Background: Patients undergoing invasive neurosurgical procedures offer researchers unique opportunities to study the brain. Deep brain stimulation patients, for example, may participate in research during the surgical implantation of the stimulator device. Although this research raises many ethical concerns, little attention has been paid to basic studies, which offer no therapeutic benefits, and the value of patient-participant perspectives.Methods: Semi-structured interviews were conducted with fourteen individuals across two studies who participated in basic intraoperative research during their deep brain stimulator surgery. (...) Interviews explored interpretations of risks and benefits, enrollment motivations, and experiences of participating in awake brain research. Reflexive thematic analysis was conducted.Results: Seven themes were identified from participant narratives, including robust attitudes of trust, high valuations of basic science research, impacts of the surgical context, and mixed experiences of participation.Conclusion: We argue that these narratives raise the potential for a translational misconception and motivate intraoperative re-consent procedures. (shrink)

In this study the awake patient's intraoperative situation and experiences during regional anaesthetics and surgery are reflected upon by using the work of the French philosopher Maurice Merleau‐Ponty. Merleau‐Ponty's phenomenological idea of the body as being at the centre of the world highlights the patient's embodied position and bestows significance onto the body as a whole, as a lived body. A case, based on the findings from a previous interview study, is presented as a contextual starting point where (...) a patient goes from having a familiar body recognized as her own to having a partially anaesthetized body experienced as an unknown object. The intraoperative caring space is described in this context as the mutual ground where the awake patient and the nurse anaesthetist (NA) can interact to create meaning. The NA can act as the patient's bodily extension to bridge the gap between the patient's experiences and the situation. This calls for the NA's proximity and genuine presence in order to meet and understand the patient's awake experiences. Learning from the patient's situatedness gives information that is valuable for NAs to share with patients who are less experienced with this contextual situation. The challenge for the NA is not to perform routine‐based care, but to acknowledge every patient's lifeworld and uniqueness thus enabling the patient to move easily along the mind–body–world continuum. The core of intraoperative care is to provide support and promote well‐being of awake patients in the intraoperative environment. The use of a philosophical perspective is relevant for nurses who work in an intraoperative setting where patients undergo regional anaesthetics. This study shows how nursing research using phenomenological philosophy can help uncover new meanings known only to the patients living the experience. (shrink)

Philosophical (p-) zombies are constructs that possess all of the behavioral features and responses of a sentient human being, yet are not conscious. P-zombies are intimately linked to the hard problem of consciousness and have been invoked as arguments against physicalist approaches. But what if we were to invert the characteristics of p-zombies? Such an inverse (i-) zombie would possess all of the behavioral features and responses of an insensate being yet would nonetheless be conscious. While p-zombies are logically possible (...) but naturally improbable, an approximation of i-zombies actually exists: individuals experiencing what is referred to as “anesthesia awareness.” Patients under general anesthesia may be intubated (preventing speech), paralyzed (preventing movement), and narcotized (minimizing response to nociceptive stimuli). Thus, they appear—and typically are—unconscious. In 1-2 cases/1000, however, patients may be aware of intraoperative events, sometimes without any objective indices. Furthermore, a much higher percentage of patients (22% in a recent study) may have the subjective experience of dreaming during general anesthesia. P-zombies confront us with the hard problem of consciousness—how do we explain the presence of qualia? I-zombies present a more practical problem—how do we detect the presence of qualia? The current investigation compares p-zombies to i-zombies and explores the “hard problem” of unconsciousness with a focus on anesthesia awareness. (shrink)

We like to think we own our memories: if technology someday enables us to alter our memories, we should have certain rights to do so. But our freedom of memory has limits. Some memories are simply too valuable to society to allow individuals the unfettered right to change them. Suppose a patient regains consciousness in the middle of surgery. While traumatized by the experience and incapable of speaking, he coincidentally overhears two surgeons make plans to set fire to the hospital. (...) Assuming there is no way to erase his traumatic memories of intraoperative awareness and still prosecute the surgeons, a patient may well have a moral duty to retain the memories for the greater good. And if the patient has such a moral duty, I argue in this brief comment, then the state plausibly has the right to limit our abilities to erase memories when necessary to protect public safety or prosecute offenders. (shrink)

