Amputation is a chronic condition. The amputation of a limb (arm or leg) profoundly upsets the biographical thread of the person going through this ordeal, and determines the entire organization of his or her life in the long term. It entails a heavy process of learning, appropriation, and development of knowledge and skills. While this process is built up in a brutal and profound way in the early stages following the amputation, it also continues, because of its (...) class='Hi'>chronic dimension, throughout the life of the amputee. The objective of this article is to highlight the different stages of this complex process and their respective stakes: from the shaping of the body during and after surgery, to adaptive learning of daily situations, to the taming of body postures and prosthesis. We also point out the extent to which devices such as interdisciplinary care, Therapeutic Patient Education or peer support can be decisive for the conditions and possibilities of rehabilitation of amputee patients with prostheses. (shrink)

Living with a chronic condition represents a strenuous experience that often could be lived as a sequence of waiting and crisis times. Therapeutic path incidents could represent however a catalysts and revelatory time, useful to patients to discover their own resources. A qualitative study according to the phenomenological hermeneutic perspective was conducted to understand the kind of skills expressed by the patients during a difficult episode, and the characteristics that identify patients who can overcome them better. From September (...) 2019 to August 2020 twenty-three patients followed-up in four Hospital Units of Northeastern of Italy were enrolled. All the patients described an episode linked whit their pathological condition; they mentioned mainly supportive, reactive, or behavioral strategies and an acceptance attitude. The sample characteristics may explain the recurring acceptance attitude; however, the younger individuals, those with a higher level of education and those who faced precedent negative life experiences seem to better overcome challenging events. It can’t be taken for granted that patients possess all the skills necessary to overcome the frequent challenging episodes they have to face; for this reason, healthcare professionals should assess their learning and reactive attitude in order to tailor for them therapeutic education paths. (shrink)

Chronic pain affects a large part of the population causing functional disability, being often associated with coexisting psychological disorders, such as depression and anxiety, besides cognitive deficits, and sleep disturbance. The world elderly population has been growing over the last decades and the negative consequences of chronic pain for these individuals represent a current clinical challenge. The main painful complaints in the elderly are related to neurodegenerative and musculoskeletal conditions, peripheral vascular diseases, arthritis, and osteoarthritis, contributing toward poorly (...) life quality, social isolation, impaired physical activity, and dependence to carry out daily activities. Organ dysfunction and other existing diseases can significantly affect the perception and responses to chronic pain in this group. It has been proposed that elderly people have an altered pain experience, with changes in pain processing mechanisms, which might be associated with the degeneration of circuits that modulate the descending inhibitory pathways of pain. Aging has also been linked to an increase in the pain threshold, a decline of painful sensations, and a decrease in pain tolerance. Still, elderly patients with chronic pain show an increased risk for dementia and cognitive impairment. The present review article is aimed to provide the state-of-art of pre-clinical and clinical research about chronic pain in elderly, emphasizing the altered mechanisms, comorbidities, challenges, and potential therapeutic alternatives. (shrink)

Interventions are medically necessary when they are vital in achieving the goal of medicine. However, with varying perspectives comes varying views on what interventions are (un)necessary and, thus, what potential treatment options are available for those suffering from the myriad of conditions, pathologies and disorders afflicting humanity. Medical necessity's teleological nature is perhaps best illustrated in cases where there is debate over using contentious medical interventions as a last resort. For example, whether it is appropriate for those suffering from body (...) integrity dysphoria to receive healthy limb amputations. This paper explores how one's perception of medicine's goal underpins whether interventions are necessary or unnecessary, using the controversial topic of therapeutic amputation as an example. By contrasting ‘classical’ amputations with their more contentious counterparts, it highlights how the idea of medical necessity influences and restrains clinical decision-making. The paper starts by giving an account of body integrity dysphoria, focusing on the debate concerning elective amputation's justifiability. It then introduces Georges Canguilhem's vitalist theory of health, paying particular attention to his emphasis on adaptability. Then, this paper uses his theory as a lens through which to evaluate the appropriateness of therapeutic amputation as a medically necessary procedure. Ultimately, the paper highlights how the label of medical necessity is withheld from potential therapeutic interventions because they fail to conform to pre-established ideas of medicine's purpose and that by doing so, potential harm befalls those who are left with no effective treatments and must look for solutions in the non-clinical world. (shrink)

This research examined the experiences of authors of academic journal articles in the educational sector of all eight universities in Finland. The ethical principles of peer review and best and worst review processes were in focus. Data were gathered by electronic questionnaire, which was completed by 121 respondents who represented well the heterogeneity of the staff in the educational sector. Out of nine ethical principles honesty, constructiveness, and impartiality were appreciated but promptness, balance, and diplomacy were criticized. According to (...) two open questions, a third of authors praised and blamed reviewers as experts and non-experts. The accuracy of feedback was more often present in the best rather than in the worst experienced review processes. Journals’ editors and their decision-making called forth more negative than positive accounts. The results were discussed in the context of ethical codes for reviewers and researchers’ findings regarding the ethical responsibilities to promote good science with thorough, appropriate, and honest feedback and feedforward. (shrink)

The article explores the complex roles shame plays in the lives of people with one or more chronic conditions. This is achieved through a participatory research process in which people with chronic conditions were invited to share stories of shame on the public social media profiles of a peer-led patient community called ‘Chronic Influencers’. The crowdsourced material shows that 7 out of 10 experience shame in relation to their illness on a daily or weekly basis. Other (...) findings are that shame seems to stick to ‘energetic failures’ of the slow or tired body in various social situations; shame is predominantly produced or anticipated in the intimate sphere; and shame can be ‘rescripted’ as culturally produced and politically contestable – and thus counter the pressure to individualise health as a project of personal improvement and self-inspection – when it is shared through voluntary storytelling among peers on social media. (shrink)

Being diagnosed with a disease is like being thrust onto a new path, a biographical bifurcation akin to a mourning process, bringing in its wake a shattering of the social self. The passage from an ideal of perfect health to a state of illness introduces various fractures into the individual's life course, leading to a process of biographization. To illustrate this, the life story of a diabetic person is used to analyze various biographical turning points. The analysis of the subjectivation (...) process highlights different reconstructions of the self through the experience of therapeutic education, seen as a relational space of in-between identities. (shrink)

Chronic pain is one of the most disabling conditions globally, yet we are still missing a satisfying theoretical framework to guide research and clinical practice. This is highly relevant as research and practice are not taking place in a vacuum but are always shaped by a particular philosophy of pain, that is, a set of implicitly or explicitly prevailing assumptions about what chronic pain is and how it is to be addressed. In looking at recent history, we identify (...) a promising trend from neuro-centrism to the application of the biopsychosocial model. Unfortunately, due to its limited theoretical foundation, the biopsychosocial model is too often implemented in a reductionist, fragmented, and linear manner. In particular, it remains too vague concerning the relationship between involved biological, psychological, and social processes. Sanneke de Haan prominently labeled this the integration problem. In this paper, we introduce five different facets of the integration problem that every philosophy of pain needs to address: (i) ontological, (ii) conceptual, (iii) explanatory, (iv) methodologicalMethodological, and (v) therapeutic. We develop an enactive theory of chronic pain and outline how far it provides solutions to these different integration challenges. (shrink)

