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)

The idea of narrative has been widely discussed in the recent health care literature, including nursing, and has been portrayed as a resource for both clinical work and research studies. However, the use of the term 'narrative' is inconsistent, and various assumptions are made about the nature (and functions) of narrative: narrative as a naive account of events; narrative as the source of 'subjective truth'; narrative as intrinsically fictional; and narrative as a mode of explanation. All these assumptions have left (...) their mark on the nursing literature, and all of them (in our view) are misconceived. Here, we argue that a failure to distinguish between 'narrative' and 'story' is partly responsible for these misconceptions, and we offer an analysis that shows why the distinction between them is essential. In doing so, we borrow the concept of 'narrativity' from literary criticism. Narrativity is something that a text has degrees of, and our proposal is that the elements of narrativity can be 'sorted' roughly into a continuum, at the 'high narrativity' end of which we find 'story'. On our account, 'story' is an interweaving of plot and character, whose organization is designed to elicit a certain emotional response from the reader, while 'narrative' refers to the sequence of events and the (claimed) causal connections between them. We suggest that it is important not to confuse the emotional persuasiveness of the 'story' with the objective accuracy of the 'narrative', and to this end we recommend what might be called 'narrative vigilance'. There is nothing intrinsically authentic, or sacrosanct, or emancipatory, or paradigmatic about narrative itself, even though the recent health care literature has had a marked tendency to romanticize it. (shrink)

We develop a notion of cell decomposition suitable for studying weak p-adic structures definable). As an example, we consider a structure with restricted addition.

This paper is a counter to the view that names are always predicates with the same extension as a metalinguistic predicate with the form “is a thing called “N”” (the Predicate View). The Predicate View is in opposition to the Referential View of names. In this paper, I undermine one argument for the Predicate View. The Predicate View’s adherents take examples of uses of names that have the surface appearance of a predicate and generalise from these to treat uses of (...) names that do not have the surface appearance of a predicate. They show that the Predicate View can provide a unified account of these two uses and assume that the Referential account cannot. I propose an alternative view of names, the Polysemy View. This view allows one to resist the pressure to generalise from the cases with the surface appearance of predicates to all uses of names while nevertheless providing connections between the uses. On the Polysemy View names are not, in their core use, metalinguistic predicates. Names are predominantly referring expressions but they also freelance as metalinguistic predicates on occasion. They have a double life. This double life is possible because of the pragmatic and conventional connections between the two aspects of that life. My main aim in this paper is to show that the Predicate View is not the only view that can give a good account of apparently predicative uses of names. In addition, I offer some inconclusive reasons to prefer the Polysemy View over the Predicate View. My paper assumes a background framework that the Predicate and Referentialist Views share and I do not attempt to justify that framework. I ignore many other views of names (notably descriptivist views and relevance theoretic views) in order to focus on the debate between these two opponents. (shrink)

I distinguish between two senses in which feminists have argued that the knower is social: 1. situated or socially positioned and 2. interdependent. I argue that these two aspects of the knower work in cooperation with each other in a way that can produce willful hermeneutical ignorance, a type of epistemic injustice absent from Miranda Fricker's Epistemic Injustice. Analyzing the limitations of Fricker's analysis of the trial of Tom Robinson in Harper Lee's To Kill a Mockingbird with attention to the (...) way in which situatedness and interdependence work in tandem, I develop an understanding of willful hermeneutical ignorance, which occurs when dominantly situated knowers refuse to acknowledge epistemic tools developed from the experienced world of those situated marginally. Such refusals allow dominantly situated knowers to misunderstand, misinterpret, and/or ignore whole parts of the world. (shrink)

This article considers some of the ways in which ‘the black woman’ as both representation and embodied, sentient being is rendered visible and invisible, and to link these to the multiple and competing ways in which she is ‘present’. The issues are engaged through three distinct but overlapping conceptualisations of ‘presence’. ‘Presence’ as conceived (and highly contested) in performance studies; ‘presence’ as conceived and worked with in psychoanalysis; and ‘presence’ as decolonising political praxis among Indigenous communities. I use these conceptualisations (...) of presence to consider the various ways in which the black woman as figure and as embodied/sentient subject has been made present/absent in different discursive registers. I also explore what is foreclosed and how this is itself linked to legacies of colonial ‘worlding’. I end with consideration of alternative modes of black women's presence and how this offers a resource for new modes of sociality. (shrink)

