Since early 2014, i have studied what life is like for staff in a mental health sanatorium at a Ghanaian prayer camp. I have traveled to the camp on six occasions to observe its rhythms and routines and interview staff about their work. What follows is an informal reflection on the role of prayer camps as a source of mental health care in Ghana. The text is based on my experience conducting the research at the camp, rather than a formal (...) reporting of results. As such, I make minimal references to theoretical frameworks and previous literature and instead have relied on my own field notes and recreated conversations I had with one staff member in particular.Despite longstanding records of human rights abuses, many... (shrink)
According to grounded cognition, words whose semantics contain sensory-motor features activate sensory-motor simulations, which, in turn, interact with spatial responses to produce grounded congruency effects. Growing evidence shows these congruency effects do not always occur, suggesting instead that the grounded features in a word's meaning do not become active automatically across contexts. Researchers sometimes use this as evidence that concepts are not grounded, further concluding that grounded information is peripheral to the amodal cores of concepts. We first review broad evidence (...) that words do not have conceptual cores, and that even the most salient features in a word's meaning are not activated automatically. Then, in three experiments, we provide further evidence that grounded congruency effects rely dynamically on context, with the central grounded features in a concept becoming active only when the current context makes them salient. Even when grounded features are central to a word's meaning, their activation depends on task conditions. (shrink)
Many health care organizations made public commitments to become antiracist in the wake of George Floyd's murder. These actions raise questions about the appropriateness of health care's engagement in racial justice and social justice movements generally. We argue that health care organizations can be usefully thought of as having two roles: a functional role to care for the sick and a meta‐role as an organizational citizen. Fulfilling the role of citizen may require participating in the pursuit of social justice, including (...) efforts to achieve racial equity. The demands of these two roles will need to be balanced, but the role of organizational citizen has been largely ignored and merits serious attention. (shrink)
This essay summarizes key insights across the essays in the Hastings Center Report's special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility of seeking to win trust without being trustworthy, building and borrowing trust as distinct strategies, and challenges to trustworthiness (...) posed by the contingent nature of science. Together, these insights stand to advance an area of research that we believe has been historically stymied by conceptual confusion and a long‐standing insistence on treating trust as a purely instrumental good. (shrink)
For global health academics and practitioners, it can feel as though we are living in a tyranny of partnerships. The primary trappings of professional success in global health—funding and publications—increasingly rely on the presence or absence of institutional partnerships. Funders often require letters of support from collaborators, and the literature routinely lauds partnerships as the "secret sauce" necessary to solve intractable problems. Commonly, the term describes relationships between entities in the Global North and the Global South, serving as a euphemism (...) for relationships that, at their core, are premised on a transfer of resources from the former to the latter. Many partnerships... (shrink)
The health policy community has a growing interest in the impact of nonmedical determinants of health, such as housing, nutrition, and social supports, on both health outcomes and costs. This interest has been spurred by the Affordable Care Act’s emphasis on prevention, Robert Wood Johnson’s grant‐making focus on a Culture of Health, and an uptick of research demonstrating the potential returns to health care from investments in social services. Much of this policy‐making, grant making, and research has focused on older (...) Americans.The direct policy implications of this strategy can be elusive. It has become clear that more than medicine will be necessary to improve older Americans’ health status. Real improvement likely requires the development of additional social service offerings, including housing that is accessible to people with disabilities, Meals on Wheels‐type nutrition supports, and transportation. But who should bear the costs and control the finances associated with these programs? In this essay, I explore the question of how policy‐makers should consider financing nonmedical investments in older Americans’ health. As the reader will recognize, I stop short of arguing for what will work. Rather, I identify the strands of an emerging strategy—namely, for health care dollars to be diverted into social service programming—and offer several cautions. It may be that policy‐makers still wish to continue down this path, but my hope is that this essay will allow them to so with greater attention to the risks and unintended consequences of that strategy. (shrink)
David Dranove and Lawton Burn’s new collaboration Big Med: Megaproviders and the High Cost of Health Care in America provides readers with a comprehensive tutorial on consolidation in United States healthcare markets over the past 40 years. Although the book is most explicitly aimed at those who look around and wonder how we arrived at a healthcare landscape dominated by giants, anyone with a serious interest in the prices of U.S. healthcare will want to have this rigorous and timely treatment (...) on their bookshelf. (shrink)
In response to Casasanto, Brookshire, and Ivry, we address four points: First, we engaged in conceptual replications of Brookshire, Casasanto, and Ivry, not direct replications. Second, we did not question the validity of Brookshire et al.'s results, nor the similar findings of other researchers, but instead explained divergent findings within an integrated theoretical framework. Third, challenges to the construct of automaticity, including ours, were widespread, long before Brookshire et al.'s article. Fourth, the planned comparisons that we reported tested our theoretical (...) claims and offered strong evidence for them. (shrink)
As the cesarean rate rises in the United States, it is sometimes hailed as a move toward increased safety or increased autonomy. But the industrialization of birth may have consequences which actually decrease women’s autonomy and strip choices away.