In a recent discussion, Walter Glannon discusses a number of ways we might try to minimize harm to patients who experience intraoperative awareness. In this response I direct attention to a possibility that deserves further attention. It might be that a kind of psychological intervention – namely, informing patients of the possibility of intraoperative awareness and of what to expect in such a case – would constitute a unique way to respect patient autonomy, as well as minimize the (...) harm that typically follows intraoperative awareness events. (shrink)

Experiences of Depression is a philosophical exploration of what it is like to be depressed. In this important new book, Matthew Ratcliffe develops a detailed account of depression experiences by drawing on work in phenomenology, philosophy of mind and psychology, and several other disciplines.

A single mother is a person who is accountable for raising their children alone because they do not have a husband or live-in partner. Single mothers claim to have no co-parenting relationships at all, comparing single parents to those who are married, cohabiting, or without children, single parents experience the worst work-life balance. A single parent may feel overwhelmed by the demands of juggling child care, a career, paying bills, and maintaining household responsibilities. Single-parent households frequently deal with several extra (...) obligations and possible complications that other families would not. The study also emphasizes the difficulties and coping mechanisms faced by contractual single parents as well as their lived experiences. The study's findings, which were based on an Interpretative Phenomenological Analysis, were as follows: (1) Work-life balance can be difficult for single parents. They struggle to keep their jobs while taking care of their family because they are the only ones in charge of the children. (2) Single contractual mothers face particular difficulties due to a lack of resources for basic expenses. (3) Contractual single women lean on their kids, the good people in their lives, and their faith in God to get through problems. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. (...) I argue that, although imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

Recent crises in Europe and beyond have renewed a longstanding debate on the status and treatment of refugees. Hannah Arendt famously questioned the limits of universalistic human rights discourse based on the widespread phenomena of statelessness and displacement that emerged during and after World War II. In this paper, we analyze recent patterns of inclusion and exclusion of refugees in Italy through the lens of Arendtian narrative and theorizing. We consider three cases of interaction between families, schools, and other public (...) institutions in light of the shifting normative framework before and during the war in Ukraine. Two major insights emerge from this analysis. From a pedagogical point of view, the most promising educational practices with refugees are those centered on enabling their agency and corresponding experiences of "natality". From an ethical-political perspective, these practices highlight a latent tension between the universalistic scope of human rights enshrined in the human rights declarations and their structural dependence on the particular norms and procedures enacted by nation states. The understanding and teaching of human rights within our political communities is inseparable from the practices that engage with refugees. In this sense, our practices of inclusion and exclusion affect the understanding of national borders as a barrier or threshold with other political communities, but also the interpretation of our own ethical-political principles. (shrink)

Most philosophers believe that we have experiences as of temporally extended phenomena like change, motion, and succession. Almost all theories of time consciousness explain these temporal experiences by subscribing to the doctrine of the specious present, the idea that the contents of our experiences embrace temporally extended intervals of time and are presented as temporally structured. Against these theories, I argue that the doctrine is false and present a theory that does not require the notion of a (...) specious present. Furthermore, I argue that the different aspects of temporal experiences arise from different mechanisms operating separately. If the theory is true, then temporal experiences do not tell us anything special about the nature of consciousness and its temporal properties per se. (shrink)

Given the lack of knowledge about safety and efficacy of many treatments for children, pediatric clinical trials are important, but recruitment for pediatric research is difficult. Little is known about children's perspective on participating in trials. The purpose of this study was to understand the experiences and motivations of young people who took part in clinical trials. This is a qualitative interview study of 25 young people aged 10–23 who were invited to take part in clinical trials. Interviews were (...) audio or video recorded and analyzed using framework analysis. Young peoples' motivations were both personal benefit and helping others. Both incentives appeared to be more complex than expected. We introduce the terms “network of exchange” and “intergenerational solidarity” to describe these motivations. To improve recruitment, professionals should be more open about research opportunities, provide better information, and give young people feedback after the trial has ended. (shrink)