Education Infrastructure and Unsustainable Development in AfricaRather than creating the appropriate social relations for the means of production, the perspective on development in Africa has hinged on "infrastructure for development" thus leading to underdevelopment. This is because the social relation of infrastructure for development is parasitic and thus cannot reproduce itself. What it does is to accumulate primitive capital for conspicuous consumption rather than the creation of reproductive capital. Consequently, a dependency relation with the source(s) of primitive capital accumulation is (...) almost inevitable if the dominant group in the relationship, with its foundation in the acquisition of formal education, is to continue to subsist. Ironically, this incapacitates the subordinate group(s) as their recruitment processes are conditioned by the powerful ideological state, now global, apparatuses. The paper shows how this process works through the empirical examples of the acclaimed "success" story of Botswana and the perceived "failed" state of Nigeria. (shrink)

There is a need for empirically based research on social and ethical challenges related to informed consent processes, particularly in studies focusing on adolescent sexual and reproductive health. In a pilot study of a school-based pregnancy prevention intervention in rural Zambia, the majority of the guardians who were asked to consent to their daughters’ participation, refused. In this paper we explore the reasons behind the low participation in the pilot with particular attention to challenges related to the community engagement and (...) informed consent process. The pilot was implemented in two schools and examined the acceptability of a package of interventions including economic support to families to keep their girls in school, pocket money for girls, youth club meetings on reproductive health, and community meetings to sensitize the community. Focus group discussions were conducted with girls who participated in the pilot, boys in their class and with parents. Individual semi-structured interviews were conducted with teachers, peer educators and community health workers involved in the coordination of the intervention as well as with religious and traditional leaders. Data were analyzed through thematic analysis. The findings indicate that inadequate use of recognized community communication channels during the community engagement process and dissemination of information about the pilot resulted in limited understanding of the pilot concept by the community. This surfaced through uncertainty and fear that the intervention may result in loss of control over daughters, worries about why money was provided unconditionally to girls, and suspicion of links to satanism. The sense of insecurity appeared to be exacerbated by low literacy levels, poverty, fear of loss of bride wealth, perceived disregard for local perceptions of social status, and scanty trust in the actors implementing the pilot. Inadequate use of locally appropriate channels in the dissemination of information created room for interpretation and facilitated development of mistrust, undermining the conditions for community engagement and actual informed consent. A key lesson learnt is the importance of taking seriously the complexity of local values and structures that may impact people’s capability to consent or not consent to a study in an informed manner. (shrink)

Collaborative practices and patient -as- partner approaches are expanding in healthcare. The involvement of patients in the training of healthcare professionals appears as an opportunity for the development of such training and contributes to the practical experience of working with patients alongside the theoretical and scientific aspects of training. However, although the theories underpinning patient involvement in training are well developed, to date theire have been few practical applications to contextual situations, and there is a need to reflect on the (...) partnership development process. Based on the theories of patient -as- partner within interprofessional collaboration in healthcare, we will present the pedagogical engineering of a co-constructed course involving patient as partners for pharmacy students. We performed a cross-analysis of patients' and students' perceptions of the session. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On "Methodolatry" and Music Teaching as Critical and Reflective Praxis Thomas Regelski State University of New York, Fredonia Introduction: Professions and Professionalism Most teachers, including those in music, like to think of themselves as professionals. However, the "professionalization" of teachers traced by sociology generally refers to only the transition early in the twentieth century from two years ofteacher preparation in normal schools to four years in newly created professional (...) schools, departments, orprogramsofeducationinuniversities. Traditional sociological theory still considers teaching to be at best a "semiprofession."1 In the "ideal" descriptionofsociologist Max Weber, professionals shared these traits: They were self-employed providers of services, diey entered dieir profession because diey were 'called' to it out of some deep personal commitment, and dieir qualifications were based upon tiieir possessionof'expert' andesotericknowledge. In addition, dieir knowledge base could be acquired only by a select few who underwent long and rigorous study. Their services dealt widi serious, often life or deadi matters, and dieywere remunerated by fees from clients. Communication between professionals and dieir clients was legally privileged so uiat courts oflaw could not require its disclosure. Most important, entrance to mese professions was controlled by professional peers, who set requirements for entry, training, and certification. Boards ofpeers also developed reviewprocesses to maintain standards and competence. 2 A further criterion of a true profession is that praxis3 relies upon underlying theory4 and the fundofwidelyacceptedpractice-basedknowledge generated by theory that is required to deal with the extensive variety ofpredictably unique problems and needs presented by those served. Teaching clearly deviates substantially from these conditions. The theory serving as the basis of any profession is not amatterofsimple speculation; it is rooted in research and theoretical principles-fundamentals that importantly include commonly recognized and accepted action ideals of the profession's ethical and other guiding philosophicalconsiderations. Uponsuchtheoretical bases, professional praxis generates ever-new praxial knowledge. Because ofthe particulars of the situatedness governing both the practitioner andthose served, praxis-based knowledge always takes idiosyncratic form for a particularpractitioner -but, importantly, within the general theoretical, ethical, and philosophical stance ofthe profession. As a result, there are no "standard results " for any practitioner or for the overall profession. Furthermore, there are no standard methods ;just "standards ofcare" rooted in the profession 's theoretical and ethical premises. Music educationhas evolvedno such shared action ideals concerning ends and so the issue of theory-guided practice or of a professional ethic remainsambiguous, evencontroversial.1 Without professionally based consensus on ends, no stable criteria exist for selecting means and evaluating results and, thus, no ethic of accountability can apply. As aconsequence, results areconsiderably unpredictable-and not infrequently negative-and the appropriateness and usefulness ofmuch what is taught and learned is regularly disputed. This is not at all to say or to argue that music education has historically brought about mainly negative results, or that individual music©Philosophy ofMusic Education Review 10, no. 2 (Fall 2002): 102-123. Thomas Regelski 103 teachers are never successful. It wouldbe wrongheaded not to acknowledge the existence ofmuch well-intentioned, hardworkby individual teachers who are both musically competent and 'naturals' in working with students. This paper addresses instead mainly structural weaknesses in the field of music education that result in it as a field falling far short of at least the general kinds of professionalism found in helping professions. The comparisons made here to helping professions are made only in a very general way. However, overall, the field ofmusic education fails to compare well with the most obvious traits of familiar professions. As shall be argued, judgments concerning successful practice in music education should depend in large part on criteria provided by theoretically substantiated auricular goals and ideals and by implied and explicit process criteria of both an ethical and practical nature.6 Lacking such criteria, the question or degree of teaching success remains vague. As a result music education fails to promote predictable and pragmatic "right results" that students, parents, and the public at large can easily recognize as the professional "value-added" to general education and society by music education and this creates the increasing need foradvocacyofschool music. Philosophy, Theory, and Professional Praxis Whetherornot teachingcan everfullymeet the sociological conditions ofbeing a true profession, it would profit from and... (shrink)

The deeper meaning of education, says Dewey in his Human Nature and Conduct (1922), which distinguishes the justly honored profession from that of mere trainer, is that a future new society of changed purposes and desires may be created by a deliberately humane treatment of the impulses of youth (p. 69). For Dewey, a truly humane education consists in an intelligent direction of native activities in the light of the possibilities and necessities of the social situation (p. 70). Student impulse (...) and interest are not to be suppressed nor continually vented in unrestrained expression. In view of the plasticity of youth, there is little danger that allowing the role of student interest will lead away from important objectives of the curriculum. Education which respects the integrity of the student is a prerequisite of the kind of educated public suited for fuller participation in the democratic processes which properly direct and reconstruct our social life. The citizen appropriate for a democratic society is neither the dull conformist nor the superficial, gushing, non-conformist or sensualist. Individual impulse and initiative is neither to be damned up nor frivolously expressed. Meaningful participation and fuller social reconstruction require that we respect the social conditions for the possibility of knowledge and its growth, and this is more easily achieved, and more broadly appealing, when we speak of plans for the school environment. Respect for the cognitive and developmental needs of our own children and young people is fundamental to the self-respect of any viable society. Education could be philosophical praxis for a better world. (shrink)

