When categories of actors are discredited, epistemic inequalities produce testimonial or hermeneutic injustices. These injustices manifest themselves in the absence of recognition of the knowledge of others and in the fact that their ability to understand is called into question. Moreover, although they are subjected to exogenous norms in which they do not find themselves, the people subjected to these injustices find it difficult to assert this and to identify their own norms. These two types of injustice alter the quality (...) of care relationships, particularly in terms of relational ethics, by eroding the trust between caregivers and patients. In order to counteract these, a pedagogical experiment based on democratic and epistemic logics was proposed to health students. This experiment has three pillars: teaching on the partnership between health professionals and patients, patients as teachers or mentors and patients as colleagues. These three pillars are presented as interrelated, one not going without the other. On the democratic level, the aim is to rebalance the power relationships. Thus, it is patients who recruit patients and the latter have a status. At the epistemic level, the aim is to rebalance knowledge relationships, which involves questioning knowledge and standards in terms of their consequences on patients, or more precisely on the “patient experience”. Two different and complementary pedagogical programs have been implemented to create a pedagogical experience within a medical faculty (Sorbonne Paris Nord University) located in the city of Bobigny, which is now called the “Bobigny experience”. The aim of the first is to use the “patient perspective” to resolve clinical situations, while the second is to use narrative medicine to combine the experiences of students and patients on specific topics. (shrink)

The motivations of health service users and health care professionals to engage in participative practices differ. Health service users want to improve the patient experience by reducing epistemic injustices and increasing well-being, from a social justice perspective. Six motivations underlying participation co-exist (utilitarian, methodological, democratic, consumerist, epistemic, and emancipatory). However, the compatibility of these motivations is not obvious. Moreover, democracy in health care has become protean and tensions are appearing between representative democracy and participatory democracy, of the indirect type. Combining (...) the epistemic profiles of users with the different motivations and reasons for action, and viewing them through the prism of complementarity could alleviate these tensions. (shrink)

It is widely acknowledged that emotions can be regulated in an astonishing variety of ways. Most research to date has focused on explicit (effortful) forms of emotion regulation. However, there is growing research interest in implicit (automatic) forms of emotion regulation. To organise emerging findings, we present a dual-process framework that integrates explicit and implicit forms of emotion regulation, and argue that both forms of regulation are necessary for well-being. In the first section of this review, we provide a broad (...) overview of the construct of emotion regulation, with an emphasis on explicit and implicit processes. In the second section, we focus on explicit emotion regulation, considering both neural mechanisms that are associated with these processes and their experiential and physiological consequences. In the third section, we turn to several forms of implicit emotion regulation, and integrate the burgeoning literature in this area. We conclude by outlining open questions and areas for future research. (shrink)

Individuals differ considerably in their emotion experience. Some experience emotions in a highly differentiated manner, clearly distinguishing among a variety of negative and positive discrete emotions. Others experience emotions in a relatively undifferentiated manner, treating a range of like-valence terms as interchangeable. Drawing on self-regulation theory, we hypothesised that individuals with highly differentiated emotion experience should be better able to regulate emotions than individuals with poorly differentiated emotion experience. In particular, we hypothesised that emotion differentiation and emotion regulation would be (...) positively related in the context of intense negative emotions, where the press for emotion regulation is generally greatest. To test this hypothesis, participants' negative and positive emotion differentiation was assessed using a 14-day diary protocol. Participants' regulation of negative and positive emotions was assessed using laboratory measures. As predicted, negative emotion differentiation was positively related to the frequency of negative emotion regulation, particularly at higher levels of emotional intensity. (shrink)

Linguists often advert to what are sometimes called linguistic intuitions. These intuitions and the uses to which they are put give rise to a variety of philosophically interesting questions: What are linguistic intuitions – for example, what kind of attitude or mental state is involved? Why do they have evidential force and how might this force be underwritten by their causal etiology? What light might their causal etiology shed on questions of cognitive architecture – for example, as a case study (...) of how consciously inaccessible subpersonal processes give rise to conscious states, or as a candidate example of cognitive penetrability? What methodological issues arise concerning how linguistic intuitions are gathered and interpreted – for example, might some subjects' intuitions be more reliable than others? And what bearing might all this have on philosophers' own appeals to intuitions? This paper surveys and critically discusses leading answers to these questions. In particular, we defend a ‘mentalist’ conception of linguistics and the role of linguistic intuitions therein. (shrink)

