Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

The legacy of Nisbett and Wilson’s classic article, Telling More Than We Can Know: Verbal Reports on Mental Processes , is mixed. It is perhaps the most cited article in the recent history of consciousness studies, yet no empirical research program currently exists that continues the work presented in the article. To remedy this, we have introduced an experimental paradigm we call choice blindness [Johansson, P., Hall, L., Sikström, S., & Olsson, A. . Failure to detect mismatches between intention and (...) outcome in a simple decision task. Science, 310, 116–119.]. In the choice blindness paradigm participants fail to notice mismatches between their intended choice and the outcome they are presented with, while nevertheless offering introspectively derived reasons for why they chose the way they did. In this article, we use word-frequency and latent semantic analysis to investigate a corpus of introspective reports collected within the choice blindness paradigm. We contrast the introspective reasons given in non-manipulated vs. manipulated trials, but find very few differences between these two groups of reports. (shrink)

BackgroundThe return of genetics and genomics research results has been a subject of ongoing global debate. Such feedback is ethically desirable to update participants on research findings particularly those deemed clinically significant. Although there is limited literature, debate continues in African on what constitutes appropriate practice regarding the return of results for genetics and genomics research. This study explored perspectives and ethical considerations of Ugandan genomics researchers regarding the return of genetics and genomics research results.MethodsThis was a qualitative study that (...) employed in-depth interviews. Thirty participants were purposively selected based on their expertise as genomics researchers in Uganda. Data were analysed through content analysis along the main themes of the study using a comprehensive thematic matrix, to identify common patterns arising from the narratives. NVivo software 12 was used to support data analysis.ResultsThe return of genetics and genomics research results was generally acceptable to researchers, and some indicated that they had previously returned individual or aggregate results to participants and communities. The main reasons cited for sharing research results with participants included their clinical utility, actionability and overall benefit to society. Ethical considerations for appropriate return of results included a need for effective community engagement, genetic counselling prior to disclosure of the results, adequate informed consent, and proper assessment of the implications of, or consequences of returning of results. However, the approaches to return of results were perceived as unstandardized due to the lack of appropriate regulatory frameworks.ConclusionsThe return of genetic and genomic research results is generally acceptable to researchers despite the lack of appropriate regulatory frameworks. Ethical considerations for return of genetics and genomics research results are highly divergent, hence the need for national ethical guidelines to appropriately regulate the practice. (shrink)

A reply to a comment by Paul Tappenden (BJPS 59 (2008) pp. 307-314) on S. Saunders and D. Wallace, "Branching and Uncertainty" (BJPS 59 (2008) pp. 298-306).

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to (...) inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

Political candidates often believe they must focus their campaign efforts on a small number of swing voters open for ideological change. Based on the wisdom of opinion polls, this might seem like a good idea. But do most voters really hold their political attitudes so firmly that they are unreceptive to persuasion? We tested this premise during the most recent general election in Sweden, in which a left- and a right-wing coalition were locked in a close race. We asked our (...) participants to state their voter intention, and presented them with a political survey of wedge issues between the two coalitions. Using a sleight-of-hand we then altered their replies to place them in the opposite political camp, and invited them to reason about their attitudes on the manipulated issues. Finally, we summarized their survey score, and asked for their voter intention again. The results showed that no more than 22% of the manipulated replies were detected, and that a full 92% of the participants accepted and endorsed our altered political survey score. Furthermore, the final voter intention question indicated that as many as 48% (69.2%) were willing to consider a left-right coalition shift. This can be contrasted with the established polls tracking the Swedish election, which registered maximally 10% voters open for a swing. Our results indicate that political attitudes and partisan divisions can be far more flexible than what is assumed by the polls, and that people can reason about the factual issues of the campaign with considerable openness to change. (shrink)

Process models are valuable conceptual tools to help in understanding the approaches to value creation in social enterprises. This teaching case illustrates the application of a process model about creating, building, and sustaining a social enterprise with a mission to provide clean water to communities in need. The social enterprise generates revenue in support of community water projects and works with community stakeholders in different locations throughout the world to provide sustainable clean water solutions. The case study uses primary data (...) from semi-structured interviews, direct observations of a community project, and archival sources to demonstrate application of the process model. The study shows how the social enterprise developed as a promising idea; was implemented through an operating model with resources to support social impact; and continues to build and evolve while guided by the social mission. The paper concludes with a discussion and teaching note on ways to use the case for educational purposes to enhance learning about the social value creation process. (shrink)

