WQ.1 “Independent men and women, in independent homes, leading separate and independent lives, with full freedom to form and dissolve relations, and with perfectly equal opportunities to happiness, development, and love.” I leave out the word “rights,” doubtful I can use it without being misunderstood. Perhaps I can succeed in dispensing with its use altogether. This ideal, so stated, is attractive to me and completely in harmony with my idea of the course in life which will best further human happiness. (...) WQ.2 I am not sure that I quite understand Victor’s position in regard to the number of.. (shrink)

“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)

This article sets my own acquaintance with Asphodel in the context of her academic and life achievements. In this long life, she has both seen and influenced changes in the work of theology and social attitudes. Her own work has been seminal and inspiring. Her life has been as radical as her writing. The article draws on conversations with others of her acquaintance, as well as her writings. I end by honouring Asphodel as a gevirah, in scriptural terms.

This article focuses on Guyanese efforts in the ​postcolonial present to address environmental issues that have become increasingly complex in the face of an awareness of climate change. It opens with an account of how the preservation of Indigenous forests contributes to international efforts to reduce carbon, while making visible the instability that the discovery of oil and gas reserves in the seabed might portend for the Guyanese economy. Specifically, the article examines how engineers have historically confronted settler-colonial discourses about (...) terra nullius unfold as they invest in sea defense. In doing so, the article foregrounds what engineers call slips—the slow or sudden displacement of a sea defense’s structural foundation. Slips are phenomena of energy conversion between land and sea. Rather than arguing for the claims of the pre-Anthropocene earth, the article suggests how many factors are in play in developing policy in the present, in an era of heightened awareness of the different forces in a changing climate. (shrink)

Any philosophy of science ought to have something to say about the nature of mathematics, especially an account like constructive empiricism in which mathematical concepts like model and isomorphism play a central role. This thesis is a contribution to the larger project of formulating a constructive empiricist account of mathematics. The philosophy of mathematics developed is fictionalist, with an anti-realist metaphysics. In the thesis, van Fraassen's constructive empiricism is defended and various accounts of mathematics are considered and rejected. Constructive empiricism (...) cannot be realist about abstract objects; it must reject even the realism advocated by otherwise ontologically restrained and epistemologically empiricist indispensability theorists. Indispensability arguments rely on the kind of inference to the best explanation the rejection of which is definitive of constructive empiricism. On the other hand, formalist and logicist anti-realist positions are also shown to be untenable. It is argued that a constructive empiricist philosophy of mathematics must be fictionalist. Borrowing and developing elements from both Philip Kitcher's constructive naturalism and Kendall Walton's theory of fiction, the account of mathematics advanced treats mathematics as a collection of stories told about an ideal agent and mathematical objects as fictions. The account explains what true portions of mathematics are about and why mathematics is useful, even while it is a story about an ideal agent operating in an ideal world; it connects theory and practice in mathematics with human experience of the phenomenal world. At the same time, the make-believe and game-playing aspects of the theory show how we can make sense of mathematics as fiction, as stories, without either undermining that explanation or being forced to accept abstract mathematical objects into our ontology. All of this occurs within the framework that constructive empiricism itself provides the epistemological limitations it mandates, the semantic view of theories, and an emphasis on the pragmatic dimension of our theories, our explanations, and of our relation to the language we use. (shrink)

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery’s effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery’s effectiveness in response to actual competition. This study examined (a), whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, (...) and (b), the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images. (shrink)

Can Covid-19 vaccines be used off-label? Should they be? These were questions on the minds of parents, pediatricians, and the media when the FDA fully approved the Pfizer-BioNTech Covid-19 vaccine for people aged 16 and up. Yet the American Academy of Pediatrics cautioned against pediatric off-label use of the vaccine, and the CDC Covid-19 Vaccine Provider Agreement appears to prohibit it. After briefly contextualizing ethical and legal precedents regarding off-label use, we offer an analysis of the ethical permissibility of and (...) considerations for pediatric off-label Covid-19 vaccination based on individual benefits, risks, and available alternatives. Our analysis challenges the ethics of a blanket prohibition on off-label pediatric Covid-19 vaccination, as it limits clinician ability to provide care they may determine to be clinically and ethically appropriate. At the same time, our analysis acknowledges that Covid-19 creates population-level ethical considerations that are at times in tension with individual health interests. (shrink)

