In the late 1990s, when otherwise healthy women in Aotearoa New Zealand started to die as a result of venous thrombosis attributed to third generation oral contraceptive pills, this contraceptive technology became the subject of media scrutiny and professional re-investigation. This research utilizes a qualitative methodology to explore the accounts of a small selection of contraceptive consumers. Many of this study’s consumers constructed an alternative framing of the 3GOC controversy, which accessed official information (such as medical statistics) but critically framed (...) these facts by grounding them in relation to how their bodies reacted to pharmaceuticals. Bricolage is used as a metaphor for thinking about the ways that women engage in decision-making by creating ‘toolboxes’ from a multitude of readily available material and information. Lévi-Strauss’s original formulation of bricolage, in particular the claim that bricoleurs do not create ‘new knowledge’, is critiqued. (shrink)

This article examines disciplinary proceedings about sexual misconduct by lawyers. Sexual misconduct in a professional relationship is harmful and unacceptable and should result in immediate disciplinary action to protect victims, future victims and the public. However, there is no explicit offence of sexual misconduct in Australian disciplinary legislation regarding lawyers. Rather, sexual misconduct must be linked to the statutory offences. While the Australian Solicitors’ Conduct Rules guide the interpretation of the offences, there is only express reference to sexual harassment. We (...) examined tribunal and court legal disciplinary cases from 2000 to 2020 across all Australian jurisdictions in which sexual misconduct had occurred. Decision makers typically only considered sexual misconduct sufficiently egregious to meet the required standard of a disciplinary offence when accompanied by a criminal conviction. The conduct was often portrayed as a result of character flaws, rather than harmful to victims and the public. Thus, decision makers failed to locate the behaviour in the wider incidence of violence against women. The profession’s failure to acknowledge sexual misconduct reflects narrow professional norms which do not robustly protect victims. Explicit acknowledgement of sexual misconduct in disciplinary proceedings is essential. These amendments would signify the importance, frequency and impact of sexual misconduct. (shrink)

Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable and irremediable (...) suffering due to an illness, disease, or disability. Do we, as a society, have a duty to protect vulnerable people from seeking certain medical procedures that are contrary to their interests, as those are perceived by others? Or do we have a duty to uphold their rights to autonomy, including the right to make choices within a range that may be constrained by many factors, some of which may be socially unjust? This is a recurrent problem in bioethics and medical law, which we explore through the lens of how Canadian courts and Parliament have grappled with defining eligibility for MAiD. (shrink)

Ethics networks have emerged over the last few decades as a mechanism for individuals and institutions over various regions, cities and states to converge on healthcare-related ethical issues. However, little is known about the development and nature of such networks. In an effort to fill the gap in the knowledge about such networks, a survey was conducted that evaluated the organizational structure, missions and functions, as well as the outcomes/products of ethics networks across the country. Eighteen established bioethics networks were (...) identified via consensus of three search processes and were approached for participation. The participants completed a survey developed for the purposes of this study and distributed via SurveyMonkey. Responses were obtained from 10 of the 18 identified and approached networks regarding topic areas of: Network Composition and Catchment Areas; Network Funding and Expenses; Personnel; Services; and Missions and Accomplishments. Bioethics networks are designed primarily to bring ethics education and support to professionals and hospitals. They do so over specifically defined areas—states, regions, or communities—and each is concerned about how to stay financially healthy. At the same time, the networks work off different organizational models, either as stand-alone organizations or as entities within existing organizational structures. (shrink)

Many of our most important goals require months or even years of effort to achieve, and some never get achieved at all. As social psychologists have lately emphasized, success in pursuing such goals requires the capacity for perseverance, or "grit." Philosophers have had little to say about grit, however, insofar as it differs from more familiar notions of willpower or continence. This leaves us ill-equipped to assess the social and moral implications of promoting grit. We propose that grit has an (...) important epistemic component, in that failures of perseverance are often caused by a significant loss of confidence that one will succeed if one continues to try. Correspondingly, successful exercises of grit often involve a kind of epistemic resilience in the face of failure, injury, rejection, and other setbacks that constitute genuine evidence that success is not forthcoming. Given this, we discuss whether and to what extent displays of grit can be epistemically as well as practically rational. We conclude that they can be (although many are not), and that the rationality of grit will depend partly on features of the context the agent normally finds herself in. In particular, grit-friendly norms of deliberation might be irrational to use in contexts of severe material scarcity or oppression. (shrink)

