Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s (...) use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family and from external sources were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support. (shrink)

This essay aims to clarify the value of developing systematic studies of ignorance as a component of any robust theory of knowledge. The author employs feminist efforts to recover and create knowledge of women's bodies in the contemporary women's health movement as a case study for cataloging different types of ignorance and shedding light on the nature of their production. She also helps us understand the ways resistance movements can be a helpful site for understanding how to identify, critique, and (...) transform ignorance. (shrink)

Problem: Medical student mistreatment, as well as patient and staff mistreatment by all levels of medical trainees and faculty, is still prevalent in U.S. clinical training. Largely missing in interventions to reduce mistreatment is acknowledgement of the abuse of power produced by the hierarchical structure in which medicine is practiced. Approach: Beginning in 2001, Yale School of Medicine has held annual “Power Day” workshops for third year medical students and advanced practice nursing students, to define and analyse power dynamics within (...) the medical hierarchy and hidden curriculum using literature, guest speakers, and small groups. During rotations, medical students write narratives about the use of power witnessed in the wards. In response to student and small group leader feedback, workshop organizers have developed additional activities related to examining and changing the use of power in clinical teams. Outcome: Emerging narrative themes included the potential impact of small acts and students feeling “mute” and “complicit” in morally distressing situations. Small groups provided safe spaces for advice, support, and professional identity formation. By 2005, students recognized residents that used power positively with Power Day awards and alumni served as keynote speakers on the use of power in medicine. By 2010, departments including OB/GYN, surgery, psychiatry, and paediatrics, had added weekly team Power Hour discussions. Next Steps: The authors highlight barriers, benefits, and lessons learned. Barriers include the notion of clinical irrelevance and resistance to the word “power” due to perceived accusation of abuse. Benefits include promoting open dialogue about power, fostering inter-professional collaboration, rewarding positive role modelling by residents and faculty, and creating a network of trainee empowerment and leadership. Furthermore, faculty have started to ask that issues of power be addressed in a more transparent way at their level of the hierarchy as well. (shrink)

Furman and Tuminello raise a central question about people living with mental illness: What kind of life is possible for them? Can one live a flourishing life even when struggling with a mental disorder? The authors draw on research studies to argue that a technique called Applied Behavioral Analysis can improve the lives of children with autism. One study, from 1987, found that 47% of children exposed to ABA attained normal IQ levels, adaptive skills, and social skills, and other studies (...) replicated these results. This is a promising avenue for those living with autism.Furman and Tuminello focus on autism, but their claims, if true, might be extended to other disorders as well; as they note, people... (shrink)

Since the beginning of the AIDS epidemic, the proportion of AIDS cases among women has continued to rise. Women constituted 23 percent of the AIDS cases reported to the Centers for Disease Control and Prevention in 1995, and 81 percent of these women were of childbearing age. It was not until 1991, however, that epidemiological studies of women were initiated. By comparison, the representation of HIV-infected women in clinical trials gradually has grown. Undoubtedly, a consequence of the increased numbers of (...) women in clinical and epidemiological research is the earlier identification of and more appropriate treatments for HIV-related syndromes when women present in the clinical setting. Despite this expanded focus on women, however, clear information to guide the treatment of HIV-infected women who are pregnant is still lagging behind. (shrink)

Like the goddess Demeter, Diotima from Mantineia, the prophetess who teaches Socrates about eros and the “rites of love” in Plato's Symposium, was a mystagogue who initiated individuals into her mysteries, mediating to humans esoteric knowledge of the divine. The dialogue, including Diotima's speech, contains religious and mystical language, some of which specifically evokes the female-centered yearly celebrations of Demeter at Eleusis. In this essay, I contextualize the worship of Demeter within the larger system of classical Athenian practices, and propose (...) that Plato borrowed Eleusinian language because it criticized conventional notions of the divine, thereby allowing him to reimagine the possibilities for the philosophical process among humans. (shrink)

