The mental health recovery movement promotes patient self-determination and opposes coercive psychiatric treatment. While it has made great strides towards these ends, its rhetoric impairs its political efficacy. We illustrate how psychiatry can share recovery values and yet appear to violate them. In certain criminal proceedings, for example, forensic psychiatrists routinely argue that persons with mental illness who have committed crimes are not full moral agents. Such arguments align with the recovery movement’s aim of providing appropriate treatment and services for (...) people with severe mental illness, but contradict its fundamental principle of self-determination. We suggest that this contradiction should be addressed with some urgency, and we recommend a multidisciplinary collaborative effort involving ethics, law, psychiatry, and social policy to address this and other ethical questions that arise as the United States strives to implement recovery-oriented programs. (shrink)

I thoroughly enjoyed Dr. Freedman’s paper on “Akratic Believing.” Often, philosophy of psychiatry offers insights to clarify psychological and psychiatric concepts. Less frequently, it involves a real dialogue between philosophy and psychological science. Dr. Freedman’s account of what is bothersome, rather than just philosophically wrong-headed, about the concept of epistemic akrasia demonstrates that, at least where anxiety is concerned, the a posteriori world may have a great deal to offer theoretical philosophy. Freedman argues that understanding somatic responses to trauma, or (...) more broadly construed, to anxiety, dissolves the problem of why there seems to be more to the problem of epistemic... (shrink)

Interest in home birth appears to be growing among American women, and most obstetricians can expect to encounter patients who are considering home birth. In 2011, the American College of Obstetricians and Gynecologists (ACOG) issued an opinion statement intended to guide obstetricians in responding to such patients.In this article, I examine the ACOG statement in light of the historical and contemporary clinical realities surrounding home birth in the United States, an examination guided in part by my own experiences as an (...) obstetrician in home-birth-friendly and homebirth-unfriendly medical milieus. Comparison with other guidelines indicates that ACOG treats home birth as an ethical exception: comparable evidence leads to strikingly different recommendations in the case of home birth and the case of trial of labor following a prior cesarean; and ACOG treats other controversial issues that involve similar ethical questions quite differently.By casting the provision of information as not just the primary but the sole ethical responsibility of the obstetrician, ACOG statement obviates obstetricians’ responsibilities to provide appropriate clinical care and to make the safest possible clinical environment for those mothers who choose home birth and for their newborns. What, on its face, seems to be a statement of respect for women’s autonomy, implicitly authorizes behaviors that unethically restrain truly autonomous choices. Obstetricians need not attend home births, I argue. Our ethical duties do, however, oblige us (1) to refer clients to skilled clinicians who will attend home birth, (2) to continue respectful antenatal care for those women choosing home birth, (3) to provide appropriate consultation to home birth attendants, and (4) to ensure that transfers of care are smooth and nonpunitive. (shrink)

Biographical essays explore the careers of two major early photographers, Joseph-Philibert Girault de Prangey and William James Stillman. in addition, portfolios with works by Maxime Du Camp, John Beasley Greene, Francis Frith, Robert Macpherson, Adolphe Braun and others testify to the strength and consistency of other early photographers who captured the antique worlds around the Mediterranean."--BOOK JACKET.

Executive functions (EFs) and impulsivity are dimensions of self-regulation that are both related to psychopathology. However, self-report measures of impulsivity and laboratory EF tasks typically display small correlations, and existing research indicates that impulsivity and EFs may tap separate aspects of self-regulation that independently statistically predict psychopathology in adulthood. However, relationships between EFs, impulsivity, and psychopathology may be different in childhood compared to adulthood. Here, we examine whether these patterns hold in the baseline assessment of the Adolescent Brain and Cognitive (...) Development (ABCD) sample, a national sample of over 11,000 children (including 749 twin pairs) ages 9–10 years. We examine the phenotypic and genetic relationships among latent variables for different components of EFs and multiple facets of impulsivity. Additionally, we assess how EFs and impulsivity relate to composite measures and latent variables of psychopathology derived from parent report. EFs were weakly correlated with impulsivity, and the strength varied by impulsivity facet, emphasizing their separability. We did not identify significant genetic and environmental correlations between EFs and impulsivity. Moreover, controlling for their small relationships with each other, both EFs and some facets of impulsivity statistically predicted an Externalizing factor, attention problems, and social problems, and twin analyses suggested these relationships were genetic in origin. These findings indicate that EFs and impulsivity represent phenotypically and genetically separable aspects of self-regulation that are both transdiagnostic correlates of psychopathology in childhood. (shrink)

