Physician religion/spirituality has the potential to influence the communication between physicians and parents of children at the end of life. In order to explore this relationship, the authors conducted two rounds of narrative interviews to examine pediatric physicians’ perspectives (N=17) of how their religious/spiritual beliefs affect end–of–life communication and care. Grounded theory informed the design and analysis of the study. As a proxy for religiosity/spirituality, physicians were classified into the following groups based on the extent to which religious/spiritual language was (...) infused into their responses: Religiously Rich Responders (RRR), Moderately Religious Responders (MRR), and Low Religious Responders (LRR). Twelve of the 17 participants (71%) were classified into the RRR or MRR groups. The majority of participants suggested that religion/spirituality played a role in their practice of medicine and communication with parents in a myriad of ways and to varying degrees. Participants used their religious/spiritual beliefs to support families’ spirituality, uphold hope, participate in prayer, and alleviate their own emotional distress emerging from their patients’ deaths. (shrink)

Semiotics has been making progressively inroads into marketing research over the past thirty years. Despite the amply demonstrated conceptual appeal and empirical pertinence of semiotic perspectives in various marketing research streams, spanning consumer research, brand communications, branding and consumer cultural studies, there has been a marked deficit in terms of consolidating semiotic brand-related research under a coherent disciplinary umbrella with identifiable boundaries and research agenda. -/- The Handbook of Brand Semiotics furnishes a compass for the perplexed, a (...) set of anchors for the inquisitive and a solid corpus for scholars, while highlighting the conceptual richness and methodological diversity of semiotic perspectives. -/- Written by a team of expert scholars in various semiotics and branding related fields, such as John A. Bateman, David Machin, Xavier Ruiz Collantes, Kay L. O’Halloran, Dario Mangano, George Rossolatos, Merce Oliva, Per Ledin, Gianfranco Marrone, Francesco Mangiapane, Jennie Mazur, Carlos Scolari, Ilaria Ventura, and edited by George Rossolatos, Chief Editor of the International Journal of Marketing Semiotics, the Handbook is intended as a point of reference for researchers who wish to enter the ‘House of Brand Semiotics’ and explore its marvels. -/- The Handbook of Brand Semiotics, actively geared towards an inter-disciplinary dialogue between perspectives from marketing and semiotics, features the state-of-the-art, but also offers directions for future research in key streams, such as: -/- · Analyzing and designing brand language across media · Brand image, brand symbols, brand icons vs. iconicity · The contribution of semiotics to transmedia storytelling · Narrativity and rhetorical approaches to branding · Semiotic roadmap for designing brand identity · Semiotic roadmap for designing logos and packaging · Sociosemiotic accounts of building brand identity online · Multimodality and Multimodal critical discourse analysis · Challenging the omnipotence of cognitivism in brand- related research · Semiotics and (inter)cultural branding · Brand equity semiotics Comparative readings of structuralist, Peircean and sociosemiotic approaches to brandcomms . (shrink)

The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.

Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

The aim of this study is to understand how governance mechanisms in cross-sector collaborations (CSCs) for sustainability affect value creation and capture and subsequently the survival of this organizational form. Drawing on a longitudinal, participatory, single-case study of collaborative action in the textile industry, we identify three governance mechanisms—safeguarding, bundling and connecting—that coevolve with the rising and waning of collaborative tensions and the shifting levels of action in the CSC we studied. These mechanisms aided value creation and helped facilitate private (...) value capture. We integrate these insights into a process model that visualizes the interplay between governance mechanisms of tensions and systems of value creation and capture in CSCs for sustainability. Our study contributes to the cross-sector collaboration literature by providing a dynamic and nuanced understanding of how governance mechanisms influence outcomes in CSCs for sustainability. We also add to the business model for sustainability literature by theorizing the value creation and capture system of collaborative rather than individual organizations. Our findings have important implications for policymakers who fund collaborative organizations and practitioners who manage or participate in them. (shrink)