Indigenous people (IP) have faced multiple difficulties in education. Indigenous students often do worse academically than non-indigenous student peers. These stated the low enrollment rates showed a dropout rate, absenteeism, repetition rates, literacy rate, and thus the educational outcomes, with retention and completion being two significant issues. Further, this study explores the lived experiences and challenges faced by indigenous high school students amidst the new normal education. Employing the Interpretative Phenomenological Analysis, the findings of this study were: (1) The (...) reason why IP learners were not satisfied with their performance is that they cannot understand some of the lessons due to the language barrier. (2) IP learners are committed to finishing their studies, however, some of the students lack resources for studying, like gadgets for researching, and they do not have cell phones. And the other students may have gadgets or cellphones, but their internet connection is low or not accessible in some places at their location. (shrink)

What happens when we consider transformative experiences from the perspective of gender transitions? In this paper I suggest that at least two insights emerge. First, trans* persons’ experiences of gender transitions show some limitations to L.A. Paul’s (forthcoming) decision theoretic account of transformative decisions. This will involve exploring some of the phenomenology of coming to know that one is trans, and in coming to decide to transition. Second, what epistemological effects are there to undergoing a transformative experience? By (...) connecting some experiences of gender transitions to feminist standpoint epistemology, I argue that radical changes in one’s identity and social location also radically affects one’s access to knowledge in ways not widely appreciated in contemporary epistemology. (shrink)

The paper develops an objection to the extensional model of time consciousness—the view that temporally extended events or processes, and their temporal properties, can be directly perceived as such. Importantly, following James, advocates of the extensional model typically insist that whole experiences of temporal relations between non-simultaneous events are distinct from mere successions of their temporal parts. This means, presumably, that there ought to be some feature(s) differentiating the former from the latter. I try to show why the extensional (...) models offers no credible ground for positing such a difference. (shrink)

Background The COVID-19 pandemic has forced rapid and widespread change to standards of patient care and nursing practice, inevitably leading to unprecedented shifts in the moral conditions of nursing work. Less is known about how these challenges have affected nurses’ capacity to meet their ethical responsibilities and what has helped to sustain their efforts to continue to care. Research objectives 1) To explore nurses’ experiences of striving to fulfill their ethical responsibilities of care during the COVID-19 pandemic and 2) (...) to explore what has fostered nurses’ capacity to fulfill these responsibilities. Research Design A generic qualitative approach was used incorporating concepts coming from fundamental features of care. Participants Twenty-four Canadian Registered Nurses from a variety of practice settings were interviewed. Ethical Considerations After receiving ethics approval, signed informed consent was obtained before participants were interviewed. Findings Four themes were identified. 1) Challenges providing good care in response to sudden changes in practice. 2) Tensions in juggling the responsibility to prevent COVID-19 infections with other competing moral responsibilities. 3) Supports to foster nurses’ capacity to meet their caring responsibilities. 4) The preservation of nurses’ moral identity through expressions of gratitude and health improvement. Discussion Infection control measures and priorities set in response to the pandemic made at distant population and organizational levels impacted nurses who continued to try to meet the ideals of care in close proximity to patients and their families. Despite the challenges that nurses encountered, the care they received themselves enabled them to continue to care for others. Nurses benefited most from the moral communities they had with their colleagues and occasionally nurse leaders, especially when they were supported in a face-to-face manner. Conclusion: Moral community can only be sustained if nurses are afforded the working conditions that make it possible for them to support each other. (shrink)

This article presents and discusses transcripts of some 270 explanations subjects provided subsequently for recognition memory decisions that had been associated with remember, know, or guess responses at the time the recognition decisions were made. Only transcripts for remember responses included reports of recollective experiences, which seemed mostly to reflect either effortful elaborative encoding or involuntary reminding at study, especially in relation to the self. Transcripts for know responses included claims of just knowing, and of feelings of familiarity. These (...) transcripts indicated that subjects were often quite confident of the accuracy of their decisions, compared with those for guess responses. Transcripts for decisions associated with guess responses also expressed feelings of familiarity but additionally revealed various strategies and inferences that did not directly reflect memory for studied items. The article concludes with a historical and theoretical overview of some interpretations of the states of awareness measured by these responses. (shrink)

