Abstract2020 saw the rapid onset of a global pandemic caused by the SARS‐CoV‐2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to (...) “being a nurse” during the COVID‐19 pandemic was experienced and understood by Danish hospital‐based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

Individuals of many animal species are said to have a personality. It has been shown that some individuals are bolder than other individuals of the same species, or more sociable or more aggressive. In this paper, we analyse what it means to say that an animal has a personality. We clarify what an animal personality is, that is, its ontology, and how different personality concepts relate to each other, and we examine how personality traits are identified in biological practice. Our (...) analysis shows that biologists often study specific personality traits, such as boldness, sociability or aggressiveness, rather than personalities in general. We claim that personality traits are best understood as dispositions and that they are operationally defined in terms of certain sets of behaviours, which are studied in specific experimental set-ups. Furthermore, we develop an integrative philosophical account that specifies and formalises three criteria for identifying personality traits, which are used in biological practice. For an individual animal to have a personality trait it must, first, behave differently than others. Second, these behavioural differences must be stable over a certain time, and third, they must be consistent in different contexts. (shrink)

BackgroundThe phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice.Research aimTo explore the concept of moral (...) distress in nursing both empirically and conceptually.MethodologyFeminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis.Ethical considerationsThe study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom.FindingsThe empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas.DiscussionWe suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress.ConclusionThe empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)

Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge (...) on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of individual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous. (shrink)

Caroline New is an energetic activist who has interpolated critical realist ideas into the front-line of political activism. In this wide-ranging interview, she begins by reflecting on her life and how she became a realist and her account is illustrated with personal anecdotes recalling memories of well-known philosophers and activists from the time. She discusses how her position set her apart from other feminists and she examines the interacting threads of longstanding debates on the political left, as well as (...) longstanding debates within critical realist circles, such as the relative importance of quantitative methods in social research and the scope for agency as a source of intentional change. Finally she brings some of her ideas to bear on contemporary issues. This engaging interview notably provides some of the social context in which critical realism developed, while also pointing towards its future potential. (shrink)

The current experiments examine mental health clinicians’ beliefs about biological, psychological, and environmental bases of the DSM‐IV‐TR mental disorders and the consequences of those causal beliefs for judging treatment effectiveness. Study 1 found a large negative correlation between clinicians’ beliefs about biological bases and environmental/psychological bases, suggesting that clinicians conceptualize mental disorders along a single continuum spanning from highly biological disorders (e.g., autistic disorder) to highly nonbiological disorders (e.g., adjustment disorders). Study 2 replicated this finding by having clinicians list what (...) they thought were the specific causes of nine familiar mental disorders and rate their bio–psycho–environmental bases. Study 3 further found that clinicians believe medication to be more effective for biologically based mental disorders and psychotherapy to be more effective for psychosocially based mental disorders. These results demonstrate that even expert mental health clinicians make strong distinctions between psychological and biological phenomena. (shrink)

Research using the intermodal preferential looking paradigm (IPLP) has consistently shown that English‐learning children aged 2 can associate transitive argument structure with causal events. However, studies using the same methodology investigating 2‐year‐old children’s knowledge of the conjoined agent intransitive and semantic role assignment have reported inconsistent findings. The aim of the present study was to establish at what age English‐learning children have verb‐general knowledge of both transitive and intransitive argument structure using a new method: the forced‐choice pointing paradigm. The results (...) suggest that young 2‐year‐olds can associate transitive structures with causal (or externally caused) events and can use transitive structure to assign agent and patient roles correctly. However, the children were unable to associate the conjoined agent intransitive with noncausal events until aged 3;4. The results confirm the pattern from previous IPLP studies and indicate that children may develop the ability to comprehend different aspects of argument structure at different ages. The implications for theories of language acquisition and the nature of the language acquisition mechanism are discussed. (shrink)