We study the relationship between algebraic structures and their inverse semigroups of partial automorphisms. We consider a variety of classes of natural structures including equivalence structures, orderings, Boolean algebras, and relatively complemented distributive lattices. For certain subsemigroups of these inverse semigroups, isomorphism of the subsemigroups yields isomorphism of the underlying structures. We also prove that for some classes of computable structures, we can reconstruct a computable structure, up to computable isomorphism, from the isomorphism type of its inverse semigroup of computable (...) partial automorphisms. (shrink)

The purpose of this article is to understand how academic integrity educational tutorials are administered across Canadian higher education. Results are shared from a survey of publicly funded Canadian higher education institutions, including universities and colleges, across ten provinces where English is the primary language of instruction. The survey contained 29 items addressing institutional demographic details, as well as academic integrity education questions. Results showed that academic integrity tutorials are inconsistent across Canadian higher education, with further differences evident within the (...) university and college sectors. (shrink)

Education is experiencing a case of misplaced accountability, where an exclusive reliance on high stakes tests overlooks the more subtle judgments of teachers and professional educators and, because of its simplicity, passes as democratic. This article investigates the theoretical underpinnings of current accountability initiatives and draws upon extensive teacher interviews to reveal the practical aspects of accountability pressures in schools today. We provide a discussion of local teacher knowledge that exposes teachers' commitments to a deeper sense of successful education that (...) is eclipsed by testing and that offers a richer resource for improving classrooms and educational outcomes. We provide a discussion of educational foundations and policy that rethinks democratic goals and encourages educationists to shift the current debate in order to make accountability truly democratic. This article suggests that the contemporary climate of accountability may be misplaced in its intentions. (shrink)

Suppose some person 'A' sets out to accomplish a difficult, long-term goal such as writing a passable Ph.D. thesis. What should you believe about whether A will succeed? The default answer is that you should believe whatever the total accessible evidence concerning A's abilities, circumstances, capacity for self-discipline, and so forth supports. But could it be that what you should believe depends in part on the relationship you have with A? We argue that it does, in the case where A (...) is yourself. The capacity for "grit" involves a kind of epistemic resilience in the face of evidence suggesting that one might fail, and this makes it rational to respond to the relevant evidence differently when you are the agent in question. We then explore whether similar arguments extend to the case of "believing in" our significant others -- our friends, lovers, family members, colleagues, patients, and students. (shrink)

Clinical trials play a crucial role in generating evidence about healthcare interventions and improving outcomes for current and future patients. For individual trial participants, however, there are inevitably trade‐offs involved in clinical trial participation, given that trials have traditionally been designed to benefit future patient populations rather than to offer personalised care. Failure to understand the distinction between research and clinical care and the likelihood of benefit from participation in clinical trials has been termed the ‘therapeutic misconception’. The evolution of (...) the clinical trials landscape, including greater integration of clinical trials into healthcare and development of novel trial methodologies, may reinforce the significance of the therapeutic misconception and other forms of misunderstanding while at the same time (paradoxically) challenging its salience. Using cancer clinical trials as an exemplar, we describe how methodological changes in early‐ and late‐phase clinical trial designs, as well as changes in the design and delivery of healthcare, impact upon the therapeutic misconception. We suggest that this provides an impetus to re‐examine the ethics of clinical research, particularly in relation to trial access, participant selection, communication and consent, and role delineation. (shrink)

Unprecedented levels of access to adolescents' time and attention provide opportunities to convert traditional character and socioemotional competencies interventions into behavioral intervention technologies. However, these new tools must be evaluated rather than assuming previously validated activities will be efficacious when converted to a mobile platform. Thus, we sought to design and provide initial data on the effectiveness of the CharacterMe smartphone app to build self-control and patience, which are built on underlying social-emotional regulation competencies, in a sample of 618 adolescents. (...) We also sought to examine whether framing the app activities as having a transcendent rather than instrumental purpose would increase engagement and change in self-control, patience, and emotion regulation. Finally, we tested the impact of framing activities as building strengths vs. fixing weaknesses. Results highlight the difficulty of translating psychological interventions to behavioral intervention technologies. Overall, the CharacterMe smartphone app was unsuccessful in increasing self-control, patience, or emotion regulation in adolescents, with analyses showing no significant mean changes over time. Framing conditions and user engagement were largely not significant predictors of change in self-control, patience, and emotion regulation. (shrink)