This book opens the door to the effects of intellectual, educational, and economic colonization of young children throughout the world. Using a postcolonial lens on current educational practices, the authors hope to lift those practices out of reproducing traditional power structures and push our thinking beyond the adult/child dichotomy into new possibilities for the lives that are created with children.

Lecturer in social foundations of education and women's studies, Victoria College, Australia.

It is an ancient view, to be found even in Aristotle’s analysis of friendship, that the other is an alter ego, another myself. More recently, this conception has provoked spirited debate within and without the phenomenological tradition. It can be found in a wide variety of texts, from Husserl’s Cartesian Meditations to Thomas Nagel’s “What is it like to be a bat?” The basic position can be summarized as follows. Intentional experiences are subjective, first-person experiences, not objective, third-person experiences.

In this qualitative study, the elements and quality of musher-sled dog relationships were investigated. In-depth interviews with a narrative design were conducted with eight mushers from northern Minnesota and northwestern Ontario. The mushers were asked to contribute ideas by sharing stories and experiences of working with dogs, as well as art or photographs. While all the participants had their own ideas about musher-sled dog relationships, six themes emerged. The mushers stated the importance of getting to know the dogs, their respect (...) for their sled dogs’ abilities, the idea of a two-way communication that takes place, the importance of trust, the notion of partnership, and what can be learned through working with sled dogs. This study supports other research suggesting that humans and animals engage in interspecies relationships and that these can be quality relationships with multiple elements. The importance of researching and teaching about dogs as subjects is discussed, as well as the significance of humans having direct experience with other animals. (shrink)

This article historicizes a single stage in how the contemporary obsessive–compulsive disorder (OCD) category was built. Starting from the position that the two central components which make up OCD are ‘obsessions’ and ‘compulsions’, it illustrates how these concepts were taken apart by a small group of clinical psychologists working at the Institute of Psychiatry and the Maudsley psychiatric hospital in south London in the early 1970s, and why compulsions were investigated whilst obsessions were ignored. The decision to distinguish the previously (...) undifferentiated symptoms is attributed to the commitment amongst psychologists at the Maudsley, most notably Stanley Rachman, to an empirical conception of science which emphasized observability. Two aspects of this are discussed. First, compulsions were deemed ‘visible’ through their correspondence with animal behaviour. Second, the symptom was seen as open to an experimental modification procedure which privileged visible outcomes. Ultimately, the article concludes that the historical division between ‘obsessions’ and ‘compulsions’, and the extensive investigation of the latter, has had substantial implications for the development of OCD as a category centred on visible behaviours and treated through behavioural means. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

The field of bioethics has evolved over the past half-century, incorporating new domains of inquiry that signal developments in health research, clinical practice, public health in its broadest sense and more recently sensitivity to the interdependence of global health and the environment. These extensions of the reach of bioethics are a welcome response to the growth of global health as a field of vital interest and activity. This paper provides a critical interpretive review of how the term “global health ethics” (...) has been used and defined in the literature to date to identify ethical issues that arise and need to be addressed when deliberating on and working to improve the discourse on ethical issues in health globally. Selected publications were analyzed by year of publication and geographical distribution, journal and field, level of engagement, and ethical framework. Of the literature selected, 151 articles were written by authors in high-income countries, as defined by the World Bank country classifications, 8 articles were written by authors in low- or middle-income countries, and 13 articles were collaborations between authors in HIC and LMIC. All of the articles selected except one from 1977 were published after 1998. Literature on global health ethics spiked considerably from the early 2000s, with the highest number in 2011. One hundred twenty-seven articles identified were published in academic journals, 1 document was an official training document, and 44 were chapters in published books. The dominant journals were the American Journal of Bioethics, Developing World Bioethics, and Bioethics. We coded the articles by level of engagement within the ethical domain at different levels: interpersonal, institutional, international, and structural. The ethical frameworks at use corresponded to four functional categories: those examining practical or narrowly applied ethical questions; those concerned with normative ethics; those examining an issue through a single philosophical tradition; and those comparing and contrasting insights from multiple ethical frameworks. This critical interpretive review is intended to delineate the current contours and revitalize the conversation around the future charge of global health ethics scholarship. (shrink)

