BackgroundUniversal standards for bioethics, including the tenet of informed consent, should be upheld in the setting of humanitarian medical missions. The obstacles to obtaining informed consent in the global health setting have been thoroughly discussed in the literature, but no studies have investigated these issues from the patient’s perspective. We sought to understand the patient’s experience of the consent process during a four-week surgical mission to Haiti.MethodsAll patients selected for surgery during a mission to Hinche, Haiti, were invited to participate (...) in a survey assessing communication between them and their physicians, their understanding of the surgical procedure, and their desire for information during the consent process. Complete data were collected from 55 patients.ResultsUnderstanding a basic explanation of surgery and the associated risks was important to 98% of Haitian surgical patients, and 96% reported the desire for extensive risk communication. All patients felt that they sho... (shrink)

Once anesthetized, patients are inherently “compliant” with surgical interventions because they can no longer intervene on their own behalf. In their target article, Minkoff et al. (2024) reasonabl...

Philosophy and Memory Traces defends two theories of autobiographical memory. One is a bewildering historical view of memories as dynamic patterns in fleeting animal spirits, nervous fluids which rummaged through the pores of brain and body. The other is new connectionism, in which memories are 'stored' only superpositionally, and reconstructed rather than reproduced. Both models, argues John Sutton, depart from static archival metaphors by employing distributed representation, which brings interference and confusion between memory traces. Both raise urgent issues about (...) control of the personal past, and about relations between self and body. Sutton demonstrates the role of bizarre body fluids in moral physiology, as philosophers from Descartes and Locke to Coleridge struggled to control their own innards and impose cognitive discipline on 'the phantasmal chaos of association'. Going on to defend connectionism against Fodor and critics of passive mental representations, he shows how problems of the self are implicated in cognitive science. (shrink)

Detailed and in-depth investigation of the important but often unappreciated work done by science technicians, in this case in the context of paleontology.

A research community must share assumptions, such as about accepted knowledge, appropriate research practices, and good evidence. However, community members also hold some divergent assumptions, which they—and we, as analysts of science—tend to overlook. Communities with different assumed values, knowledge, and goals must negotiate to achieve compromises that make their conflicting goals complementary. This negotiation guards against the extremes of each group’s desired outcomes, which, if achieved, would make other groups’ goals impossible. I argue that this diversity, as a form (...) of value pluralism, regularly influences scientific practice and can make scientific evidence and knowledge more useful and more reliable. As an example, I examine vertebrate paleontology laboratories, which house a variety of workers with different training and priorities, particularly about the meaning of time. Specifically, scientists want to study fully prepared fossils immediately, conservators want to preserve fossils for future use, and preparators mediate between the other groups’ conflicting goals. After all, one cannot study a fossil encased in rock, and one cannot remove that rock without removing information from that specimen. In response, these coworkers articulate their assumptions in everyday deliberations about how scientific evidence should be made and used. I argue that this exchange of assumptions is crucial for a research community to achieve mutually beneficial compromises that benefit current and future knowledge construction. (shrink)

An argument that takes issue with the contemporary epistemological consensus that justification is distinct from knowledge, proposing instead that justified belief simply is knowledge, and arguing in detail that a belief is justified when ...

New technologies can upset scientific workplaces’ established practices and social order. Scientists may therefore prefer preserving skilled manual work and the social status quo to revolutionary technological change. For example, digital imaging of rock-encased fossils is a valuable way for scientists to “see” a specimen without traditional rock removal. However, interviews in vertebrate paleontology laboratories reveal workers’ skepticism toward computed tomography imaging. Scientists criticize replacing physical fossils with digital images because, they say, images are more subjective than the “real thing.” (...) I argue that these scientists are also implicitly supporting rock-removal technicians, who are skilled and trusted experts whose work would be made obsolete by widespread implementation of CT scanning. Scientists’ view of CT as a sometimes useful tool rather than a universal new approach to accessing fossils preserves the laboratory community’s social structure. Specifically, by privileging “real” specimens and trusted specimen-processing technicians over images and imaging experts, scientists preserve the lab community’s division of labor and skill, hierarchy between scientists and technicians, and these groups’ identity and mutual trust. (shrink)