BackgroundDespite its ubiquity, it is often not clear what organizations and services mean by well-being. Visual impairment has been associated with poorer well-being and well-being has become a key outcome for support and services for adults living with VI. A shared understanding of what well-being means is therefore essential to enable assessment of well-being and cross-service provision of well-being support.ObjectivesTo provide an overview of the ways in which well-being has been conceptualized in research relating to adults living with VI.Eligibility criteriaArticles (...) were included in the review if the article discussed well-being in the context of adults living with VI, was available in English and as a full text.Data sourcesA systematic search using search terms relating to VI and well-being was conducted in EBSCOHost and Ovid.ChartingA team of three reviewers screened titles, abstracts and full-texts articles and extracted data. Ambiguous articles were referred to the research group and discussed.ResultsOf 10,662 articles identified in the search, 249 were included in the review. These referred to 38 types of well-being. The most common types were general well-being emotional well-being and psychological well-being. Most articles referred to one type only, with a maximum of 9 listed in one article. A large number of articles did not clearly define well-being. A wide range of indicators of well-being related to the domains of hedonia, mood, positive and negative affect, quality of life, mental health, eudaimonia, self/identity, health, psychological reactions to disability and health problems, functioning, social functioning and environment, were extracted, many of which were used just once.ConclusionsThere remains a lack of consensus on how well-being is conceptualized and assessed in the context of adult VI. A standardized multi-domain approach derived with input from adults with VI and practitioners working with them is required to enable comparison of findings and cross-organizational provision of support. (shrink)

Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing. Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights—the right not to know, and the child’s (...) right to an open future—frequently invoked in discussions of predictive genetic testing, in order to explore their potential contribution to evaluating this new practice. Ultimately, we conclude that traditional clinical and public health ethics frameworks, and these two rights in particular, should be complemented by a social justice perspective in order adequately to characterize the ethical dimensions of general population PGS programs. (shrink)

Prompted by the development of the Theory of Challenge and Threat States in Athletes (Jones et al, 2009), recent years has witnessed a considerable increase in research examining challenge and threat in sport. This manuscript provides a critical review of the literature examining challenge and threat in sport, tracing its historical development and some of the current empirical ambiguities. In an attempt to reconcile some of these ambiguities, and utilising neurobiological evidence associated with approach- and avoidance-motivation (cf. Elliot & Covington, (...) 2001), this paper draws upon the Evaluative Space Model (ESM: Cacioppo et al., 1997) and considers the implications for understanding challenge and threat in sport. For example, rather than see challenge and threat as opposite ends of a single bipolar continuum, the ESM implies that individuals could be (1) challenged, (2) threatened, (3) challenged and threatened, or (4) neither challenged or threatened by a particular stimulus. From this perspective it could be argued that the appraisal of some sport situations as both challenging and threatening could be advantageous, whereas the current literature seems to imply that the appraisal of stress as a threat is maladaptive for performance. In drawing upon the ESM, we outline the Evaluative Space Approach to Challenge and Threat and provide several testable hypotheses for advancing understanding of challenge and threat (in sport). We also outline a number of cardiovascular and experiential measures that can be used to examine these hypotheses. In sum, this paper provides a significant theoretical, empirical and practical contribution to our understanding of challenge and threat (in sport). (shrink)

L’enfant exposé aux violences conjugales est encore trop peu considéré comme victime directe de ces violences, malgré les études réalisées en France et en Amérique du Nord. Les auteures ont mené une recherche qualitative clinique auprès de huit enfants témoins de violences conjugales durant leur petite enfance, accueillis avec leur mère dans deux structures dédiées, afin d’étudier leur fonctionnement psychique en leur proposant le test projectif du Patte-Noire. L’intérêt de cette étude réside dans le fait de recueillir la parole de (...) l’enfant, alors que les recherches internationales sont souvent basées sur des questionnaires adressés à la mère. Les résultats révèlent l’intériorisation précoce de modalités relationnelles violentes et pointent l’importance d’un accompagnement sur le versant psychologique de l’enfant et du (des) parent(s). (shrink)