The literature on epistemic injustice has been helpful for highlighting some of the epistemic harms that have long troubled those working in area studies that concern oppressed populations. Nonetheless, a good deal of this literature is oriented toward those in a position to perpetrate injustices, rather than those who historically have been harmed by them. This orientation, I argue, is ill-suited to the work of epistemic decolonization. In this essay, I call and hold attention to the epistemic interests of those (...) who are epistemically marginalized on account of relations of dominance and oppression. To do so, I draw on Kristie Dotson’s work, which uses a systems approach focused on epistemic agency. I develop Dotson’s insights further to argue that epistemic inclusions may be just as pernicious as epistemic exclusions Specifically, I highlight some of the ways in which epistemic agents can be included in epistemic systems in a manner that is epistemically exploitative—extracting epistemic labor coercively or in ways that are distinctly non-reciprocal. I then turn to María Lugones’ distinction between horizontal and vertical practices to discuss avenues of resisting both exclusions and inclusions that thwart the epistemic agency of marginalized knowers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sexual Difference as Model: An Ethics for the Global FutureGail SchwabIn Éthique de la différence sexuelle (1984), Luce Irigaray targeted language and love—for her, inseparable from each other—as the two areas of focus for the elaboration of an ethics of sexual difference. The heterosexual couple seemed to have taken on a new, and somehow inappropriately central, importance in Irigaray’s thought in the early eighties; however, the projected mutations in (...) language and love theorized in Éthique did not exclusively concern the heterosexual relationship, even though many readers of Irigaray expressed just such reservations about the book. Éthique foregrounded the couple in the love relationship in order to rethink the philosophical basis of ethics in general, to develop new paradigms, beyond or outside of Western totalizing phallo- and logocentrism, for human relations—not only relations between women and men, but also, and perhaps even more importantly, relations among women and relations among men. Irigaray carried on this project in subsequent works, in Sexes et parentés (1987), which as the title explicitly indicates, opens up the ethical debate to familial and genealogical issues and broadens her focus to include children and the ethical basis of their relationships to parents and more generally to adults of both sexes, and in Sexes et genres à travers les langues (1990), a cross-cultural report on her empirical studies of gender differences in language usage, which sheds new light on the linguistic and communicational issues she had presented in Éthique and even before, in several seldom read and even more rarely analyzed works of the late seventies and early eighties. J’aime à toi (I Love to You) (1992) returns specifically to the more traditionally philosophical approach to the problems of language and love and their intertwining, and carries on the work projected in Éthique, but it goes much further in both the theoretical and the practical development of the concept of sexual difference as the foundation for a new ethics, a new culture of universal validity. J’aime à toi can be read as a follow-up to Éthique and as a founding text for the construction of an ethics of difference modeled on sexual difference, an ethics for the future of humanity in all of its diversity.Western Feminism and the Global FutureIrigaray is very much aware of the limits of the various Western political and academic feminisms, of the need to broaden their scope, both horizontally across cultures and vertically within specific cultures, before they can serve as the basis for a new ethics. Irigaray expresses the concern that Western feminists, rather than represent the exploited women of the world, may exploit them ideologically for their own personal or political purposes, at the risk of preventing them from coming to a feminism of their own making, appropriate to their own cultures and historical moments. “Certain women do implement power strategies—including the power of the media—but not solely for the benefit of the exploited women they use as an alibi. They thus run the risk of clouding the issues and [End Page 76] preventing their consciousness from being raised” [Irigaray, J’aime à toi 15]. 1 Irigaray calls this “egological” feminism (Dare I invent a new term here? Now we have “egofeminists” as well as “ecofeminists”...) and demonstrates its totally undemocratic orientation, despite its representative claims.Certain militants..., practicing direct democracy or an egological feminism, based on their own real, or imagined, needs and desires, rather than on those of all women, leave women subject to existing legislation. Indifferent to the rights necessary for all women—including the little girls of the present and the future, and the women of other cultures—they make decisions that perpetuate, and even aggravate, through unnecessary misunderstandings, the injustices done the female gender.[J’aime à toi 13]As a feminist, in general, it always pains me to read criticisms of feminism, even cogent and theoretically valid criticisms, and I am even now painfully aware of the political dangers of criticizing feminism myself in a public forum such as this one. However, if I have managed to learn anything from the works of Western feminists of color and from Third World feminists, it is... (shrink)