Background Some have hypothesized that changing attitudes toward medical aid in dying (MAID) contribute to increased suicide rates, perhaps by increasing interest in dying or the perceived acceptability of suicide. This would represent a strong criticism of MAID policies. We sought to evaluate the association between the legalization and implementation of MAID across the U.S. and changing suicide rates.Methods We evaluated state-level monthly suicide death rates from 1995 to 2021. Because suicide rates vary by state, we constructed geographically-weighted regression models (...) controlling for annualized state-level sociodemographic factors, such as racial distribution (percent Caucasian), average age, income levels, unemployment rates, rates of spiritual engagement, firearm ownership rates, gender ratios, and education levels. We applied a difference-in-difference analysis within our geographically-weighted models.Results 927,929 Suicide deaths were represented in the study. Ten states and the District of Columbia had legalized MAID within the study period. In an univariable analysis, states that legalized MAID differed significantly from non-MAID states with respect to mean monthly suicide rate (non-MAID States: 1.46; MAID states: 1.78; p < 0.0001), as well as several covariates. Monthly suicide death rates were spatially autocorrelated (Moran’s I = 0.607, p < 0.0001). In separate geographically-weighted difference-in-difference analyses, changes in suicide rates were not significantly associated with MAID legalization (β = 0.042, p = 0.33) or with later MAID implementation (β = 0.030, p = 0.63), with differences in suicide rates in MAID and non-MAID states being attributable to baseline between-state differences.Conclusions Our study failed to find evidence that suicide rates were positively associated with MAID legalization or MAID implementation, when controlling for geographic variation and multiple sociodemographic factors associated with suicide risk. This finding contrasts with other studies that have reported a positive association between suicide rates and MAID, and so calls into question one argument against MAID legalization. (shrink)

A major challenge in neuroscience is to understand what happens to a brain as it ages. Such insights could make it possible to distinguish between individuals who will undergo typical aging and those at risk for neurodegenerative disease. Over the last quarter century, thousands of human brain imaging studies have probed the neural basis of age-related cognitive decline. “Aging” studies generally enroll adults over the age of 65, a historical precedent rooted in the average retirement age of U.S. wage-earners. A (...) consequence of this research tradition is that it overlooks one of the most significant neuroendocrine changes in a woman’s life: the transition to menopause. The menopausal transition is marked by an overall decline in ovarian sex steroid production – up to 90% in the case of estradiol – a dramatic endocrine change that impacts multiple biological systems, including the brain. Despite sex differences in the risk for dementia, the influence that biological sex and sex hormones have on the aging brain is historically understudied, leaving a critical gap in our understanding of the aging process. In this Perspective, we highlight the influence that endocrine factors have on the aging brain. We devote particular attention to the neural and cognitive changes that unfold in the middle decade of life, as a function of reproductive aging. Next, we consider emerging evidence from animal and human studies that other endocrine factors occurring earlier in life (e.g. pregnancy, hormonal birth control use) also shape the aging process. Applying a women’s health lens to. (shrink)

Philosophers of science are well aware that theories are underdetermined by data. But what about the data? Scientific data are selected and processed representations or pieces of nature. What is useless context and what is valuable specimen, as well as how specimens are processed for study, are not obvious or predetermined givens. Instead, they are decisions made by scientists and other research workers, such as technicians, that produce different outcomes for the data. Vertebrate fossils provide a revealing case of this (...) data-processing, because they are embedded in rock that often matches the fossils’ color and texture, requiring an expert eye to judge where the fossil/context interface is. Fossil preparators then permanently define this interface by chiseling away the material they identify as rock. As a result, fossil specimens can emerge in multiple possible forms depending on the preparator’s judgment, skill, and chosen tools. A prepared fossil then is not yet data but potential data, following Leonelli’s relational framework in which data are defined as evidence that scientists have used to support a proposed theory. This paper draws on ethnographic evidence to assess how scientists overcome this underdetermination of specimens, as potential data, in addition to the underdetermination of theories and of data, to successfully construct specimen-based knowledge. Among other strategies, paleontology maintains a division of labor between data-makers and theory-makers. This distinction serves to justify the omission of preparators’ nonstandard, individualized techniques from scientific publications. This separation has benefits for both scientists and technicians; however, it restricts knowledge production by preventing scientists from understanding how the pieces of nature they study were processed into researchable specimens. (shrink)

