Background People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. Method This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of (...) suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. Results The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. Conclusion There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them. Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area. (shrink)

Alison Bailey has recently explored the nature of what she calls privilege‐evasive epistemic pushback or “the variety of willful ignorance that many members of dominant groups engage in when they are asked to consider both the lived experience and structural injustices that members of marginalized groups experience daily.” In this article, I want to use Bailey's argument to demonstrate how privilege‐evasive epistemic pushback is facilitated and obscured by the disciplinary tools of traditional Western philosophy. Specifically, through exploring philosophical cultures (...) of justification and case studies, this work will reveal how students engage in privilege‐evasive epistemic pushback by deploying the reason/emotion divide and various philosophical norms and practices it underlies to protect their epistemic home turf. Then, I offer three emotion‐enhancing critical philosophical practices aimed at disrupting the ignorance‐promoting moves of privilege‐evasive epistemic pushback and, instead, engage emotion as epistemically significant. (shrink)

In the early 1990s, Sara Ruddick's Maternal Thinking was criticized for harboring a latent ethnocentrism. Ruddick responded to these critiques in the 1995 edition of her book, but her response has not yet been addressed in the feminist philosophical literature. This essay addresses this lacuna in the scholarship on Ruddick. In the last installment of this critique, Alison Bailey and Patrice DiQuinzio suggested that the only way for Ruddick to avoid the ethnocentrism charge would require her near-universalistic claims about (...) mothering to be rejected in favor of “particularized, localized accounts of mothering.” In this essay I'll show that this claim goes too far. After reviewing Lugones's and Bailey's critiques of Ruddick, along with Ruddick's response, I propose a “modified universalism” that addresses the concerns raised by Ruddick's critics while preserving key elements of her theory. (shrink)

In The Racial Contract, Charles Mills introduces the notion of an ‘inverted epistemology,’ an epistemology that construes social and racial ignorance as knowledge (p.18). As Mills points out, such ignorance can be used to oppress people by creating alternate realities or ‘white mythologies’ about race (p. 19). If the racial contract results in a society that oppresses people of color and supports white supremacy, then the question of how to correct an inverted epistemology becomes critical. Mills proposes the correction of (...) history and the racist thinking underwriting it as a solution to the problem. Others, like Alison Bailey, seek to confront racial ignorance with active resistance by suggesting that individuals from historically marginalized groups exploit what members of dominant society don’t know (p. 77). While Bailey’s solution, referred to as strategic ignorance, may originate from good intentions, I argue that it is in general inappropriate for Indigenous people. Strategic ignorance is a product of the Western worldview, and it privileges Western values. In fact, both solutions offered by Mills and Bailey fail to consider Indigenous values. Mills’ proposed solution, however, is less objectionable. Instead of either solution, a more suitable form of resistance – one that embraces connectedness, balance, and harmony – would be ideal for the Indigenous communities of Turtle Island. (shrink)

Doctors routinely refuse donation offers from prospective living kidney donors with certain comorbidities such as diabetes or obesity out of concern for donor wellbeing. This refusal occurs despite the ongoing shortage of kidney transplants and the superior performance of living donor kidney transplants compared to those from deceased donors. In this paper, we argue that this paternalistic refusal by doctors is unjustified and that, within limits, there should be greater acceptance of such donations. We begin by describing possible weak and (...) strong paternalistic justifications of current conservative donor acceptance guidelines and practices. We then justify our position by outlining the frequently under-recognised benefits and the routinely overestimated harms of such donation, before discussing the need to respect the autonomy of willing donors with certain comorbidities. Finally, we respond to a number of possible objections to our proposal for more liberal kidney donor acceptance criteria. We use the situation in Australia as our case study, but our argument is applicable to comparable situations around the world. (shrink)