Some monothematic types of delusions may arise because subjects have unusual experiences. The role of this experiential component in the pathogenesis of delusion is still not understood. Focussing on delusions of alien control, we outline a model for reality testing competence on unusual experiences. We propose that nascent delusions arise when there are local failures of reality testing performance, and that monothematic delusions arise as normal responses to these. In the course of this we address questions concerning the (...) tenacity with which delusions are maintained, their often bizarre content, the patients’ inability to dismiss them, and their often circumscribed character. (shrink)

It is often held that in imagining experiences we exploit a special imagistic way of representing mentality—one that enables us to think about mental states in terms of what it is like to have them. According to some, when this way of thinking about the mind is paired with more objective means, an explanatory gap between the phenomenal and physical features of mental states arises. This paper advances a view along those lines, but with a twist. What many take (...) for a special imagistic way of thinking about experiences is instead a special way of misconstruing them. It is this tendency to misrepresent experiences through the use of imagery that gives rise to the appearance of an explanatory gap. The pervasiveness and tenacity of this misrepresentational reflex can be traced to its roots in a particular heuristic for monitoring and remembering the mental states of others. The arguments together amount to a new path for defending the transparency of perceptual experience. (shrink)

Education is essential to life, and the epidemic affected everything. Parents want to get their kids the most important teaching. However, since COVID-19 has affected schools and other institutions, providing education has become the most significant issue. Online learning pedagogy uses technology to provide high-quality learning environments for student-centered learning. Further, this study explores the experiences and challenges faced by Filipino tertiary students regarding the lack of gadgets amidst online learning. Employing the Interpretative Phenomenological Analysis, the findings of this (...) study were: Some college students still have difficulty with online learning. Attending online classes is difficult, especially for students with limited resources. Smartphones, other gadgets, and internet connections play a significant role in online classrooms because they are the ones that students utilize while learning online, which is essential for successful participation in online higher education as well as for solving a variety of other difficulties in the new normal. Further, College students face similar health challenges. Having an online learning setup is not just about students' struggles with learning resources but also about their health issues. When our respondents used their smartphones for an extended period, they reported eye aches and blurred vision. They also said that some of their body parts, such as their legs and back, are aching, and feel pressured because they tend to overthink things in their surroundings, which causes them incredible difficulty in performing their best in attending online classes. Even though college students continue to suffer from a lack of learning resources during online sessions, they do their best to manage their needs and the scarcity of learning resources. Students have unique coping methods for dealing with difficulties in online classes. (shrink)

Dualists believe that experiences have neither location nor extension, while reductive and ‘non-reductive’ physicalists (biological naturalists) believe that experiences are really in the brain, producing an apparent impasse in current theories of mind. Enactive and reflexive models of perception try to resolve this impasse with a form of “externalism” that challenges the assumption that experiences must either be nowhere or in the brain. However, they are externalist in very different ways. Insofar as they locate experiences anywhere, (...) enactive models locate conscious phenomenology in the dynamic interaction of organisms with the external world, and in some versions, they reduce conscious phenomenology to such interactions, in the hope that this will resolve the hard problem of consciousness. The reflexive model accepts that experiences of the world result from dynamic organism–environment interactions, but argues that such interactions are preconscious. While the resulting phenomenal world is a consequence of such interactions, it cannot be reduced to them. The reflexive model is externalist in its claim that this external phenomenal world, which we normally think of as the “physical world,” is literally outside the brain. Furthermore, there are no added conscious experiences of the external world inside the brain. In the present paper I present the case for the enactive and reflexive alternatives to more classical views and evaluate their consequences. I argue that, in closing the gap between the phenomenal world and what we normally think of as the physical world, the reflexive model resolves one facet of the hard problem of consciousness. Conversely, while enactive models have useful things to say about percept formation and representation, they fail to address the hard problem of consciousness. (shrink)