First-in-human research has several characteristics that require special attention with respect to ethics and human subjects protections. At least some nanomedical technologies may also have characteristics that merit special attention in clinical research, as other papers in this symposium show. This paper considers how to address these characteristics in the consent form and process for FIH nanomedicine research, focusing principally on experimental nanotherapeutic interventions but also considering nanodiagnostic interventions.It is essential, as a starting point, to recognize that the consent form (...) and process are by no means the primary protectors of human subjects. Instead, consideration of the form and content of informed consent becomes relevant only after a clinical trial has been reviewed and deemed scientifically and ethically acceptable.Two convergent types of challenges to informed consent are posed by nanomedicine FIH research. First, some issues appear generally applicable to FIH research, but have specific nanomedicine implications. (shrink)

Building computational models of engineered exemplars, or prototypes, is a common practice in the bioengineering sciences. Computational models in this domain are often built in a patchwork fashion, drawing on data and bits of theory from many different domains, and in tandem with actual physical models, as the key objective is to engineer these prototypes of natural phenomena. Interestingly, such patchy model building, often combined with visualizations, whose format is open to a wide range of choice, leads to the discovery (...) of new concepts and control structures. Two key questions are raised by this practice: how could discoveries arise from building external representations for which there is wide latitude in choice of the components from which they are built, and thus can be considered significantly arbitrary, and how could such discoveries allow engineering a real-world prototype system. To examine these questions, we present two case studies of discoveries that emerged from the building of such computational models in the bioengineering sciences. We then develop a process model that accounts for the discovery and transfer problems raised by both these cases, focusing on the process of building the model. Specifically, to account for the discovery problem, we propose that the process of building such models gradually leads to a close coupling between the modeler’s internal processes and the external dynamic model. To account for the transfer problem, we propose that the process of building the model leads to the creation of an enactive model that is generic, which closely enacts, and thus reveals, the way the system-level behavior of the engineered prototype emerges in time through the interaction of its parts. This enactive replication process leads to the model and the prototype forming a new class, which allows concepts and control structures developed for the computational model to be transfered to the real-world prototype. We argue that this account requires rethinking correspondence in engineering sciences as a plastic and enactive relation. A closer focus on the process of building models is required to develop a general account of this emerging approach to discovery. (shrink)

What is commonly called Reichenbach’s “Principle of the Common Cause” is not a general criterion for a common cause, as many philosophers nowadays suppose. Examples include W. Salmon in his accounts of causal processes and Bas van Fraassen in his new book on quantum mechanics, in which he argues that the quantum world has no causal structure. This does not matter for Reichenbach’s purposes. Indeed it should not be surprising from his point of view that in different situations we need (...) different criteria or different methods for testing for the same phenomenon. The third thesis begins from a question: Where do probabilistic criteria for causality come from? (shrink)

This essay examines the relationship between nonviolence and trustworthiness. I focus on questions of accountability for people in midlevel positions of power, where multiple loyalties and responsibilities create conflicts and where policies can push people into actions that reinstate hegemonic relations. A case study from crisis counseling is presented in which the management of the case exacerbated previous violence done to a biracial female. The importance of resistance to dominant ideology is scrutinized.

This essay takes up an apparently minor idea of Susan Moller Okin's Justice, Gender, and the Family—that employers should split the paycheck of wage-earning husbands between employees and their stay-at-home spouses—and suggests that it actually threatens to undermine Okin's entire argument by perpetuating the most central cause of women's inequality by Okin's own account: the sexual division of labor. Recognizing the vital contributions that Okin's seminal work made and the impact that it had on the field of feminist philosophy and (...) political theory, the essay explores the ethical, political, and philosophical problems with this solution to the dire problems of gender inequality and injustice that Okin correctly identifies. The essay suggests that her commitment to liberalism may have resulted in a commitment to an inadequate vision of how to solve the problems of gender inequality, and offers other possibilities that Okin could have pursued instead that sustain her strong commitment to liberalism. (shrink)