On the extended mind hypothesis (EM), many of our cognitive states and processes are hybrids, unevenly distributed across biological and nonbiological realms. In certain circumstances, things - artifacts, media, or technologies - can have a cognitive life, with histories often as idiosyncratic as those of the embodied brains with which they couple. The realm of the mental can spread across the physical, social, and cultural environments as well as bodies and brains. My independent aims in this chapter are: first, to (...) describe two compatible but distinct movements or "waves" within the EM literature, arguing for the priority of the second wave (and gesturing briefly toward a third); and, second, to defend and illustrate the interdisciplinary implications of EM as best understood, specifically for historical disciplines, by sketching two case studies. (shrink)

This paper introduces a new, expanded range of relevant cognitive psychological research on collaborative recall and social memory to the philosophical debate on extended and distributed cognition. We start by examining the case for extended cognition based on the complementarity of inner and outer resources, by which neural, bodily, social, and environmental resources with disparate but complementary properties are integrated into hybrid cognitive systems, transforming or augmenting the nature of remembering or decision-making. Adams and Aizawa, noting this distinctive complementarity argument, (...) say that they agree with it completely: but they describe it as “a non-revolutionary approach” which leaves “the cognitive psychology of memory as the study of processes that take place, essentially without exception, within nervous systems.” In response, we carve out, on distinct conceptual and empirical grounds, a rich middle ground between internalist forms of cognitivism and radical anti-cognitivism. Drawing both on extended cognition literature and on Sterelny’s account of the “scaffolded mind” (this issue), we develop a multidimensional framework for understanding varying relations between agents and external resources, both technological and social. On this basis we argue that, independent of any more “revolutionary” metaphysical claims about the partial constitution of cognitive processes by external resources, a thesis of scaffolded or distributed cognition can substantially influence or transform explanatory practice in cognitive science. Critics also cite various empirical results as evidence against the idea that remembering can extend beyond skull and skin. We respond with a more principled, representative survey of the scientific psychology of memory, focussing in particular on robust recent empirical traditions for the study of collaborative recall and transactive social memory. We describe our own empirical research on socially distributed remembering, aimed at identifying conditions for mnemonic emergence in collaborative groups. Philosophical debates about extended, embedded, and distributed cognition can thus make richer, mutually beneficial contact with independently motivated research programs in the cognitive psychology of memory. (shrink)

Human development takes place in a social context. Two pervasive sources of social information are faces and hands. Here, we provide the first report of the visual frequency of faces and hands in the everyday scenes available to infants. These scenes were collected by having infants wear head cameras during unconstrained everyday activities. Our corpus of 143 hours of infant-perspective scenes, collected from 34 infants aged 1 month to 2 years, was sampled for analysis at 1/5 Hz. The major finding (...) from this corpus is that the faces and hands of social partners are not equally available throughout the first two years of life. Instead, there is an earlier period of dense face input and a later period of dense hand input. At all ages, hands in these scenes were primarily in contact with objects and the spatio-temporal co-occurrence of hands and faces was greater than expected by chance. The orderliness of the shift from faces to hands suggests a principled transition in the contents of visual experiences and is discussed in terms of the role of developmental gates on the timing and statistics of visual experiences. (shrink)

In mining, manufacturing and industrial process industries, maintenance procedures are used as an aid to guide technicians through complex manual tasks. These procedures are not machine-readable, and cannot support reasoning in digitally integrated manufacturing systems. Procedure documents contain unstructured text and are stored in a variety of formats. The aim of this work is to query information held in real industrial maintenance procedures. To achieve this, we develop an ontology for maintenance procedures using the OWL 2 description language. We leverage (...) classes and object properties from the ISO 15926 Part 14 Upper Ontology and create a domain ontology. The key contribution of this paper is a demonstration of trade-offs required when modelling an existing engineering artifact, where an abstraction of its contents is given a-priori. We provide an ontologically rigorous abstraction of notions captured in procedure documentation to a set of classes, relations and axioms that allow reasoning over the contents. Validation of the ontology is performed via a series of competency questions based on queries relevant to technicians, engineers and schedulers in industry. The ontology is applied to real world maintenance procedures from two industrial organisations. (shrink)

‘There is no place in the phenomenology of fully absorbed coping’, writes Hubert Dreyfus, ‘for mindfulness. In flow, as Sartre sees, there are only attractive and repulsive forces drawing appropriate activity out of an active body’1. Among the many ways in which history animates dynamical systems at a range of distinctive timescales, the phenomena of embodied human habit, skilful movement, and absorbed coping are among the most pervasive and mundane, and the most philosophically puzzling. In this essay we examine both (...) habitual and skilled movement, sketching the outlines of a multidimensional framework within which the many differences across distinctive cases and domains might be fruitfully understood. Both the range of movement phenomena which can plausibly be seen as instances of habit or skill, and the space of possible theories of such phenomena are richer and more disparate than philosophy easily encompasses. We seek to bring phenomenology into contact with relevant movements in psychological theories of skilful action, in the belief that phenomenological philosophy and cognitive science can be allies rather than antagonists. (shrink)