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample (...) of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries. (shrink)

Numerous researchers have investigated accounting students’ levels of moral reasoning, ethical choice and judgment employing the Defining Issues Test and using its P score as an indicator of moral reasoning. Not surprisingly, a number of DIT studies report conflicting results. Moreover, despite widespread use of the DIT, there is concern that it may not adequately measure all facets of ethical judgment :1–26, 2010). Thus, we endeavor to provide insight not only into the contradictory results but also about the applicability of (...) the DIT for studying accounting students. To do so, we collect published and unpublished DIT studies employing accounting students as subjects and use meta-analysis to aggregate findings across these studies to quantify their results, examining commonly employed variables. We show significant relationships between P scores and some variables but not others. Further, our findings demonstrate that the DIT provides added insights when exploring questions of ethical choice, and ethics instruction, particularly when the instruction is embedded in an accounting course. Finally, we find that the level of DIT P scores reported in the studies relates to whether the study was published. We discuss the implications of our findings for future research. (shrink)

Measuring responsiveness to gain accurate diagnosis in populations with disorders of consciousness (DOC) is of central concern because these patients have such complex clinical presentations. Due to the uncertainty of accuracy for both behavioral and neurophysiological measures in DOC, combined assessment approaches are recommended. A number of standardized behavioral measures can be used with adults with DOC with minor to moderate reservations relating to the measures’ psychometric properties and clinical applicability. However, no measures have been standardized for use with pediatric (...) DOC populations. When adapting adult measures for children, confounding factors include developmental considerations for language-based items included in all DOC measures. Given the lack of pediatric DOC measures, there is a pressing need for measures that are sensitive to the complex clinical presentations typical of DOC and that can accommodate the developmental levels of pediatric populations. The music therapy assessment tool for awareness in disorders of consciousness (MATADOC) is a music-based measure that has been standardized for adults with DOC. Given its emphasis on non-language based sensory stimuli, it is well-suited to pediatric populations spanning developmental stages. In a pre-pilot exploratory study, we examined the clinical utility of this measure and explored trends for test-retest and inter-rater agreement as well as its performance against external reference standards. In several cases, MATADOC items in the visual and auditory domains produced outcomes suggestive of higher level functioning when compared to outcomes provided by other DOC measures. Preliminary findings suggest that the MATADOC provides a useful protocol and measure for behavioral assessment and clinical treatment planning with pediatric DOC. Further research with a larger sample is warranted to test a version of the MATADOC that is refined to meet developmental needs of pediatric DOC populations. (shrink)

Our purpose in this article is to identify and suggest resolution for two core problematics of grounded theory. First, while grounded theory provides transparency to one part of the conceptualization process, where codes emerge directly from the data, it provides no such systematic or transparent way for gaining insight into the conceptual relationships between discovered codes. Producing a grounded theory depends not only on the definition of conceptual pieces, but the delineation of a relationship between at least two of those (...) pieces. Second, the conceptualization process of grounded theory is done in hierarchical fashion, where individual codes emerge from the data but then are used to generate insight into more general concepts and thematic statements. But various works on grounded theory have failed to provide any systematic way of using data specific levels of scale (the codes) to gain insight into more macro levels of scale (concepts and themes). We offer fractal concept analysis as a means of resolving both of these issues. By using a logic structure generator, fractal concept analysis delineates self-similar conceptual frameworks at various levels of abstraction, yielding a method for linking concepts together within and between levels of scale encountered in the grounded theory coding and categorization process. We conclude that this fractal analytic technique can bolster the aims of grounded theory as a formalized and systematic process for generating theory from empirical data. (shrink)

L’analyse d’itinéraires féminins à travers l’histoire du Comité Catholique des Intellectuels Français (CCIF) met en valeur trois profils d’intellectuelles catholiques qui cherchent à résoudre les interrogations posées à l’intelligence croyante par les derniers développements de la connaissance. La majeure partie de ces femmes forment ainsi un groupe d’expertes qui refusent de s’engager au service d’une cause politique ou sociale. Elles sont donc bien éloignées du modèle intellectuel qui prévaut alors et qu’incarne Jean-Paul Sartre.