How we engage in epistemic practice, including our methods of knowledge acquisition and transmission, the personal traits that help or hinder these activities, and the social institutions that facilitate or impede them, is of central importance to our lives as individuals and as participants in social and political activities. Traditionally, Anglophone epistemology has tended to neglect the various ways in which these practices go wrong, and the epistemic, moral, and political harms and wrongs that follow. In the past decade, however, (...) there has been a turn towards the non-ideal in epistemology. This volume gathers new works by emerging and world-leading scholars on a significant cross section of themes in non-ideal epistemology. Articles focus on topics including intellectual vices, epistemic injustices, interpersonal epistemic practices, and applied epistemology. In addition to exploring the various ways in which epistemic practices go wrong at the level of both individual agents and social structures, the papers gathered herein discuss how these problems are related, and how they may be addressed. -/- Contributors: Alison Bailey, Olivia Bailey, Simon Barker, Heather Battaly, Havi Carel, Quassim Cassam, Charlie Crerar, Miranda Fricker, Trystan S. Goetze, Heidi Grasswick, Keith Harris, Casey Rebecca Johnson, Ian James Kidd, and Alessandra Tanesini. (shrink)

Dementia has rapidly become a major global health crisis. As the aging population continues to increase, the burden increases commensurately on both individual and societal levels. The behavioral and psychological symptoms of dementia are a prominent clinical feature of Alzheimer’s disease and related dementias. BPSD represent a myriad of manifestations that can create significant challenges for persons living with dementia and their care providers. As such, BPSD can result in detriments to social interaction with others, resulting in harm to the (...) psychosocial health of the person with dementia. While brain deterioration can contribute to BPSD as the disease progresses, it may be confounded by language and communication difficulties associated with ADRD. Indeed, when a person with dementia cannot effectively communicate their needs, including basic needs such as hunger or toileting, nor symptoms of pain or discomfort, it may manifest as BPSD. In this way, a person with dementia may be attempting to communicate with what little resources are available to them in the form of emotional expression. Failing to recognize unmet needs compromises care and can reduce quality of life. Moreover, failing to fulfill said needs can also deteriorate communication and social bonds with loved ones and caregivers. The aim of this review is to bring the differential of unmet needs to the forefront of BPSD interpretation for both formal and informal caregivers. The overarching goal is to provide evidence to reframe the approach with which caregivers view the manifestations of BPSD to ensure quality of care for persons with dementia. Understanding that BPSD may, in fact, be attempts to communicate unmet needs in persons with dementia may facilitate clinical care decisions, promote quality of life, reduce stigma, and foster positive communications. (shrink)

In the last few years, conference programs and publications have begun to appear that reflect a growing interest, among North American archaeologists, in research initiatives that focus on women and gender as subjects of investigation. One of the central questions raised by these developments has to do with their "objectivity" and that of archaeology as a whole. To the extent that they are inspired by or aligned with explicitly political (feminist) commitments, the question arises of whether they do not themselves (...) represent an inherently partial and interest-specific standpoint, and whether their acceptance does not undermine the commitment to value neutrality and empirical rigor associated with scientific approaches to archaeology. I will argue that, in fact, a feminist perspective, among other critical, explicitly political perspectives, may well enhance the conceptual integrity and empirical adequacy of archaeological knowledge claims, where this is centrally a matter of deploying evidential constraints. (shrink)

The recent Science Wars have brought into sharp focus, in a public forum, contentious questions about the authority of science and what counts as properly scientific practice that have long structured archaeological debate. As in the larger debate, localized disputes in archaeology often presuppose a conception of science as a unified enterprise defined by common goals, standards, and research programs; specific forms of inquiry are advocated (or condemned) by claiming afiliation with sciences so conceived. This pattern of argument obscures much (...) that is most creative in archaeological practice. Archaeologists routinely exploit both integrating and fragmenting relations among the sciences, especially in establishing evidential claim. I will argue that the credibility of these claims is a function, not of scientific status acquired by corporate affiliation, but of the substantive trade in tools and techniques, empirical insights, models, and theories that is made possible by local interactions between archaeology and a wide range of other disciplines. There is much more to be gained by developing a rich critical understanding of the interfield relations that make this trade possible than by appealing to generic ideals of science. (shrink)