In this article we outline the history, elements, and variations of functional accounts of emotions. Summarising diverse theories and observations, we propose that functional accounts of emotions: (1) address why humans have emotions; (2) define emotions as solutions to problems and opportunities related to physical and social survival; (3) treat emotions as systems of interrelated components; and (4) focus on the beneficial consequences of emotions. This conceptual approach to emotion is complemented by several empirical strategies, including the study of emotion (...) dysfunction, the effects of emotions on others, and the relations between emotions and personal and social outcomes. We conclude by considering how functional accounts of emotion vary, including in terms of their level of analysis, specificity, manner of organisation, and range of focus, and the implications functional accounts have for the study of emotion. (shrink)

Drawing on victim precipitation theory, we propose that certain employees are more likely to perceive abusive supervision because of their personality traits. Specifically, we hypothesize that subordinates’ emotional stability, conscientiousness, and agreeableness will be negatively related to perceived abuse from their supervisor and that negative emotions at work will mediate these relationships. We surveyed 222 employees and found that emotional stability and conscientiousness negatively predicted employees’ self-reports of abusive supervision and that this relationship was mediated by negative emotions. Thus, employees (...) lower in emotional stability or conscientiousness are more likely to experience negative emotions, which in turn is related to higher levels of abuse. (shrink)

According to legal tradition, the ideal judge is entirely dispassionate. Affective science calls into question the legitimacy of this ideal; further, it suggests that no judge could ever meet this standard, even if it were the correct one. What judges can and should do is to learn to effectively manage—rather than eliminate—emotion. Specifically, an emotion regulation perspective suggests that judicial emotion is best managed by cognitive reappraisal and, often, disclosure; behavioral suppression should be used sparingly; and suppression of emotional experience (...) is rarely helpful. We argue that the dispassionate-judge ideal presents a barrier to achieving the flexibility necessary for adaptive judicial emotion regulation. We suggest a new ideal, that of the emotionally well-regulated judge, and propose several directions for future research to strengthen ties between law and psychology, with particular attention to the study of emotion. (shrink)

Background:Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career.Aim:To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries.Research design:A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with (...) a single question (visual analogue scale 0–100), the questionnaire also covered several background variables.Participants and research context:The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.Ethical considerations:Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.Results:The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.Discussion and conclusions:In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research. (shrink)

Background: The 21-item Nurses’ Moral Courage Scale was developed and validated in 2018 in Finland with the purpose of measuring moral courage among nurses. Objectives: The objective of this study was to make a Dutch translation of the Nurses’ Moral Courage Scale to describe the level of nurses’ self-assessed moral courage and associated socio-demographic factors in Flanders, Belgium. Research design: A forward–backward translation method was applied to translate the English Nurses’ Moral Courage Scale to Dutch, and a pilot study was (...) conducted to improve readability and understandability. A non-experimental, descriptive cross-sectional exploratory design was used to conduct a survey. Descriptive analysis was used. Participants: The data were collected from a convenience sample of 559 nurses from two hospitals in Flanders. Ethical considerations: Ethical approval was obtained from the university ethics committee, permission to conduct the study was obtained from the participating hospitals. Participants received a guide letter and gave their informed consent. Findings: The readability and understandability of the Dutch Nurses’ Moral Courage Scale were positively evaluated, and the scale revealed a good level of internal consistency for the total scale (α =.914) and all subscales. Nurses’ mean score of the 21-item Nurses’ Moral Courage Scale was 3.77 (standard deviation = 0.537). The total Nurses’ Moral Courage Scale score was associated with age (p <.001), experience (p <.001), professional function (p =.002), level of education (p =.002) and personal interest (p <.001). Discussion and Conclusion: The Nurses’ Moral Courage Scale was successfully translated to Dutch. The Flemish nurses perceived themselves as morally courageous, especially when they were in a direct interpersonal relationship with their patients. Acting courageously in ethical dilemmas that involved other actors or organizations appeared to be more challenging. The results strongly suggest the important role of education and ethical leadership in developing and supporting this essential virtue in nursing practice. (shrink)

