Aldo Leopold was a pragmatist in the vernacular sense of the word. Bryan G. Norton claims that Leopold was also heavily influenced by American Pragmatism, a formal school of philosophy. As evidence, Norton offers Leopold's misquotation of a definition of right (as truth) by political economist, A.T. Hadley, who was an admirer of the philosophy of William James. A search of Leopold's digitised literary remains reveals no other evidence that Leopold was directly influenced by any actual American Pragmatist or by (...) Pragmatism (although he may have been indirectly influenced by Pragmatism early in his career). A 1923 reference, by Leopold, to Hadley and Hadley's putative definition of truth, cited by Norton, is dripping with irony. Leopold, as he matured philosophically, regarded a profound cultural shift from anthropocentric dominionism and consumerism to an evolutionary-ecological worldview and an associated non-anthropocentric 'land ethic' to be necessary for successful and sustainable conservation. Hadley espoused a brutal form of Social Darwinism and his philosophy, as expressed in the book of Hadley's that Norton cites, is politically reactionary, militaristic and unconcerned with conservation. Leopold's mature philosophy and Hadley's – far from consonant, as Norton claims – are diametrically opposed. (shrink)

OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

Engagement in marine science has historically been the privilege of a small number of people with access to higher education, specialised equipment and research funding. Such constraints have often limited public engagement and may have slowed the uptake of ocean science into environmental policy. Recognition of this disconnect has spurred a growing movement to promote ocean literacy, defined as one’s individual understanding of how the ocean affects people and how people affect the ocean. Over the last 2 decades, this concept (...) has gained significant traction in marine biology and environmental education circles and now plays a prominent role in the UN’s Decade of Ocean Science for Sustainable Development. Here, we argue that the ocean literacy agenda has largely been shaped and discussed by marine scientists and educators but needs to be expanded to a much larger constituency to be more effective, accessible and inclusive. We discuss diverse cultural settings from around the world and provide examples of indigenous, spiritual, art, ocean user and other groups that are already deeply engaged with the ocean and could provide a variety of perspectives to enrich the ocean literacy concept beyond an understanding of marine science. We suggest that such inclusiveness could remove the historic barriers that have surrounded the field, transform our collective awareness of and relationship with the ocean and help support ongoing efforts to restore marine biodiversity. (shrink)

Certainly I am in no way opposed to philosophy, or metaphysics in the sense that Wm. James defined it as a particularly intense effort to think clearly. Indeed, Klein would like to say that what I am talking about is nothing but metaphysics. But the kind of philosophy/metaphysics that is needed here is of a particular kind: a kind that does not separate philosophy/metaphysics and physics into two disjoint realms. It is of the kind that seeks to construct useful testable (...) physical theories that are adequately connected to what we can know. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

The emergence of vibrant research communities of computer scientists in Kenya and Uganda has occurred in the context of neoliberal privatization, commercialization, and transnational capital flows from donors and corporations. We explore how this funding environment configures research culture and research practices, which are conceptualized as two main components of a research community. Data come from a three-year longitudinal study utilizing interview, ethnographic and survey data collected in Nairobi and Kampala. We document how administrators shape research culture by building academic (...) programs and training growing numbers of PhDs, and analyze how this is linked to complicated interactions between political economy, the epistemic nature of computer science and sociocultural factors like entrepreneurial leadership of key actors and distinctive cultures of innovation. In a donor-driven funding environment, research practice involves scientists constructing their own localized research priorities by adopting distinctive professional identities and creatively structuring projects. The neoliberal political economic context thus clearly influenced research communities, but did not debilitate computing research capacity nor leave researchers without any agency to carry out research programs. The cases illustrate how sites of knowledge production in Africa can gain some measure of research autonomy, some degree of global competency in a central arena of scientific and technological activity, and some expression of their regional cultural priorities and aspirations. Furthermore, the cases suggest that social analysts must balance structure with culture, place and agency in their approaches to understanding how funding and political economy shape scientific knowledge. (shrink)

