PurposeTo explore the mindfulness practice, its long-term effects, facilitators and barriers, in clinical clerkship students 2 years after participation in an 8-week mindfulness-based stress reduction training.MethodA qualitative study was performed by semi-structured in-depth interviews with 16 clinical clerkship students selected by purposive sampling. Students had participated in a MBSR training 2 years before and were asked about their current mindfulness practice, and the long-term effects of the MBSR training. Thematic analysis was conducted using the constant comparison method. Data saturation was (...) reached after 16 interviews.ResultsMost interviewees were still engaged in regular, predominantly informal, mindfulness practice, although some discontinued mindfulness practice and reported an “unchanged lifestyle.” Three main themes came forward; “focused attention and open awareness” during daily activities as core elements of long-term mindfulness practice; “changes in behavior and coping” that resulted from taking a pause, reflecting, recognizing automatic behavioral patterns and making space for a conscious response; “integration in personal and professional life” by enhanced enjoyment of daily activities, improved work-life-balance and making different career choices. Barriers and facilitators in starting and maintaining mindfulness practice were understanding and intention as “pre-conditions”; practical, personal, and professional factors of students in maintaining practice.ConclusionTwo years after participation in a MBSR training, many interviewees were still engaged in mindfulness practice contributing to both personal and professional changes. In light of the high clerkship demands, MBSR training could be a valuable addition to medical curricula, supporting medical students in developing necessary competencies to become well-balanced professionals. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:130 Feminist Studies 46, no. 1. © 2020 by Feminist Studies, Inc. Laura Bisaillon, Alana Cattapan, Annelieke Driessen, Esther van Duin, Shannon Spruit, Lorena Anton, and Nancy S. Jecker Doing Academia Differently: “I Needed Self-Help Less Than I Needed a Fair Society” A great deal of harm is being done by belief in the virtuousness of work. — Bertrand Russell, “In Praise of Idleness” We are committed to (...) doing academia in particular ways, and not in others. — Brocher Foundation Feminist Collective I had decided that becoming a university professor might be a good fit; friends and colleagues had suggested that I would be valuable to a university, so I prepared for a restructuring of my family life.1 I read Tokarczyk and Fay’s Working-Class Women in the Academy and Babcock and Laschever’s Women Don’t Ask to gather understandings of the milieu I was entering. I now see that my preparations had not shined sufficient light on the social and structural factors that organize the contemporary university.... As it turns out, the restructuring of our lives within the working conditions, priorities, and rationalities of this professional milieu triggered unanticipated and painful effects.... Had Mountz published her article “Women on the Edge” before I decided on a career migration into the university system and, had I been fortunate enough to discover it, I would have made other career choices.2 1. The authors, who describe themselves as the Brocher Foundation Feminist Collective, indicate their personal narratives in this text using italics. 2. Michelle M. Tokarczyk and Elizabeth A. Fay, eds., Working-Class Women in the Academy: Laborers in the Knowledge Factory (Amherst: University of Massachusetts Press, 1993); Linda Babcock and Sara Laschever, Women Don’t Ask: Negotiation and the Gender Divide (Princeton, NJ: Princeton University Bisaillon et al. 131 Introduction: Personal, Professional, and Political We are seven women who met at the Brocher Foundation in Hermance, Switzerland, in July 2017, where we had been selected to spend a few months as research fellows. This competitively awarded opportunity is open to persons fluent in English, from graduate students to senior scholars, with or without academic appointment, whose scholarship advances knowledge about the ethical, legal, and social implications of health and biotechnologies.3 When we found ourselves on the shores of Lake Leman with the gift of time, we began opening up to each other in unexpected, compelling ways. Whatever our vantage point in the hierarchy of the university system, we discovered that there was remarkable overlap in our experiences as women in academia. When we began writing, our authoring team was composed of two graduate students, four faculty members at the assistant professor rank, and one full professor, residing in Canada, the Netherlands, Romania, the United Kingdom, and the United States. Our plural subject position led us to underexplored and imaginative responses to broader social issues, which we share in this article as the “Brocher Foundation Feminist Collective.” We analyze our experiences from our standpoint as women health researchers laboring in the academy. Our similarities and differences were exciting entry points for discussion and analysis: we are all of eastern or western European descent. We have different countries of birth, mother tongues, ages, disciplinary training and career trajectories, relationships to chronic illness and disability, marital status, and experiences with parenthood. We bring the troubles and contradictions we experience as academics into conversation with each other. We seek to productively illustrate and emphasize that the tensions we see around us, and also feel within us, arise as a result of how the academic system is organized, produced, and sustained across time, place, and space. Press, 2003); Alison Mountz, “Women on the Edge: Workplace Stress at Universities in North America,” The Canadian Geographer 60, no. 2 (2016): 205–18. 3. We experienced this fellowship as a valuable opportunity. But we also recognized that our access to it was mediated by social, economic, or other obligations. As countries in the global north continue to tighten their national border regimes, marginalized academics, especially those from the global South, were less likely to succeed in getting a Swiss visa or securing relevant temporal and economic resources. 132 Bisaillon et al. The promise here, we posit... (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Rechtsfilosofische studie over de Italiaanse denker (1668-1744).

