In this article, Heather Greenhalgh-Spencer argues that deep listening is the foundational component of bridge-building; that it is deep listening that foments the trust and desire for action that undergirds our building of bridges. While “listening” is not a new topic, Greenhalgh-Spencer adds to the literature by expanding on what are the essential components of the kind of listening — which she calls “deep listening” — that can lead to ethical action, change, and connection. She identifies desire, care, (...) acknowledgment of difference, acknowledgment of power, and courage as the key components of this form of listening. Furthermore, she aims to provide concrete examples of how deep listening enables — in fact, is the primary foundation for — bridge-building. She begins the article by defining “deep listening” and then moves to an example of deep listening in action, one taken from the context of community-engaged partnerships — a type of bridge-building in which university faculty create partnerships with community members. In taking this approach, Greenhalgh-Spencer provides a clear illustration of the essential role deep listening plays in the ethical bridge-building process. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

Moral disengagement is a process whereby the self-regulatory mechanisms that would otherwise sanction unethical conduct can be selectively disabled. The present research proposed that moral disengagement might be adopted in the endorsement of asylum seeker policies in Australia, and in order to test this, a scale was developed and was validated in two studies. Factor analysis demonstrated that a 2-factor, 16-item structure had the best fit, and the construct validity of the scale was supported. Results provide evidence for the use (...) of moral disengagement in the context of asylum seekers as a means of rationalizing conduct that may otherwise be sanctioned. (shrink)

Guattari's ecosophy has implications for many types of pedagogy practiced in the school. While Guattari never explicitly advocated the educational use of ecosophy, I explore in this article how it can be used as a lens to ‘read’ pedagogy in nuanced ways, highlighting oppressive premises and practices. I first discuss Guattari's ecosophy, defining key terms and advocating ecosophy as a philosophy that calls attention to the interactions and ‘parts’ of assemblages of existence—a philosophy radical and encompassing enough to make intelligible (...) the dynamic connections between various fields of existence, trajectories into the new, and trajectories more destructive in nature. I then offer a ‘reading’ of two different pedagogical strategies that have achieved a wide following in the last few decades: direct instruction, and critical pedagogy. Reading these pedagogies through ecosophy allows us to name more fully the troubling assumptions and lacunae to be found within them. (shrink)

This is a precious companion for all those who want to achieve a deeper understanding of the complex dynamics of innovation."--Roberto Verganti, author of "Design-Driven Innovation".

Within the digital workforce, women are disappearing. While there are many factors that could be ‘blamed’ for this phenomenon, this article takes issue with the sexist and patriarchal discourses that are deployed within the digital workforce. In many ways, sexist discourses are taken for granted within the digital workplace; and in that way, the discourses themselves are rendered invisible through a lack of concerted uncovering of the ways that these sexist discourses produce—and reproduce—women as sexual objects and outsiders in this (...) field of work. The sexist and patriarchal discourses I address in this article validate the gender binary even as there is gendered play. It is this ‘play’ that also makes counter-hegemonic discourse and discursive acts productive, as I argue toward the end of the paper. Schools are a place where counter-hegemonic discourses and acts can be nurtured and, hopefully, affect and counteract the disappearance of women in digital fields. (shrink)

“Coca-cola Funds scientists Who shiFt Blame for Obesity Away from Bad Diets.” Thus began the August 9, 2015 New York Times article that alerted the public and the wider scientific community to the secret tactics the soda industry was using to protect its profits on a product known to harm health and contribute to the obesity epidemic, one of the leading public health crises of our day. Following the lead of the tobacco industry, Coca-Cola was funding leading exercise scientists to (...) promote the message that physical activity was the main solution to the obesity epidemic—a claim few obesity experts accept. The response was condemnation and a deeper appreciation of the political obstacles to regulating... (shrink)

Haraway foregrounds many stories that we, in a late capitalist era, tell ourselves in order to justify, or not even notice, actions that are harmful to all living things. While I am mindful of Haraway’s excellent attention to the ways that ‘stories tell stories, thoughts think thoughts, and knots knot knots,’ I argue that we must take great care when we, as educators, blur the lines between facts and fiction; reality and art. When everything becomes a story—with some stories simply (...) being more compelling than other stories—we run the risk of contributing to the very sense of unmooring that has led us to the status quo where arctic icecaps are melting, living things are becoming extinct, and humans are suffering from man-made pollution. In this paper, I trouble the use of stories to draw attention to the ecological harm we have done to our earth. While stories can be powerful, there are risks associated with how we tell stories; and particular risks when we blur the lines between critical storytelling and the idea of something as ‘factual’. Storytelling, and blurring the lines between stories and facts, can have negative implications for our quest to generate a sense of ‘response-ability’ for our planet and all who live on it. In order to make that argument, I first talk about my own story and the ways that I have used stories in the classroom. I then touch on Haraway and her particular use of stories. I then foreground the practice of telling truths with stories by exploring the use of critical fiction and narrative inquiry. I conclude with implications for pedagogy. (shrink)