Examined as an isolated situation, and through the lens of a rare and feared disease, Mr. Duncan's case seems ripe for second-guessing the physicians and nurses who cared for him. But viewed from the perspective of what we know about errors and team communication, his case is all too common. Nearly 440,000 patient deaths in the U.S. each year may be attributable to medical errors. Breakdowns in communication among health care teams contribute in the majority of these errors. The culture (...) of health care does not seem to foster functional, effective communication between and among professionals. Why? And more importantly, why do we not do something about it? (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

Volume 20, Issue 8, August 2020, Page 76-78.

Many of those teaching at the intersection of medicine and the humanities are siloed within institutional spaces. This essay recounts the teaching of Sarah Manguso’s The Two Kinds of Decay to students across different academic contexts and considers what we can learn when we put classrooms in conversation with each other. This essay argues for the value of texts like Manguso’s, which explicitly hold the narrating subject and form of illness narrative up for critical examination. The authors call for (...) more collaborative teaching, which has special resonance in the health humanities, where conversations already depend on bridging disciplines and listening to the stories others can tell. (shrink)

Symbolic arithmetic is fundamental to science, technology and economics, but its acquisition by children typically requires years of effort, instruction and drill1,2. When adults perform mental arithmetic, they activate nonsymbolic, approximate number representations3,4, and their performance suffers if this nonsymbolic system is impaired5. Nonsymbolic number representations also allow adults, children, and even infants to add or subtract pairs of dot arrays and to compare the resulting sum or difference to a third array, provided that only approximate accuracy is required6–10. Here (...) we report that young children, who have mastered verbal counting and are on the threshold of arithmetic instruction, can build on their nonsymbolic number system to perform symbolic addition and subtraction11–15. Children across a broad socio-economic spectrum solved symbolic problems involving approximate addition or subtraction of large numbers, both in a laboratory test and in a school setting. Aspects of symbolic arithmetic therefore lie within the reach of children who have learned no algorithms for manipulating numerical symbols. Our findings help to delimit the sources of children’s difficulties learning symbolic arithmetic, and they suggest ways to enhance children’s engagement with formal mathematics. We presented children with approximate symbolic arithmetic problems in a format that parallels previous tests of non-symbolic arithmetic in preschool children8,9. In the first experiment, five- to six-year-old children were given problems such as ‘‘If you had twenty-four stickers and I gave you twenty-seven more, would you have more or less than thirty-five stickers?’’. Children performed well above chance (65.0%, t1952.77, P 5 0.012) without resorting to guessing or comparison strategies that could serve as alternatives to arithmetic. Children who have been taught no symbolic arithmetic therefore have some ability to perform symbolic addition problems. The children’s performance nevertheless fell short of performance on non-symbolic arithmetic tasks using equivalent addition problems with numbers presented as arrays of dots and with the addition operation conveyed by successive motions of the dots into a box (71.3% correct, F1,345 4.26, P 5 0.047)8.. (shrink)

In ‘The Complex Case of Ellie Anderson’, Joona Rasanen and Anna Smajdor raise several ethical questions about the case. One question asks, but does not answer, whether Ellie faced discrimination for being transgender when her mother was not allowed access to Ellie’s sperm following her death. In raising the question, the authors imply anti-trans bias may have influenced this determination. However, this inference is not supported by current ethical and legal guidance for posthumous use of gametes, with which Ellie’s case (...) is consistent. We consider the authors’ responses to their other ethical queries, and how their suggestions for what options might have been available to Ellie and her family are instructive for addressing attempts in the USA and UK to restrict minors’ access to gender-affirming medical treatment, including puberty-blocking therapy. (shrink)