Vraagt onze samenleving om een nieuwe politieke formule, om met Alexis de Tocqueville (1805-1859) te spreken? Op het eerste gezicht niet. De democratie is stevig verankerd in de Grondwet en verdragen en is ingebed in de rechtsstaat, en zowel democratie als rechtsstaat maken deel uit van ons collectieve bewustzijn. Toch is er wat aan de hand in de verhouding tussen overheid, samenleving en individu, zoals de inmiddels structurele onvrede met het publieke domein laat zien. Dat vraagt om een richtinggevende doordenking (...) van de vooronderstellingen van ons democratisch bestel en de fundamenten waarop het berust. Dat is wat dit boek zich ten doel stelt. Het biedt toekomstgerichte ideeën voor ons publieke domein aan de hand van kernbegrippen als legitimiteit, staat, politiek, instituties, identiteit, burgerschap, kerk en theologie. Het gedachtegoed van Tocqueville, die geldt als een van de grootste en meest interessante denkers over de moderne democratie, de democratische samenleving en de democratische mens, vormt daarvoor de inspiratiebron. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

Moral case deliberation (MCD) is a specific form of clinical ethics, aiming to stimulate ethical reflection in daily practice in order to improve the quality of care. This article focuses on the implementation of MCD in nursing homes and the questions how and where to organize MCD. The purpose of this study was to evaluate one way of organizing MCD in two Dutch nursing homes. In both of these nursing homes the MCD groups had a heterogeneous composition and were organized (...) apart from existing institutional communication structures. As part of a naturalistic evaluation, systematic observations, interviews and focus groups were completed. The findings indicate that the heterogeneous composition and MCD meetings separate from existing structures have benefits. However, the participants also reported negative experiences. This gives rise to the question whether a mixed MCD group which meets separately is an effective way to embed MCD as an instrument for reflection on moral issues in daily practice. We conclude that there is no single answer to that question. In the end, the two implementation strategies (i.e. within existing communication structures and a mixed MCD group) can be complementary to each other. (shrink)

In defining physical (i.e. causal dynamic) units to which conscious experience is to be ascribed, integrated information theory (IIT) raises three notable requirements: (1) that a unit to which consciousness is ascribed must be defined, or circumscribed, by some intrinsic aspect or property, where intrinsic implies existing 'for itself' or 'from its point of view'; (2) that the intrinsic aspect that defines the unit to which consciousness is ascribed must be dynamic (i.e. involve causal power) rather than purely structural or (...) kinematic; (3) that this dynamic aspect must involve the integration of elements of information in such a way that semantic values of elements are interdependent, allowing rich meaning. It will be argued that, although these requirements are all well-motivated, IIT falls short on them within a testable natural science framework. Concerns raised about the three requirements all point towards one central problem: that the concept of 'integrated information' does not involve any specific causal relation. Although IIT starts from strictly causal premises, the final analysis appears to invoke two incompatible accounts of the same events, with 'integration' having no causal relational basis. It will also be argued that the way IIT attempts to provide a testable theory of dynamic units to which consciousness is ascribed mustcausal reason inherent in any means of testing, be at best redundant for in the human case and, as a general principle, untenable. (shrink)

This article provides ethical guidance on using race in health research as a variable or in defining the study population. To this end, a plain, non-exhaustive checklist is provided for researchers and research ethics committees, preceded by a brief introduction on the need for justification when using race as a variable or in defining a study population, the problem of exoticism, that distinctions pertain between race, ethnicity and ancestry, the problematic naming of races, and that race does not serve well (...) as a presumed biological construct in genetic research. (shrink)

Human neural and behavioral activities have been reported to exhibit fractal dynamics known as 1/f noise, which is more aptly named 1/f scaling. Some argue that 1/f scaling is a general and pervasive property of the dynamical substrate from which cognitive functions are formed. Others argue that it is an idiosyncratic property of domain‐specific processes. An experiment was conducted to investigate whether 1/f scaling pervades the intrinsic fluctuations of a spoken word. Ten participants each repeated the word bucket over 1,000 (...) times, and fluctuations in acoustic measurements across repetitions generally followed the 1/f scaling relation, including numerous parallel yet distinct series of 1/f fluctuations. On the basis of work showing that 1/f scaling is a universal earmark of metastability, it is proposed that the observed pervasiveness of 1/f fluctuations in speech reflects the fact that cognitive functions are formed as metastable patterns of activity in brain, body, and environment. (shrink)

Many studies have suggested that the motor system is organized in a hierarchical fashion, around the prototypical end location associated with using objects. However, most studies supporting the hierarchical view have used well-known actions and objects that are highly over-learned. Accordingly, at present it is unclear if the hierarchical principle applies to learning the use of novel objects as well. In the present study we found that when learning to use a novel object subjects acquired an action representation of the (...) end location associated with using the object, as evidenced by slower responses in an action observation task, when the object was presented at an incorrect end location. By showing the importance of knowledge about end locations when learning to use a novel object, the present study suggests that end locations are a fundamental organizing feature of the human motor system. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

The explanatory gap refers to the lack of concepts for understanding “how it is that . . . a state of consciousness comes about as a result of irritating nervous tissue.” By assuming that there are colours in the outside world, Block needlessly widens this gap and Lycan and Kitcher simply fail to see the gap. When such assumptions are abandoned, an unnecessary and incomprehensible constraint disappears. It then becomes clear that the brain can use its own neural language for (...) representing aspects of the outside world. While this may not close the gap, it becomes clearer where we need new concepts. (shrink)