In this article, Aislinn O'Donnell offers a set of reflections on the relation between therapy and education. In the first section, she examines criticisms of therapeutic education, mobilizing the example of prison education to highlight the difficulties that arise from imposing prescriptive modes of subjectification and socialization in pedagogy. In the second section, she addresses the relation between therapy and education by focusing on just one element of the experience of education: those moments at which a subject has the (...) potential of becoming significant in the life of a student. An important dimension of the educator's authority involves noticing such moments, fostering the conditions that make them more likely, and engaging in the creative process and practice of deciding how best pedagogically to respond to these moments. In the third section, O'Donnell develops this idea by detailing a philosophical approach and practice that understands “effectiveness” in education as bound to practice, creative responsiveness, and the judgment of the educator in concrete, singular pedagogical situations, rather than construed in terms of generic models of “best practice.”. (shrink)

The relevance of the chosen direction of research is determined by the need to improve the higher education system in accordance with the requirements of postmodernism. Based on the results of research by domestic and foreign scientists, the features of distance education, its advantages and disadvantages are established, which are taken into account in further scientific research. Required solutions in order to ensure high-quality distance education for music students, as well as identified topical issues: creation of an organizational model of (...) distance learning; selection of appropriate means and tools, taking into account the peculiarities of professional training of music students, as well as substantiation of the system of methodological support of distance learning in accordance with the cycle of disciplines and the purpose of the educational program. It was noted that distance education makes it possible to introduce innovative technologies into the process of professional training of musicians, to build an individual educational trajectory, taking into account the needs of students. (shrink)

From the beginning the process of education in Ukraine was based on such existential features of national self-consciousness as polyphony (tolerance to various spiritual features of other peoples), anteism (pronounced “earthly” material principle in culture and life), cosmocentrism (“cordiality” focused on “Inner” being), which are inextricably linked with individualism.The educational process in Ukraine has a clear anti-positivist humanistic orientation and is focused on the education of moral qualities which are characterized by heroic ideals. Nowadays we have necessary to accelerate this (...) process, especially in the direction of its existential-humanistic content. The teaching of any science can not ignore the worldview and moral assessments of those things which characterize, for example, a market economy. The basis of moral charity should be the national state of patriotism.The nation asserts its right to exist as an ethnic community when it reaches a level of self-awareness that requires active formation. The culture of the “national spirit” is an objectified spiritual form of human self-determination, which allows it to maintain positive personal qualities in the real contradictions of public life. The culture of national self-consciousness, as a factor of positive action on public life, includes an understanding of the real conditions for the implementation of the principles of morality and the objective historical situation in which social classes and specific individuals operate. Awareness of each person as an object and “demiurge” of the historical process, the generalization of personal practical position through the prism of social requirements of the modern time in a contradictory world, real social, national, professional and other differences in humanity is the main condition of human living.Individual opposites in their social essence can be spiritually identified. In the national self-consciousness, the opposite becomes identical, and this identity is affirmed with the help of appropriate philosophical considerations, which can determine people’s self-esteem of the essence of their existence. Conversely, the ability of individuals to rise above their objective differences and contradictions in order to solve national (and ultimately universal) tasks is an expression of their moral nobility and wisdom.To organize the practical life of individuals on the basis of national principles is a manifestation of a certain culture of their self-consciousness. This culture is not based on dogmatic attitudes, but it’s based on the truth of national interpersonal and social ties of individuals and on their real life. In public life, people are the bearers of only certain, defined national principles. This certainty is determined by the level of historical development of the nation, social relations, which are formed objectively. To a large extent, the culture of national self-consciousness is manifested in the language, which is the basis of ethnic consciousness, ethnocultural. Religious beliefs have a great influence on the formation of the culture of national self-consciousness. Freedom of conscience implies the right of citizens to profess any faith or to be an atheist, while respecting the views and beliefs of everyone. (shrink)

In conditions of post-pandemic reality, the creation of optimal psychological and pedagogical conditions for the formation of future specialists, raising the level of their professional training, socialization and adaptation to work in the work collective requires appropriate psychological support, the development of cognitive and psychological support technologies for the constructive implementation of practical social psychological assistance in the pedagogical process, as well as the use of modern cognitive-psychological approaches by teachers, the development of psychological recommendations on the style of pedagogical (...) impact and the like.The article highlights the important socio-psychological conditions for preparing a future teacher for socio-pedagogical activity in the context of post-pandemic realities. The necessity of using cognitive psychology technologies in the process of forming professionally speaking competencies of future psychologists and their speech culture in the process of professional speech training is substantiated. The technologies and conditions for the organization of the pedagogical process for the preparation of future practical psychologists who have undergone changes as a result of recent events related to the implementation of the educational process in a remote mode are described. The structure of the seminar on the basics of speech competence of a psychologist is presented as a result of using a dialogical approach in the system of professional training at a university.In our opinion, the materials in this article will be of interest to educators, practical psychologists, and social educators of the vocational education system, since they will help not only better understand the psychological characteristics of the professional and personal development of future specialists, but also constructively solve the urgent problems of their professional training. (shrink)

A plethora of studies stress students’ self-regulated learning skills to be conditional for successful learning in school and beyond. In general, self-regulated learners are actively engaged in constructing their own understanding also including the regulation of contextual features in the environment. Within the contextual features, the regulation of peer interaction is necessary, because college courses increasingly require peer learning. This goes along with the increasing interest for online learning settings, due in no small part to the recent COVID-19 (...) pandemic. In the present study we explore how social presence, social space and sociability are essential elements in the regulation of online peer interaction. To shed light in this matter, higher education students were qualitatively followed for 1 year in an online academic writing course by using retrospective interviews and reflective questions. Additionally, for social presence, students’ perceptions were quantitatively measured with a validated questionnaire. The results show that the planning phase is the most important phase for supporting students’ social presence because that is where the regulation of peer interaction becomes important. The sociability has an important role here as well becoming less prominent further on in the self-regulation process. In the SRL follow-up phases, students look for other ways to increase their social presence and social space in order to shape the regulation of peer interaction from a position of trust. In the evaluation phase, students are aware of the importance of social presence but less of social space for the regulation of peer interaction. We conclude with some design principles to facilitate students’ regulation of peer interaction in online settings. (shrink)