Eigenfeatures are created by the principal component approach (PCA) used on objects described by a low-level code (i.e., pixels, Gabor jets). We suggest that eigenfeatures act like the flexible features described by Schyns et al. They are particularly suited for face processing and give rise to class-specific effects such as the other-race effect. The PCA approach can be modified to accommodate top-down constraints.

The neural basis of progress monitoring has received relatively little attention compared to other sub-processes that are involved in goal directed behavior such as motor control and response inhibition. Studies of error-monitoring have identified the dorsal anterior cingulate cortex (dACC) as a structure that is sensitive to conflict detection, and triggers corrective action. However, monitoring goal progress involves monitoring correct as well as erroneous events over a period of time. In the present research, 20 healthy participants underwent fMRI while playing (...) a game that involved monitoring progress towards either a numerical or a visuo-spatial target. The findings confirmed the role of the dACC in detecting situations in which the current state may conflict with the desired state, but also revealed activations in the frontal and parietal regions, pointing to the involvement of processes such as attention and working memory in monitoring progress over time. In addition, activation of the cuneus was associated with monitoring progress towards a specific target presented in the visual modality. This is the first time that activation in this region has been linked to higher-order processing of goal-relevant information, rather than low-level anticipation of visual stimuli. Taken together, these findings identify the neural substrates involved in monitoring progress over time, and how these extend beyond activations observed in conflict and error monitoring. (shrink)

This article presents results from a multidisciplinary research project on the integration and transfer of language knowledge into robots as an empirical paradigm for the study of language development in both humans and humanoid robots. Within the framework of human linguistic and cognitive development, we focus on how three central types of learning interact and co-develop: individual learning about one's own embodiment and the environment, social learning (learning from others), and learning of linguistic capability. Our primary concern is how these (...) capabilities can scaffold each other's development in a continuous feedback cycle as their interactions yield increasingly sophisticated competencies in the agent's capacity to interact with others and manipulate its world. Experimental results are summarized in relation to milestones in human linguistic and cognitive development and show that the mutual scaffolding of social learning, individual learning, and linguistic capabilities creates the context, conditions, and requisites for learning in each domain. Challenges and insights identified as a result of this research program are discussed with regard to possible and actual contributions to cognitive science and language ontogeny. In conclusion, directions for future work are suggested that continue to develop this approach toward an integrated framework for understanding these mutually scaffolding processes as a basis for language development in humans and robots. (shrink)

A distorted representation of one's own body is a diagnostic criterion and core psychopathology of both anorexia nervosa (AN) and bulimia nervosa (BN). Despite recent technical advances in research, it is still unknown whether this body image disturbance is characterized by body dissatisfaction and a low ideal weight and/or includes a distorted perception or processing of body size. In this article, we provide an update and meta-analysis of 42 articles summarizing measures and results for body size estimation (BSE) from 926 (...) individuals with AN, 536 individuals with BN and 1920 controls. We replicate findings that individuals with AN and BN overestimate their body size as compared to controls (ES= 0.63). Our meta-regression shows that metric methods (BSE by direct or indirect spatial measures) yield larger effect sizes than depictive methods (BSE by evaluating distorted pictures), and that effect sizes are larger for patients with BN than for patients with AN. To interpret these results, we suggest a revised theoretical framework for BSE that accounts for differences between depictive and metric BSE methods regarding the underlying body representations (conceptual vs. perceptual, implicit vs. explicit). We also discuss clinical implications and argue for the importance of multimethod approaches to investigate body image disturbance. (shrink)