This editorial critically engages with the understanding of openness by attending to how notions of presence and absence come bundled together as part of efforts to make open. This is particularly evident in contemporary discourse around data production, dissemination, and use. We highlight how the preoccupations with making data present can be usefully analyzed and understood by tracing the related concerns around what is missing, unavailable, or invisible, which unvaryingly but often implicitly accompany debates about data and openness.

Telepsychiatry has long been discussed as a supplement to or substitute for face-to-face therapeutic consultations. The current pandemic crisis has fueled the development in an unprecedented way. More and more psychiatric consultations are now carried out online as video-based consultations. Treatment results appear to be comparable with those of face-to-face care in terms of clinical outcome, acceptance, adherence and patient satisfaction. However, evidence on videoconferencing in a variety of different fields indicates that there are extensive changes in the communication behaviour (...) in online conversations. We hypothesise that this might impact ethically relevant aspects of the therapeutic relationship, which plays a prominent role in psychiatry. In this paper, we review effects of video-based consultations on communication between therapists and patients in psychiatry. Based on a common understanding of video-based consultations as changing the lived experience of communication, we categorise these effects according to sensory, spatial and technical aspects. Departing from a power-based model of therapeutic relationships, we then discuss the ethical significance of this changed communication situation, based on dimensions of respect for autonomy, lucidity, fidelity, justice and humanity. We conclude that there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations. These changes need to be more carefully considered in psychiatric practice and future studies. (shrink)

Existing metasemantic projects presuppose that word- (or sentence-) types are part of the non-semantic base. We propose a new strategy: an endogenous account of word types, that is, one where word types are fixed as part of the metasemantics. On this view, it is the conventions of truthfulness and trust that ground not only the meaning of the words (meaning by convention) but also what the word type is of each particular token utterance (words by convention). The same treatment extends (...) to identifying the populations through which the conventions prevail. We consider whether this proposal leads to new underdetermination challenges for metasemantics, and make a case that it does not. (shrink)

Meno's Paradox from Socrates to Sextus Gail Fine. sense that they consider the issues it raises; and they argue, against its conclusion, that inquiry is possible. Like Plato and Aristotle, they also explain what makes inquiry possible; and they do ...