In recent years in Turkey, it has been attempted to ensure that students who need special education are educated through inclusion. In the meanwhile, it became important to reveal scientifically the educational theories on which the inclusive education is based and the approach of Islam towards inclusive education that somehow has an influence on our national education policy. This study aims to examine the educational theories on which the inclusive education is based and the Islamic approach towards inclusive education. The (...) data of the study was collected by literature review. As a result, it is possible to say that the underlying theories of inclusive education are integrated education theory, cognitive democrative theory and dysontogenesis theories. In addition, although there are no specific verses for inclusive education in the Qurʾān and the Sunnah, it can be said that Islam has an positive approach to the inclusive education in general. Depending on this result, formal education should be conducted in the context of the principle of “least restricted education environment”.Summary: It is a matter of controversy about how education that increases the potential of human beings can be given to people who differ from their peers and who need special education. In recent years, there have been two prominent views in literature on this issue: The first is the ‘discriminatory’ view, which advocates that individuals with special needs should receive education in special spaces with similar students. The second is the ‘integrative view’, which states that these students should receive inclusive education with their peers. This view defends that students with special needs should be educated in separate boarding/day special education schools and special education classes within the normal schools. Recently in Turkey it is aimed to provide education to the students who need special education mostly by means of inclusion as an alternative to the first group. For this education, which is held with the claim of a less restricted environment, the conditions of the students are constantly improved with new regulations.This study aims to reveal the theories that can be the basis of inclusive education and Islam's approach to inclusive education. In this study, I will try to find answers to the following questions.1. What are the educational theories and claims that can be the basis of inclusive education?2. What are the principles of inclusive education in the Qur’an and Sunnah?This study is important in terms of revealing general opinions that may be the basis of theoretical foundations of inclusive education and examining Islam’s approach to inclusive education. The study, which was prepared by examining the English and Turkish literature available within the scope of the possibilities, was designed with theoretical analysis method. Although ‘accessibility’, which is considered among the shortcomings of theoretical studies in literature, is an important limitation for this study, the fact that it constitutes a theoretical ground for future studies and fills an important gap in the literature determines the importance of the study.Integrated education theory, cognitive democratic theory and dyontogenesis theories can be regarded as the establishing theoretical foundations of inclusive education. Integrated education theory is based on Whitehead’s philosophy of education. This philosophy sees the individual as a whole. It does not intend to make people have a profession or make money by simply using their intelligence. Instead, it helps to ensure that both the individual and society as a whole are happy by helping them to make the most of their potential. This model is based on developing emotion, mind, body, and spirituality as a whole. The distinctness and sacredness of human life and the need to know about this sacredness are the main pillars of integrated education theory. In this model all people are seen equal. According to this theory, the “natural” as well as the “beautiful” is appreciated. Therefore, no one feels bad in such an environment because of its differences. Because of the value given to them, each individual’s love of learning and ideals remain alive. The individual makes use of his/her mind to make a connection between the meaning of life and the school.Cognitive democratic theory asserts that educational arrangements should be made to prevent any feelings of alienation, oppression, and insignificance by considering different groups in education. This theory, which emphasizes the phenomenon of democracy and citizenship, aims at social cohesion in the light of epistemological principles. The theory is based on the fact that social change and change in education support each other. According to the theory, the formation of democratic citizenship is only possible if the school environment is a place where students can internalize democratic values. This is achieved by equal consideration of each segment at different levels. According to this theory, elements such as classroom environment, discipline, program, rights, participation in decisions, educational activities should be organized according to democratic values. In such an environment, different special education students find a place for themselves.Vygotsky's dysontogenesis thesis is based on his theory of social learning. His theory provides a methodological framework for inclusion in special education. The theory states that information is obtained through social communication. In this theory, knowledge is an element that is acquired together with other people rather than something that happens in the human mind. According to this theory, instead of focusing on the brain (head), where social knowledge is formed, self, mind, emotion should be included in education. Also, disability is a social deviation rather than a biological disease. Social relations and the environment mostly shape this deviation. Therefore, the abnormal child approach that has become a place in the society should be abandoned. The theory opposes the concept of mental retardation. Because mental disability should be explained by the differences in mental development. According to this theory, mental retardation is a social problem; education should be provided with appropriate methods over the examples that can be experienced in a commonplace with their peers. Distracting the student from his/her normal peers due to his/her differences, creates negative social conditions and harms his/herself.As far as I have examined, there is no direct Qur’anic verse or phrase about inclusive education for the disabled. However, there are verses regarding the integration and solidarity of the society on righteousness. Principles for inclusive education can be drawn from these verses. The Prophet valued the disabled and settled the principles on how society should treat them. He frequently visited them, enabled them to employ appropriate jobs, determined the conditions of the economic order by considering them, and dignified them with honor. In other words, he tried to make provisions to prevent the disabled from being separated from society. For example he urged Zahir bin Itban to continue trade, asked Abdullah Ibn Umm Mektum to come to community prayers, thus he sought different ways to integrate disabled people into society. These practices can be seen as a positive outlook towards the mainstreaming education of today. In the period of the four great caliphs, practices for mainstreaming education continued. (shrink)

Over the last 30 years the effects of economic globalisation have transformed education and its relationship to work and everyday working lives. Market reform and the appropriation of ‘learning’ to fuel the knowledge economy produced a lifelong learning educational order, complemented by social inclusion to manage residual and resistant populations. In the process education was decentred, learning spaces were diversified within an education market that served the world of work. Educators were remaindered by a rising tide of coaches, counsellors, (...) learning managers and mentors who ‘facilitate’ rather than ‘teach’. In this groundbreaking book the author contextualises these changes as a way of re-reading our times and its educational effects. The chapters examine the interface of policy and practice and map the shifting relations between educational work and social organisations of learning by developing three key themes: _Liquid learning_: drawing on Bauman’s characterisation of ‘liquid modernity’, the concept of liquid leaning details the cultural conditions that confront educators and those who seek to use education as a social instrument to address economic, social, cultural, environmental and political development _Making spaces of orientation_: designing and realising strategies to address the challenges of "liquid modernity" _Educational work_: considering the specialist expertise that educators as an occupational group bring to the challenges of liquid learning. The case examples that make up the main body of this book show how spaces of orientation are made and how they can be designed to support learning for living in interdependence. Each of these cases is informed by substantial empirical research and fine-grained analyses are used to define the nature of educational work, the resources that are mobilised in constructing contexts for learning, and its contribution to the art of politics that makes spaces of orientation. As the author demonstrates, educators have expertise that is critical in the contemporary globalised world and its politics. (shrink)

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are (...) not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time. (shrink)

Background The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making. Methods Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews. The participants were thirteen paediatric (...) oncologists, 13 parents or primary carers, and six adolescents with incurable cancer. The participants were recruited from the paediatric oncology services of three national tertiary-care medical centres in Mexico City. Results The oncologists stated that they broach the subject of palliative management when they have determined that curative treatment has failed. Respect for autonomy was understood as the assent of the parent/adolescent to what the oncologist determined to be in the best interest of the adolescent. The oncologists thought that the adolescent should be involved in the decision-making. They also identified the ability to count on a palliative care clinic or service as an urgent need. For the parents, it was essential that the oncologist be truly interested in their adolescent child. The parents did not consider it necessary to inform the child about impending death. The adolescents stated that the honesty of their oncologists was important; however, several of them opted for a passive role in the decision-making process. Conclusion The findings of this study evidence that to achieve good medical practice in low-middle income countries, like Mexico, it is urgent to begin effective implementation of palliative care, together with appropriate training and continuing education in the ethics of clinical practice. (shrink)

Inclusive education is a process that integrates students with special needs inmainstream schools, providing them with appropriate support and adaptations. Thispaper discusses the differences between mainstream and special education, focusing onthe right to education, aims and approaches, responsibilities and competences, curricula,focus of education, teacher preparation, learning conditions, teaching methods, learningstandards, assessment and evaluations, teacher competencies, educational researchand legislation. In Macedonia, inclusive education started in 1998 and is still in theprocess of development, aimed at the full inclusion of students with disabilities, (...) which isstipulated in the Law on Basic Education passed in 2019.The methodology includes an analysis of existing research and laws, as well as acomparative study of regular and special education. Data from relevant sources such asEuropean and national education agencies, UNICEF reports and laws on special educationwere used. This methodology enables a detailed overview of the current situationand challenges in inclusive education.The conclusion is that although significant efforts have been made for theintegration of students with special needs in mainstream schools, there are manychallenges that need to be overcome. Better support for teachers, more resources andfunding, and a change in attitudes of the society are needed. With appropriate measuresand policies, real inclusion and quality education for all students can be achieved. (shrink)

