabilizing tendency toward democratic judgment in the emergence of public opinion. I conclude by raising the possibility that political education poses an entropic, “democratic” threat to the modern state. (shrink)

Treatise 2.3.6, “Of the influence of the imagination on the passions,” provides a magnified view into the relationship between motivation, morality, and politics in Hume’s philosophy. Here, Hume analyzes a “noted passage” from the history of antiquity in which the citizens of fifth-century Athens deliberated over whether to burn the ships of their neighboring Grecians after winning a decisive naval victory against the Persians. Hume finds the passage notable precisely because of a failure of the imagination to exert an influence (...) on the Athenians’ passions during their deliberations, leading them to abstain from further military action. This paper discusses how Hume’s analysis of this event reveals new connections between his passional, moral, and political theories in the Treatise. (shrink)

The number of homebound individuals in the United States is on the rise, causing health-care professionals to expand in-home health services to help meet the increased demand. Due to the prevalence of feelings of isolation and depression in this population, it is imperative that mental health professionals join this effort to increase access to mental health services. Delivering psychotherapy in clients’ homes presents many advantages to these homebound individuals, but there is a dearth of literature addressing how therapists should handle (...) unique ethical issues that arise in this type of setting. This article addresses ethical considerations and guidelines for in-home provision of mental health services. General ethical issues related to home-based psychotherapy include boundaries, confidentiality and privacy, competency, insurance coverage, and autonomy. Issues pertaining to different categories of homebound individuals, including persons with agoraphobia, chronic illnesses, and older adults, are then discussed in turn. Recommendations on how to best manage these issues by applying the American Psychological Association’s, the American Counseling Association’s, and the National Association of Social Workers’ Ethics Codes are provided. (shrink)

Curiously, while the efficacy of the arts for the development of multicultural understandings has long been theorized, empirical studies of this effect have been lacking. This essay recounts our combined empirical and philosophical study of this issue. We explicate the philosophical considerations that shaped the development of the arts course we studied, which was grounded in rather traditional humanist educational thought, informed by Deweyan considerations for pedagogy and multiculturalism. We also provide an overview of the course and of the study (...) design: the ways in which the course worked to teach aesthetic theory through a combination of popular and canonical works, and the ways in which it sought to instill a sense of cross-cultural appreciation and solidarity among students through the inclusion of art from different cultures and generations. We then share our research findings and our return to the realm of philosophy to interpret them. Our postcolonial analysis incorporates emerging discussions of the arts as a tool for resistance and dialogue within the system of public education, and revisit and reconsider the very concept of education for pluralistic democracy. This approach problematizes traditional conceptions of pluralism, in which an attempt is made to dissolve difference in a common understanding, and instead advocates that works from among the contemporary popular arts and works drawn from the artistic “canon” alike must be considered and employed for their instrumental value to the educational process—especially for their ability to prompt an intersubjectivity that is accompanied by a heightened awareness of difference. (shrink)

© 2019 The Author. Background: The phenomenon of being 'with woman' is fundamental to midwifery as it underpins its philosophy, relationships and practices. There is an identified gap in knowledge around the 'with woman' phenomenon from the perspective of midwives providing care in a variety of contexts. As such, the aim of this study was to explore the experiences of being 'with woman' during labour and birth from the perspective of midwives' working in a model where care is provided by (...) a known midwife. Methods: A descriptive phenomenological design was employed with ten midwives working in a 'known midwife' model who described their experiences of being 'with woman' during labour and birth. The method was informed by Husserlian philosophy which seeks to explore the same phenomenon through rich descriptions by individuals revealing commonalities of the experience. Results: Five themes emerged 1) Building relationships; 2) Woman centred care; 3) Impact on the midwife; 4) Impact on the woman; and 5) Challenges in the Known Midwife model. Midwives emphasised the importance of trusting relationships while being 'with woman', confirming that this relationship extends beyond the woman - midwife relationship to include the woman's support people and family. Being 'with woman' during labour and birth in the context of the relationship facilitates woman-centred care. Being 'with woman' influences midwives, and, it is noted, the women that midwives are working with. Finally, challenges that impact being 'with woman' in the known midwife model are shared by midwives. Conclusions: Findings offer valuable insight into midwives' experiences of being 'with woman' in the context of models that provide care by a known midwife. In this model, the trusting relationship is the conduit for being 'with woman' which influences the midwife, the profession of midwifery, as well as women and their families. Descriptions of challenges to being 'with woman' provide opportunities for professional development and service review. Rich descriptions from the unique voice of midwives, provided insight into the applied practices of being 'with woman' in a known midwife model which adds important knowledge concerning a phenomenon so deeply embedded in the philosophy and practices of the profession of midwifery. (shrink)