In recent years, several countries have enacted guidelines and/or mandatory laws to increase the presence of women on the boards of companies. Through these regulatory interventions, the aim is to eradicate the social and labor grievances that women have traditionally experienced and which has relegated them to smaller-scale jobs. Nevertheless, and despite the advances achieved, the female representation in the boardroom remains far from the desired levels. In this context, it is now necessary to enhance the advantages of board gender (...) diversity from both ethical and economic points of view. This article examines the relation between board gender diversity and economic results in Spain: the second country in the world to legally require gender quotas in boardrooms and historically characterized by a minimal female participation in the workforce. Based on a sample of 125 non-financial firms listed on the Madrid Stock Exchange from 2005 to 2009, our findings show that in the period analyzed the increase of the number of women on boards was over 98 %. This suggests that compulsory legislation offers an efficient framework to execute the recommendation of Spanish codes of good governance by means of the increase in the number of women in the boards of firms. Furthermore, we find that the increase in the number of women on the boards is positively related to higher economic results. Therefore, both results suggest that gender diversity in boardrooms should be incremented, mandatory laws being a key factor to do so. (shrink)

This study explores the connections between time, travel, and creative acts such as painting and poetry, highlighting the similarities that unite these themes. It also focuses on the relationships between the East and the West in regards to these subjects, and posits that travel can be understood as an active form of meditation. The study argues that the meaning of wanderings can be found by learning to make them conscious, and that there has been a deep reflection on time, consciousness, (...) and mobility since ancient times. (shrink)

Understanding the link between brain evolution and the evolution of distinctive features of modern human cognition is a fundamental challenge. A still unresolved question concerns the co-evolution of tool behavior (i.e., tool use or tool making) and language. The shared neurocognitive processes hypothesis suggests that the emergence of the combinatorial component of language skills within the frontal lobe/Broca's area made possible the complexification of tool-making skills. The importance of the frontal lobe/Broca's area in tool behavior is somewhat surprising with regard (...) to the literature on neuropsychology and cognitive neuroscience, which has instead stressed the critical role of the left inferior parietal lobe. Therefore, to be complete, any version of the shared neurocognitive processes hypothesis needs to integrate the potential interactions between the frontal lobe/Broca's area and the left inferior parietal lobe as well as their co-evolution at a phylogenetic level. Here, we sought to provide the first elements of answer through the use of the massive deployment framework, which posits that evolutionarily older brain areas are deployed in more cognitive functions (i.e., they are less specific). We focused on the left parietal cortex, and particularly the left areas PF, PGI, and anterior intraparietal (AIP), which are known to be involved in tool use, language, and motor control, respectively. The deployment of each brain area in different cognitive functions was measured by conducting a meta-analysis of neuroimaging studies. Our results confirmed the pattern of specificity for each brain area and also showed that the left area PGI was far less specific than the left areas PF and AIP. From these findings, we discuss the different evolutionary scenarios depicting the potential co-evolution of the combinatorial and generative components of language and tool behavior in our lineage. (shrink)

Understanding the link between brain evolution and the evolution of distinctive features of modern human cognition is a fundamental challenge. A still unresolved question concerns the co-evolution of tool behavior (i.e., tool use or tool making) and language. The shared neurocognitive processes hypothesis suggests that the emergence of the combinatorial component of language skills within the frontal lobe/Broca's area made possible the complexification of tool-making skills. The importance of the frontal lobe/Broca's area in tool behavior is somewhat surprising with regard (...) to the literature on neuropsychology and cognitive neuroscience, which has instead stressed the critical role of the left inferior parietal lobe. Therefore, to be complete, any version of the shared neurocognitive processes hypothesis needs to integrate the potential interactions between the frontal lobe/Broca's area and the left inferior parietal lobe as well as their co-evolution at a phylogenetic level. Here, we sought to provide the first elements of answer through the use of the massive deployment framework, which posits that evolutionarily older brain areas are deployed in more cognitive functions (i.e., they are less specific). We focused on the left parietal cortex, and particularly the left areas PF, PGI, and anterior intraparietal (AIP), which are known to be involved in tool use, language, and motor control, respectively. The deployment of each brain area in different cognitive functions was measured by conducting a meta-analysis of neuroimaging studies. Our results confirmed the pattern of specificity for each brain area and also showed that the left area PGI was far less specific than the left areas PF and AIP. From these findings, we discuss the different evolutionary scenarios depicting the potential co-evolution of the combinatorial and generative components of language and tool behavior in our lineage. (shrink)