This multidisciplinary book brings together a series of critical engagements regarding the notion of ethical practice. As a whole, the book explores the question of how the current neo-liberal socio-political moment, and its relationship to the historical legacies of colonialism, white settlement, and racism, informs and shapes our practices, pedagogies, and understanding of encounters in diverse settings. Drawing largely on the work of Sara Ahmed’s Strange Encounters: Embodied Others in Post-Coloniality, each chapter in this book takes up a particular encounter (...) and unravels the elements that created these meetings in specific times and spaces. Sites of encounters included in this volume range from the classroom to social work practice and from literary to media interactions, and take place both within Canada and internationally. Paramount to the discussions is a consideration of how relations of power and legacies of oppression shape self and others, and draw boundaries between bodies within an encounter. From a social justice perspective, Unravelling Encounters exposes the political conditions that configure our meetings with one another, and inquires into what it means to care, to respond, and to imagine oneself as an ethical subject. (shrink)

Museum displays tend to black-box science, by displaying scientific facts without explanations of how those facts were made. A recent trend in exhibit design upends this omission by putting scientists, technicians, and volunteers to work in glass-walled laboratories, just a window away from visitors. How is science conceived, portrayed, and performed in glass-walled laboratories? Interviews and participant observation in several “fishbowl” paleontology laboratories reveal that glass walls alter lab workers’ typical tasks and behavior. However, despite glass-walled labs’ incomplete and edited (...) enactment of scientific work, displaying an active workplace valuably challenges visitors’ assumptions that science is passive and that museums are home only to facts and dead things. Thus, glass-walled labs do not destroy the black box that obscures scientific practice for nonscientists. Instead, they exemplify a glass box, a kind of black box that contains a performance of scientific work. Glass-boxing describes a common way in which museums present scientific practice—that is, by making it observable but incompletely so—by inviting the public to construct a rich understanding of science as human work. (shrink)

I propose that constitution is a case of composition in which, for example, the lump of clay composes the statue. In other words, we can reduce constitution to composition. Composition does all of the work that we want from an account of constitution, and we do not need two separate relations. Along the way, I offer reasons to reject weak supplementation. Acknowledgments (which by my mistake were not included in the journal publication): Many people have given me feedback over the (...) years on this paper or an ancestor of it, and I apologize for oversights in my acknowledgments here. Special thanks to Trenton Merricks for comments on several drafts of this paper. Thanks also for helpful comments and discussions to Eugene Mills, Donald Smith, Peter Sutton, David Liebesman, Charlie Tanksley, Amanda Hicks, Kristl Laux, and to an audience at the University at Buffalo conference in honor of E. J. Lowe, an audience at Amherst College, and an audience at the 2017 APA Eastern Division Meeting. Thank you also to multiple anonymous referees along the way. (shrink)

The “headscarf affair,” Muslim girls wearing veils to school, has generated a storm of controversy in France. This study uses the headscarf affair to explore Muslim immigrant women's views of their place in French society and reveals that even those who disagree with French public opinion often invoke arguments that are more French than North African. Interviews with 41 North African women show that younger, well-educated women defend the headscarf as a matter of personal liberty and cultural expression. Older, poorly (...) educated women either defend or reject the veil but never discuss the issue of secularism. In dismissing the veil, they rely on a different understanding of Muslim womanhood. A third group opposes the veil, arguing that the goal of school is integration. Respondents' answers are interpreted according to structural factors and cultural repertoires, both North African and French. (shrink)

Synthesizing the domains of investigation highlighted in current research in distributed cognition and related fields, this paper offers an initial taxonomy of the overlapping types of resources which typically contribute to distributed or extended cognitive systems. It then outlines a number of key dimensions on which to analyse both the resulting integrated systems and the components which coalesce into more or less tightly coupled interaction over the course of their formation and renegotiation.