Alzheimer’s disease is an insidious onset neurodegenerative syndrome without effective treatment or cure. It is rapidly becoming a global health crisis that is overwhelming healthcare, society, and individuals. The clinical nature of neurocognitive decline creates significant challenges in bidirectional communication between caregivers and persons with Alzheimer’s disease that can negatively impact quality-of-life. This paper sought to understand how and to what extent would awareness training about the levels of consciousness in AD influence the quality-of-life interactions in the caregiver-patient dyad. A (...) literature review of multiple databases was conducted utilizing a transdisciplinary approach. The sum of findings indicates a positive relationship between enhanced caregiver awareness and training, positive interactions, and improved QOL measures among patients and caregivers. A multidirectional relationship was found among healthcare policies, training and education resources, caregivers, and persons with AD. Specifically, the current lack of policy and inadequate training and educational resources has various detrimental effects on patients and caregivers, while improvements in training and education of caregivers yields positive outcomes in communication and QOL. Furthermore, evidence of preserved consciousness in persons with AD was demonstrated from multiple disciplines, including neurobiological, psychological, and biopsychosocial models. The literature further revealed several methods to access the preserved consciousness in persons with AD and related dementias, including sensory, emotional, and cognitive stimulations. The evidence from the literature suggests a reframed approach to our understanding and treatment of persons with AD is not only warranted, but crucial to address the needs of those affected by AD. (shrink)

ABSTRACT Historically, maternal HIV research has focused on prevention of mother‐to‐child transmission and child outcomes, with little focus on the health outcomes of mothers. Over the course of the HIV epidemic, the approach to including pregnant women in research has shifted. The current landscape lends itself to reviewing the public health ethics of this research. This systematic review aims to identify ethical barriers and considerations for including pregnant and postpartum women living with HIV in treatment adherence and retention research. We (...) completed a systematic literature review following PRISMA guidelines with analysis using a relational ethics perspective. The included studies (n = 7) identified ethical barriers related to (a) women research participants as individuals, (b) partner and family dynamics, (c) community perspectives on research design and conduct, and (d) policy and regulatory implications. These broader contextual factors will yield research responsive to, and respectful of, the needs of pregnant and postpartum women living with HIV. While current regulatory and policy environments may be slow to change, actions can be taken now to foster enabling environments for research. We suggest that a relational approach to public health ethics can best support the needs of pregnant and postpartum women living with HIV; acknowledging this population as systematically disadvantaged and inseparable from their communities will best support the health of this population. (shrink)

IntroductionThe pelvic floor muscles are active during motor tasks that increase intra-abdominal pressure, but little is known about how the PFM respond to dynamic activities, such as gait. The purpose of this study was to characterize and compare PFM activity during walking and jogging in continent adults across the entire gait cycle.Methods17 able-bodied individuals with no history of incontinence participated in this study. We recorded electromyography from the abdominal muscles, gluteus maximus, and PFM while participants performed attempted maximum voluntary contractions (...) of all muscles and completed 60–70 strides in four gait conditions: slow walk ; regular walk ; transition walk ; jog. We quantified activity throughout the whole gait cycle and during periods of bursting for each participant, and analyzed the timing of PFM bursting periods to explore when the PFM were most active in the gait cycle. We also conducted a phase metric analysis on the PFM and GM burst timings. We performed a Spearman's rank-order correlation to examine the effect of speed on %aMVCGC, %aMVCBR, and phase metric score, and used the Wilcoxon Signed-Rank test to evaluate the effect of gait modality, matched for speed, on these variables.ResultsThe PFM were active throughout the gait cycle, with bursts typically occurring during single-leg support. The PFM and GM were in phase for 44–69% of the gait cycle, depending on condition. There was a positive correlation between gait speed and both %aMVCGC and %aMVCBR. Phase metric scores were significantly higher during jogging than transition walking, but there was no difference between gait modality on %aMVCGC or %aMVCBR. Where possible we disaggregated data by sex, although were unable to make statistical comparisons due to low sample sizes.ConclusionThe PFM are active during walking and jogging, with greater activity at faster speeds and with bursts in activity around single-leg support. The PFM and GM co-activate during gait, but are not completely in phase with each other. (shrink)

In the past three decades scholars in virtually every humanistic and social scientific research discipline, and in some natural sciences, have drawn attention to quite striking instances of gender bias in the modes of practice and theorizing typical of traditional fields of research. They generally begin by identifying explicit androcentric biases in definitions of the subject domains appropriate to specific scientific fields. Their primary targets, in this connection, have been research that leaves women out altogether, research that ignores women’s contributions (...) or victimization, and research that conceptualizes its subject, male or female, human or non-human, in explicitly gender biased terms. (shrink)