Background The globalization of clinical research in the last two decades has led to a significant increase in the volume of clinical research in developing countries. As of 2016, Uganda was the third largest destination for clinical trials in Africa. This requires adequate capacity and systems to facilitate ethical practice. Methods This was a retrospective study involving review of laws, guidelines, policies and records from 1896 to date. Results Modern medicine evolved from 1896 and by the time of Uganda's independence (...) in 1962, a 1500 bed national referral hospital was in place and a fully‐fledged medical school was established at the Makerere University. As the practice of medicine evolved in the country, so did medical research that addressed priority health issues. The growth in modern medicine was not matched with development of research infrastructure and regulatory systems. The first documented regulation of research activities was in 1970 while the first research ethics committee established in 1986 was to facilitate review of research related to the HIV/AIDs pandemic. In 1990 an Act of Parliament was passed to facilitate development and implementation of policies, hence the development of the national guidelines in 1997, training, establishment and accreditation of research ethics committees, conferences and research site monitoring. Conclusion Over the past 120 years, the implementation and structural aspects of research ethics in Uganda have evolved through 70 years of no regulation, followed by 30 years of rudimentary regulation while the last 20 years have shown significant growth in the regulatory system associated with supportive laws, institutionalization of regulatory and training processes. (shrink)

Research Ethics, Volume 18, Issue 3, Page 193-209, July 2022. This study aimed to explore experiences and practices of key research team members in obtaining informed consent for pharmacogenetics research and to identify the approaches used for enhancing understanding during the consenting process. Data collection involved 15 qualitative, in-depth interviews with key researchers who were involved in obtaining informed consent from HIV infected individuals in Uganda for participation in pharmacogenetic clinical trials. The study explored two prominent themes: approaches used to (...) convey information and enhance research participants’ understanding and challenges faced during the consenting process. Several barriers and facilitators for obtaining consent were identified. Innovative and potentially effective consenting strategies were identified in this study that should be studied and independently verified. (shrink)

BackgroundInvolvement of adolescent girls in biomedical HIV research is essential to better understand efficacy and safety of new prevention interventions in this key population at high risk of HIV infection. However, there are many ethical issues to consider prior to engaging them in pivotal biomedical research. In Uganda, 16–17-year-old adolescents can access sexual and reproductive health services including for HIV or other sexually transmitted infections, contraception, and antenatal care without parental consent. In contrast, participation in HIV prevention research involving investigational (...) new drugs requires adolescents to have parental or guardian consent. Thus, privacy and confidentiality concerns may deter adolescent participation. We describe community perspectives on ethical considerations for involving adolescent girls in the MTN 034 study in Uganda.MethodsFrom August 2017 to March 2018, we held five stakeholder engagement meetings in preparation for the MTN 034 study in Kampala, Uganda (NCT03593655): two with 140 community representatives, two with 125 adolescents, and one with 50 adolescents and parents. Discussions were moderated by the study team. Proceedings were documented by notetakers. Summary notes described community perspectives of adolescent participation in HIV research including convergent, divergent or minority views, challenges, and proposed solutions.ResultsMost community members perceived parental or guardian consent as a principal barrier to study participation due to concerns about adolescent disclosure of pre-marital sex, which is a cultural taboo. Of 125 adolescent participants, 119 (95%) feared inadvertent disclosure of sexual activity to their parents. Community stakeholders identified the following critical considerations for ethical involvement of adolescents in HIV biomedical research: (1) involving key stakeholders in recruitment, (2) ensuring confidentiality of sensitive information about adolescent sexual activity, (3) informing adolescents about information to be disclosed to parents or guardians, (4) offering youth friendly services by appropriately trained staff, and (5) partnering with community youth organizations to maximize recruitment and retention.ConclusionsStakeholder engagement with diverse community representatives prior to conducting adolescent HIV prevention research is critical to collectively shaping the research agenda, successfully recruiting and retaining adolescents in HIV clinical trials and identifying practical strategies to ensure high ethical standards during trial implementation. (shrink)

Bibliographic records published by the British Education Index (BEI) between 1957 and 2000 are analysed in the context of a history of the BEI's changing presentation of information about the field. The value of frequency counts for BEI subject terms is discussed, in relation to their potential for revealing trends in the fields of educational studies and information management.