Psychedelic experiences are often compared to “transformative experiences” due to their potential to change how people think and behave. This study empirically examines whether psychedelic experiences constitute transformative experiences. Given psychedelics’ prospective applications as treatments for mental health disorders, this study also explores neuroethical issues raised by the possibility of biomedically directed transformation—namely, consent and moral psychopharmacology. To achieve these aims, we used both inductive and deductive coding techniques to analyze transcripts from interviews with 26 participants in psychedelic retreats. Results (...) indicate that psychedelic experiences can constitute transformative experiences. Twenty participants reported experiences or insights that were seemingly inaccessible or impossible to attain if not for the psychoactive effects of psychedelics. All participants besides one reported some change in identity, values, beliefs, desires, and behavior—changes in behavior being the most common. Participants also reported feeling capable deciding to use psychedelics in part due to information seeking prior to their retreats. Finally, several participants reported an enhanced capacity for enacting changes in their lives. Our results underscore both the importance of subjective embodiment to transformation and the role of transformative agency in shaping outcomes of the psychedelic experience. We examine our results relative to neuroethical issues and advocate for centering the person in psychedelic research and neuroethical inquiry about psychedelics to avoid pitfalls associated with psychedelics’ potential as moral psychopharmacological agents. (shrink)

Wijdicks and colleagues1 recently presented the Full Outline of UnResponsiveness (FOUR) scale as an alternative to the Glasgow Coma Scale (GCS)2 in the evaluation of consciousness in severely brain-damaged patients. They studied 120 patients in an intensive care setting (mainly neuro-intensive care) and claimed that “the FOUR score detects a locked-in syndrome, as well as the presence of a vegetative state.”1 We fully agree that the FOUR is advantageous in identifying locked-in patients given that it specifically tests for eye movements (...) or blinking on command. This is welcomed given that misdiagnosis of the locked-in syndrome has been shown to occur in more than half of the cases (see Laureys and colleagues3 for review). As for the diagnosis of the vegetative state, the scale explicitly tests for visual pursuit, and hence can disentangle the vegetative state from the minimally conscious state (MCS). The diagnostic criteria for MCS have been proposed4 only recently, but Wijdicks and colleagues1 do not mention the existence of this clinical entity in their article. As for the vegetative state, MCS can be encountered in the acute or subacute setting as a transitional state on the way to further recovery, or it can be a more chronic or even permanent condition. The MCS refers to patients showing inconsistent, albeit clearly discernible, minimal behavioral evidence of consciousness (eg, localization of noxious stimuli, eye fixation or tracking, reproducible movement to command, or nonfunctional verbalization).4 The FOUR scale does not test for all of the behavioral criteria required to diagnose MCS.4 It is known from the literature (see Majerus and colleagues5 for review) that about a third of patients diagnosed with vegetative state are actually in MCS, and this misdiagnosis can lead to major clinical, therapeutic, and ethical consequences. We tested the ability of the newly proposed FOUR scale to correctly diagnose the vegetative state in an acute (intensive care and neurology ward) and chronic (neurorehabilitation) setting.. (shrink)

Can we build endogenous expectations about the locus of occurrence of a target without being able to describe them? Participants performed cue–target detection tasks with different proportions of valid and invalid trials, without being informed of these proportions, and demonstrated typical endogenous effects. About half were subsequently able to correctly describe the cue–target relationships . However, even non-verbalizer participants showed endogenous orienting with peripheral cues , not depending solely on practice . Explicit instructions did not bring about dramatic advantages in (...) performance .With central symbolic cues, only verbalizers showed reliable endogenous effects . We concluded that endogenous orienting with peripheral cues can occur independently of participants developing explicit hypotheses about the cue–target relationships. (shrink)