Living with cancer: a state of perpetual emergency -- Notes -- References -- PART IV: Environmental aesthetics and resistance -- 12. The great turning -- 13. The underestimated power effects of the discourses and practices of the food justice movement -- Pessimist premise -- General system failure -- The transformative strength of the three Foucaults -- How practices and discourses of the food justice movement illustrate the three Foucaults -- The biopolitical disaster of industrial agriculture -- Via Campesina: peasant knowledge, (...) land and power -- Urban agriculture: eaters' resistance and practices for a new food system -- Slow Food: putting eaters' culture back into "agriculture" -- Conclusion: get your hands dirty! -- Acknowledgements -- References -- 14. Interrogating the neoliberal biopolitics of the sustainable development-resilience nexus -- The political genealogy of sustainable development -- From security to resilience -- The disastrous and politically debased subject of resilience -- Conclusion: development contra neoliberalism? -- References -- 15. The aesthetics of triage: Towards life beyond survival -- Mechanism of a triage -- Photographic triage -- The cinematic triage -- Beyond survival -- References -- 16. End piece: Dealing with disastrous life -- Extra/ordinary disasters -- Dread life -- Towards a new critical framework? -- References -- Index. (shrink)

In this study, we analyzed the academic integrity policies of colleges in Ontario, Canada, casting a specific lens on contract cheating. We extracted data from 28 individual documents from 22-publicly-funded colleges including policies and procedures (n = 27) and code of conduct (n = 1). We analyzed the characteristics of the documents from three perspectives: (a) document type and titles; (b) policy language; and (c) policy principles. Then we examined five core elements of the documentation including (a) access; (b) approach; (...) (c) responsibility; (d) detail; and (e) support. Key findings revealed that specific and direct language pertaining to contract cheating was largely absent from the policy documents, that underlying policy principles lacked clear definition, and that exemplary policy has yet to be developed in this context. We conclude with recommendations for increased policy research in the area of academic integrity and a call for policy revision in Canadian higher education institutions to more explicitly address the issue of contract cheating, as well as provide more support to students and other campus stakeholders to better understand how contract cheating impacts and impedes teaching and learning. (shrink)

Objective:Prior research examining sexual and intimacy concerns among metastatic breast cancer patients and their intimate partners is limited. In this qualitative study, we explored MBC patients’ and partners’ experiences of sexual and intimacy-related changes and concerns, coping efforts, and information needs and intervention preferences, with a focus on identifying how the context of MBC shapes these experiences.Methods:We conducted 3 focus groups with partnered patients with MBC [N = 12; M age = 50.2; 92% White; 8% Black] and 6 interviews with (...) intimate partners [M age = 47.3; 83% White; 17% Black]. Participants were recruited through the Fox Chase Cancer Center Tumor Registry and the Cancer Support Community. Qualitative data were analyzed using the Framework Method and Dedoose software.Results:Qualitative analyses revealed several key themes reflecting ways in which MBC shapes experiences of sex/intimacy: the heavy disease/treatment burden leads to significant, long-term sexual concerns and consequent heightened emotional distress for both patients and partners ; viewing the relationship as having “an expiration date” influences patients’ and partners’ concerns related to sex/intimacy and complicates coping efforts; and information needs extend beyond managing sexual side effects to include emotional aspects of intimacy and the added strain of the life-limiting nature of the disease on the relationship. The heightened severity of sexual concerns faced by patients with MBC, compounded by the terminal nature of the disease, may place patients and partners at risk for significant adverse emotional and interpersonal consequences.Conclusion:Findings suggest unique ways in which sex and intimate relationships change after a diagnosis of metastatic breast cancer from both patients’ and partners’ perspectives. Consideration of the substantial physical and emotional burden of MBC and the broader context of the relationship and intimacy overall is important when developing a sexuality-focused intervention in this population. Addressing sexual concerns is a critical part of cancer care with important implications for patients’ health and quality of life. (shrink)