Lecture was the most prevalent teaching style in the colleges and universities we attended. Hired as a lecturer by a local university, the lead author choose to approach teaching based on two principles: first to teach the way she preferred to learn, which is in groups, and second to be both a teacher and a fellow learner.Ten adult practitioners were enrolled in the graduate course Iisted as “The Trainer/Manager as Coach.” This article includes their experiences along with those of the (...) instructor / facilitator.Critical thinking and critical self-reflection are ways to help participants explore assumptions about coaching and particularly about their roles as coaches in the workplace. Critical thinking is a means of examining assumptions by identifying patterns in ourselves and in others-patterns that influence our thinking and subsequent actions. Critical self-reflection is “challenging the vaIidity of presuppositions in prior learning” (Mezirow, 1990, p. 14). Our purpose together was to develop critical thinking skills and practice critical self-reflection as they related to coaching within our practices.Participants used time between class sessions for integration of learning and self-reflection on their own assumptive worlds. Students participated in electronic dialogue and in action research. The online dialogue provided opportunities to share experiences from our places of work. It further served as a collaborative means for building a knowledge base from onIine discussion of coaching literature.Action research is a means of studying one’s practice for the purpose of improvement. Students applied an action research model to a workplace problem that involved them in the role of coach.The results were transformational for all co-Iearners. Changes took pIace in our approaches to coaching. Changes in the focus of coaching, from focusing on the coach to focusing on the learner, are prevalent. (shrink)

Book reviewed in this article: The Custom‐Made Child? Women‐Centered Perspectives. Helen B. Holmes, Betty B. Hoskins, Michael Gross, editors.

Patient-centered pharmacy practice involves increased pharmacist engagement in patient care. This increased involvement can sometimes require diverse decision-making when handling various situations, ranging from simple matters to major ethical dilemmas. There is literature about pharmacy ethics in developed Western countries. However, little is known about pharmacists’ practices in many developing countries. For example, there is a paucity of research conducted in the area of pharmacy ethics in Jordan. This study aimed to explore the manner in which ethical dilemmas were handled (...) by Jordanian pharmacists, the resources used and their attitudes towards them. Semi-structured, face to face interviews were carried out with 30 Jordanian registered pharmacists. The transcribed interviews were thematically analysed for emerging themes. Four major themes were identified: legal practice; familiarity with the code of ethics; personal judgement, cultural and religious values; and Experience. Findings showed that ethical decision-making in pharmacy practice in Jordan was decisively influenced by pharmacists’ personal moral values, legal requirements and managed by exercising common sense and experience. This pointed to gaps in Jordanian pharmacists’ understanding and application of basic principles of pharmacy ethics and highlighted the need for professional ethics training, incorporating pharmacy ethics courses in pharmacy undergraduate curricula, as well as professional development courses. This study highlighted that paternalism, personal values and legal obligations were major drivers influencing decision-making processes of Jordanian pharmacists. Findings also highlighted an inclination towards lack of respect for patient autonomy. This illuminated the need for increasing pharmacists’ literacy in professional ethics. (shrink)

PurposeIn Western society, the measurement of weight is prioritized over a person’s bodily experience. Hermeneutic philosopher Gadamer warned against the emphasis on measurement, rather than experience, in the medical sciences. An examination of the complexity of the experience of weight provides the opportunity to shift focus from quantifying the connection between health and weight to the experience of the person being weighed.MethodsThis qualitative hermeneutic study aims to understand people’s experiences of weight from the interviews of professionals and lay experts. Interviews (...) were analyzed using an interpretive hermeneutic method.ResultsThe interviews revealed that weight was experienced as a number imbued with meaning and bias, as a number that could be manipulated, and as a constant and anticipated bodily change. Weight change was expected and often unwelcomed, despite weight being a quality of the body that is always in flux. External measures of weight meant to monitor wellness and health inadvertently became an unhealthy fixation that prevented some participants from fully participating in life events and appreciating the stages their bodies were in.ConclusionWeight change is a necessary condition of being human, and bodies are and will be constantly changing. To achieve health and harmony, one must fit together the acceptance of change and their bodily experience of weight. It is often the preoccupation with weight, not weight itself, that gets in the way of living. (shrink)