Haraway foregrounds many stories that we, in a late capitalist era, tell ourselves in order to justify, or not even notice, actions that are harmful to all living things. While I am mindful of Haraway’s excellent attention to the ways that ‘stories tell stories, thoughts think thoughts, and knots knot knots,’ I argue that we must take great care when we, as educators, blur the lines between facts and fiction; reality and art. When everything becomes a story—with some stories simply (...) being more compelling than other stories—we run the risk of contributing to the very sense of unmooring that has led us to the status quo where arctic icecaps are melting, living things are becoming extinct, and humans are suffering from man-made pollution. In this paper, I trouble the use of stories to draw attention to the ecological harm we have done to our earth. While stories can be powerful, there are risks associated with how we tell stories; and particular risks when we blur the lines between critical storytelling and the idea of something as ‘factual’. Storytelling, and blurring the lines between stories and facts, can have negative implications for our quest to generate a sense of ‘response-ability’ for our planet and all who live on it. In order to make that argument, I first talk about my own story and the ways that I have used stories in the classroom. I then touch on Haraway and her particular use of stories. I then foreground the practice of telling truths with stories by exploring the use of critical fiction and narrative inquiry. I conclude with implications for pedagogy. (shrink)

A common and driving assumption in agricultural research is that the introduction of research trials, new practices and innovative technologies will result in technology adoption, and will subsequently generate benefits for farmers and other stakeholders. In Lao PDR, the potential benefits of introduced technologies have not been fully realised by beneficiaries. We report on an analysis of a survey of 735 smallholder farmers in Southern Lao PDR who were questioned about factors that influenced their decisions to adopt new technologies. In (...) this study, we have constructed measures or states of adoption which identify key elements of an adoption decision-making nexus. Analysis was conducted to statistically group explanatory factors of adoption. The key explanatory factors represented attributes of the farmer, the factors considered when undertaking production decisions and elements of the agricultural value chain that present as opportunities or constraints. We describe the combination of farmer’s personal attributes, perceptions of the value chain, and the introduction of new technologies by external actors as an “agricultural research value chain”, where agricultural research activities intervene to derive greater benefits for local farmers. A generalised linear model, via Poisson regression analysis on the identified explanatory factors, was applied to explore how they influence adoption measures and we found several significant relationships. (shrink)

This chapter describes a study undertaken as part of the UCL Evidence programme to explore how policymakers talk about and reason with evidence. Specifically, researchers were interested in the micro-processes of deliberation and meaning-making practices of a group of people charged with prioritising health care in an NHS Primary Care Trust in the UK. The chapter describes how the research study brought together ideas from rhetorical theory and methods of discourse analysis to develop an innovative approach to exploring how evidence (...) is constituted at the micro-level of social interaction and communication. It presents empirical data to illuminate the representation and meaning of evidence within one particular policymaking forum, and to highlight contrasting constructions of the policymaking process. (shrink)

The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)

Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.

BackgroundImplementation science research, especially when using participatory and co-design approaches, raises unique challenges for research ethics committees. Such challenges may be poorly addressed by approval and governance mechanisms that were developed for more traditional research approaches such as randomised controlled trials.DiscussionImplementation science commonly involves the partnership of researchers and stakeholders, attempting to understand and encourage uptake of completed or piloted research. A co-creation approach involves collaboration between researchers and end users from the onset, in question framing, research design and delivery, (...) and influencing strategy, with implementation and broader dissemination strategies part of its design from gestation. A defining feature of co-creation is its emergent and adaptive nature, making detailed pre-specification of interventions and outcome measures impossible. This methodology sits oddly with ethics committee protocols that require precise pre-definition of interventions, mode of delivery, outcome measurements, and the role of study participants. But the strict requirements of ethics committees were developed for a purpose – to protect participants from harm and help ensure the rigour and transparency of studies. We propose some guiding principles to help square this circle. First, ethics committees should acknowledge and celebrate the diversity of research approaches, both formally and informally ; without active support, their members may not understand or value participatory designs. Second, ground rules should be established for co-design applications and communicated to committee members and stakeholders. Third, the benefits of power-sharing should be recognised and credit given to measures likely to support this important goal, especially in research with vulnerable communities. Co-design is considered best practice, for example, in research involving indigenous peoples in New Zealand, Australia and Canada. (shrink)

In this influential study of central issues in the philosophy of science, Paul Horwich elaborates on an important conception of probability, diagnosing the failure of previous attempts to resolve these issues as stemming from a too-rigid conception of belief. Adopting a Bayesian strategy, he argues for a probabilistic approach, yielding a more complete understanding of the characteristics of scientific reasoning and methodology. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Colin Howson, illuminating (...) its enduring importance and relevance to philosophical enquiry, this engaging work has been revived for a new generation of readers. (shrink)

An estimated 700,000 people in the United States have "long COVID," that is, symptoms of COVID-19 persisting beyond three weeks. COVID-19 and its long-term sequelae are strongly influenced by social determinants such as poverty and by structural inequalities such as racism and discrimination. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, and addressing the multiple nested domains of inequity.

Kant and the Claims of Taste, published here for the first time in paperback in a revised version, has become, since its initial publication in 1979, the standard commentary on Kant's aesthetic theory. The book offers a detailed account of Kant's views on judgments of taste, aesthetic pleasure, imagination and many other topics. For this new edition, Paul Guyer has provided a new foreword and has added a chapter on Kant's conception of fine art. This re-issue will complement the (...) author's companion volume, Kant and the Experience of Freedom, which places Kant's aesthetics in its historical context and examines the fundamental connection between Kant's aesthetics and his moral theory. (shrink)