Given emerging evidence that learning to play a musical instrument may lead to a number of cognitive benefits for older adults, it is important to clarify how these training programs can be delivered optimally and meaningfully. The effective acquisition of musical and domain-general skills by later-life learners may be influenced by social, cultural and individual factors within the learning environment. The current study examines the effects of a 10-week piano training program on healthy older adult novices’ cognitive and motor skills, (...) in comparison to an inactive waitlisted control group. Fifteen participants completed piano training led by a music facilitator in small groups (max n = 4 per lesson class; two experimental, two waitlisted control groups). Data was collected using an explanatory sequential design: quantitative data from a battery of cognitive and motor tests was collected pre/post-test on all participants, with further post-test data from the waitlisted control group (n = 7). Qualitative data included weekly facilitator observations, participant practice diaries, and an individual, semi-structured, post-experiment interview. Bayesian modelling demonstrated moderate evidence of a strong positive impact of training on part A of the Trail Making test (TMT), indicating improved visuo-motor skills. Moderate evidence for negative impacts of training on part B of the Trail Making Test (and difference score delta) was also found, suggesting no benefit of cognitive... (shrink)

Research on pornography has distinguished between its violent and nonviolent forms. Analyses of the content of violent pornography have largely focused on readily available soft-core images in adult films and magazines. However, current research has not adequately addressed pornography on the Internet. We show that discussions about violent pornography are incomplete without an understanding of the Internet as a unique and rapidly expanding medium for disseminating images of sexual violence against women. This article attempts to fill that gap by examining (...) violent pornography using a sample of 31 free Internet sites. Each site was analyzed for its portrayal of women victims, male perpetrators, and its story of rape. Please be advised that the analysis contains graphic descriptions of violence toward women found on Internet rape sites. (shrink)

With the rapid growth of native advertising, there has been an increased interest to address ethical concerns and deception online. To address this concern, we look at the consumer's ethical efficacy toward native ads and we compare native ads to banner ads. Results confirm that consumers trust native ads more than banner ads. Moreover, we uncover that consumers ethical efficacy affects their intention to share native ads through eWOM. However, consumer individual differences influence intention to share content online and trust (...) in the native ads. We study the moderating effects of salience, using the fashion context, and its influence on ad trust and willingness to share through eWOM. Recommendations for business professionals and academics are discussed and future research guidelines are addressed. (shrink)

This essay argues that pre-health humanities programs should focus on intensive research practice for baccalaureate students and provides three guiding principles for implementing it. Although the interdisciplinary nature of health humanities permits baccalaureate students to use research methods from the natural sciences, social sciences, and humanities, pre-health humanities coursework tends to force students to adopt only one of many disciplinary identities. Alternatively, an intensive research approach invites students to critically select and combine methods from multiple disciplines to ask and answer (...) questions about health problems more innovatively. Using the authors’ experiences with implementing health humanities baccalaureate research initiatives at The University of North Carolina at Chapel Hill, the authors contend that pre-health humanities programs should teach and study multiple disciplinary research methods and their values; examine how health humanities research might transfer across disciplines; and focus on mentoring opportunities for funding, presenting, and publishing research. These recommendations have the potential to create unprecedented research experiences for baccalaureate students as they prepare to enter careers within and beyond the allied health professions. (shrink)

Health systems are integrating medical-legal partnerships (MLPs) into clinical care and increasingly center “complex care” patients. These patients have intersecting medical and social needs and often face systemic inequities that exacerbate their chronic health conditions. This paper describes a role for MLPs in hospital quality initiatives; examines the ethics of MLPs assisting with guardianship and institutionalization of hospital patients including marginalized groups; and advocates for MLP interventions designed to address intersectional and ethical concerns.

The objective of this study is to investigate the effects of emotional labor on job performance and satisfaction, as well as to examine the mediating effect of sleep problems and the moderating effects of personality traits. A time-lagged study was conducted on 864 health professionals. Scales for emotional labor, sleep, personality traits, and job satisfaction were used and job performance data was obtained from records maintained by human resources. Structural equation modeling was performed to investigate the relations. Sleep problems only (...) partially mediated the relationship between surface acting and job satisfaction but completely mediated the relationship between surface acting and job performance. Several personality traits were shown to moderate the relationship between surface acting and sleep problems. The effects were stronger for people with low agreeableness and high neuroticism. The relationship between high levels of deep acting and low levels of sleep problems was more pronounced in individuals with low extraversion. Supervisors should be conscious of emotional labor in the work context and provide necessary deep acting training to facilitate emotional regulation. (shrink)

Medical legal partnerships address individual legal needs that can create impediments to health. Little is known about outcomes from medical legal partnerships and their relationship to access to justice. This paper reports outcomes from one medical legal partnership from the perspective of the client, with specific emphasis on impact on health and concepts related to access to justice. We suggest a conceptual model for incorporating medical legal partnerships into a broader framework about access to justice.