Humans can follow different social learning strategies, sometimes oriented toward the models’ characteristics. The goal of the present study was to explore which who-strategy is preferentially followed in the technological context based on the models’ psychological characteristics. We identified three potential who-strategies: Copy the pedagogue, copy the engineer, and copy the friend. We developed a closed-group micro-society paradigm in which participants had to build the highest possible towers. Participants began with an individual building phase. Then, they were gathered to discuss (...) the best solutions to increase tower height. After this discussion phase, they had to make a new building attempt, followed by another discussion phase, and so forth for a total of six building phases and five discussion rounds. This methodology allowed us to create an attraction score for each participant. We also assessed participants’ theory-of-mind skills, technical-reasoning skills, and prosocialness to predict participants’ attraction scores based on these measures. Results show that we learn from engineers because they are the most successful. Their attraction power is not immediate, but after they have been identified as attractors, their technique is copied irrespective of their pedagogy or friendliness. These findings open avenues for the study of the cognitive bases of human technological culture. (shrink)

to be published in the Proceedings of the 18. International Conference of Linguistics, Seoul, Korea.

Discute-se a interface entre discursos poéticos e proféticos e a área de atuação de seus respectivos especialistas, na Grécia arcaica, a partir de uma análise de certas passagens dos poemas Teogonia e Trabalhos e dias de Hesíodo. O enfoque é a afirmação, na Teogonia , que a consagração do poeta pelas Musas, ou seja, sua união com uma realidade sagrada, lhe permite celebrar o futuro. A afirmação é discutida através da interpretação de passagens em Trabalhos e dias.

Coming to Life: Philosophies of Pregnancy, Childbirth and Mothering is a superlative collection of essays that does what too few scholarly works have dared: it takes seriously the philosophical significance of women’s lived experience. Every woman, regardless of her own reproductive story, is touched by the often restrictive beliefs and norms governing discourses about pregnancy, childbirth and mothering. Thus the concerns of this anthology are relevant to all women and central to any philosophical project that takes women’s lives seriously. In (...) this volume 16 authors- including both established feminists and some of today’s most innovative new scholars- engage in sustained reflection on the experiences of pregnancy, childbirth and mothering, and on the beliefs, customs, and political institutions by which those experiences are informed. Many of the topics in this collection, though familiar, are here taken up in a new way: contributors think beyond the traditional pro-choice/pro-life dichotomy, speak to the manifold nature of mothering by considering the experiences of adoptive mothers and birthmothers, and upend the belief that childrearing practices must be uniform despite psycho-sexual differences in children. Many chapters reveal the radical shortcomings of conventional philosophical wisdom by placing trenchant assumptions about subjectivity, gender, power and virtue in dialogue with women’s experience. The volume is diverse both in its content and in its scholarly approach; certain of the essays are informed by their authors’ own experiences, others draw from extant narratives; many engage such canonical thinkers as Plato, Aristotle, Nietzsche and Heidegger, while others draw from the works of contemporary feminists including Sara Ruddick, Iris Marion Young, Virginia Held, Julia Kristeva and Luce Irigaray. All readers, regardless of their philosophical training and commitments, will find much to appreciate in this volume. (shrink)

Mitochondrial donation poses the latest regulatory challenge for policy-makers in the context of assisted conception. Since 2010 the Human Genetics Commission, the Human Fertilisation and Embryology Authority and the Nuffield Council on Bioethics have all considered the policy implications of permitting use of these techniques in treatment. The Nuffield Council on Bioethics reported its recommendations in June 2012 following a consultation on the ethical issues raised by these techniques; and a separate consultation by the Human Fertilisation and Embryology Authority in (...) conjunction with Sciencewise-ERC followed in September 2012. Matters for consideration included the potential relationships created by the use of three parties’ genetic material and the associated ramifications, eg whether or not there is a need to establish records of such donations and, if so, to whom should information later be provided? Thus, mitochondrial donation poses both novel and familiar questions about the ‘genetic family’, ‘parentage’ and ‘identity’. This article explores some of the ways in which mitochondrial DNA is constructed as relatively significant in recent Parliamentary debates, policy and consultation documents. It reflects on the ways in which the role of some genetic connections, or lack thereof, are mediated in law and policy. (shrink)