The number of women living with HIV/AIDS is increasing worldwide, and there is an urgent public health need to develop new user-initiated HIV prevention methods, including microbicides. Although funding for microbicide development has increased since 2000, financial support is provided predominantly by governmental agencies and private foundations. Many donors, including the US Agency for International Development and the US National Institutes of Health, have policies that restrict how research funds may be used. Among these are the now-rescinded Mexico City Policy, (...) elements of the US Foreign Assistance Act, and restrictions on non-study-related care. The effect of these restrictions on the design and conduct of clinical research is poorly understood. As part of a recent mapping exercise conducted by the Global Campaign for Microbicides, we reviewed the impact of donor restrictions on seven HIV prevention trials. We found considerable confusion within the HIV prevention field as to whether and how Mexico City and other policies affect the use of research funds. We also found that these donor-imposed policies limited the level of care provided to trial participants and the types of capacity building projects undertaken. (shrink)

Deeply rooted structures of racism, ableism, misogyny, ageism, and transphobia hurt great numbers of people, exposing them to intolerance, economic exclusion, and physical harm around the globe. Billions of land animals suffer and die annually in concentrated feeding operations and slaughterhouses. Our planet and all who live here are in perilous straights as the climate changes. In the face of such grievous problems, people who want to find positive ways to respond often grapple with difficult questions about how to make (...) a difference. Effective Altruism has arisen as an attempt to help answer these questions, encouraging people to give as much money as they can in the most effective ways to address human and animal suffering. But the Effective Altruists’ answers support some of the very social structures that cause suffering, undermining its efforts to “do the most good.” The Good It Promises, The Harm It Does is the first book-length critique of Effective Altruism. It brings together a diverse group of activists and scholars to explore Effective Altruism’s failure to meaningfully address forms of human and animal suffering. (shrink)

This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 young elite athletes were recruited for no-treatment control purposes. The ethical decision-making training comprised six 30-min online sessions in which the participants had to work through 18 ethical dilemmas related to doping. The standard-knowledge-based educational program was also conducted in six online (...) sessions of comparable length to that of the ethical training. A short version of the Performance Enhancement Attitude Scale was administered to measure the effects of the trainings on doping attitude. Prior to as well as after the intervention, the mean doping attitude scores of the young athletes were low to very low, indicating vehement rejections of doping. The results of our experiment showed that the ethical training led to an attenuation of these rejections. No intervention effect was found in the standard education group. The observed slight increase in the doping attitude score could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping. (shrink)

In clinical practice, evidence suggests that teaching ethics using normative ethical theory has little influence on the ethical actions of providers in practice. Thus, new training methods are needed that improve clinician response to ethical problems. A sensemaking approach to ethics training has demonstrated promise as an evidence-based pedagogical method to improve ethical reasoning and response. Project ECHO is theoretically linked to improved sensemaking. This study examines the effectiveness of ECHO and training in use of sensemaking approaches to ethical response (...) by clinicians. A quasi-experimental design study using univariate linear regression was used to examine the effect of the three types of ethics training on ethical response self-efficacy scores, while controlling for participant characteristics of years in practice, discipline and sex. We found evidence that training in sensemaking through participation in ECHO promotes improved ethical response self-efficacy of clinicians. However, results also suggest that a traditional ECHO format that does not explicitly introduce sensemaking strategies into the training does not result in the same learning outcomes as measured through an ethical response self-efficacy survey. This study found important preliminary results to support use of sensemaking approaches in clinical ethics training. (shrink)

The neuropsychoanalytic approach solves important aspects of how to use our understanding of the brain to treat patients. We describe the neurobiology underlying motivation for healthy behaviors and psychopathology. We have updated Freud’s original concepts of drive and instinct using neuropsychoanalysis in a way that conserves his insights while adding information that is of use in clinical treatment. Drive (Trieb) is a pressure to act on an internal stimulus. It has a motivational energic source, an aim, an object, and is (...) terminated by the satisfaction of a surge of serotonin. An instinct (Instinkt) is an inherited pattern of behavior that varies little from species to species. Drives are created by internal/ventral brain factors. Instincts require input from the outside that arrive through dorsal brain structures. In our model unpleasure is the experience of unsatisfied drives while pleasure if fueled by a propitious human environment. Motivational concepts can be used guide clinical work. Sometimes what had previously described psychoanalytically as, “Internal conflict,” can be characterized neurobiologically as conflicts between different motivational systems. These motivational systems inform treatment of anxiety and depression, addiction in general and specific problems of opioid use disorder. Our description of motivation in addictive illness shows that the term, “reward system,” is incorrect, eliminating a source of stigmatizing addiction by suggesting that it is hedonistic. Understanding that motivational systems that have both psychological and brain correlates can be a basis for treating various disorders. Over many papers the authors have described the biology of drives, instincts, unpleasure and pleasure. We will start with a summary of our work, then show its clinical application. (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)