An Amnesty International briefing, published in July 2020, highlights the grave risks health workers are facing globally, particularly in the face of the COVID-19 pandemic.1 The report uses data from 63 countries across the world from January to June 2020 and is rich with examples. While recognising that information about the pandemic is constantly evolving, and each country is in a separate phase of the outbreak, Amnesty International draws attention to several troubling trends. By virtue of the role undertaken by (...) health workers, they face a greater exposure to COVID-19, which has contributed to many of the concerns they now deal with. The briefing notes the evidence of the higher death rate from health workers compared with the general population in countries ranging from Denmark to Argentina, while also pointing out the significantly higher death rate in BAME health workers raised by the BMA in the UK.2 PPE shortages had been reported in nearly all of the 63 countries analysed. Many health workers globally stated that they had to buy their own PPE and others described cases of ‘improvisation’, when suitable PPE was not available, such as using bin bags or raincoats. Furthermore, health workers in several countries had experienced increases in workload with formal measures to extend health workers’ contracted hours passed in some countries as well as further changes to their terms and conditions of service. There were also reports of increased mental stress, particularly from those working in ICUs; the increased work and stress is not being matched with suitable compensation or remuneration. Despite many countries passing special benefits for health workers, it was commonly stated that these benefits had not been received yet or that they did not apply to all health workers, with cleaners and other lower-paid yet vital roles excluded. Deeply concerning …. (shrink)

Shamatha, Transcendental, and Stillness Meditation are said to aim for “contentless” experiences, where mental content such as thoughts, perceptions, and mental images is absent. Silence is understood to be a central feature of those experiences. The main source of information about the experiences is texts by experts from within the three traditions. Previous research has tended not to use an explicit scientific method for selecting and reviewing expert texts on meditation. We have identified evidence synthesis as a robust and transparent (...) method that is suitable for this purpose. In this paper we use evidence synthesis based on expert texts to examine silence/quietness as a feature of the contentless experiences in the three practices. Objective criteria were used to select a sample of 135 expert texts. A database containing the expert descriptions of the meditation techniques and experiences was produced by extracting the relevant material from the publications and coding that material to differentiate individual features. The database, which forms part of the Supplementary Material for this paper, identifies each feature of the contentless experiences referred to in the expert texts, including silence/quietness. Our key finding is that the experts indicate silence/quietness has a particular connection with stillness, and the absence of concepts, mental activity/noise, thoughts, and disturbance. Further analysis leads to the following insights. The silence/quietness reflects the absence of thoughts and sounds, and this fits neatly with a conception of silence/quietness as the absence of internal and external noise. In some cases the terms silence and quietness may also reflect the absence of other disturbances such as non-auditory perceptions, mental images, and negative feelings. That would fit with a conception of silence/quietness as complete calm or absence of disturbance. It is not clear from the expert texts how silence/quietness is distinct from other features such as stillness that also reflect the absence of disturbances. As a separate matter, silence/quietness has connections with all the other features of the contentless experiences, but the closeness of the connections varies. Our work uncovers fine distinctions and ambiguities which lead to new research questions that can be explored in future studies. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

In contentless experience (sometimes termed _pure consciousness_) there is an absence of mental content such as thought, perception, and mental imagery. The path to contentless experience in meditation can be taken to comprise the meditation technique, and the experiences (“interim-states”) on the way to the contentless “goal-state/s”. Shamatha, Transcendental, and Stillness Meditation are each said to access contentless experience, but the path to that experience in each practice is not yet well understood from a scientific perspective. We have employed evidence (...) synthesis to select and review 135 expert texts from those traditions. In this paper we describe the techniques and interim-states based on the expert texts and compare them across the practices on key dimensions. Superficially, Shamatha and Transcendental Meditation appear very different to Stillness Meditation in that they require bringing awareness to a meditation object. The more detailed and systematic approach taken in this paper indicates that posturally Shamatha is closer to Stillness Meditation, and that on several other dimensions Shamatha is quite different to both other practices. In particular, Shamatha involves greater measures to cultivate attentional stability and vividness with respect to an object, greater focusing, less tolerance of mind-wandering, more monitoring, and more deliberate doing/control. Achieving contentless experience in Shamatha is much slower, more difficult, and less frequent. The findings have important implications for taxonomies of meditation and for consciousness, neuroscientific, and clinical research/practice, and will provide new and useful insights for meditation practitioners. (shrink)

Advances in our understanding of appraisal processes and emotion regulation have been two of the most important contributions of research on cognition and emotion in recent decades. Interestingly, however, progress in these two areas has been less mutually informative than one might expect or desire. To help remedy this situation, we provide an integration of appraisal theory and the process model of emotion regulation by describing parallel, interacting and iterative systems for emotion generation and emotion regulation. Outputs of the emotion (...) generation system are perceived by the emotion regulation system, and emotion regulation strategies then modulate emotion by intervening at specific stages of the emotion generation system, ultimately changing appraisal dimensions. We hope that our unified perspective will encourage and guide future research at the interface of cognition and emotion. (shrink)