Following years of debate over the effectiveness of cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), public health bodies in the UK and beyond have determined that no psychotherapy is clinically proven for this patient group. In the field of ME/CFS and the wider arena of ‘medically unexplained symptoms’ (MUS), patient survey data and qualitative research capturing patient experiences and psychotherapist attitudes suggest that therapeutic practice may sometimes fall short of required ethical standards. This raises questions about (...) how psychotherapists can safely support, as opposed to treat, people with these debilitating conditions. We consider four ethical principles that feature throughout psychotherapists’ codes of practice, those of respect, competence, responsibility and integrity, and discuss examples of good and poor practice in this arena as evinced by recent empirical literature. Following this, we offer a variety of suggestions to help strengthen ethical psychotherapy practice with patients with ME/CFS and other MUS. In terms of practitioner education, we recommend greater emphasis on humility, reflexivity and disability-affirming practices, exploration of personal as well professional ethics, and integration of patient expertise-by-experience, accompanied with the latest evidence, into foundational and ongoing training. In terms of ongoing practice, we suggest consideration of formalised patient-focused feedback systems and greater transparency vis-à-vis patient access to clinical notes. Finally, we underline the importance of elevating patients from mere subjects to co-producers of psychotherapy research. (shrink)

BackgroundInformed consent is an important factor in a child’s moral structure from which different types of doctor–patient relationships arise. Children’s autonomy is currently under discussion in terms of their decent treatment, beyond what doctors and researchers perceive. To describe the influential practices that exist among clinicians and researchers toward children with chronic diseases during the process of obtaining informed consent.MethodsThis was a cross-sectional, qualitative study via a subjective and interpretivist approach. The study was performed by conducting semi-structured interviews of (...) 21 clinicians and researchers. Data analysis was performed using the SPSS version 21® and Atlas Ti version 7.0® programs.ResultsThe deliberative and paternalistic models were influential practices in the physician–patient relationship. In the deliberative model, the child is expected to have a moral awareness of their care. The paternalistic model determined that submission was a way of structuring the child because he or she is considered to be a subject of extreme care.ConclusionsThe differentiated objectification [educational] process recognizes the internal and external elements of the child. Informed consent proved to be an appropriate means for strengthening moral and structuring the child. (shrink)

The present study investigates how laughter features in the everyday lives of 3-5-year old children in Swedish preschools. It examines and discusses typical laughter patterns and their functions with a particular focus on children’s and intergenerational (child-adult/educator) laughter in early education context. The research questions concern: who laughs with whom; how do adults respond to children’s laughter, and what characterizes the social situations in which laughter is used and reciprocated. Theoretically, the study answers the call for sociocultural approaches that contextualize (...) children’s everyday social interaction, e.g., in different institutions or homes, to study the diverse conditions society forms for learning, sociality and socialization and development of shared norms. Methodologically, the study makes use of mixed methods: it uses descriptive statistics that identify prevalent patterns in laughter practices and, on the basis of these results, examines social-interactional situations of children’s laughter in detail. It was found that children’s laughter tended to be directed to children and adults’ laughter tended to be directed to adults. 87% of children’s laughter was directed to other children, and adults directed their laughter to other adults 2,7 times as often as to children. The qualitative interaction analysis shows that children and adults exhibited different patterns of laughter. Children primarily sought and received affiliation through laughter in the peer group, and the adults were often focused on the institutional and educational goals of the preschool. Overall, the study shows that intergenerational reciprocal laughter was a rare occurrence and suggests that laughter between generations is interesting in that it can be seen as indicative of how children and adults handle alterity in their everyday life. By deploying multiple methods, the present study points to the importance of viewing emotion and norm sharedness in social interaction not just as a matter of communicating an emotion from one person to another, but as an intricate process of inviting the others into or negotiating the common emotional and experiential ground. (shrink)

Kyrgyz people lived under the control of Soviet Union for about 70 years. During this time, they were forbidden to practice any kinds of religious duties. Their religious schools and mosques were closed or used for other aims rather than religious needs. In short, all kinds of religious freedom and practices were forbidden strictly. The aim was to bring up an atheistic people during the days of Soviet Union. However, when Kyrgyz people won their independence and established a new country, (...) all kinds of restrictions in terms of religion were abrogated and people began to establish their religious schools and mosques. While during the first years of independency of the country in 1991, there were only 39 mosques, as of 2018 there are nearly 3,000 mosques in the country. In addition to the increase of mosques, the number of people going to mosques also increases day by day. This article examines mainly the development of religious freedom in terms of legal aspect from the beginning of the establishment of the country to our time; the legal statues, functions, and duties of State Commission for Religious Affairs and Religious Office of Kyrgyzstan Muslims, and as common religious educational places mosques, religious activities done at mosques, the factors effecting these activities negatively.Summary: Kyrgyz Turks are one of the most ancient tribes in Central Asia. Although there are various views and knowledge about the religious life and the process of Islamization of them in various sources, there is no doubt that one of the most important elements which shapes Kyrgyz culture and social life is Islam. Even though they continued the activities of Islamic education and training under the rule of many nations thorough the history, all activities of religious education were tried to be forgotten and religion was removed from daily life under the Soviet communist regime. However, with the establishment of the Republic of Kyrgyz based on the secular and democratic bases on 31 August 1991, Muslim people showed a great effort and endeavor to open some institutions where they could live their religion, perform their religious duties, and teach religious and moral values for people. After the declaration of independence, with the enacting of “Freedom of Faith and Religious Institutions” on 16 December 1991 which was one of the first enacting laws, very important developments happened in terms of both formal and informal education. Some knowledge concerning Islam is given in some culture courses and “Religious Office of Kyrgyzstan Muslims” was created for meeting all kinds of religious needs of Muslims in the country in 1993. With the establishment of the “State Commission for Religious Affairs” in 1996, some new legal regulations were made. Thus the state’s policy about religious education and teaching gained a new dimension. During this process, the state faced some problems concerning developments in religious education. Although some of these problems have been solved legally, there are still many problems about religious education today. Since the independency until now, there have been many researches as articles, books, master theses and doctorate dissertations about various fields of religious education, religion-state relations, religious institutions, course books and their curriculums. However, a great majority of these studies belong to religion-state relations and the field of formal religious education. There aren’t any academic studies or research about mosques and imams that concern the great majority of the country population. In fact, from the point of religious education, common or informal religious education is as extremely important as formal religious education. For the mosques that are one of the most important institutions of common religious education are spread to the most remote corner of the country and serve for all people of different ages for the whole year. The effects of common religious education increase day by day. While there were just 33 mosques in 1933, there were 39 mosques in the independency year of 1991, as of 2018 this number has risen to 2830. Relating the imams who work at mosques, it is not possible to speak about a systematic structure. Since imams are generally graduated from madrasas, their educational levels are very low. As they have not enough financial support and highly educated teachers, they cannot give good education to their students and cannot adopt themselves to the modern educational levels in teaching religious issues. In order to solve this problem, Muftiyat either sends students to abroad or gives in service trainings for imams. Another important problem in relation to imams is the way of assignment. There is no criterion for assignment of imams. They are not designated by the Muftiyat, but it just legitimizes those imams who are chosen by congregation. Imams receive neither any salary from the Muftiyat, nor they have any social assurance. They work either voluntary or their incomes are paid by people. Although all of these negative conditions, mosques and imams have a great importance on Kyrgyz people’s education, culture, worship, and moral teaching. It can be said that there are two kinds of education at mosques and masjids. One of these is “moldos”, some men of religion who gather students and give some religious knowledge without following any curriculum. Although some of them take education from some Arabic countries or Pakistan, their educational level is very low and cannot recite even the Qur’an correctly. In addition, they have very little knowledge about pedagogy and religious themes, and they have not enough educational experience. The second type of education at mosques and masjids is carried out through Friday sermons and preaching. However, this is not an effective way in giving religious education. Because the way in which the Friday sermon is given is not appropriate as a good teaching method. As the sermons are done in Arabic, there is no effective communication between the imam and the congregation. However, Friday sermons and preaching are very important for people’s religious education and socialization. This article firstly deals with the developments in religion in the times of freedom of the country, secondly, it examines the institution of Muftiyat to which all mosques are adhered and “State Commission for Religious Affairs” that register the mosques which the Muftiyat approves, and lastly gives information about mosques and their congregations in the country. (shrink)