Essential skills and attitudes necessary for active citizenship need to be cultivated as early as prekindergarten. This exploratory study investigated if three and four-year olds could be actively engaged in social studies practices through inquiry learning in a school garden. Eleven children openly interacted and conducted personally-driven investigations on a daily basis in the school garden located on their playground over nine-months. Three interviews with children, teacher observation notes, and lesson plans were analyzed to discover whether NCSS preK-12 learning themes (...) (2010) for the social studies curriculum could be correlated with garden inquiries. Three prevalent NCSS themes surfaced from data analysis with Civic Ideals and Practices, People, Places, and Environments, and Time, Continuity, and Change being most prevalent. Results imply that working in a school garden through inquiry learning can foster the development of democratic competencies and thus, could be used to design C3 lessons for preschoolers in the garden. (shrink)

Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching (...) and evaluating a videotaped CEC performance. We report how we set a criterion cut score (i.e., minimally acceptable score) for judging the ability of users of the ACES tool to evaluate simulated CEC performances.Methods: A modified Angoff standard-setting procedure was used to establish the cut score for an end-of-life case included on the ACES training website. The standard-setting committee viewed the Futility Case and estimated the probability that a minimally competent CEC would correctly answer each item on the ACES tool. The committee further adjusted these estimates by reviewing data from 31 pilot users of the Futility Case before determining the cut score.Results: Averaging over all 31 items, the proposed proportion correct score for minimal competency was 80%, corresponding to a cut score that is between 24 and 25 points out of 31 possible points. The standard-setting committee subsequently set the minimal competency cut score to 24 points.Conclusions: The cut score for the ACES tool identifies the number of correct responses a user of the ACES tool training website must attain to “pass” and reach minimal competency in recognizing competent and incompetent skills of the CECs in the simulated ethics consultation videos. The application of the cut score to live training of CECs and other areas of practice requires further investigation. (shrink)

The rapid and unplanned change to teaching and learning in the online format brought by COVID-19 has likely impacted many, if not all, aspects of university students' lives worldwide. To contribute to the investigation of this change, this study focuses on the impact of the pandemic on student well-being, which has been found to be as important to student lifelong success as their academic achievement. Student well-being has been linked to their engagement and performance in curricular, co-curricular, and extracurricular activities, (...) intrinsic motivation, satisfaction, meaning making, and mental health. The purpose of this study was to examine how student perceptions of their degree completion and future job prospects during the pandemic impact their well-being and what role university support plays in this relationship. We used the conservation of resources theory to frame our study and to develop five hypotheses that were later tested via structural equation modeling. Data were collected from 2,707 university students in France, Germany, Russia, and UK via an online survey. The results showed that university support provided by instructors and administration plays a mediating role in the relationship between the perceived impact of COVID-19 on degree completion and future job prospects and levels of student well-being. Student well-being is decreased by their concerns for their degree completion but not by their concerns for future job prospects. In turn, concerns for future job prospects affect student well-being over time. These results suggest that in a “new normal,” universities could increase student well-being by making support to student studies a priority, especially for undergraduates. Also, universities should be aware of the students' changing emotional responses to crisis and ensure visibility and accessibility of student support. (shrink)

We conducted a survey of residents of Kingston, Ontario, Canada, (n = 107) to understand their attitudes to and experiences of waste management and governance. Currently, the municipality is emphasising waste diversion and exploring new waste processing systems (WPS; e.g., incineration) to reduce costs. Using Foucault's governmentality theory, our data suggest Kingston's reliance on an attitude-behaviour-context model of behaviour change successfully fosters an environmental citizenship identity based on waste diversion (e.g., recycling). However, we argue that the neoliberal governmentality upon which (...) the attitude-behaviour-context model is predicated elides the need for, and inhibits consideration of, broader societal change concerning urgent environmental issues involving consumption and waste. (shrink)

In this article, we explore the act of resistance by nurses and midwives at the nexus of abortion care and gender-based violence. We commence with a brief overview of a multiphased extended grounded theory doctoral project that analysed the individual, situational and socio-political experiences of Australian nurses and midwives who provide abortion care to people victimised by gender-based violence. We then turn to Essex's conceptualisation of resistance in health and healthcare and draw upon these concepts to tell a unifying and (...) cohesive story about how nurses and midwives exercise their politics. Vignettes taken from the three study phases are provided for demonstrative purposes. Finally, we discuss the potential of resistance in health and healthcare as a postmodern feminist research tool to analyse acts by nurses and midwives that could be categorised as political. (shrink)

As a conservation policy advocate and practitioner, Leopold was a pragmatist (in the vernacular sense of the word). He was not, however, a member of the school of philosophy known as American Pragmatism, nor was his environmental philosophy informed by any members of that school. Leopold's environmental philosophy was radically non-anthropocentric; he was an intellectual revolutionary and aspired to transform social values and institutions.