Click on the DOI link to access the article.

Background: In the ever-changing and complex healthcare environment, nurses encounter challenging situations that may involve a clash between their personal and professional values resulting in a profound impact on their practice. Nevertheless, there is a dearth of literature on how nurses develop their personal–professional values. Aim: The aim of this study was to understand how nurses develop their foundational values as the base for their value system. Research design: A constructivist grounded theory methodology was employed to collect multiple data sets, (...) including face-to-face focus group and individual interviews, along with anecdote and reflective stories. Participants and research context: Fifty-four nurses working across various nursing settings in Indonesia were recruited to participate. Ethical considerations: Ethics approval was obtained from the Monash University Human Ethics Committee, project approval number 1553. Findings: Foundational values acquisition was achieved through family upbringing, professional nurse education and organisational/institutional values reinforcement. These values are framed through three reference points: religious lens, humanity perspective and professionalism. This framing results in a unique combination of personal–professional values that comprise nurses’ values system. Values are transferred to other nurses either in a formal or informal way as part of one’s professional responsibility and customary social interaction via telling and sharing in person or through social media. Discussion: Values and ethics are inherently interweaved during nursing practice. Ethical and moral values are part of professional training, but other values are often buried in a hidden curriculum, and attained and activated through interactions during nurses’ training. Conclusion: Developing a value system is a complex undertaking that involves basic social processes of attaining, enacting and socialising values. These processes encompass several intertwined entities such as the sources of values, the pool of foundational values, value perspectives and framings, initial value structures, and methods of value transference. (shrink)

While it is acknowledged that there is a need for more qualitative research on suicide, it is also clear that the ethics of undertaking such research need to be addressed. This article uses the case study of the authors’ experience of gaining ethics approval for a research project that asks people what it is like to feel suicidal to (a) analyse the limits of confidentiality and anonymity and (b) consider the ways in which the process of ethics review can shape (...) and constrain suicide research. This leads to a discussion of the ways in which ethics committees assess and monitor qualitative research more generally and some preliminary suggestions for how this might be improved. (shrink)

The focus of this book is to explore teachers' evolving personal epistemologies, or the beliefs we hold about the origin and development of knowledge in the context of teaching. The chapters focus on a range of conceptual frameworks about how university and field-based experiences influence the connections between teachers' personal epistemologies and teaching practice. In an earlier volume we investigated ways in which we might change preservice teachers' beliefs and teaching practice (Brownlee, Schraw and Berthelsen, 2011). While we addressed the (...) nature of teachers' personal epistemology, learning and teaching practices, and approaches for changing beliefs throughout teacher education programs, the volume did not address conceptual frameworks for the development of teacher's personal epistemologies. The book is focused on teacher educators, teachers and teacher education programmers in universities with an overall aim of highlighting how we might support students to engage in learning that is challenging and to engage in professional experiences that promote changes in teaching practice. We argue that students need to be encouraged to question their beliefs and develop increasingly sophisticated beliefs about their knowledge and their students' knowledge that facilitate learning and intellectual growth. (shrink)

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what (...) is done with their genetic data, amplify the privacy concerns. (shrink)