Women generally initiate, lead, and constitute the rank and file of environmental justice activism. However, there is little research on why there are comparatively so few men involved in these movements. Using the environmental justice movement in the Central Appalachian coalfields as a case study, we examine the ways that environmental justice activism is gendered, with a focus on how women’s and men’s identities both shape and constrain their involvement in gendered ways. The analysis relies on 20 interviews with women (...) and men grassroots activists working for environmental justice in the coalfields of Appalachia. We find that women draw on their identities as “mothers” and “Appalachians” to justify their activism, while the hegemonic masculinity of the region, which is tied to the coal industry, has the opposite effect on men, deterring their movement involvement. We explore the implications of these findings for understanding the relationship of gender to environmental justice activism. (shrink)

An important role for all health care professionals is to be an advocate for their patients, and there is no question that many patients need advocacy to reach their health care goals. The role of advocate takes many forms, but one is to speak up when one is concerned for the safety or well‐being of a patient. A nurse is often the member of a health care team most likely to notice changes that might signal problems or poor responses to (...) treatment. The duty of the nurse is to speak up in a timely and urgent manner when the nurse believes—or fears—that the patient's safety may be at risk. Yet the role of nurses as advocates for their patients has assumed near‐mythic status. Rather than seeing advocate as one among many equally important and interrelated professional roles, the nurse, when asked, “Who are you?” is likely to give the heartfelt and passionate answer, “The patient's advocate!” This essay examines and critically analyzes the advocacy role adopted by the nursing profession and outlines the challenges it has created to nursing's contributions to collaborative practice, ethics, and policy in health care. (shrink)

ObjectiveParenting sensitivity and mutual parent-child attunement are key features of environments that support children’s learning and development. To-date, observational measures of these constructs have focused on children aged 2–6 years and are less relevant to the more sophisticated developmental skills of children aged 7–8 years, despite parenting being equally important at these ages. We undertook a rigorous process to adapt an existing observational measure for 7–8-year-old children and their parents. This paper aimed to: describe a protocol for adapting an existing (...) framework for rating parent-child interactions, determine variations in parents’ sensitive responding and parent-child mutual attunement by family demographics, and evaluate the psychometric properties of the newly developed measure.MethodParent-child dyads completed one home visit, including a free-play observation and parent questionnaire. Dyads were provided with three toy sets: LEGO® Classic Box, Classic Jenga®, and animal cards. The Coding of Attachment-Related Parenting was adapted for use with 7–8-year-old children, and rating procedures were streamlined for reliable use by non-clinician/student raters, producing the SCARP:7–8 Years. Trained staff rated video-recorded observations on 11 behaviors across two domains.ResultsData were available for 596 dyads. Consistently strong inter-rater agreement on the 11 observed behaviors was achieved across the 10-week rating period. Average ICCs were 0.77 for sensitive responding and 0.84 for positive mutuality. These domains were found to be related but distinct constructs. For both domains, average ratings were strongly associated with the main toy used during the observation. Adjusted multivariate linear regression models revealed that less sensitive responding was associated with younger parent, male parent, non-English speaking background, and greater neighborhood disadvantage. Construct validity was demonstrated using six parent-reported psychosocial and parenting measures.ConclusionThe SCARP: 7–8 Years shows promise as a reliable and valid measure of parent-child interaction in the early school years. Toy selection for direct observation should be considered carefully in research and practice settings. (shrink)

Farmers have been characterized as people whose ties to the land have given them a deep awareness of natural cycles, appreciation for natural beauty and sense of responsibility as stewards. At the same time, their relationship to the land has been characterized as more utilitarian than that of others who are less directly dependent on its bounty. This paper explores this tension by comparing the attitudes and beliefs of a group of conventional farmers to those of a group of organic (...) farmers. It was found that while both groups reject the idea that a farmer’s role is to conquer nature, organic farmers were significantly more supportive of the notion that humans should live in harmony with nature. Organic farmers also reported a greater awareness of and appreciation for nature in their relationship with the land. Both groups view independence as a main benefit of farming and a lack of financial reward as its main drawback. Overall, conventional farmers report more stress in their lives although they also view themselves in a caretaker role for the land more than do the organic farmers. In contrast, organic farmers report more satisfaction with their lives, a greater concern for living ethically, and a stronger perception of community. Finally, both groups are willing to have their rights limited (organic farmers somewhat more so) but they do not trust the government to do so. (shrink)