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

Catholic health care has long been a key place where the Church embodies its social doctrine. However, the moral methodology that shapes Catholic bioethics relies on an act-based approach to decision making, which is rooted in the pre–Vatican II manualist tradition, focusing primarily on clinical issues related to the beginning and end of life. This essay argues that given the doctrinal status of Catholic social thought, Catholic bioethics must revisit its scope and methodology. It proceeds in three steps: a meta-analysis (...) of traditional Catholic bioethics, validating the claim made above; an overview of the limited literature published since 1980 engaging Catholic bioethics and CST; and a map of a Catholic bioethics informed by CST generated from a dual starting point. The essay concludes by focusing on both the places where marginalized persons encounter Catholic health care and the ethical issues presented, including race, health care disparities, immigration status, and gender inequality, as well as the interrelated perspective of the common good, expanding the array of issues to include environmental degradation, unions, health care financing, and more. (shrink)

Previous research has demonstrated that individuals from Western cultures exhibit categorical perception (CP) in their judgments of emotional faces. However, the extent to which this phenomenon characterises the judgments of facial expressions among East Asians remains relatively unexplored. Building upon recent findings showing that East Asians are more likely than Westerners to see a mixture of emotions in facial expressions of anger and disgust, the present research aimed to investigate whether East Asians also display CP for angry and disgusted faces. (...) To address this question, participants from Canada and China were recruited to discriminate pairs of faces along the anger-disgust continuum. The results revealed the presence of CP in both cultural groups, as participants consistently exhibited higher accuracy and faster response latencies when discriminating between-category pairs of expressions compared to within-category pairs. Moreover, the magnitude of CP did not vary significantly across cultures. These findings provide novel evidence supporting the existence of CP for facial expressions in both East Asian and Western cultures, suggesting that CP is a perceptual phenomenon that transcends cultural boundaries. This research contributes to the growing literature on cross-cultural perceptions of facial expressions by deepening our understanding of how facial expressions are perceived categorically across cultures. (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

Background High levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention. Aim “Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses. Research Design A Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s (...) Moral Distress Scale–Revised (MDS-R.) This program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices. Participants Clinical nurses working on an adult leukemia/lymphoma unit. Ethical considerations This was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation. Findings While improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills. Discussion Measurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions. Conclusion This QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)

The use of cost-benefit analysis (CBA) in environmental decision-making and the contingent valuation (CV) technique as input into traditional CBA to elicit environmental values in monetary terms has stimulated an extensive debate. Critics have questioned the appropriateness of both the method and the technique. Some alternative suggestions for the elicitation of environmental values are based on a social process of deliberation. However, just like traditional economic theory, these alternative approaches may be questioned on their implicit value judgements regarding the legitimacy (...) of the social-political organisation of the process of value elicitation. Instead of making assumptions a priori, research efforts should be focused on the processes by which actual public attitudes and preferences towards the environment can best be elicited and fed into environmental or other public policy decision-making. In the study presented in this paper, support was found for both the individual WTP based approach and a participatory social deliberation approach to inform the environmental decision-making process, suggesting that a combination of both approaches is most appropriate. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