The current system of ethical review for medical research in the United Kingdom is changing from the current system involving large committees of 7–18 members reviewing every individual application to a system involving pre-review by small sub-committees of National Research Ethics Officers , who have a remit to approve studies if they believe there are no material ethical issues imposed by the research. The reliability of this new system depends on the reliability of the NREAs and in particular the ability (...) of small groups to effectively identify and appropriately assess the seriousness of all the material ethical issues that may be posed by an application. There is anecdotal evidence to suggest that many individual research ethics committee members have had experience of believing that a study presents no material ethical concerns, then on reaching the committee and discussing the application they realise that the committee feels it does present significant ethical concerns. If this is the case then this casts doubt on the reliability of NREAs or small groups to effectively identify ethically problematic research and appropriately respond to this to protect research participants. In this paper we describe a small questionnaire based piece of research carried out to assess how common this and other relevant experiences are. (shrink)

Several philosophers have distinguished between three distinct mental states that play a role in visual recognition: experiences, propositional seemings, and beliefs. I clarify and offer some reasons for drawing this three-fold distinction, and I consider its epistemological implications. Some philosophers have held that propositional seemings always confer prima facie justification, regardless of a particular seeming's relation to experience. I add to criticisms of this view in the literature by arguing that it fails to solve a version of the ‘problem (...) of the speckled hen’. A more promising view holds that propositional seemings confer justification only when appropriately related to experiences. I offer advice for developing such an account. (shrink)

It is a common assumption among philosophers of perception that phenomenal colors are exhaustively characterized by the three phenomenal dimensions of the color solid: hue, saturation and lightness. The hue of a color is its redness, blueness or yellowness, etc. The saturation of a color refers to the strength of its hue in relation to gray. The lightness of a color determines its relation to black and white. In this paper, I argue that the phenomenology of shadows forces us to (...) consider illumination as an additional dimension of phenomenal colors. For this purpose, I will first introduce two different interpretations of shadow-experiences, which Chalmers has called the simple and the complex interpretations, and show that they both fail to account for important phenomenal facts about shadow-experiences. I will then introduce my own alternative interpretation based on the idea that illumination is a dimension of phenomenal colors and explain how it can account for these facts. (shrink)

Dignity is a human right and a base for human health. This right must be observed in work environments as a moral obligation. This qualitative study aimed to understand nurses’ experiences of violation of their dignity at work and to explore its dimensions. The participants were 15 nurses working in two hospitals in Tehran. The data were collected through 26 unstructured interviews and analyzed using content analysis. The dimensions of violation were ‘irreverence’, including experiences of abuse and violence, (...) humiliation, and being ignored; ‘coercion and violation of autonomy’, consisting of the control of relationships, lack of privacy, rigidness, and imposition; ‘ignoring professional and scientific ability’, indicating impossibilities in applying nurses’ knowledge; and ‘denying the value of nurse/care’, being the theme that verified the dominance of treatment/cure and lack of recognition of care value. Health systems should take the promotion of the nurses’ dignity into account through providing a dignified work environment. (shrink)

In this musing we consider how social distancing, the primary public health measure introduced to mitigate the spread of the COVID-19 virus, is creating social encounters characterized by a self-and-other-consciousness and an atmosphere of suspicion, leading to what we call “alienated embodied communication.” Whilst interaction rituals dominated by avoidance, fear and distrust are novel for many individuals who occupy positions of social privilege, Black and ethnic minority writers have demonstrated that the alienated bodily communication of COVID-19 social distancing is “nothing (...) new” for people who routinely experience marginalization as a result of racism. Our aim in this musing, then, is to reflect on how on-going experiences of stigma, shame, and marginalization can shape how social distancing is registered on an embodied and existential level, and therefore how social distancing may differentially impact individuals with lived experiences of racism. (shrink)

Dignity is a human right and a base for human health. This right must be observed in work environments as a moral obligation. This qualitative study aimed to understand nurses’ experiences of violation of their dignity at work and to explore its dimensions. The participants were 15 nurses working in two hospitals in Tehran. The data were collected through 26 unstructured interviews and analyzed using content analysis. The dimensions of violation were ‘irreverence’, including experiences of abuse and violence, (...) humiliation, and being ignored; ‘coercion and violation of autonomy’, consisting of the control of relationships, lack of privacy, rigidness, and imposition; ‘ignoring professional and scientific ability’, indicating impossibilities in applying nurses’ knowledge; and ‘denying the value of nurse/care’, being the theme that verified the dominance of treatment/cure and lack of recognition of care value. Health systems should take the promotion of the nurses’ dignity into account through providing a dignified work environment. (shrink)