This article explores the development of a novel biomedical research organism, and its potential to remake the species and spaces of translational medicine. The humanized mouse is a complex experimental object in which mice, rendered immunodeficient through genetic alteration, are engrafted with human stem cells in the hope of reconstituting a human immune system for biomedical research and drug testing. These chimeric organisms have yet to garner the same commentary from social scientists as other human–animal hybrid forms. Yet, they are (...) rapidly being positioned as central to translational medicine in immunological research and pharmaceutical development. This article explores the complex relations between species and spaces they seek to enact. Humanizing mice simultaneously moves these animal forms towards the intimate geographies of corporeal equivalence with humans and the expansive geographies of translational research. These multiple trajectories are achieved by the way humanized mice function as both uncertain ‘epistemic things’ and as expansive ‘collaborative things’, articulating mouse genetics with other research, notably stem cell science. In the context of post-genomics, their indeterminacy is critical to their collaborative value; their expansive potential follows as much from their biological openness as from specific expectations. Yet, these new research organisms have both accumulative and disruptive capacities, for there are patterns of interference between these trajectories, remaking boundaries between experimental practices and clinical contexts. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Representing a new generation of theorists reaffirming the radical dimensions of art, Gail Day launches a bold critique of late twentieth-century art theory and its often reductive analysis of cultural objects. Exploring core debates in discourses on art, from the New Left to theories of "critical postmodernism" and beyond, Day counters the belief that recent tendencies in art fail to be adequately critical. She also challenges the political inertia that results from these conclusions. Day organizes her defense around critics (...) who have engaged substantively with emancipatory thought and social process: T. J. Clark, Manfredo Tafuri, Fredric Jameson, Benjamin H. D. Buchloh, and Hal Foster, among others. She maps the tension between radical dialectics and left nihilism and assesses the interpretation and internalization of negation in art theory. Chapters confront the claim that exchange and equivalence have subsumed the use value of cultural objects—and with it critical distance— and interrogate the proposition of completed nihilism and the metropolis put forward in the politics of Italian operaismo. Day covers the debates on symbol and allegory waged within the context of 1980s art and their relation to the writings of Walter Benjamin and Paul de Man. She also examines common conceptions of mediation, totality, negation, and the politics of anticipation. A necessary unsettling of received wisdoms, _Dialectical Passions_ recasts emancipatory reflection in aesthetics, art, and architecture. (shrink)

Introduces teens to the benefits of working with and caring for animals, and includes personal experiences of teens who have become involved with animals in a ...

John Kelly has replied to my assessment of his Rethinking Industrial Relations published earlier in this journal in a fraternal and constructive manner. Here, I wish to undertake two tasks. The first is to assess the response of other academics and writers to his book, in terms of reviews and the use of his work by others. The second is to engage with the points he makes to take the debate further forward.

How are we to think and act constructively in the face of today’s environmental and political catastrophes? Gail Stenstad finds inspiring answers in the thought of German philosopher Martin Heidegger. Rather than simply describing or explaining Heidegger’s transformative way of thinking, Stenstad’s writing enacts it, bringing new insight into contemporary environmental, political, and personal issues. Readers come to understand some of Heidegger’s most challenging concepts through experiencing them. This is a truly creative scholarly work that invites all readers to (...) carry Heidegger’s transformative thinking into their own areas of deep concern. (shrink)

How likely is it that traumatic childhood events are misremembered or forgotten? Research on children′s recollections of painful or frightening medical procedures may help answer this question by identifying predictors of accurate versus inaccurate memory. In the present study, 46 3- to 10-year-old children were interviewed after undergoing a stressful medical procedure involving urethral catheterization. Age differences in memory emerged, especially when comparing 3- to 4-year-olds with older children. Children′s understanding of the event, parental communication and emotional support, and children′s (...) own emotional reactions also predicted accuracy. Memory did not reliably vary for children who endured the medical procedure once versus multiple times. Results are discussed in relation to possible precursors of accurate and false memories, and forgetting, of traumatic events experienced in childhood. (shrink)

This paper uses the figure of the inbred laboratory mouse to reflect upon the management and mobilization of biological difference in the contemporary biosciences. Working through the concept of shifting experimental systems, the paper seeks to connect practices concerned with standardization and control in contemporary research with the emergent and stochastic qualities of biological life. Specifically, it reviews the importance of historical narratives of standardization in experimental systems based around model organisms, before identifying a tension in contemporary accounts of the (...) reproduction and differentiation of inbred mouse strains within them. Firstly, narratives of new strain development, foregrounding personal biography and chance discovery, attest to the contingency and situatedness of apparently universal biotechnological production. Secondly, discoveries of unexpected animal litters challenge efforts to standardize mouse phenotypes and control the reproduction of murine strains over space. The co-existence of these two narratives draws attention to the importance of and interplay between both chance and control, determination and emergence, and the making and moving of experimental life in biomedical research. The reception or denial of such biological excess reflects the distribution of agencies and the emerging spatialities of the global infrastructures of biotechnological development, with implications for future relations between animal lives and human becomings in experimental practices. (shrink)