In this paper we suggest that there is a need to examine what is meant by “context” in Social Psychology and present an example of how to place identity in its social and institutional context. Taking the case of British naturalisation, the process whereby migrants become citizens, we show that the identity of naturalised citizens is defined by common-sense ideas about Britishness and by immigration policies. An analysis of policy documents on “earned citizenship” and interviews with naturalised citizens shows that (...) the distinction between “elite” and “non-elite” migrants is evident in both the “reified” sphere of policy and the “common sense” sphere of everyday identity construction. While social representations embedded in lay experience construct ethno-cultural similarity and difference, immigration policies engage in an institutionalised positioning process by determining migrants' rights of mobility. These spheres of knowledge and practice are not disconnected as these two levels of “managing otherness” overlap—it is the poorer, less skilled migrants, originating outside the West who epitomise difference (within a consensual sphere) and have less freedom of mobility (within a reified sphere). We show that the context of identity should be understood as simultaneously psychological and political. (shrink)

The term “race,” and the concept it refers to, namely genetically different human populations in the world, is one of the most intellectually and emotionally charged in society, and in science as well. This article focuses on how human beings recognize individual faces of their own versus another “racial group,” and the term “face race” is used in the context of visual recognition, as traditionally done in the scientific literature. The article reviews the well-known phenomenon that people have greater difficulty (...) distinguishing and recognizing individual faces from a different human population, or “race,” than their own. Experience-based holistic accounts encompass and extend most other proposals, such as a more densely clustered organization of other-race faces in an internal face-space centered on a “norm,” and it leads to a number of interesting predictions about the processing of same race and other-race faces. (shrink)

Circadian rhythm abnormalities in bipolar disorder have led to a search for genetic abnormalities in circadian "clock genes" associated with BD. However, no significant clock gene findings have emerged from genome-wide association studies. At least three factors could account for this discrepancy: complex traits are polygenic, the organization of the clock is more complex than previously recognized, and/or genetic risk for BD may be shared across multiple illnesses. To investigate these issues, we considered the clock gene network at three levels: (...) essential "core" clock genes, upstream circadian clock modulators, and downstream clock controlled genes. Using relaxed thresholds for GWAS statistical significance, we determined the rates of clock vs. control genetic associations with BD, and four additional illnesses that share clinical features and/or genetic risk with BD. Then we compared the results to a set of lithium-responsive genes. Associations with BD-spectrum illnesses and lithium-responsiveness were both enriched among core clock genes but not among upstream clock modulators. Associations with BD-spectrum illnesses and lithium-responsiveness were also enriched among pervasively rhythmic clock-controlled genes but not among genes that were less pervasively rhythmic or non-rhythmic. Our analysis reveals previously unrecognized associations between clock genes and BD-spectrum illnesses, partly reconciling previously discordant results from past GWAS and candidate gene studies. (shrink)

This study investigates the choice of genitive forms (the woman’s book vs. the book of the woman) in the English of Japanese-English bilingual returnees (i.e. children who returned from a second language dominant environment to their first language environment). The specific aim was to examine whether change in language dominance/exposure influences choice of genitive form in the bilingual children; the more general question was the extent to which observed behaviour can be explained by cross linguistic influence (CLI). First, we compared (...) the choice of genitive form between monolingual Japanese speakers and bilinguals who had recently returned to Japan from an English monolingual environment. Second, we tracked changes in genitive preference within bilingual children, comparing their performances upon return to Japan to those of one year later. Results show that CLI alone is insufficient to explain the difference in genitive evaluation between bilinguals and monolinguals, as well as the intra-group bilingual variation over time. We suggest that both CLI and general processing considerations couple together to influence the changes in genitive preference. (shrink)