Philosophers of perception often claim that usual perceptual experiences not only present particulars but also phenomenally present them as particulars. Nevertheless, despite the initial plausibility of this thesis, it is not clear what exactly it means to say that particularity is phenomenally presented. The paper aims to provide a deeper analysis of the claim that perceptual experiences phenomenally present objects as particulars. In doing so, I distinguish two theses regarding phenomenally presented particularity: Generic Particularity and Specific Particularity. According (...) to the first thesis, vision phenomenally presents particularity of objects, understood as a general characteristic that may be shared by many entities. The second thesis states that vision phenomenally presents particularity of objects, understood as an individual characteristic unique to each particular. I argue that, relying on knowledge concerning the functioning of perceptual mechanisms, vision does not phenomenally present generic particularity but it has certain abilities for presenting specific particularity. (shrink)

A number of philosophers are committed to the view that sense experiences, in so far as they have contents, have propositional contents, but this is more often tacitly accepted than argued for in the literature. This paper explains the propositional account and presents a basic case in support of it in a simple and straightforward way which does not involve commitment to any specific philosophical theory of perception.

BackgroundDecisions about limitations of life sustaining treatments are made for end-of-life patients in intensive care units. The aim of this research was to explore the professional and ethical attitudes and experiences of medical professionals on treatment of end-of-life patients in ICUs in the Republic of Croatia.MethodsA cross-sectional study was conducted among physicians and nurses working in surgical, medical, neurological, and multidisciplinary ICUs in the total of 9 hospitals throughout Croatia using a questionnaire with closed and open type questions. Exploratory (...) factor analysis was conducted to reduce data to a smaller set of summary variables. Mann–Whitney U test was used to analyse the differences between two groups and Kruskal–Wallis tests were used to analyse the differences between more than two groups.ResultsLess than third of participants stated they were included in the decision-making process, and physicians are much more included than nurses. Sixty two percent of participants stated that the decision-making process took place between physicians. Eighteen percent of participants stated that ‘do-not-attempt cardiopulmonary resuscitations’ orders were frequently made in their ICUs. A decision to withdraw inotropes and antibiotics was frequently made as stated by 22.4% and 19.9% of participants, respectively. Withholding/withdrawing of LST were ethically acceptable to 64.2% of participants. Thirty seven percent of participants thought there was a significant difference between withholding and withdrawing LST from an ethical standpoint. Seventy-nine percent of participants stated that a verbal or written decision made by a capable patient should be respected. Physicians were more inclined to respect patient’s wishes then nurses with high school education. Nurses were more included in the decision-making process in neurological than in surgical, medical, or multidisciplinary ICUs. Male participants in comparison to female, and physicians in comparison to nurses with high school and college education displayed more liberal attitudes about LST limitation.ConclusionsDNACPR orders are not commonly made in Croatian ICUs, even though limitations of LST were found ethically acceptable by most of the participants. Attitudes of paternalistic and conservative nature were expected considering Croatia’s geographical location in Southern Europe. (shrink)

Lorraine Besser argues that interesting experiences confer prudential value on those who have them. After summing up what Besser means by this, I question whether interesting experiences always confer such value and whether the experience of the interesting has its own distinctive phenomenal feel. Beyond this, I ponder the contours of Besser’s discussion of how people with Alzheimer’s might experience the interesting, agreeing with her that it seems likely that they can but questioning her suggestion that they may (...) even be more prone to experience the interesting than those without the disease. I wrap up with a brief musing about whether today’s culture of constant distractions is robbing us of the value of being deeply interested in things. (shrink)