Graduates of doctoral programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete their studies in (...) one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study. (shrink)

Bloom's eloquent and comprehensive treatment of early word learning holds that social intention is foundational for language development. While we generally support his thesis, we call into question two of his proposals: (1) that attention to social information in the environment implies social intent, and (2) that infants are sensitive to social intent at the very beginnings of word learning.

The editors of the JRE solicited short essays on the COVID‐19 pandemic from a group of scholars of religious ethics that reflected on how the field might help them make sense of the complex religious, cultural, ethical, and political implications of the pandemic, and on how the pandemic might shape the future of religious ethics.

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

In this article, the authors introduce the concept of a “queer counter-mythology.” They do so by discussing a speculative song they wrote as an enactment of research-creation. Research-creation names an interdisciplinary scholarly praxis where artist-scholars create the artefacts they want to think-with, rather than analysing existing cultural productions. The song discussed in this article, “Cosmic Beavers,” proposes a queer counter-mythology that reimagines the historical, colonial archive by foregrounding the stories of giant, trans-dimensional beavers who shred Lewis and Clark and use (...) them to reinforce their Time-Dam. Drawing on this song, as well as queer theories of time and anti-colonial thinkers, the authors suggest that artistic interventions invoke speculative lures that, while not changing history, can complicate state-sanctioned archives and narratives of the past and future: they frame this intervention as a queer counter-mythology. (shrink)

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)

Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long‐term care (LTC). Nurses from an older persons’ mental health and dementia LTC unit in Australia participated in this study. Forty‐one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty‐nine nurses participated in individual interviews to (...) further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well‐being of people in LTC. (shrink)

Spirituality is an important, but oft-overlooked, aspect of the self that may affect college students’ wellbeing and belonging. Few studies have systematically examined closeness to God and spiritual struggles as predictors of college student wellbeing during early college, which is a critical window for identity development. Moreover, research exploring interactions between spiritual struggles and closeness to God in predicting wellbeing outcomes is scarce. We address these gaps in the literature with an analytic sample comprised of 839 first-year college participants who (...) identify as religious. The results of correlational analyses and linear mixed effect models are presented. Closeness to God was associated with greater wellbeing and belonging, and spiritual struggles were associated with lower wellbeing and belonging. In exploratory analyses, a moderating effect of closeness to God on the relation between spiritual struggles and negative outcomes was observed. Implications for higher education and college student development are discussed. (shrink)

Venturing into novel terrain poses physical risks to a female and her offspring. Females have a greater tendency to avoid physical harm, while males tend to have larger range sizes and often outperform females in navigation-related tasks. Given this backdrop, we expected that females would explore a novel environment with more caution than males, and that more-cautious exploration would negatively affect navigation performance. Participants explored a novel, large-scale, virtual environment in search of five objects, pointed in the direction of each (...) object from the origin, and then navigated back to the objects. We found that females demonstrated more caution while exploring as reflected in the increased amounts of pausing and revisiting of previously traversed locations. In addition, more pausing and revisiting behaviors led to degradation in navigation performance. Finally, individual levels of trait harm avoidance were positively associated with the amount of revisiting behavior during exploration. These findings support the idea that the fitness costs associated with long-distance travel may encourage females to take a more cautious approach to spatial exploration, and that this caution may partially explain the sex differences in navigation performance. (shrink)

Competent patients’ refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on (...) the merits and limitations of five well-known ethical positions: pure autonomy, conscientious objection, paternalism, communitarianism, and feminism. We found each lacking and argue for a ‘negotiated reliance’ response where nurses and others tread as lightly as possible on the patient’s autonomy while negotiating a compromise, but are obligated to match the patient’s sacrifice by extending themselves beyond their usual professional practice. (shrink)

ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)