Traces of many past events are often layered or superposed, in brain, body, and world alike. This often poses challenges for individuals and groups, both in accessing specific past events and in regulating or managing coexisting emotions or attitudes. We sometimes struggle, for example, to find appropriate modes of engagement with places with complex and difficult pasts. More generally, there can appear to be a tension between what we know about the highly constructive nature of remembering, whether it is drawing (...) on neural or worldly resources or both, and the ways that we need and use memory to make claims on the past, and to maintain some appropriate causal connections to past events. I assess the current state of work on situated affect and distributed memory, and the recent criticisms of the ‘dogma of harmony’ in these fields. I then deploy these frameworks to examine some affective dimensions of place memory, sketching a strongly distributed conception of places as sometimes partly constituting the processes and activities of feeling and remembering. These approaches also offer useful perspectives on the problems of how to engage – politically and aesthetically – with difficult pasts and historically burdened heritage. In assessing artistic interventions in troubled places, we can seek responsibly to do justice to the past while fully embracing the dynamic and contested constructedness of our present emotions, memories, and activities. (shrink)

On the extended mind hypothesis (EM),l many of our cognitive states and processes are hybrids, unevenly distributed across biological and nonbiological realms (Clark 1997; Clark and Chalmers 1998). In certain circumstances, things-artifacts, media, or technologies-can have a cognitive life, with histories often as idiosyncratic as those of the embodied brains with which they couple (Sutton 2002a, 2008). The realm of the mental can spread across the physical, social, and cultural environments as well as bodies and brains. My independent aims (...) in this chapter are: first, to describe two compatible but distinct movements or "waves" within the EM literature, arguing for the priority of the second wave (and gesturing briefly toward a third); and, second, to defend and illustrate the interdisciplinary implications of EM as best understood, specifically for historical disciplines, by sketching two case studies. (shrink)

Background Over the last decade, the return of results (ROR) in precision medicine research (PMR) has become increasingly routine. Calls for individual rights to research results have extended the “duty to report” from clinically useful genetic information to traits and ancestry results. ROR has thus been reframed as inherently beneficial to research participants, without a needed focus on who benefits and how. This paper addresses this gap, particularly in the context of PMR aimed at increasing participant diversity, by providing investigator (...) and researcher perspectives on and questions about the assumed value of ROR in PMR.Methods Semi-structured interviews with a purposive sample of investigators and researchers across federally funded PMR studies in three national consortia, as well as observations of study activities, focused on how PM researchers conceptualize diversity and implement inclusive practices across research stages, including navigating ROR.Results Interviewees (1) validated the value of ROR as a benefit of PMR, while others (2) questioned the benefit of clinically actionable results to individuals in the absence of sufficient resources for translating findings into health care for diverse and disadvantaged populations; (3) expressed uncertainties in applying the presumed value of ROR as a benefit for non-clinical results; and (4) and debated when the promise of the value of ROR may undermine trust in PMR, and divert efforts to return value beyond ROR.Conclusions Conceptualizations of diversity and inclusion among PM researchers and investigators raise unique ethical questions where unexamined assumptions of the value of ROR inform study recruitment efforts to enroll minoritized and under-represented populations. A lack of consideration for resources and infrastructure necessary to translate ROR into actionable information may hinder trustworthy community-research relationships. Thus, we argue for a more intentional interrogation of ROR practices as an offer of benefit and for whom. (shrink)

As a topic in the philosophy of psychology, dreaming is a fascinating, diverse, and severely underdeveloped area of study. The topic excites intense public interest in its own right, while also challenging our confidence that we know what the words “conscious” and “consciousness” mean. So dreaming should be at the forefront of our interdisciplinary investigations: theories of mind which fail to address the topic are incomplete. This chapter illustrates the tight links between conceptual and empirical issues by highlighting surprisingly deep (...) disagreements among leading dream scientists over what might seem basic aspects of their topic. (shrink)

A woman is listening to Sinatra before work. As she later describes it, ‘suddenly from nowhere I could hear my mother singing along to it … I was there again home again, hearing my mother … God knows why I should choose to remember that … then, to actually hear her and I had this image in my head … of being at home … with her singing away … like being transported back you know I got one of those (...) … like shivery feelings really suddenly’ (Anderson 2004, 9-10). An older couple, discussing their honeymoon forty years ago, each say that they can’t remember the show they saw, until through iterative, puzzled cross-cuing they finally get there – ‘Desert Song, that’s it’ (Harris et al 2011, 292). An elderly English veteran of a prisoner of war camp in Japan, finishing up morning tea with a young Japanese social scientist interested in reconciliation, suddenly calls out loudly - in Japanese - ‘stand to attention’. He stands to attention in front of her: like many of the men she interviews, he physically re-enacts fragments of that long-past world of the camp, bringing that absent past into this new present context with a visceral shock (Murakami 2001, 2012; Middleton & Brown 2005, 133-136). (shrink)