This study examines the connections among cultural tourism, spirituality, and associated factors among religious tourists in Saudi Arabia. It focuses on how cultural tourism impacts spiritual fulfilment, considering visitors' intentions to visit religious sites, while also factoring in cultural competence and trust in tourism brands as moderators. This study involved 244 participants, who were administered self-report surveys during their visits to religious sites and cultural attractions in Saudi Arabia. Data analysis employed Stata-SEM software, utilizing structural equation modelling (SEM) to assess (...) the hypothesized relationships among the variables. The results indicate noteworthy positive associations between cultural tourism and the spiritual experiences of tourists, with mediating effects observed through their intentions to visit religious sites. Additionally, the study identified that cultural competence and trust in tourism brands exerted a moderating influence on the relationship between cultural tourism and spiritual experiences. This research contributes to the advancement of knowledge and practical applications in the realms of spirituality and cultural tourism. It substantiates the proposition that cultural tourism has the potential to influence the spiritual dimensions of visitors. The results underscore the significance of incorporating cultural and spiritual components in tourism marketing and destination management strategies. Moreover, they provide insights for destination stakeholders seeking to enhance cultural tourism initiatives, not only in Saudi Arabia but also in other contexts. (shrink)

Based on a longitudinal interview study of students at a liberal arts college, this book provides a rich description of how aspects of the college community and how relationships developed within that community create opportunities for transformative experiences that lead to personal and academic growth for students.

This paper models knowledge in cases where an agent has multiple experiences over time. Using this model, we introduce a series of observations that undermine the pretheoretic idea that the evidential significance of experience depends on the extent to which that experience matches the world. On the basis of these observations, we model knowledge in terms of what is likely given the agent’s experience. An agent knows p when p is implied by her epistemic possibilities. A world is epistemically (...) possible when its probability given the agent’s experiences is not significantly lower than the probability of the actual world given that experience. (shrink)

The introduction of social distancing, as part of efforts to try and curb the spread of the COVID-19 pandemic, has brought about drastic disruption to the world of the performing arts. In the UK the majority of professional orchestral musicians are freelance and therefore self-employed. These players, previously engaged in enjoyable, busy, successful, portfolio careers, are currently unable to earn a living carrying out their everyday work of performing music, and their future working lives are surrounded by great uncertainty. The (...) aim of the present study was to examine how established professional musicians are experiencing this period, and to look for similarities and differences between the experiences of musicians in the middle of their performing careers, with those of older players. Single semi-structured interviews were carried out over Zoom with 24 freelance, self-employed orchestral musicians; 12 mid-career musicians aged 35–45, and 12 seasoned musicians aged 53 and over. Thematic analysis identified themes common to both groups: the loss of a much-loved performing career, missing music making and colleagues, and anxiety about the future of the music profession. It also identified differences between the two groups: challenges to their identity as a musician, the extent of their anxiety about finances, the extent of their emotional distress, attitudes toward practicing and engaging in collaborative music making, and confusion over future career plans. Findings are discussed with reference to lifespan models of musicians' career development, the PERMA model of wellbeing, and the concept of resilience. (shrink)

This article presents narratives from 13 Indigenous early career academics (ECAs) at one university in Auckland, New Zealand. These experiences are likely to represent those of Indigenous Māori and Pasifika ECAs nationally, given the small, centralised nature of the national academy of Aotearoa New Zealand. The narratives contain testimony, fictionalised vignettes of experience, and poetic expressions. Meeting the demands of an academic role in one’s first years of working at a university is a big deal for anyone; the extra (...) pressures and challenges for Indigenous Māori and Pacific staff are immense, yet little understood by White ‘others.’ A writing workshop was the initial catalyst of this collective writing project. Through these insider narratives, this article presents a collective description of, and response to, the experience of Māori and Pasifika early career academics. (shrink)

Emergency care providers regularly deal with ethical dilemmas that must be addressed. In comparison with in-hospital nurses, emergency medical service personnel are faced with more problems such as distance to resources including personnel, medico-technical aids, and information; the unpredictable atmosphere at the scene; arriving at the crime scene and providing emergency care for accident victims and patients at home. As a result of stressfulness, unpredictability, and often the life threatening nature of tasks that ambulance professionals have to deal with every (...) day, ethical decision-making has become an inevitable challenge. The content analysis approach was used to conduct the present qualitative study in Iran. The participants consisted of 14 EMS personnel selected through purposive sampling, which continued until the data became saturated. Data were collected using semi-structured interviews and analyzed concurrently with their collection through the constant comparison method. The process of data analysis resulted in the emergence of 3 main categories “respecting client’s values”, “performing tasks within the professional manner”, “personal characteristic”, and the emergence of eight sub-categories signifying participants’ experiences with regard to EDM. According to the results, when EMS personnel are faced with ethical dilemmas, they consider the client’s values and professional dignity, and perform the assigned tasks within the framework of the regulation. The findings also suggest that pre-hospital care providers assess legal consequences before making any decision. Further studies should be conducted regarding the experiences of the subordinates and other related parties. (shrink)