Schools, colleges, and universities have become homogenizing systems that are almost exclusively focused on imposing a pre-ordered curricula through exams and grades or tight research lines. In the process, they are killing passion, creativity, and individuals’ potential and skills. Ultimately, schools and academia make up a system that serves a collective machinery but suffocates individual growth. This state of affairs is not a necessary evil. Learning, discovering and teaching can be a natural, spontaneous and luminous expressions of a free and (...) progressive growth if they are allowed to be practiced in an appropriate environment. This is a ‘manifesto’ for a Free-Progress-Education (FPE) paradigm according to which the best way of learning, acquiring knowledge, and doing research comes through a process of free self-directed learning, and a progress of self-unfoldment and self-discovery, that must be guided from within. In schools, colleges, universities and beyond. A FPE learning centre would be expected to foster curiosity, intuition, self-directed-learning in diversity, and, especially, wholesome respect for the practice of complete and responsible freedom of individual expression.FPE goes beyond the standard paradigm of unschooling or the pedagogical approach of democratic schools since it includes self-directed-education that can also work in high schools, colleges, universities, and research centres. It iAfter a brief introductory presentation, a personal preamble of the author describes his experiences with institutionalized learning from childhood to the doctoral dissertation and in a high school as a teacher. Then, the roots of the stagnant state of education will be investigated which is still based on an industrial and mechanistic mindset, and is perceived with increasing dissatisfaction. While analysing the detrimental effects that a managerial and industrial mentality has had on the education and intellectual growth of several generations, we will take as an example the deficiencies of the so-called big science, i.e. of the modern, large-scale scientific initiatives. Surveying past and present learning approaches such as the interesting renaissance of homeschooling and welcoming new trends such as unschooling or democratic education, the second part of this book looks beyond these paradigms searching for a wider spirit of education. It is emphasized that no reform is possible inside the current school and university paradigm, because it is in its essence an authoritarian system that won't allow itself to be dismantled from within. The last part of this book focuses upon a brief set of alternative proposals, which aim at overcoming the centuries-old shortcomings of the present educational system, by favouring intrinsic over extrinsic motivation. Preliminary practical ideas are put forward on what a free-progress learning community might look like, and what the first steps for its realization might be. It is explained there why it is only through a change from the ground up that the certificate-oriented educational system can transform itself into a project-oriented, self-organized, competence-portfolio based one, with no exams, grades, degrees, or other administrative trammels. At the same time, it must be made clear that the ultimate aim of doing away with the present system of assessment criteria would be to install a much deeper and articulated paradigm shift than some superficial reform and even beyond the actually undeveloped democratic education concept which still falls short beyond high-school level. What is visualized is an evolutionary pedagogical perspective, compared to the conventional one, and presented as the necessary condition for a 'Copernican approach' to education. Only after that perspective has been realized can new competences, curiosity, intuition, and real forms of creative learning return to flourish in schools and academia. (shrink)

Many adoptees face a number of challenges relating to separation from biological parents during the adoption process, including issues concerning identity, intimacy, attachment, and trust, as well as language and other cultural challenges. One common health challenge faced by adoptees involves lack of access to genetic-relative family health history. Lack of GRFHx represents a disadvantage due to a reduced capacity to identify diseases and recommend appropriate screening for conditions for which the adopted person may be at increased risk. In this (...) article, we draw out common features of traditionally understood “health disparities” in order to identify analogous features in the context of adoptees’ lack of GRFHx. (shrink)

The aim of educational organizations is to raise students as individuals who can analyze their conditions well, are sensitive to the environment, think, research and question. Teachers must be conscious and equipped in this process, and more importantly, they must definitely not make mistakes. The following sentences said by Socrates clearly reveal what a strategic position the teacher has in education. The school administrator is not only the manager of the teachers. Therefore, the leadership behavior of the school director affects (...) non-educator staff and students as well as teachers. The leadership of the school director is of great importance in helping students acquire certain desired behaviors. Since students are in constant development, the school administrator must demonstrate leadership behavior appropriate to the developmental periods of the students. Teachers, who are education workers, are like the windows of schools opening to the outside. Therefore, they have a direct impact on the school's reputation. Their direct contact with students and society makes the size of this impact even more important. Because, in parallel with the positive or negative behaviors displayed by teachers, the stakeholders’ perspective on the school is also shaped. The general purpose of the research is to determine the perceptions of internal and external stakeholders in educational organizations regarding corporate reputation in the form of school principals and to determine whether there is a difference between the perceptions of these stakeholders. For this purpose, a literature review was conducted. (shrink)

The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions to the virtual exclusion of the capacity to execute the treatment plan. However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose (...) of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. (shrink)

Variability in the symptom experience in patients diagnosed with chronic conditions may be related to social determinants of health (SDoH). The purpose of this critical review was to (1) summarize the existing literature on SDoH and symptom clusters (i.e., multiple, co‐occurring symptoms) in patients diagnosed with common chronic conditions, (2) evaluate current variables and measures used to represent SDoH, (3) identify gaps in the evidence base, and (4) provide recommendations for the incorporation of SDoH into future symptom cluster (...) research. We identified 118 articles including information on SDoH in chronic condition symptom cluster research. Articles primarily focused on cancer populations. Few articles had the explicit purpose of investigating relationships between SDoH and symptom clusters, and the inclusion of SDoH was often limited to variables used to describe samples. Future studies should be designed to “move beyond Table 1” in their utilization of SDoH as variables and examine relationships between SDoH and symptom clusters. Attention should be paid to the appropriateness of measures being used to collect information on SDoH, and analysis methods that estimate causal connections between variables should be considered. Research regarding the relationship of SDoH with symptom clusters in patients with chronic conditions has the potential to reveal mechanisms of symptom disparities and guide changes to alleviate these disparities. (shrink)

This study was conducted to determine the appropriateness and potential of a set of books as a resource for infusing character education in a social studies classroom. Based on a research review, the literature chosen was the past decade (2001–2011) of Newbery-Award winning books. As recipients of perhaps the most prestigious award for children's literature, Newbery books were of exceptional quality and widely available. Narrative analysis ( Neuendorf, 2002 ) allowed us to explore their suitability for character education. The Josepheson (...) Institute's character pillars, the Katz and Braly List of Verbal Stereotypes, identification of moral dilemmas in these stories, and factors of race, gender, and disability provided tools for coding elements as part of the narrative-analysis methodology. Additional literacy and social studies activities were developed to enhance peer interaction, a component determined essential to future programs ( Berkowitz & Bier, 2005 ). Ultimately these 10 books were deemed viable tools for addressing character education. The authors found a key benefit of our process to be the messy self-examination, the inward look at one's own values, beliefs, and behaviors, and the subsequent interaction and collaboration that either validated or challenged those beliefs. (shrink)