Este artigo aborda as motivações para a docência e os desafios enfrentados por licenciandos em psicologia. A metodologia utilizada foi a abordagem qualitativa, e o instrumento de coleta de dados questionário online com questões abertas e fechadas. Participaram do estudo, onze estudantes de cursos de licenciatura em psicologia de quatro instituições universitárias das regiões sul e sudeste do Brasil. Os resultados demonstraram que a escolha pela licenciatura se deu, sobretudo, pelo interesse e curiosidade na área da educação, apropriação dos saberes (...) pedagógicos, ampliação do mercado de trabalho, bem como as possibilidades de atuação profissional. As dificuldades apontadas revelaram: a falta de informações sobre as especificidades do curso de licenciatura e da atuação do professor de psicologia e a ausência de docentes com saberes pedagógicos para atuar na licenciatura em psicologia. Embora seja considerada formação complementar entre os estudantes, observou-se possibilidades de um ensino-aprendizagem de psicologia engajada e inventiva. (shrink)

As more young people feel safe to outwardly identify as transgender or gender expansive (TGE), meaning that their gender identity does not align with the sex they were assigned at birth, an increasing number of youth who identify as TGE seek gender-affirming medical care (GAMC). GAMC raises a number of ethical questions, such as the capacity of a minor to assent or consent, the role of parents or legal guardians in decisions about treatment, and implications for equitable access to care (...) when differing parental or custodial viewpoints are present. These questions are further complicated by the difficulties in explaining the limits of long-term research in GAMC, with regard to the preservation of fertility, for example. We present two de-identified composite case studies to highlight dilemmas that may arise and offer recommendations to better support patient- and family-centered decision making for GAMC. These include employing a multidisciplinUniverary shared decision-making approach, disentangling informed consent and assent from chronological age, developing a consistent approach to the assessment of decisional capacity, and developing age-appropriate informational materials. (shrink)

BackgroundImplementation of recommendations from clinical practice guidelines is essential for evidence based clinical practice. However, the most effective methods of implementation are unclear. We conducted a national, cluster-randomised, blinded implementation trial to determine if midwife or doctor local implementation leaders are more effective in implementing a guideline for use of oral dextrose gel to treat hypoglycaemic babies on postnatal wards. To prevent any conscious or unconscious performance bias both the doctor and midwife local implementation leaders were kept unaware of the (...) trial. This paper reports the ethical dilemmas and practical challenges of ensuring clinicians remained unaware of their involvement in an implementation trial.MethodsWe sought approval from the National Health and Disability Ethics committee to keep clinicians unaware of the trial by waiving the standard requirement for locality approval usually required for each district health board. The ethics committee did not approve a waiver of consent but advised that we approach the chief executive of each district health board to ask for provisional locality approval. Ultimately it was necessary to seek ethics approval for three separate study designs to keep clinicians unaware of the trial.ResultsThe median time for chief executive approval was 16 days and for locality approval was 57 days. We completed 21 different locality approval forms for 27 hospitals.ConclusionsKeeping clinicians unaware of their involvement in a national implementation cluster-randomised trial is feasible. However, despite a national ethics committee, significant logistical challenges were time consuming and delayed trial completion. Co-ordination of the locality approval process would help facilitate multi-centre trials. (shrink)

This article aims to deepen and extend theoretical understanding of mobility by exploring some of the mechanisms by which it operates. It introduces the concept and practices of ‘tacking’ as a frame for examining the creative processes of navigation and improvisation through which people approach and reflect on the irregularities and uncertainties of their everyday rounds, enacted or otherwise narrated as spatial biography – lives conceived in mobile-spatial terms. ‘Tacking’ also travels beyond this frame of reference, i.e. it is ‘good (...) to think with’ across different substantive contexts of social interaction. Tacking suggests ongoing adjustment and modification that respond to shifting circumstances and may create new facts on the ground, which elicit further adjustments. (shrink)