Despite the growing popularityof farmers' markets (FMs) across the UnitedStates, the experiences and perspectives offarmers who sell at markets have received verylittle research attention. This study describesthe views of 18 farmers from Upstate New Yorkon the importance of FMs as part of theirlifestyle and livelihood, the challenges theyface selling at markets, and their conceptionsof ideal FMs. Through in-depth, semi-structuredinterviews, farmers expressed economic andsocial motivations for selling at FMs; socialbenefits from interacting with customers; andthe challenges they faced as small-scalefarmers and (...) sellers, including extra-marketcompetition, uncooperative and problematicmarket vendors, rising farm input costs, andchanging consumer trends. Farmers alsodiscussed personal values associated withselling at FMs, such as pride in raising andmarketing one's own products, working togetherwith other farmer-vendors, and providingcustomers with honest information. Visions ofideal FMs were varied among farmers, but therewas general agreement that FMs should provide adiversity of products to attract customers andeducational opportunities for the public tolearn more about FMs and local produce. Theinterdependence of FM farmers was a majoremergent theme across interviews. Findingssuggested that market experiences of FMfarmers, including economic success, are notonly contingent on personal effort, but canalso be affected by the work of fellow vendors.Future research may look to further explore howFM farmers and other vendors interact ascooperative and competitive social and economicunits. At the community level, FM leadershipshould continue to focus on the experiences andperspectives of farmers and other marketvendors, in addition to identifying ways forenhancing cooperative FM enterprises. (shrink)

This paper defends the Content View: the thesis that all visual experiences have contents.

When you hallucinate an object, you are not in the normal sort of concurrent causal sensory interaction with that object. It's standardly further inferred that the hallucinated object does not actually exist. But the lack of normal concurrent causal sensory interaction does not imply that there does not exist an object that is hallucinated. It might be a past‐perceived object. In this paper, I argue that this claim holds for at least some interesting cases of hallucination. Hallucinations generated by misleading (...) cues (e.g. ‘seeing’ Kanizsa triangles), hallucinations of Charles Bonnet Syndrome patients, and dreams are experiences of past‐perceived objects. (shrink)

Review of Oksala's 2016 Feminist Experiences: Foucauldian and Phenomenological Investigations.

In everyday life we take it for granted that we have conscious control of some of our actions and that the part of us that exercises control is the conscious mind. Psychosomatic medicine also assumes that the conscious mind can affect body states, and this is supported by evidence that the use of imagery, hypnosis, biofeedback and other ‘mental interventions’ can be therapeutic in a variety of medical conditions. However, there is no accepted theory of mind/body interaction and this has (...) had a detrimental effect on the acceptance of mental causation in science, philosophy and in many areas of clinical practice. Biomedical accounts typically translate the effects of mind into the effects of brain functioning, for example, explaining mind/body interactions in terms of the interconnections and reciprocal control of cortical, neuroendocrine, autonomic and immune systems. While such accounts are instructive, they are implicitly reductionist, and beg the question of how conscious experiences could have bodily effects. On the other hand, non-reductionist accounts have to cope with three problems: 1) The physical world appears causally closed, which would seem to leave no room for conscious intervention. 2) One is not conscious of one’s own brain/body processing, so how could there be conscious control of such processing? 3) Conscious experiences appear to come too late to causally affect the processes to which they most obviously relate. This paper suggests a way of understanding mental causation that resolves these problems. It also suggests that “conscious mental control” needs to be partly understood in terms of the voluntary operations of the preconscious mind, and that this allows an account of biological determinism that is compatible with experienced free will. (shrink)

Background: Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy. Aim: To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care. Research design: The study has (...) a qualitative, inductive design. Participants and research context: Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis. Ethical considerations: The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university. Findings: Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together. Discussion: Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy. Conclusion: If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient. (shrink)