The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with (...) class='Hi'>chronic care. The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. (shrink)

The article considers questions about the role and significance of art education in the context of ensuring sustainable development of society. The features of the development of art education in the postmodern era, its functions and specific features are analyzed. The interdependence of arts education and sustainable development are characterized. The exceptional importance for ensuring sustainable development of an appropriately oriented and updated arts education was emphasized. In particular, it seems possible to ensure a change in stereotypes, ways of thinking (...) and actions of people, the formation of appropriate motivation and public opinion in the context of applied nature through the influence of art. Ways to improve art education with the aim of ensuring sustainable development are proposed: integration of formal and non-formal art education, ensuring innovativeness, interdisciplinarity and multiculturalism of art education, creating an inclusive environment in higher educational institutions. We see prospects for further scientific research in the creation of a model for training specialists with certain properties and substantiation of the features of its implementation in real conditions of the educational process in higher education institutions of the artistic direction. (shrink)

Self‐management programmes provide strategies to optimise health while educating and providing resources for living with enduring illnesses. The current paper describes the development of a community‐based programme that combines a transdiagnostic approach to self‐management with mindfulness to enhance psychological coping for older people with long‐term multimorbidity. The six steps of intervention mapping (IM) were used to develop the programme. From a needs assessment, the objectives of the programme were formulated; the theoretical underpinnings then aligned to the objectives, which informed programme (...) design, decisions on implementation, programme adoption and evaluation steps. Bandura's social cognitive theory informed the methods and practical strategies of delivery. Among the features addressed with participants are transdiagnostic dimensions such as fatigue, pain, breathlessness, sleep disturbances. The programme utilises mindfulness to aid coping and ameliorate the psychological distresses associated with chronicity. Findings from an initial feasibility study and subsequent pilot assisted in conceptualising our programme. In conclusion, applying IM gave the planners confidence the programme is robust and evidence‐based with clearly articulated links between the behavioural goals and design elements to obtain the desired outcomes. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S24-S29, March‐April 2022.

Background: Nurses have always been known as an advocate for the rights of patients. The recognition of what is perceived as the violation of patients’ rights can help nurses to understand patients’ concerns and priorities. Thus, it helps nurses play their supportive roles more effectively. Objective: The aim of this study was to explore different dimensions of the violation of patients’ rights. Research design: Data were collected utilizing unstructured interviews and field notes. Data analysis was conducted using the qualitative content (...) analysis approach. Prolonged engagement, maximum variation sampling, and member check were among the factors which enriched the research. Participants and research context: The sample consisted of 18 patients and 11 members of their families. They were purposively selected from two hospitals in Tehran during 2009–2012. Ethical considerations: The research was approved by the Ethics Committee of the university and hospitals. Finding: The patients’ rights were violated in a variety of ways. There were three main dimensions to this issue: (a) care recession including deprivation of the caregiver’s presence and the delay/lack of needed responses; (b) receiving mechanical care including superficiality, lack of emotion, and failure to understand the situation; and (c) being disrespected including humility and aggression. Conclusion: The patients and their families consider any shortcomings in relation to the patient and the quality of care as the violation of the rights. The findings of the study imply sensitizing managers toward providing appropriate conditions as well as educating nurses to observe patients’ rights. It is suggested that the processes leading to the violation of patients’ rights be discovered and prevented in the future. (shrink)

First the ‘Weismann barrier’ and later on Francis Crick’s ‘central dogma’ of molecular biology nourished the gene-centric paradigm of life, i.e., the conception of the gene/genome as a ‘central source’ from which hereditary specificity unidirectionally flows or radiates into cellular biochemistry and development. Today, due to advances in molecular genetics and epigenetics, such as the discovery of complex post-genomic and epigenetic processes in which genes are causally integrated, many theorists argue that a gene-centric conception of the organism has become problematic. (...) Here, we first explore the causal implications of the following two central dogma-related issues: (1) widespread reverse transcription—arguing for an extension from ‘DNA-genome’ to RNA-encompassing ‘NA-genome’ and, thus, from traditional DNA-centrism to a broader ‘NA-centrism’; and (2) the absence of a mechanism of reverse translation—arguing for the ‘structural primacy’ of NA-sequence over protein in cellular biochemistry. Secondly, we explore whether this latter conclusion can be extended to a ‘functional primacy’ of NA-sequence over protein in cellular biochemistry, which would imply a limited kind of ‘gene/NA-centrism’ confined to the subcellular level of NA/protein-based biochemistry. Finally, we explore the conditions—and their (non)fulfilment—for a more generalised form of gene-centrism extendable to higher levels of biological organisation. We conclude that the higher we go in the biological hierarchy, the more dubious gene-centric claims become. (shrink)

One of the major tasks of medical educators is to help maintain and increase trainee empathy for patients. Yet research suggests that during the course of medical training, empathy in medical students and residents decreases. Various exercises and more comprehensive paradigms have been introduced to promote empathy and other humanistic values, but with inadequate success. This paper argues that the potential for medical education to promote empathy is not easy for two reasons: a) Medical students and residents have complex and (...) mostly unresolved emotional responses to the universal human vulnerability to illness, disability, decay, and ultimately death that they must confront in the process of rendering patient care b) Modernist assumptions about the capacity to protect, control, and restore run deep in institutional cultures of mainstream biomedicine and can create barriers to empathic relationships. In the absence of appropriate discourses about how to emotionally manage distressing aspects of the human condition, it is likely that trainees will resort to coping mechanisms that result in distance and detachment. This paper suggests the need for an epistemological paradigm that helps trainees develop a tolerance for imperfection in self and others; and acceptance of shared emotional vulnerability and suffering while simultaneously honoring the existence of difference. Reducing the sense of anxiety and threat that are now reinforced by the dominant medical discourse in the presence of illness will enable trainees to learn to emotionally contain the suffering of their patients and themselves, thus providing a psychologically sound foundation for the development of true empathy. (shrink)

Obstacles in dealing with child sexual abuse can hinder survivors in the process of coming to terms with their experiences. The present study aims to identify and analyze factors that may pose obstacles in the long-term process of dealing with CSA. It is part of a larger research consortium “Auf-Wirkung,” funded by the German Federal Ministry of Education and Research, and was conducted in cooperation with the Independent Inquiry into Child Sexual Abuse in Germany. The IICSAG was appointed by the (...) Independent Commissioner for Child Sexual Abuse Issues and the German Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth in 2016. To determine responsibilities, recognize injustice, and further acknowledge the survivors of CSA in the Federal Republic of Germany and the German Democratic Republic, the Independent Inquiry has held 1,303 private sessions with survivors of CSA by Oct. 17th, 2020. The present study focuses on exploring reoccurring problematic experiences reported by survivors in private sessions regarding the long-term process of dealing with experiences of CSA. A total of 30 transcripts of private sessions, conducted by members and appointees of the IICSAG between September 2016 and June 2019, were analyzed using qualitative content analysis. Attendants of private sessions described a variety of obstacles, including negative social reactions to disclosure, institutions' unwillingness to elucidate occurrences of CSA within their midst, as well as general financial difficulties, and those linked to redress claims. Manipulative grooming by perpetrators and limited access to adequate psychotherapy were perceived as obstructive by survivors dealing with CSA. In the context of criminal proceedings, survivors reported long durations of court proceedings and negative experiences in connection to credibility assessment. Results will be discussed to better support survivors of CSA in the process of dealing with their experiences in the future. (shrink)