We investigate whether the disclosure of a firm’s decision to organize as a benefit corporation (BC) rather than a traditional C corporation (CC) influences investors. We survey 136 investors and 57 MBA students and find that they expect BCs to attain higher future corporate social responsibility (CSR) than CCs even when both have equal CSR ratings. Approximately one third of our sample prefers to invest in BCs when CCs have greater financial returns, indicating a willingness by some investors to sacrifice (...) personal financial gain for social good. Our results suggest that investors weight the information contained in BC disclosures as reliable and value-relevant in their investment decisions. We extend the CSR disclosure literature by indicating how investors weight this new type of CSR information, which may affect how BCs fare as publicly traded companies. (shrink)
Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)
DeStefano, Oey, Brockbank, and Vul explore interdisciplinary collaboration using data‐driven measures of research topics and co‐authorship, constructed from a rich dataset of over 11,000 Cogsci conference papers. Findings suggest the cognitive science research community has become increasingly integrated in the last 19 years.
A substantial portion of the developed world's population is increasingly dependent on machines to make their way in the everyday world. For certain privileged groups, computers, cell phones, PDAs, Blackberries, and IPODs, all permitting the faster processing of information, are commonplace. In these populations, even exercise can be automated as persons try to achieve good physical fitness by riding stationary bikes, running on treadmills, and working out on cross-trainers that send information about performance and heart rate.
Mechanical devices implanted in the body present implications for broad themes in religious thought and experience, including the nature and destiny of the human person, the significance of a person's embodied experience, including the experiences of pain and suffering, the person's relationship to ultimate reality, the divine or the sacred, and the vocation of medicine. Community-constituting convictions and narratives inform the method and content of reasoning about such conceptual questions as whether a moral line should be drawn between therapeutic or (...) enhancement interventions and/or between somatic and neural/cognitive interventions. By attending to these broader community-forming concepts, it is possible to identify three general orienting themes in religious perspectives on incorporated mechanical devices, which we shall designate as perspectives of “appropriation,” “ambivalence,” and “resistance.”. (shrink)
Despite sustained philosophical attention, no theory of humor claims general acceptance. Drawing on the resources provided by intentional systems theory, this article first outlines an approach to investigating humor based on the idea of a comic stance, then sketches the Dismissal Theory of Humor that has resulted from pursuing that approach. According to the DTH, humor manifests in cases where the future-directed significance of anticipatory failures is dismissed. Mirth, on this view, is the reward people get for declining to update (...) predictive representational schemata in ways that maximize their future-oriented value. The theory aims to provide a plausible account of the role of humor in human mental and social life, but it also aims to be empirically vulnerable, and to generate testable predictions about how the comic stance may actually be undergirded by cognitive architectures. (shrink)
This article presents data from the Growing up with Media study related to the implementation of a risk reduction protocol that resulted in three groups of youth: low-risk youth (no flags), youth flagged because of violence involvement and not clinically referred; and flagged youth who were referred to a team clinician due to additional risk considerations. Data are from 3,979 US youth 14–15 years of age recruited through social media between October 2018-August 2019. Four in ten youth were flagged for (...) review. Findings suggest that this methodology of identifying and reviewing cases appears to be working as intended: Not only did referred youth have more flags than non-referred youth, but post-hoc analyses suggested that these youth also had higher rates of psychosocial problems (e.g., non-victimization adversity, substance use, and depressed mood). The implementation of a risk reduction protocol such as the one described in this article adds a layer of human subject protection beyond the more standard list of websites and hotlines provided to all participants in most studies. This protocol leads the way for future studies to recreate a similar process to address concerning responses collected from survey research. (shrink)
This article is an attempt to develop a measure of ethical sensitivity to racial and gender intolerance that occurs in schools. Acts of intolerance that indicate ethically insensitive behaviors in American schools were identified and tied to existing professional ethical codes developed by school-based professional organizations. The Racial Ethical Sensitivity Test consists of 5 scenarios that portray acts of racial intolerance and ethical insensitivity. Participants viewed 2 videotaped scenarios and then responded to a semistructured interview protocol adapted from Bebeau and (...) Rest. After a 2-week interval, this procedure was repeated. Stability of the REST across time was determined by using the overall test-retest coefficient. Internal as well as interrater consistency was also calculated for each scenario. Overall findings indicate promise for the REST as a reliable measure to assess racial and ethnic sensitivity. (shrink)