L’Inra a mis en place en 2002 une activité d’expertise scientifique collective dans ses domaines de compétences – agriculture, environnement, alimentation – pour répondre à des questions d’action publique, portées principalement par les ministères de l’agriculture et de l’écologie. C’est sur la base de l’expérience acquise qu’ont été formulés les principes qui encadrent l’exercice et qui figurent dans la charte de l’expertise scientifique à l’Inra, et qu’on été construites les procédures de conduite qui en garantissent la qualité. Cet article s’attache (...) à la phase initiale du processus, déterminante pour la pertinence du travail, consacrée à l’instruction de la question d’expertise et à sa traduction de la sphère de l’action à celle de la recherche. Pour les experts, il s’agit de saisir le contexte, les enjeux, la logique de la commande, et pour les décideurs, de comprendre ce qu’ils peuvent attendre de la démarche d’analyse et d’assemblage des connaissances dans les limites de temps assignées à l’exercice.In 2002, Inra included collective expert scientific studies in its areas of competence – agriculture, environment and food – in response to public policy issues mainly arising in the Ministries of Agriculture and Ecology. The governing principles of the exercise, set out in Inra’s Charter on expert scientific studies, were formulated on the basis of prior experience, as were the procedures built up to guarantee the quality of the studies. This article describes on the first phase of the process, which is decisive in terms of the relevance of the work undertaken. For the experts, the task requires an understanding of the context, the issues and the reasons for the request, while the decision-makers have to understand what they can expect from an approach that sets out to analyse and compile knowledge within the time allotted to the exercise. (shrink)

L'actuel regain d'intérêt pour la philosophie témoigne de l'attente la plus légitime qui soit, eu égard aux prétentions traditionnelles et à l'aura de cette discipline, mais également la plus difficile à satisfaire : qu'elle mène celui qui épouse ses chemins à une véritable réappropriation de sa propre existence, à une recréation personnelle. Impossible ici de se satisfaire d'un horizon de consolations aimables et de recettes de prospérité, non plus que de vertiges théorisants ou d'érudition monomaniaque. Face à un monde qui (...) semble avoir d'avance consumé nos élans et consommé nos révoltes, les postures et commodités ne sont plus de mise. Un retour d'authenticité s'impose à l'engagement philosophique lui-même. En fait, la mise à l'épreuve de soi est passage obligé, dès lors que de mort de Dieu en chute des idoles de remplacement, nul ne peut plus prétendre faire surgir la valeur irréductible de l'humain d'ailleurs que de l'homme... D'où la pertinence et l'attrait de l'exploration, ici proposée, des voies traditionnelles et ressorts nouveaux d'une maïeutique propre à faire naître l'homme à lui-même, à travers la mise à nu et le retrait de tous les masques que nous imposent la vie en société et le respect de ses codes. Poussant au déracinement du moi comme à une étape nécessaire au dévoilement de notre vérité, les auteurs de cet essai s'inscrivent dans la lointaine filiation de ces philosophes de l'Antiquité (Stoïciens, Cyniques) qui vivaient leur philosophie comme un travail sur soi, voire une ascèse, et dans le prolongement de tout ce pan de la pensée contemporaine qui, avec Foucault notamment, s'est employé à armer la philosophie d'un pouvoir maximal de transformation croisée de celui qui s'y adonne et du social qui l'environne. (shrink)

In the year 2000 the artist Eduardo Kac made TV news by declaring he had ordered the « creation » of a genetically modified bunny. In 2004 the artist Steve Kurtz was detained by the FBI on the suspiscion of bioterrorism, because of the laboratory equipment he uses in installations that demistify biotechnology. The contrast between an artist-publicist who lends a showy allure to biotech and an artist-researcher who critiques its effects serves as the departure point for an examination of (...) the functions of science and art in a neoliberal society. Faced with trade secrets, the privatization of knowledge and ever-tightening control of laboratories, the artist-researcher can intervene to make public the research process and the consequences of commercializing a given discovery, particularly by using installations that allow the participant to manipulate both lab equipment and scientific concepts. But to do so, the artist must also interrupt the normal functioning of the neoliberal art world, where institutions supported by private sponsorship retain exclusive rights over fetishized products, destined to feed financial speculation. The article closes with a look at the work of Brandon Ballangee, an artist-researcher working in the field of ecology. (shrink)