Persons think. Bodies, time-slices of persons, and brains might also think. They have the necessary neural equipment. Thus, there seems to be more than one thinker in your chair. Critics assert that this is too many thinkers and that we should reject ontologies that allow more than one thinker in your chair. I argue that cases of multiple thinkers are innocuous and that there is not too much thinking. Rather, the thinking shared between, for example, persons and their bodies is (...) exactly what we should expect at the intersection of part sharing and the supervenience of the mental on the physical. I end by responding to the overcrowding objection, the personhood objection, the personal-pronoun reference problem and the epistemic objection. (shrink)

This paper defines and analyzes the processes of “othering” as they manifest in the practice and praxis of nursing education. Othering is bound up in the establishment and reinforcement of norms, and shores up power inequities that negatively impact faculty, students, and patients. While previous analyses have addressed othering in nursing more broadly, this paper adds a consideration of the multiple processes of othering that operate within the context of nursing education spaces. Cases from recent nursing education literature are interpreted (...) through the frameworks of exclusionary, inclusionary, and structural othering, and provide specific illustrations of the concepts described. The paper concludes by arguing for an application of norm‐critical pedagogical practice to counteract, disrupt and dismantle othering processes within nursing education. (shrink)

Globally, one in eight people lacks access to potable water; more people die from unsafe drinking water than from all forms of violence, including war. A substantial body of research documents that the privatization of water – led by global financial institutions working in collusion with governments and corporations – does not lead to more people gaining access to safe water. In fact, the opposite is true: privatization leads to both higher cost and lower quality water. For the past century, (...) the dominant focus of transnational organizing has been “from the West to the rest,” and the frequent attention to movements in the global North has led to the neglect of transnational linkages between movements. Drawing on fieldwork conducted on three right to water movements that span three continents, this paper examines effortsto reclaim the water commons,and how struggles have been driven by grassroots movements demanding that democracy, transparency, and the human right to water are prioritized over corporate profit. As feminist scholars have pointed out, the “standpoint” offered by marginalized actors offers important insights into the operation of systems of power and the strategies of survival and resistance that less powerful actors adopt in order to survive and thrive. This paper explores how transnational movements around water and other basic rights engage with and learn from each other. (shrink)

I will be arguing that a subject’s belief that p is justified if and only if he knows that p: justification is knowledge. I will start by describing two broad classes of allegedly justified beliefs that do not constitute knowledge and which, hence, cannot be what they are often taken to be if my view is correct. It is far from clear what my view is until I say a lot more about the relevant concept or concepts of justification that (...) concern me. The following section describes several concepts of justification that epistemologists have employed, and, in particular, identifies the two concepts of justification that I claim are coextensive with the concept of knowledge. One of those is the deontological conception of justification: I will be arguing that one ought not believe that p unless one knows that p. I imagine that the major opposition to my view will be that it is simply obvious that there are justified false beliefs, a feeling that I try to dispel in the lengthy section on concepts of justification before I finally get around to giving the main arguments in favor of my view. A view as unorthodox as mine demands more than a single argument: I offer four in the third section. Everyone allows that many people have many unjustified beliefs, and everyone has some unjustified beliefs, but such beliefs appear to be far more prevalent on my view than on more orthodox views. In the last section, I argue that unjustified beliefs, although widespread, are not quite as common as they might appear to be on my view. (shrink)

Osteoporosis, a disease of bone loss associated with aging and estrogen loss, can be crippling but is ‘silent’ prior to bone fracture. Despite its disastrous health effects, high prevalence, and enormous associated health care costs, osteoporosis lacked a universally accepted definition until 1992. In the 1980s, the development of more accurate medical imaging technologies to measure bone density spurred the medical community’s need and demand for a common definition. The medical community tried, and failed, to resolve these differing definitions several (...) times at consensus conferences and through published articles. These experts finally accepted a standard definition at an international consensus conference convened by the World Health Organization in 1992. The construction of osteoporosis as a disease of quantifiable risk diagnosed by medical imaging machines reflects contemporary trends in medicine, including the quantification of disease, the risk factor model, medical disciplinary boundaries, and global standardization of medical knowledge. (shrink)