The office of the United nations high commissioner for human rights (OHCHR): serious human rights abuses against the Uyghur people in Xinjiang, China Very close to midnight on the 31 August 2022, minutes before Michelle Bachelet’s four-year term as UN Commissioner for Human Rights came to an end, her office finally succeeded in publishing her long-delayed report into serious human rights violations in the Xinjiang province in China. According to The Guardian newspaper, papers leaked in July of the same year (...) showed sustained efforts by China to prevent the report’s release, and Bachelet has subsequently spoken of the intense pressure she was put under by the Chinese to prevent the report’s publication. 1 The report is sobering. 2 It is explicit that the Peoples’ Republic of China (PRC) has committed systematic violations of fundamental human rights against the Uyghur and other Turkic Muslim minorities in Xinjiang... (shrink)

This paper traces the unspoken, implicit white racial logic of the brain disease model of addiction, which is based on seemingly universal, disembodied brains devoid of social or environmental influences. In the United States, this implicit white logic led to “context-free” neuroscience that made the social hierarchies of addiction and its consequences invisible to, and thus exacerbated by, national policies on opioids. The brain disease model of addiction was selectively deployed among the white middle-class population that had long accessed narcotics (...) and pharmaceutical treatments for narcotics disorders from biomedical clinics, as opposed to from illegal sources subject to law enforcement. In turn, new treatments for opioid addiction were racially marketed to the same white clientele to which newly patented opioid analgesics were marketed, tapping into a circumscribed but highly lucrative consumer base that has long benefited from a legally protected, racially segregated safe space for white narcotics consumption. The connecting thread for the contemporary white opioid “crisis,” therefore, is white race as a ghost variable in addiction neuroscience and in its pharmaceutical and biotechnological translation. (shrink)

Only when students feel engaged both socially and academically can schools and teachers lay the groundwork to motivate achievement. This volume, the fifth in the _Harvard Education Letter _Spotlight series, brings together fifteen seminal articles that examine research and practice on these complex and interrelated issues. Foreword by Sam M. Intrator, associate professor of education and of the Program in Urban Studies at Smith College and codirector of Smith’s Urban Education Initiative. Contributors include: Michael Bitz, James Paul Gee, Pedro A. (...) Noguera, Laura Pappano, George Sugai, and Richard Weissbourd. (shrink)

This volume maps the areas of ethical concern in the debate regarding the governance of genetic information, and suggests alternative ethical frameworks and models of regulation in order to inform its restructuring. Genetic governance is at the heart of medical and scientific developments, and is connected to global exploitation, issues of commodification, commercialisation and ownership, the concepts of property and intellectual property and concerns about individual and communal identity. Thus the decisions that are made in the next few years about (...) appropriate models of genetic governance will have knock-on effects for other areas of governance. In short the final answer to 'Who Decides?' in the context of genetic governance will fundamentally shape the ethical constructs of individuals and their networks and relationships in the public sphere. (shrink)

In Denmark, teaching the famous fairy tales of Hans Christian Andersen poses a challenge in primary education because cultural heritage status and oversimplified readings make it difficult to engage students in authentic readings. A strategy could be to use philosophical dialogues from the tradition of philosophy with children because this is a student-centred approach to teaching where students explore questions and ideas together, and where the teacher assumes the role not as authority, but as facilitator of the dialogue. This kind (...) of dialogic teaching has been encouraged as especially suitable for literary education where teachers aim to engage students in reading the literature with an open mind. However, this article presents a case study that gives reason for caution. It analyses materials for philosophical dialogues on Hans Christian Andersen’s fairy tales and concludes that despite the dialogic ideals, the teaching design caves in to the weight of the cultural and historical impact of Hans Christian Andersen and his work. (shrink)