Background Financial relationships between physicians and industry are extensive and public reporting of industry payments to physicians is now occurring. Our objectives were to describe physician recipients of large total payments from these seven companies, and to examine discrepancies between these payments and conflict of interest (COI) disclosures in authors’ concurrent publications. Methods The investigative journalism organization, ProPublica, compiled the Dollars for Docs database of payments to individuals from publically available data from seven US pharmaceutical companies during the period 2009 (...) to 2010. We examined the cohort of 373 physicians in this database who each received USD $100,000 or more in the reporting period 2009 to 2010. Results These physicians received a total of $52,600,624 during this period (mean payment per physician $141,020). The predominant specialties were internal medicine and psychiatry. 147 of these physicians authored a total of 134 publications in the first quarter of 2011 and 77% (103) of these publications provided a COI disclosure. 69% of the 103 publications did not contain disclosures of the payment listed in the Dollars for Docs database. Conclusions With increased public reporting of industry payments to physicians, it is apparent that large sums are being paid for services such as consulting and peer education. In over two-thirds of publications where COI disclosures were provided, the disclosures by physician authors did not include industry payments that were documented in the Dollars for Docs database. (shrink)
Answering important public health questions often requires collection of sensitive information about individuals. For example, our understanding of how HIV is transmitted and how to prevent it only came about with people's willingness to share information about their sexual and drug-using behaviors. Given the scientific need for sensitive, personal information, researchers have a corresponding ethical and legal obligation to maintain the confidentiality of data they collect and typically promise in consent forms to restrict access to it and not to publish (...) identifying data.The interests of others, however, can threaten researchers' promises of confidentiality when legal demands are made to access research data. In some cases, the subject of the litigation is tightly connected to the research questions, and litigants' interest in the data is not surprising. Researchers conducting studies on tobacco or occupational or other chemical exposures, for example, are relatively frequent targets of subpoenas. (shrink)
This handbook provides an overview of the research on the changing nature of work and workers by marshalling interdisciplinary research to summarize the empirical evidence and provide documentation of what has actually changed. Connections are explored between the changing nature of work and macro-level trends in technological change, income inequality, global labor markets, labor unions, organizational forms, and skill polarization, among others. This edited volume also reviews evidence for changes in workers, including generational change, that has accumulated across domains. Based (...) on documented changes in work and worker behavior, the handbook derives implications for a range of management functions, such as selection, performance management, leadership, workplace ethics, and employee well-being. This evaluation of the extent of changes and their impact gives guidance on what best practices should be put in place to harness these developments to achieve success. (shrink)
Everyone, it seems, is talking and arguing about Evidence-Based Practice. Those therapies and assessments designated as EBP increasingly determine what is taught, researched, and reimbursed in health care. But exactly what is it, and how do you do it? The second edition of Clinician's Guide to Evidence-Based Practices is the concise, practitioner-friendly guide to applying EBPs in mental health. Step-by-step it explains how to conduct the entire EBP process-asking the right questions, accessing the best available research, appraising the research, translating (...) that research into practice, integrating that research with clinician expertise and patient characteristics, evaluating the entire enterprise, attending to the ethical considerations, and when done, moving the EBP process forward by teaching and disseminating it. This book will help you:. Formulate useful questions that research can address. Search the research literature efficiently for best practices. Make sense out of the research morass, sifting wheat from chaff. Incorporate patient values and diversity into the selection of EBP. Blend clinician expertise with the research evidence. Translate empirical research into practice. Ensure that your clients receive effective, research-supported services. Infuse the EBP process into your organizational setting and training methods. Identify and integrate ethics in the context of EBP Coauthored by a distinguished quartet of clinicians, researchers, and a health care librarian, the Clinician's Guide has become the classic for graduate students and busy professionals mastering EBP. ". (shrink)