This article presents evidence supporting the claim that ethical reasoning is a skill that can be taught and assessed. We propose a working definition of ethical reasoning as 1) the ability to identify, analyze, and weigh moral aspects of a particular situation, and 2) to make decisions that are informed and warranted by the moral investigation. The evidence consists of a description of an ethical reasoning education program—Ethical Reasoning in Action —designed to increase ethical reasoning skills in a variety of (...) situations and areas of life. ERiA is housed at a public, major comprehensive U.S. university—James Madison University—and assessment of the program focuses on interventions delivered prior to and during orientation for incoming first-year students. Findings indicate that the interventions measurably enhance the ability of undergraduate students to reason ethically. ERiA’s competency-targeted program and positive student learning outcomes offers a promising model for higher education ethics programs seeking to connect classroom learning in ethics to decision-making in everyday life. (shrink)

Volume 24, Issue 7, July 2024, Page 6-12.

This article aims to focus on how signatories versus nonsignatories in the U.S. pharmaceutical sector compare with respect to the internal and external stakeholders and principles of the United Nations Global Compact (UNGC). We seek to answer the question: Do signatories to the UNGC walk the talk better than nonsignatories as determined by a variety of published rankings and data? This research presents an innovative approach to the evaluation of UNGC signatories. It uses several objective and independent data sources to (...) assess a matched group of signatories versus nonsignatories in the U.S. pharmaceutical sector. Signatory organizations in the same sector as determined by SIC codes were matched with nonsignatories on variables such as size and number of employees in U.S. pharmaceutical companies. Then both types of organizations were compared on the following data sources: Coalition for Environmentally Responsible Economies ratings, ratings by external stakeholders, ratings by employees, unionization data, financial measures, and annual reports to shareholders. Using nonparametric testing the research found there are differences between signatories and nonsignatories in the U.S. pharmaceutical sector for some of the external stakeholder measures and no differences were found for the internal stakeholder measures. (shrink)

Deciding whether to grant an expanded access request for a child whose sibling is enrolled in a gene therapy trial involves a number of complex factors: considering the best interests of the child, the psychosocial and economic impact on the family, and the concerns and obligations of researchers. Despite the challenges in coming to a substantively fair outcome in cases of discordant eligibility, creating a procedurally fair decision-making process to adjudicate requests is essential.

The relationship between corporate executives and shareholders has riveted the attention of business ethicists since the inception of the field. Most ethicists agree that corporate executives owe their investors the duties of loyalty, candor, and care. These fiduciary duties undergird the promises made to shareholders at the time of incorporation, placing on executives moral obligations to engage in fair dealing and to avoid conflicts of interest.We concur that executives owe all of their existing shareholders both promise-keeping and fiduciary duties and (...) argue that some corporateexecutives violate these responsibilities by attempting to withhold information from or limit information to some shareholders while courting others. We analyze the ethical implications of six techniques and tools that executives use to attract certain types of shareholders while deterring others. We conclude with recommended structural and behavioral changes to these current managerial and investor practices. (shrink)

Drosophila neural progenitor cells, or neuroblasts, alter their transcriptional profile over time to produce different neural cell types. A recent paper by Pearson and Doe shows that older neuroblasts can be reprogrammed to behave like young neuroblasts, and to produce early neural cell types, simply by expressing the transcription factor, Hunchback.1 The authors show that competence to respond to Hunchback diminishes over time. Mani pulating neural progenitors in this way may have important implications for therapeutic uses of neural stem cells. (...) BioEssays 26:711–714, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

This volume provides a concentrated and powerful dialog about the nexus between schools, prisons, and the free-market economy where youth are on fast tracks from schools to prisons.

In most western countries, there is a ‘human organ shortage’ with waiting lists for the performance of transplantation. In a recent report of the UNOS Ethics Committee it is stated that there are approximately 31,000 potential recipients on waiting lists, but only one fourth of potential donors gave their specific consent.Xenotransplantation – defined as the transplantation of animal cells, tissues or organs into human beings – is associated with particular ethical dilemmas, namely the problems of efficiency and safety of this (...) medical procedure. The objective of this study is to analyse the ethical dilemmas in xenotransplantation with the background of a personal view of moral life. Also, xenotransplantation will be evaluated as far as the legal regulation of transplantation is concerned. In particular, we will consider patients rights in accordance with existing laws on organ and tissue transplantation, animal research and clinical trials. (shrink)