This is a description of an avian-shaped feature that rests below a network of cellular structures found on a mound within the Argyre Basin of Mars in Mars Global Surveyor image M14-02185, acquired on April 30, 2000, and released to the public on April 4, 2001. The area examined is located near 48.0° South, 55.1° West. The formation is approximately 2,400 meters long from the tip of its beak to the tip of its farthest tail feather. There is a minimum (...) of six different variations in appearance of the surface material over this small area. Utilizing the public targeting request form provided on the Mars Global Surveyor (MGS) website, co-author Miller secured a second image of the area that was obtained on July 3, 2006, showing this feature under different conditions S20-00165. The new image was then released to the public on August 11, 2006. A third image of the formation identified as MGS S13-01480 was acquired on December 15, 2005, and although officially processed on June 20, 2006, it was not made available to the public until August 22, 2009, on NASA’s Planetary Data System (PDS) website. All three of the MGS images reveal defining aspects of this avian feature, including a head, beak, body, eye, leg, foot, toes, wing, and feathers. When taken together, these components induce the visual impression of an avian-shaped formation that exhibits a unique set of proportional features. Adjoining this formation is a composite of complex cellular features that form a compartmentalized infrastructure. The three authors who are veterinarians provide a critical analysis of the avian features, and the geologist and geoscientist authors examine natural mechanisms that could contribute to the formation of this feature. An extensive search of comparable regions within and beyond the area of the Argyre Basin was conducted. A list of these sites is provided, and terrestrial comparisons are also offered. (shrink)

Contexte : Dans les systèmes de santé universitaires complexes, les projets d’amélioration de la qualité (AQ) destinés à améliorer les soins et l’apprentissage prolifèrent, mais il existe des différences considérables quant à la manière dont ces projets sont supervisés sur le plan éthique, voire même s’ils le sont. À la suite d’un volume élevé de projets soumis à l’un de nos comités d’éthique de la recherche (CER), mais considérés comme n’étant pas de la recherche et donc non éligibles à un (...) examen, des questions ont commencé à se poser au sein de notre organisation sur la manière dont les dimensions éthiques des projets d’AQ pourraient être évaluées et sur les approbations institutionnelles qui pourraient être nécessaires pour garantir la conformité avec les normes émergentes. Méthodes : Une enquête environnementale à méthodes mixtes a conduit à une analyse quantitative rétrospective des projets d’AQ de notre organisation, associée à des consultations qualitatives approfondies avec le personnel, les médecins et les apprenants de l’ensemble de notre réseau de santé. Les exemptions de CER ont été analysées à l’aide de diagrammes d’exécution afin d’évaluer les volumes de base des projets d’AQ, et des analyses thématiques ont été menées sur les notes de terrain de 133 consultations avec les parties prenantes. Résultats : Au cours d’une période de 34 mois, 117 lettres d’exemption du CER ont été émises pour des projets d’AQ. Les consultations ont mis en évidence la nécessité d’un processus d’évaluation éthique clairement défini pour les projets d’AQ, de structures de gouvernance appropriées et de possibilités d’identifier et d’atténuer les risques. Les personnes interrogées ont également évoqué l’impératif éthique de mener des initiatives d’AQ. Le présent document explique comment ces thèmes ont contribué à l’élaboration et à la mise en place de notre comité d’examen de l’amélioration de la qualité (CEAQ). Conclusion : Depuis 2020, plus de 840 projets ont été examinés par notre CEAQ, dans le but d’atténuer les risques pour les patients, le personnel et les équipes de projet d’AQ dans l’ensemble de l’UHN. (shrink)

It is often suggested that during development the brain barriers are immature. This argument stems from teleological interpretations and experimental observations of the high protein concentrations in fetal cerebrospinal fluid (CSF) and decreases in apparent permeability of passive markers during development. We argue that the developmental blood–CSF barrier restricts the passage of lipid‐insoluble molecules by the same mechanism as in the adult (tight junctions) rendering the paracellular pathway an unlikely route of entry. Instead, we suggest that both protein and passive (...) markers are transferred across the epithelium through a transcellular route. We propose that changes in volume of distribution can largely explain the decrease in apparent permeability for passive markers and that developmentally regulated cellular transfer explains changes in CSF protein concentrations. The blood–CSF tight junctions are functionally mature from very early in development, and it appears that transfer from blood into embryonic brain occurs predominately via CSF rather than the vasculature. BioEssays 30:237–248, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