The purpose of the study was to develop an understanding of how nursing students gained perspective on nursing care of diverse populations through watching documentaries in a cultural diversity course. The basis of this paper is our analyses of students’ written responses and reactions to documentaries viewed in class. The guiding theoretical frameworks for the course content and the study included postcolonial feminism, Foucauldian thought, and cultural safety. Krathwohl's Taxonomy of the Affective Domain was used to identify themes and determine (...) how undergraduate nursing students were progressing in achieving learning outcomes. Our findings suggest that while the use of documentaries serves as a tool for deepening students’ understanding of the realities of various populations, this activity, in the absence of critical reflection, may inadvertently promote stereotypes and further marginalize different people groups. Even though nursing students reflected on the importance of cultural safety in nursing, our findings indicate that their actions may not reflect this, especially since these students are in the early stages of the nursing program. Students need to be provided with a space where they can explore implicit biases evoked by exposure to new information about different people groups as a way of enhancing culturally safe care. (shrink)

The molecular mechanism of temperature‐dependent sex determination (TSD) is a long‐standing mystery. How is the thermal signal sensed, captured and transduced to regulate key sex genes? Although there is compelling evidence for pathways via which cells capture the temperature signal, there is no known mechanism by which cells transduce those thermal signals to affect gene expression. Here we propose a novel hypothesis we call 3D‐TSD (the three dimensions of thermolabile sex determination). We postulate that the genome has capacity to remodel (...) in response to temperature by changing 3D chromatin conformation, perhaps via temperature‐sensitive transcriptional condensates. This could rewire enhancer–promoter interactions to alter the expression of key sex‐determining genes. This hypothesis can accommodate monogenic or multigenic thermolabile sex‐determining systems, and could be combined with upstream thermal sensing and transduction to the epigenome to commit gonadal fate. (shrink)

The COVID-19 pandemic is negatively impacting people’s mental health worldwide. The current study examined the effects of COVID-19 lockdown on adult women’s eating, body image, and social media habits. Furthermore, we compared individuals with and without signs of orthorexia nervosa, a proposed eating disorder. Participants were 143 women, aged 17–73 years, recruited during a COVID-19 lockdown in Canada from May-June 2020. Participants completed self-report questionnaires on their eating, body image, and social media habits during the pandemic. The Eating Habits Questionnaire (...) assessed symptoms of orthorexia nervosa. Compared to the period prior to lockdown, women with higher total orthorexia nervosa scores reported eating a lot more than usual, feeling greater pressure to diet and lose weight, thinking about food more often than usual, experiencing greater weight gain, and perceiving more pressure from social media specifically to lose weight and to exercise, compared to their healthy counterparts. We examined associations between individual EHQ subscales and perceived changes to eating and weight. Women who scored high on EHQ-Problems reported seeing more weight loss content on their social media than those who reported fewer orthorexia nervosa symptoms. Conversely, those who scored low on EHQ-Feelings reported feeling a lot less pressure to lose weight, somewhat less or a lot less pressure to lose weight or to exercise from social media specifically, and trended toward less laxative use during lockdown, compared to those who scored higher on orthorexia nervosa. And those who scored low on EHQ-Knowledge reported feeling somewhat less or a lot less pressure to lose weight than those who reported more orthorexia nervosa symptoms. Together, the findings suggest that women with symptoms of orthorexia nervosa are experiencing an exacerbation of disordered eating thoughts and behaviors during COVID-19, and that social media may be a contributing factor. (shrink)

We study the weak truth-table and truth-table degrees of the images of subsets of computable structures under isomorphisms between computable structures. In particular, we show that there is a low c.e. set that is not weak truth-table reducible to any initial segment of any scattered computable linear ordering. Countable $\Pi _{1}^{0}$ subsets of 2ω and Kolmogorov complexity play a major role in the proof.

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)