BackgroundReturning neuroimaging incidental findings may create a challenge to research participants’ health literacy skills as they must interpret and make appropriate healthcare decisions based on complex radiology jargon. Disclosing IF can therefore present difficulties for participants, research institutions and the healthcare system. The purpose of this study was to identify the extent of the health literacy challenges encountered when returning neuroimaging IF. We report on findings from a retrospective survey and focus group sessions with major stakeholders involved in disclosing IF.MethodsWe (...) surveyed participants who had received a radiology report from a research study and conducted focus groups with participants, parents of child participants, Institutional Review Board members, investigators and physicians. Qualitative thematic analyses were conducted using standard group-coding procedures and descriptive summaries of health literacy scores and radiology report outcomes are examined.ResultsAlthough participants reported high health literacy skills, 67 % did not seek medical care when recommended to do so; and many participants in the focus groups disclosed they could not understand the findings described in their report. Despite their lack of understanding, participants desire to have information about their radiology results, and the investigators feel ethically inclined to return findings.ConclusionsThe language in clinically useful radiology reports can create a challenge for participants’ health literacy skills and has the potential to negatively impact the healthcare system and investigators conducting imaging research. Radiology reports need accompanying resources that explain findings in lay language, which can help reduce the challenge caused by the need to communicate incidental findings. (shrink)

Embodied human minds operate in and spread across a vast and uneven world of things—artifacts, technologies, and institutions which they have collectively constructed and maintained through cultural and individual history. This chapter seeks to add a historical dimension to the enthusiastically future-oriented study of “natural-born cyborgs” in the philosophy of cognitive science,3 and a cognitive dimension to recent work on material memories and symbol systems in early modern England, bringing humoral psychophysiology together with material culture studies. The aim is to (...) sketch an integrative framework which spans early modern ideas and practices relating to brains, bodies, memory, and objects. Embodiment and environment, I’ll argue, were not (always) merely external influences on feeling, thinking, and remembering, but (in certain circumstances) partly constitutive of these activities. (shrink)

Through a selective historical, theoretical, and critical survey of the uses of the concept of scaffolding over the past 30 years, this chapter traces the development of the concept across developmental psychology, educational theory, and cognitive anthropology, and its place in the interdisciplinary field of distributed cognition from the 1990s. Offering a big-picture overview of the uses of the notion of scaffolding, it suggests three ways to taxonomise forms of scaffolding, and addresses the possible criticism that the metaphor of scaffolding (...) retains an overly individualist vision of cognition. The chapter is aimed at a broad interdisciplinary audience interested in processes of learning, teaching, and apprenticeship as they apply to the study of memory. (shrink)

The search for meaningful work has been of interest to researchers from a variety of disciplines for decades and seems to have grown even more recently. Much of the literature assumes that employees share a sense of what is meaningful in work and there isn’t much attention given to how and why meanings might differ. Researchers have not only called for more research studying demographic differences in definitions of meaning :77–90, 2014), but also more research utilizing mixed methods to study (...) psychological concepts like meaningful work Handbook of multimethod measurement in psychology, American Psychological Association, Washington, 2006). This study specifically examines differences across generational cohorts on their prioritization of sources of meaningful work through qualitative, in-depth interviews followed by a more generalizable, quantitative survey. Findings from the qualitative study show that generational cohorts define the meaning in their jobs differently, and they hold negative perceptions about the lack of desire for meaning in each of the other cohorts. Study 2 maps generational cohorts on the comprehensive model of meaningful work designed by Lips-Wiersma and Morris :491–511, 2009) to reveal that although there are some differences in prioritization of sources of meaningful work, all generational cohorts share similar desire to “develop and become themselves” when asked about their definitions of meaningful work. Implications and future research are discussed. (shrink)

I start with a brief assessment of the implications of Sterelny’s anti-individualist, anti-internalist apprentice learning model for a more historical and interdisciplinary cognitive science. In a selective response I then focus on two core features of his constructive account: collaboration and skill. While affirming the centrality of joint action and decision making, I raise some concerns about the fragility of the conditions under which collaborative cognition brings benefits. I then assess Sterelny’s view of skill acquisition and performance, which runs counter (...) to dominant theories that stress the automaticity of skill. I suggest that it may still overestimate the need for and ability of experts to decompose and represent the elements of their own practical knowledge. (shrink)

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of (...) CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19. (shrink)