MENDENHALL TJ, BERGE JM, HARPER P, GREENCROW B, LITTLEWALKER N, WHITEEAGLE S and BROWNOWL S. Nursing Inquiry 2010; 17: 359–372 The Family Education Diabetes Series (FEDS): community‐based participatory research with a midwestern American Indian communityIndigenous people around the globe tend to struggle with poorer health and well‐being than their non‐indigenous counterparts. One area that this is especially evident is in the epidemic of diabetes in North America’s American Indians (AIs) – who evidence higher prevalence rates and concomitant disease‐related complications than (...) any other racial/ethnic group. As researchers and AI communities work together to transcend conventional top‐down, service‐delivery approaches to care, community‐based participatory research is beginning to show promise as a way to partner contemporary biomedical knowledge with the lived‐experience, wisdom, and customs of Indigenous people. This study describes the Family Education Diabetes Series (FEDS) as an example of such effort, and highlights pilot findings assessing its value and impact across key diabetes‐relevant variables. Following 36 intervention participants across baseline, 3‐month, and 6‐month time periods, data show significant improvements in weight, blood pressure, and metabolic control (A1c). Strengths and limitations of this investigation are presented, along with suggestions about how to further advance and empirically test the work across other Indigenous communities. (shrink)

This project seeks to highlight the benefits of the implementation and management of the teaching digital portfolio. In today's world full of technology and tools that facilitate daily activities, education and its various processes must also embrace the digital tools available and make them the basis for any innovation and improvement process. The teaching portfolio in physics has long been the means by which teachers have organized the processes, evidence, and other results of educational work. Nowadays, all that range of (...) evidence and productions, which signify the achievement and advances in each group of students, has been able to be integrated into technology. (shrink)

There is an inextricable link between cultural and clinical safety. In Australia high‐profile Aboriginal deaths in custody, publicised institutional racism in health services and the international Black Lives Matter movement have cemented momentum to ensure culturally safe care. However, racism within health professionals and health professional students remains a barrier to increasing the number of Aboriginal and Torres Strait Islander Health professionals. The Australian Health Practitioner Regulation Agency's Aboriginal and Torres Strait Islander Health Strategy's objective to ‘eliminate racism from the (...) health system’, and the recent adoption of the Aboriginal and Torres Strait Islander peoples led cultural safety definition, has instigated systems level reflections on decolonising practice. This article explores cultural safety as the conceptual antithesis to racism, examining its origins, and contemporary evolution led by Aboriginal and Torres Strait Islander peoples in Australia, including its development in curriculum innovation. The application of cultural safety is explored using in‐depth reflection, and the crucial development of integrating critical consciousness theory, as a precursor to culturally safe practice, is discussed. Novel approaches to university curriculum development are needed to facilitate culturally safe and decolonised learning and working environments, including the key considerations of non‐Indigenous allyship and collaborative curriculum innovations and initiatives. (shrink)

Patients who are dying of cancer usually give up eating and then stop drinking. This raises ethical dilemmas about providing nutritional support and fluid replacement. The decision-making process should be based on a knowledge of the risks and benefits of giving or withholding treatments. There is no clear evidence that increased nutritional support or fluid therapy alters comfort, mental status or survival of patients who are dying. Rarely, subcutaneous fluid administration in the dying patient may be justified if the family (...) remain distressed despite due consideration of the lack of medical benefit versus the risks. Some cancer patients who are not imminently dying become dehydrated from reversible conditions such as hypercalcaemia. This may mimic the effects of advanced cancer. These conditions should be sought and fluid replacement therapy should be given along with the specific treatments for the condition. (shrink)

These essays apply influential, pathbreaking psychological studies about women's lives to literature. In their analyses of fictional portraits, contributors both challenge and confirm psychological theories about female identity, about 'connection/separation' as developmental catalysts, and about the impact of gender on 'voice,' moral decision-making, and epistemology in relation to classical and contemporary literary texts, written by both women and men.