In February 2020, the British Medical Association will be surveying members for their views on what the BMA’s position on physician-assisted dying should be. The BMA is currently opposed to physician-assisted dying in all its forms, a position that was agreed in 2006 at the annual representative meeting, the Association’s policy-making conference.1 As previously reported in Ethics briefing,2 the decision to survey members follows a motion passed at last year’s ARM which called on the BMA to “carry out a poll (...) of members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying”. The results from the survey will not determine BMA policy. Rather, the results be published ahead of this year’s ARM and provided to those attending to inform a debate and discussion on the BMA’s policy position. More information about the survey, including a briefing pack of useful information, and information for BMA members on how to participate can be found online at www.bma.org.uk/PAD. ### High Court rejects Judicial reviews on assisted suicide The High Court has refused permission for two separate challenges to the law on assisted suicide in the UK to proceed to a full hearing. In the first case, Phil Newby, who has motor neuron disease, applied for judicial review of the law on assisted suicide and asked for the court to carry out a detailed examination of what he termed “legislative facts” – that is, an examination of the existing evidence on the “costs, risks and benefits” of regulating assisted suicide – including a cross-examination of relevant expert witnesses.1 Handing down the judgement, Lord Justice Irwin and Mrs Justice May, held that assisted dying …. (shrink)

Rimé makes the important observation that the literature on adult emotion and emotion regulation has largely focused on the individual level of analysis. He argues, we believe correctly, that emotion research would benefit by addressing the fact that emotional events provoke not only individual responses, but systematic social responses as well. We present examples of our own research that are in accord with Rimé's central claims, and that demonstrate the benefits of considering the goals that are provoked and satisfied by (...) emotions, as well as the social context of emotional responding. We conclude by advocating a dynamic systems approach that would allow an integration of individual and social levels of analysis in the study of adult emotion and emotion regulation. (shrink)

Accumulating evidence indicates that simulated natural settings can engage mechanisms that promote health. Simulations offer alternatives to actual natural settings for populations unable to travel outdoors safely; however, few studies have contrasted the effects of simulations of natural settings to their actual outdoor counterparts. We compared the impacts of simulated and actual natural settings on positive and negative affect (mood) levels using a pooled sample of participants enrolled in extant experimental studies. Relevant articles were identified from a review of research (...) published/in press by March 2020 and updated during the peer review of the current study. Of 16 articles identified, 6 met the inclusion criteria and administered a single cross-cutting, standardized instrument [the Positive and Negative Affect Schedule (PANAS)] before and after exposure. Random effects meta-analysis of pooled effects showed that positive affect increased in the actual settings but not in their simulated counterparts (Hedge's g = 0.87; 95% CI, 0.54, 1.20). We observed little difference in effects on negative affect change scores ( g = −0.28; 95% CI, −0.62, 0.06), with studies generally showing reductions in negative affect in both settings. Further research with additional populations, settings, antecedent conditions, and durations would provide a more robust understanding of differences in effects between these two ways to enhance mood by viewing nature. (shrink)

People who expect to be successful in regulating their emotions tend to experience less frequent negative emotions and are less likely to suffer from depression. It is not clear, however, whether beliefs about the likelihood of success in emotion regulation can shape actual emotion regulation success. To test this possibility, we manipulated participants' beliefs about the likelihood of success in emotion regulation and assessed their subsequent ability to regulate their emotions during a negative emotion induction. We found that participants who (...) were led to expect emotion regulation to be more successful were subsequently more successful in regulating their emotional responses, compared to participants in the control condition. Our findings demonstrate that expected success can contribute to actual success in emotion regulation. (shrink)

Women’s health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women’s health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands (...) of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups’ agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy. (shrink)

Table of Contents -- Acknowledgments -- Abbreviations -- Introduction, by Olivia Custer, Penelope Deutscher, and Samir Haddad -- Part I: Openings -- 1. The Foucault-Derrida Debate on the Argument Concerning Madness and Dreams, by Pierre Macherey -- 2. Looking Back at History of Madness, by Lynne Huffer -- 3. Violence and Hyperbole: From "Cogito and the History of Madness" to The Death Penalty, by Michael Naas -- Part II: Surviving the Philosophical Problem: History Crosses Transcendental Analysis.