Community engagement (CE) contributes to successful research. There is, however, a lack of literature on the effectiveness of different models of CE and, specifically, on CE strategies for the conduct of genomic research in sub-Saharan Africa. There is also a need for models of CE that transcend the recruitment stage of engaging prospective individuals and communities and embed CE throughout the research process and after the research has concluded. The qualitative study reported here was designed to address these knowledge gaps (...) and comprised of 36 key informant semi-structured interviews and fifteen focus groups with 50 participants. We interviewed selected stakeholders in genomic research in Nigeria: biomedical researchers, community rulers, opinion leaders, community health workers, and prospective research participants. We explored these stakeholders’ views on their understanding of community engagement, their expectations, experiences, and their opinions on acceptable processes of community consultation in genomic research. The methodological design, adapted from grounded theory, used the constant comparative method of data analysis; while normative conclusions were made using the symbiotic empirical ethics approach. Data analysis revealed five main themes important for successfully engaging communities in genomic research: effective communication, diversity of community gatekeeping, trust, cultural integration of research, and conservation of the research setting. From these themes, we have developed a four-stage model of community engagement that covers all stages of the research process; namely, the Community Approach, Intermediate phase, Collaboration and Post-research Cordiality model (CICP). This model could be used to improve the integration of CE in genomic research among local communities. (shrink)

Sir Austin Bradford Hill’s ‘aspects of causation’ represent some of the most influential thoughts on the subject of proximate causation in health and disease. Hill compiled a list of features that, when present and known, indicate an increasing likelihood that exposure to a factor causes—or contributes to the causation of—a disease. The items of Hill’s list were not labelled ‘criteria’, as this would have inferred every item being necessary for causation. Hence, criteria that are necessary for causation in health, disease (...) and intervention processes, whether known, knowable, or not, remain undetermined and deserve exploration. To move beyond this position, this paper aims to explore factors that are necessary in the constitution of causative relationships between health, disease processes, and intervention. To this end, disease is viewed as a causative pathway through the often overlapping stages of aetiology, pathology and patho-physiology. Intervention is viewed as a second, independent causative pathway, capable of causing changes in health for benefit or harm. For the natural course of a disease pathway to change, we argue that intervention must not only occupy the same time and space, but must also share a common form; the point at which the two pathways converge and interact. This improved conceptualisation may be used to facilitate the interpretation of clinical observations and inform future research, particularly enabling predictions of the mechanistic relationship between health, disease and intervention. (shrink)

Through discourse with international groups of physicians, we conducted a cross-cultural analysis of the types of ethical dilemmas physicians face. Qualitative analysis was used to categorise the dilemmas into seven themes, which we compared among the physicians by country of practice. These themes were a-theoretically-driven and grounded heavily within the text. We then subjected the dilemmas to an analysis of moral intensity, which represents an important theoretical perspective of ethical decision making. These constructs represent salient determinants of ethical behaviour and (...) our cross-cultural sample afforded us the opportunity to consider both the pragmatic aspects of culture, as they are perceived by physicians, as well as the theory-driven concept of moral intensity. By examining both culture and moral intensity, we hope to better elucidate the complexities of ethical decision-making determinants among physicians in their daily practice. Doing so may potentially have practical implications for ethics training of medical students and foreign physicians. (shrink)

Contexte : Dans les systèmes de santé universitaires complexes, les projets d’amélioration de la qualité (AQ) destinés à améliorer les soins et l’apprentissage prolifèrent, mais il existe des différences considérables quant à la manière dont ces projets sont supervisés sur le plan éthique, voire même s’ils le sont. À la suite d’un volume élevé de projets soumis à l’un de nos comités d’éthique de la recherche (CER), mais considérés comme n’étant pas de la recherche et donc non éligibles à un (...) examen, des questions ont commencé à se poser au sein de notre organisation sur la manière dont les dimensions éthiques des projets d’AQ pourraient être évaluées et sur les approbations institutionnelles qui pourraient être nécessaires pour garantir la conformité avec les normes émergentes. Méthodes : Une enquête environnementale à méthodes mixtes a conduit à une analyse quantitative rétrospective des projets d’AQ de notre organisation, associée à des consultations qualitatives approfondies avec le personnel, les médecins et les apprenants de l’ensemble de notre réseau de santé. Les exemptions de CER ont été analysées à l’aide de diagrammes d’exécution afin d’évaluer les volumes de base des projets d’AQ, et des analyses thématiques ont été menées sur les notes de terrain de 133 consultations avec les parties prenantes. Résultats : Au cours d’une période de 34 mois, 117 lettres d’exemption du CER ont été émises pour des projets d’AQ. Les consultations ont mis en évidence la nécessité d’un processus d’évaluation éthique clairement défini pour les projets d’AQ, de structures de gouvernance appropriées et de possibilités d’identifier et d’atténuer les risques. Les personnes interrogées ont également évoqué l’impératif éthique de mener des initiatives d’AQ. Le présent document explique comment ces thèmes ont contribué à l’élaboration et à la mise en place de notre comité d’examen de l’amélioration de la qualité (CEAQ). Conclusion : Depuis 2020, plus de 840 projets ont été examinés par notre CEAQ, dans le but d’atténuer les risques pour les patients, le personnel et les équipes de projet d’AQ dans l’ensemble de l’UHN. (shrink)