Public disclosure of industry payments to physicians is one way to address financial conflicts of interest in medicine. As part of the Patient Protection and Affordable Care Act, the Physician Payment Sunshine Act requires pharmaceutical, medical device, and biologics manufacturers who have at least one product reimbursed by Medicare or Medicaid to disclose payments to physicians and teaching hospitals on a public website starting in 2014. The physician payment data will contain individual physician names, monetary values, and specific products connected (...) to payments.According to the Final Regulations issued by the Centers for Medicare and Medicaid Services in February 2013, the law will make transparent the extent and nature of relationships between physicians, teaching hospitals, and manufacturers. (shrink)

Standpoint theory is an explicitly political as well as social epistemology. It’s distinctive features are commitment to understand the social locations that shape the epistemic capacities and resources of individuals in structural terms, and a recognition that those who are marginalized within hierarchically structured systems of social differentiation are often epistemically advantaged. In some crucial domains they know more and know better as a contingent function of their situated experience and knowledge. This “inversion thesis” counters the alignment of social with (...) epistemic privilege. (shrink)

I am on record as a fan of Rock, Bone, and Ruin, and I was pleased to discover that, in our paired cover blurbs, Martin Rudwick and I make essentially the same point: the great virtue of Rock, Bone, and Ruin is that Adrian Currie combines what you might describe as a jeweler’s-eye view, in his attention to the messy details of research practice in the historical sciences, with a cartographer’s breadth of vision that, as Rudwick puts it, leads him (...) to “explore the surprising commonalities that underlie these superficially diverse sciences.” Rather than appraising the epistemic prospects of the historical sciences against an abstract, trans-contextual template, Currie builds this breadth from close analysis of the strategies by which epistemically “unlucky” historical scientists parlay their limited evidential resources into a robust understanding of temporally remote geological events, evolutionary processes and cultural dynamics. As a demonstration of how productive such a turn to practice can be, Currie’s approach has meta-philosophical implications to which I return at the end, but first I offer a selective review of his appraisal of the limitations of trace-centric accounts. (shrink)

During the 1998 Victoria CAA conference, an afternoon was devoted to a plenary discussion on the future of archaeology in Canada, and particularly the role the CAA should take in this future. The plenary was divided into two sections. First, a series of presenters discussed the future of Canadian archaeology from their particular vantage at the intersection of government, academe, First Nations and private industry. The second half of the plenary consisted of a series of presentations from CAA committee chairs, (...) presenting some tangible ideas on the directions the CAA may need to take in responding to the challenges of change. The following represents the compiled presentations offered during the first half of the plenary, along with some compiled observations and conclusions on the challenges and opportunities facing both the CAA and the archaeological community in this country. This is then followed by a series of commentaries on the plenary presentations, solicited from a number of archaeologists from different sectors of the CAA community. As the CAA begins a new millennium, century, or just start to another year, the issues raised in the presentations and commentaries, particularly in terms of the role the CAA sees for itself, will need to be met with more than talk. (shrink)

My aim here is to focus attention on a shift, over the last decade, in how gender inequity in understood in North American academic settings, and to draw out some implications for the analysis of the status of women in archaeology.

Georges Bataille's powerful writings have fascinated many readers, enmeshed as they are with the themes of sex and death. His emotive discourse of excess, transgression, sacrifice, and the sacred has had a profound and notable influence on thinkers such as Foucault, Derrida and Kristeva. Bataille: Writing the Sacred examines the continuing power and influence of his work. The full extent of Bataille's subversive and influential writings has only been made available to an English-speaking audience in recent years. By bringing together (...) international specialists on Bataille from philosophy and literature to art history, this collection is able to explore the many facets of his writings. (shrink)

Georges Bataille's powerful writings have fascinated many readers, enmeshed as they are with the themes of sex and death. His emotive discourse of excess, transgression, sacrifice, and the sacred has had a profound and notable influence on thinkers such as Foucault, Derrida and Kristeva. _Bataille: Writing the Sacred_ examines the continuing power and influence of his work. The full extent of Bataille's subversive and influential writings has only been made available to an English-speaking audience in recent years. By bringing together (...) international specialists on Bataille from philosophy and literature to art history, this collection is able to explore the many facets of his writings. (shrink)