Cette étude préliminaire avait pour objectif de documenter les besoins d’information des familles ayant un enfant avec une déficience du point de vue des parents et des professionnels de la santé impliqués auprès d’eux. Trois groupes de discussion ont été réalisés: deux auprès de parents d’enfant ayant une trisomie 21 ou une déficience motrice cérébrale et un autre auprès de professionnels de la santé impliqués auprès d’eux. Les résultats montrent que l’information recherchée par les parents concerne le problème de santé, (...) les soins et les ressources disponibles. Les parents consultent entre autres sources les professionnels de la santé, d’autres parents, les médias et l’Internet. L’information obtenue par les parents a un impact sur leur adaptation à la situation de santé et sur leur relation avec les professionnels. Enfin, des recommandations sont proposées par les parents et les professionnels en regard des interventions. (shrink)

Partant du constat que l’amitié n’est pas traitée par les femmes écrivains, cet article relit et analyse la portée du célèbre roman Kokoro de l’écrivain Natsume Sôseki (1867-1916), pilier de la littérature japonaise moderne, qui repose sur deux histoires consécutives d’amitié. Un jeune homme découvre l’amitié avec un homme un peu plus âgé, qui a lui-même dans sa jeunesse connu une amitié très vive avec un jeune homme du même village, avant qu’une histoire d’amour les séparent tragiquement. La lecture de (...) ce récit fondateur, pendant longtemps commune à tous les lycéens nippons, a assurément contribué au façonnement de la notion d’amitié au Japon. Il s’agit dans le roman d’un lien exigeant qui ne peut souffrir aucune trahison. (shrink)

Aujourd’hui, l’exposition plasticienne crée un nouveau langage en direction du spectateur. Réinventant des signes et des qualités sensibles, elle redéfinit la fabrique comme la perception du plaisir et du jugement de goût et, d’un même élan, restitue à l’œuvre ce que l’esthétique, comme science de l’art, n’aurait jamais dû lui soustraire : la foi en sa capacité critique.

Introduction Ce texte explore une dimension profondément « pré-réfléchie » de notre expérience vécue, qui semble jouer un rôle essentiel dans la genèse d’une perception, mais aussi d’une compréhension, d’un sens. À partir de plusieurs exemples, et notamment celui de l’écoute d’un son, je montrerai que cette dimension possède des caractéristiques structurelles spécifiques, qui semblent très différentes de celles de l’expérience dont nous sommes habituellement conscients. Notamment, la distinct...

La construction de l’arbre généalogique tend à se répandre comme médiateur au cours d’entretiens dans des cadres aussi différents que le travail social, les enquêtes de recherche et le travail clinique thérapeutique. Mise en place de repères structurants pour l’identité singulière et familiale de la personne, outil de médiation facilitant la parole, cette technique semble présenter nombre d’avantages. Pourtant son utilisation avec des enfants ou des adolescents mérite d’être interrogée. En effet, la construction de l’arbre généalogique est un médiateur particulier (...) car il sollicite directement les données familiales. Or, le repérage dans ces données est le fruit d’un travail d’élaboration qui nécessite un temps psychique et un cadre transférentiel qui ne peuvent être courtcircuités. (shrink)

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

Le travail présenté dans cet article s’inscrit dans une recherche qui a pour but la constitution d’un corpus scolaire et le développement d’un outil d’aide à son exploitation à partir de l’annotation de phénomènes linguistiques saillants. Nous nous concentrerons ici sur les écrits produits en fin de classe de CP par des scripteurs encore débutants. L’objet de ce travail est d’explorer les possibilités qu’offre le traitement automatique des langues pour appréhender ces écrits particulièrement éloignés de la norme. L’hypothèse est que (...) la connaissance du contexte de production facilite ce processus. Nous mesurons cet apport au travers d’un exemple de traitement, à savoir le développement d’un outil d’aide à l’annotation de certaines erreurs orthographiques. Après une rapide présentation du projet et des caractéristiques du corpus élaboré, l’article propose un exposé détaillé du module d’annotation de ces erreurs. Il en expose la méthode d’identification et de correction au moyen d’une ressource lexicale de formes phonologiques ainsi que le modèle d’annotation élaboré. (shrink)