_La Peste_, originally published in 1947 by the Nobel Prize-winning writer Albert Camus, chronicles the progression of deadly bubonic plague as it spreads through the quarantined Algerian city of Oran. While most discussions of fictional examples within aesthetics are either historical or hypothetical, Camus offers an example of "pestilence fiction." Camus chose fiction to convey facts--about plagues in the past, his own bout with tuberculosis at age seventeen, living under quarantine away from home for several years, and forced separation from (...) his wife who remained in Algiers while he was abroad in Nazi-occupied France. His own lived experiences undergird an imaginative account of shared human realities with which we can identify: vulnerability to the disease, isolation, fear, and finally humanitarianism. _The Plague_ teaches us to neither covet nor expect what we so casually took for granted. This collection of original essays on philosophical themes in _The Plague_ is of special relevance during and in the aftermath of Covid-19 but also provides reflections that will be of lasting value to those interested in this classic work of literature. The novel explores questions of enduring importance. Do we collectively meet the threshold of ethical behavior posed by Camus who wrote, "What's true of all the evils in the world is true of plague as well. It helps men to rise above themselves"? Or does the absurd undermine the compassionate? Do "heroes" dutifully fight a plague with "common decency," or does human nature resign itself to the normalization of uncontrollable suffering and death? There are myriad ways to approach the novel and this volume encourages readers to ponder human dilemmas in fictional Oran informed by our current pandemic. Series editor forward by Richard Eldridge. List of Contributors includes Steven G. Kellman, Jane E. Schultz, Andrew Edgar, Kathleen Higgins, Edward B. Weiser, Cynthia A. Freeland, and Margaret E. Gray; see "Introduction" by Peg Brand Weiser below. (shrink)

Pleiotropically acting eukaryotic corepressors such as retinoblastoma and SIN3 have been found to physically interact with many widely expressed “housekeeping” genes. Evidence suggests that their roles at these loci are not to provide binary on/off switches, as is observed at many highly cell‐type specific genes, but rather to serve as governors, directly modulating expression within certain bounds, while not shutting down gene expression. This sort of regulation is challenging to study, as the differential expression levels can be small. We hypothesize (...) that depending on context, corepressors mediate “soft repression,” attenuating expression in a less dramatic but physiologically appropriate manner. Emerging data indicate that such regulation is a pervasive characteristic of most eukaryotic systems, and may reflect the mechanistic differences between repressor action at promoter and enhancer locations. Soft repression may represent an essential component of the cybernetic systems underlying metabolic adaptations, enabling modest but critical adjustments on a continual basis. (shrink)

Cognitive systems face a tension between stability and plasticity. The maintenance of long‐term representations that reflect the global regularities of the environment is often at odds with pressure to flexibly adjust to short‐term input regularities that may deviate from the norm. This tension is abundantly clear in speech communication when talkers with accents or dialects produce input that deviates from a listener's language community norms. Prior research demonstrates that when bottom‐up acoustic information or top‐down word knowledge is available to disambiguate (...) speech input, there is short‐term adaptive plasticity such that subsequent speech perception is shifted even in the absence of the disambiguating information. Although such effects are well‐documented, it is not yet known whether bottom‐up and top‐down resolution of ambiguity may operate through common processes, or how these information sources may interact in guiding the adaptive plasticity of speech perception. The present study investigates the joint contributions of bottom‐up information from the acoustic signal and top‐down information from lexical knowledge in the adaptive plasticity of speech categorization according to short‐term input regularities. The results implicate speech category activation, whether from top‐down or bottom‐up sources, in driving rapid adjustment of listeners' reliance on acoustic dimensions in speech categorization. Broadly, this pattern of perception is consistent with dynamic mapping of input to category representations that is flexibly tuned according to interactive processing accommodating both lexical knowledge and idiosyncrasies of the acoustic input. (shrink)