Monoclonal antibodies are essential biomedical research and clinical reagents that are produced by companies and research laboratories. The NIAID ImmPort (Immunology Database and Analysis Portal) resource provides a long-term, sustainable data warehouse for immunological data generated by NIAID, DAIT and DMID funded investigators for data archiving and re-use. A variety of immunological data is generated using techniques that rely upon monoclonal antibody reagents, including flow cytometry, immunofluorescence, and ELISA. In order to facilitate querying, integration, and reuse of data, standardized terminology (...) for describing monoclonal antibody reagents and their targets needs to be used for annotating data submitted to ImmPort. (shrink)

This research used the embodied approach to analyse the pain experiences of 25 heterosexually married Israeli-Jewish women undergoing in vitro fertilization (IVF) treatments for a first pregnancy. Semi-structured interviews were conducted to allow the women to openly discuss issues concerning their perceptions of pain. Research findings show that the women’s pain perceptions dictated two distinct categories of discourse. The first category of discourse surfaced in the accounts of 14 of the interviewees. Women belonging to this category expressed their willingness to (...) “do everything for a child”. These women insisted on silencing pain and considered it to be irrelevant. They refused to locate bodily pains at the centre of their experience, fearing that this would delay their goal of reproducing. The second discourse of pain emerged from the accounts of 11 interviewees. This discourse was associated with women’s motivation to maintain an active dialogue with painful experiences. They obstinately sought to direct internal attentiveness to what was happening inside their bodies. This approach enabled them to define body boundaries and form an active negotiation with the authority treating their bodies. The research findings suggest that women who share the same socio- cultural environment (Israeli pronatalism) and physical circumstances (the inability to conceive) have varied and wideranging interpretations of pain. It seems that medical authorities can benefit the understanding of pain by providing new support resources to women undergoing IVF treatments. (shrink)

The global #MeToo movement has precipitated a reckoning with gendered, sexual, and other forms of harassment and bullying in higher education. In academia, harassment is rooted in the history of re...

Early exposure to stressful life events is associated with greater risk of chronic diseases and mental health problems, including anxiety. However, there is significant variation in how individuals respond to environmental adversity, perhaps due to individual differences in processing and regulating emotional information. Differences in cognitive control – processes necessary for implementing goal directed behavior – have been linked to both stress exposure and anxiety, but the directionality of these links is unclear. The present study investigated the longitudinal pathway of (...) environmental stress exposure during early adolescence on later adolescent anxiety, and the possible mediating mechanism of cognitive control. Participants were 674 Mexican-origin adolescents (mean age = 10.8 years, 50% male) enrolled in the California Families Project, an ongoing longitudinal study of Mexican-origin families. In the current analysis, we examined self-reports of environmental stressors at age 14 (Time 1), cognitive control at age 16 (Time 2), and anxiety at age 18 (Time 3). Structural equation modeling revealed that environmental stressors (Time 1) had both direct and indirect effects on later anxiety (Time 3) through their effects on cognitive control (Time 2), even when accounting for prior levels of anxiety (Time 2). Cognitive control accounted for 18% of the association between environmental stressors and adolescent anxiety: an increase in stressors decreased cognitive control (β = −0.20, p p = 0.004). These findings deepen our understanding of the mechanisms underlying the development of anxiety and highlight the importance of cognitive control as a potential protective factor. (shrink)

A influência da família no desenvolvimento da criança e do adolescente é um foco importante de pesquisa atualmente. Para estudar a relação entre a interação familiar e a auto-estima de adolescentes, 111 alunos (13 e 14 anos), de três escolas particulares de Porto União (SC) responderam a Escala de A..

Since the development of the first neural prosthesis, that is, the cochlear implant in 1957, neural prosthetics have been one of the highly promising, yet most challenging areas of medicine, while having become a clinically accepted form of invasiveness into the human body. Neural prosthetic devices, of which at least one part is inserted into the body, interact directly with the nervous system to restore or replace lost or damaged sensory, motor, or cognitive functions. This field is not homogenous and (...) encompasses a variety of technologies, which are in various stages of development. Some devices are well established in clinical practice and have become routine, such as cochlear implants. By comparison, other technologies are in experimental phases and still need to be further developed to achieve the desired results. (shrink)