Much is said about Middle Eastern and North African publics opposing gender equality, often referring to patriarchal Islam. However, nuanced large-scale studies addressing which specific aspects of religiosity affect support for gender equality across the MENA are conspicuously absent. This study develops and tests a gendered agentic socialization framework that proposes that MENA citizens are not only passively socialized by religion but also have agency. This disaggregates the influence of religiosity, highlights its multifacetedness, and theorizes the moderating roles that gender (...) and sociocognitive empowerment play via gendered processes of agentic dissociations. Using 15 World Values Surveys and multilevel models, our analyses show that most dimensions of religiosity fuel opposition to gender equality. However, the salience of religion in daily life is found to increase women’s support for gender equality and cushion the negative impact of religious service attendance. Also, gender and education moderate the impacts of several religiosity dimensions; for instance, women’s support for gender equality more sharply declines with increased service attendance than men’s. Altogether, this study finds that religious socialization is multifaceted and gendered, and that certain men and women are inclined and equipped to deviate from dominant patriarchal religious interpretations. (shrink)

This article elaborates on Alasdair MacIntyre’s virtue ethics, exploring the plausibility of his claim that each praxis has its own appropriate set of virtues. The exploration will be applied to what I term military praxis. Firstly, the article analyses what is meant by the concept of a praxis and how a military praxis can be defined, as well as the wider purpose of military praxis. From there it proceeds to the “internal goods”, the desires, to be realized in joining the (...) military. Which are these desires that are satisfied by participating in military praxis? Next, by combining the preceding steps, the article suggests which virtues are appropriate to the military praxis, focusing on seven virtues of military character: responsibility, competence, comradeship, respect, courage, resilience and discipline. This framework is completed by practical wisdom, the military virtue of intellect. I will conclude my article by elaborating on the role of narrative in integrating the virtues and by giving some concrete directions about ways in which education in the military virtues could take place. (shrink)

Habermas's educational importance is usually misconstrued or underestimated, partly because the scope and implications of ideal speech conditions are generally misunderstood. These conditions are only relevant to discursive speech situations, but non-manipulative teaching need not be discursive. And not even discursive teaching is an appropriate occasion for ideal speech conditions. They properly apply to discourse institutions, at the ‘epistemic centre of modernity’. Thus, the concept of ideal speech conditions impinges on the relation of school to higher education and on curricular (...) change as an agency of modernisation, and illuminates the need for access to discourse institutions, if personal autonomy is an aim for school children, students or adults. Neo-Marxists, traditionalists and progressives all misunderstand the importance of discourse institutions. (shrink)

Neglected diseases are severe conditions that mainly affect the world's poorest people. Those suffering from neglected diseases are mostly suffering from tropical infections that have failed to receive priority in pharmaceutical research and development programs, as well as in public health policies aimed at improving availability and access to preventive, diagnostic and curative medicine. The World Health Organization has issued a number of documents directing attention to the plight affecting one third of the world's population, assisted by active support from (...) private organizations, notably the Bill and Melissa Gates Foundation, but the overall situation remains dismal. In the wake of major socioeconomic processes including globalization, steadily growing economic disparity, healthcare inequality, the instability created by rogue states and terrorism, as well as massive migration, and epidemic outbreaks, the features of neglected diseases have been changing. Neglected populations affected by tropical diseases are suffering increasingly from non-infectious degenerative conditions and disabilities due to untreated chronic maladies. Pockets of poverty and neglect can also be detected in high-income countries, contributing to the emergence of new diseases and the reemergence of infections believed to be disappearing such as tuberculosis and the measles. Included in the issues of neglect are rare diseases, mostly of genetic origin, affecting a small number of patients that suffer from multiple life-shortening functional impairment and organ defects. Effective medicines are extremely expensive, allegedly because research and development of appropriate drugs is resources and time consuming, requiring exorbitant prices to recoup investment from a small number of consumers. Bioethics has been tardy in addressing the suffering and destitution of neglected and rare diseases. Convinced that permanently repeated denunciations blunt the sensitivity towards suffering, whereas statistics are bloodless and unable to elicit commitment, this book attempts to explore a different strategy. In an upstream approach, bioethics needs to engage in ethnographic fieldwork that confronts and shares the context in which people suffer, vividly presenting what epidemiological research has blunted into statistical data. Additionally, a downstream approach is suggested, requiring bioethics to vigorously and openly denounce unethical biomedical and pharmaceutical research, misdeeds in registration and marketing of drugs, and misalignment of policies with the unmet healthcare needs of the destitute. More than being critical observers, bioethicists ought to shed lurking conflicts of interests and seek active participation in planning research and public healthcare practices aimed at improving the lives of medically neglected populations. (shrink)

The article is based on selected findings from a study in the field of rehabilitation in a religious context viewed from the perspective of cognitive psychology and psychology of religion. The study shows how a therapeutic process can be facilitated in cases where the psychotherapeutic intervention is co-ordinated with a creative, sound religious activity. One central phenomenon that emerged from the study was the experience of a therapeutic dialogue with the divine person God and/ or Jesus being apprehended (...) as a crucial therapeutic agent. The material is analysed focusing on criteria for creative persons and products. A basic mechanism of creativity is hypothesised by Martindale to be defocused attention. The greater the spread of the attention capacity, the more likely the combinational leap, giving the rich possibility of combining elements in new ways. Religion can extend the perspective and thereby increase the possibilities of finding new and appropriate emotional and cognitive combinations. The analysis shows significant creative qualities in the treatment model studied. (shrink)

In the United States, the federal Individuals with Disabilities Education Act specifies that students with disabilities should be educated in the “least restrictive environment,” yet little is known about how successfully schools have been able to apply appropriate supports, practices and resources so that all students benefit from inclusion. Using a quasi-experimental method and a longitudinal data-set provided by the Florida Department of Education that spans an eight-year panel from 2001 through 2009, this paper analyses the relationship between the density (...) and diversity of peers with special educational needs and general education students’ absence rates in grades three through eight. Results show that a one standard deviation increase in the measure of special education peers is associated with an increase in general education students’ absences of.03 to.43 more days per year, depending on the empirical specification chosen. This represents as much as a five percent increase in the a... (shrink)

Vascular calcifications are the consequence of several pathological conditions such as atherosclerosis, diabetes, hypercholesterolemia and chronic renal insufficiency. They are associated with risks of amputation, ischemic heart disease, stroke and increased mortality. A growing body of evidence indicates that vascular smooth muscle cells (VSMCs) undergo chondrogenic commitment eventually leading to vascular calcification, by mechanisms similar to those governing ossification in the cartilage growth plate. Our knowledge of the formation of cartilage growth plate can therefore help us to understand why (...) and how arteries calcify and, consequently, develop new therapeutic strategies. Reciprocally, thorough consideration of the events leading to ectopic chondrocyte differentiation appears crucial to further increase our understanding of growth plate formation. In this context, we will review the effects of known or suspected factors that promote chondrogenic differentiation in growth plate and arteries. BioEssays 27:708–716, 2005. © 2005 Wiley Periodicals, Inc. (shrink)