Access to a deep pool of talent is essential to the success of every professional services firm. The supply of that talent is contingent upon the available rewards for the exercise of that talent, and both the existence of the potential rewards and the beliefs that individuals hold about the existence of the rewards affect the decision to remain in the field. One structural factor that may affect the judgment about whether to remain in a profession concerns promotions based on (...) the gender of the employee. In this study, we examine the “glass ceiling” within the context of the accounting profession. While advances have been made within the accounting profession to address the glass ceiling, the continued existence—and perceptions about the continued existence—of the issue exert adverse effects upon the available talent pool and may create long-term problems for the profession. In this study, we investigate glass ceiling perceptions among a large sample of female accounting professionals employed in accounting; the sample includes both public accountants, and those employed in industry accounting. Our study yields the finding of beliefs in bias-driven effects, structural effects, and cultural effects among these accounting professionals. Glass ceiling perceptions are also influenced by several demographic factors. Furthermore, accounting professionals employed by industry are more likely to report a glass ceiling within their firms than accounting professionals employed by public accounting firms. The findings are of interest to researchers who explore gender-related issues in professional service firms such as the field of accounting, and to senior members of practice who are tasked with ensuring the integrity and quality of the talent pool and the equitable distribution of rewards to employees. (shrink)

Can an ordinary viewer ever experience art---particularly politically charged, socially relevant art--in a neutral, detached, and objective way? The familiar philosophical notion of disinterestedness has its roots in eighteenth-century theories of taste and was refined throughout the twentieth century. In contrast, many contemporary theorists have argued for what I call an "interested approach" in order to expand beyond the traditional emphasis on neutrality and universality. Each group, in effect, has argued for the value of a work of art by excluding (...) the other's approach. This essay will consider the legacy of the concept of disinterestedness for contemporary aesthetic theory in light of challenges posed by postmodern skepticism regarding the possibility of disinterestedness, and by the difficulties involved in appreciating political art with a disinterested attitude. My principle example of political art will be drawn from feminist art--the extraordinary and controversial performance art of the French artist, ORLAN. Unlike traditional philosophers, I will advocate that an interested stance toward art is, at times, inevitable and appropriate. I will also argue not only that feminist art--and by extension political art of all kinds--can be experienced disinterestedly, but that it should be. As a position inconsistent with both traditionalists and feminist critics of tradition, my recommendation of both disinterestedness and interestedness affords what I take to be the fullest and fairest experience of a work of art. (shrink)

Providing comprehensive sexuality education in schools is a work in progress in many countries throughout the world. In some countries, the journey is just beginning; in others, investments in this field have been made for many years. It is and has been difficult in Pakistan to implement and promote reproductive health, women’s empowerment, and CSE. In Pakistan, previous implementation efforts revealed the critical role of community influencers in propagating misleading information about the initiatives, inciting organized community resistance, and provoking backlash. (...) This paper looked at several aspects of community resistance, as well as approaches for overcoming the resistance for increasing community engagement in the implementation of CSE in Islamabad, Pakistan. To analyze community perceptions of CSE implementation in Islamabad, the community readiness assessment questionnaire was adapted. Questions and prompts for discussion included leadership, current initiatives, community knowledge, resource availability, community support, and implementation strategies. A total of 35 in-depth interviews were conducted. Data was analyzed and interpreted using qualitative content analysis to explore community perspectives that contribute to resistance around CSE, as well as implementation options. Using inter-code relationship data, network analysis was conducted to provide a graphical representation of the analyzed qualitative data. The study reveals community resistance to CSE being implemented in schools. Misconceptions, a lack of awareness, a lack of priority, and the lack of dedicated resources are just a few of the primary implementation challenges to consider when implementing CSE in practice. Network analysis identified, based on modularity class, five distinct clusters of highly connected nodes/codes: non-governmental organizations, misconceptions, resources and policy, strategies and community support, and personal social and health education and current efforts. In conservative environments and when confronted with resistance, innovative marketing and rebranding are critical for priority setting and community engagement, especially when developing curriculum and implementing CSE. Some of the suggested strategies for implementation include community sensitization through strategic awareness campaigns, involving already established infrastructure and NGOs, endorsement by all major stakeholders, particularly decision-makers, and the use of creative digital platforms for better dissemination. (shrink)