Although living conditions have improved throughout history, protest, at least in the last few decades, seems to have increased to the point of becoming a normal phenomenon in modern societies. Contributors to this volume examine how and why this is the case and argue that although problems such as poverty, hunger, and violations of democratic rights may have been reduced in advanced Western societies, a variety of other problems and opportunities have emerged and multiplied the reasons and possibilities for protest.

Heidegger’s two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries . Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking with emphasis on economic concerns. Meditative responses represented 24% of the statements and were mostly generated by Canadian physicians whose patients typically were not faced with economic barriers (...) to treatment due to Canada’s universal health care system. (shrink)

Aim: To explore healthcare chaplains’ experience of providing spiritual support to individuals and families from minority religious and non-religious faiths and to identify key elements of the role. Background: Currently, there is limited research uncovering the essential elements of healthcare chaplaincy, specifically with reference to religious and/or spiritual diversity, and as interprofessional collaborators with nurses and midwives in healthcare. Research design and participants: Using phenomenology, we interviewed eight healthcare chaplains from a variety of healthcare settings in the Republic of Ireland. (...) Data were analysed using a seven-step framework comprising Moustakas’ (1994) modification of the Van Kaam method of data analysis. Ethical considerations: Ethical approval was granted by the university and the principles of informed consent applied. Findings: Three main themes emerged: what the chaplain brings; components of ritual, minority faith or no faith; and practising chaplaincy. Subthemes included ‘offering’, ‘awareness and insight’, ‘acceptance and empathy’, ‘skilled companionship’, ‘presence’, ‘a confidant and holder of hope’ and ‘a vital resource’. Discussion and conclusions: The healthcare chaplain is a key collaborator in facilitating holistic person-centred care and in supporting healthcare professionals. Chaplaincy services are an essential but largely unrecognised and potentially cost-effective component of interprofessional team working. Relevance to clinical practice: This study has illuminated key aspects of the healthcare chaplain’s role as interprofessional collaborator in person-centred care, in navigating diversity and ensuring respect and dignity for the person irrespective of religious or spiritual care needs. (shrink)

We used a participatory approach and a rural livelihoods framework to explore the knowledge and capacity of southeast Queensland graziers to adapt to climate change. After being presented with information on climate change projections, participants identified biophysical and socio-economic opportunities and challenges to adaptation. Graziers identified key opportunities as components of resilience (incremental change), and in many cases were options that they had some knowledge of either from their own region or elsewhere in the grazing industry. The major constraint to (...) adaptation was the lack of financial capital: with low profitability of the industry and high land costs restricting their capacity to diversify and exploit economies of scale. These constraints were exacerbated by the pressure many graziers experienced from the demand for land as a result of urban expansion. While the focus of the workshop was on the impact of climate change and capacity to adapt, many of the issues raised by graziers were pressures not solely related to climate change. Adaptation needs to be considered in light of the appropriate level (resilience–transition–transformation) and spatial scale (field to region) required to tackle the issues identified. Policy needs to support good natural resource management, rural amenity, and food and fibre production close to urban population and markets in the face of urban encroachment. (shrink)

BackgroundScientific literature on posttraumatic growth after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.MethodsWe examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks. The participants had been injured by a terrorist attack or were first-degree relatives of people who had been (...) killed or injured by a terrorist attack. They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.ResultsMultiple regression analyses revealed gender differences and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.ConclusionThe findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research. (shrink)

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary (...) knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves. The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical and semantic comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed. (shrink)