We begin at the site of borders, the demarcations between us, between: my body and your body, humans and nonhuman animals, habits of thought and institutional structures, nature and culture, subject and object. We find ourselves between the devil and the deep blue sea. Differences, distinctions, and borders are key to knowing and acting responsibly. Yet we are “held captive” by particular habits of understanding that police such borders with unbecoming fervor. We desire to trouble these borders with the aim (...) of transforming habits of thought and embodied dispositions, to give rise to new appreciations of difference through the deep, ongoing play of the in-between. Ours is an ontology of the in-between... (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)

This paper addresses the question of whether Derrida's “hauntology” as developed in Specters of Marx and related texts, can be anything more than yet another repetition of a specifically male preoccupation with the Father inscribed on the bodies of women, in this case the always absent daughter. A careful reading suggests that Derrida, and playwnght fathers of daughters such as Shakespeare and August Wilson, may be aware of the paradoxes of their situation.

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response (...) to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all. (shrink)

Work by social constructionists over the past decade and a half has reenforced the epistemological pessimist's despair that our system of science could ever be a mirror of nature. Realists argue that the amazing success of modern science at precise prediction and control indicates just the contrary. In response, social constructionists often point out that these successes seldom apply to the world as it comes naturally, but only as it is reconstructed in the scientist's laboratory. But this does not explain (...) how scientific accounts, which are as wide of the mark as constructionists suppose in their general descriptions of the natural world, could be so effective in a limited environment, even if that environment is as benignly constructed as possible. This paper suggests that a more wholistic view of nature than modern science usually presupposes may provide an answer. (shrink)

Editorial peer reviewers play an important role in shaping the direction of knowledge growth of their discipline. Recent concern over reports of peer review misconduct has led some to advocate the establishment of a code of ethics for peer reviewers. Such a code should include guidelines for the discipline and for society at large, but it should also contain guidelines for the authors whose manuscripts are reviewed. Peer reviewers have a special obligation to show beneficence and fairness or impartiality towards (...) the authors for whom they review. The practical application of these two ethical concepts is discussed. (shrink)

Empiricism has traditionally been concerned with two questions: What is the source of our concepts and ideas? and How should claims to empirical knowledge be judged? The empiricist answer to the first question is ‘From observation or experience.’ The concern in the second question is not to ground science in pure observation or in direct experience, but rather to ensure that claims to scientific knowledge are judged against the natural phenomena themselves. Questions about nature must be settled by nature — (...) not by faith, nor metaphysics, nor mathematics, and not by convention or convenience either. From Francis Bacon to Karl Popper empiricists have wanted to police the methods of scientific enquiry. (shrink)

: The idea of an exact science unified and complete has been advocated throughout the history of thought, but the sciences continue to cover only small patches of the world we live in. We may dream that the exact sciences will some day cover everything. But I argue that the very ways we do our exact sciences when they are most successfully done seems likely to confine them within limited domains. I discuss three cases to illustrate: the use of broad-scale (...) non-experimental statistics for causal modelling across the social sciences, an economic model on skill-loss during unemployment, and the quantum theory of superconductivity. In all cases, where we can expect exact order depends on where we can fit our models. And by the nature of how models do-and should-get constructed in exact science, they fit readily onto only very special bits of the world around us. I also maintain that an ill-supported belief in the universality of our favourite exact science can lead us to adopt bad methodologies for carrying out the central aim of the sciences, namely to make the world the way it ought to be. (shrink)

Once there were brook trout in the streams in the mountains. You could see them standing in the amber current where the white edges of their fins wimpled softly in the flow. They smelled of moss in your hand. Polished and muscular and torsional. On their backs were vermiculate patterns that were maps of the world in its becoming. Maps and mazes. Of a thing which could not be put back. Not be made right again. In the deep glens where (...) they lived all things were older than man and they hummed of mystery.Cormac McCarthy, The Road. (shrink)

This volume features new findings by nine interdisciplinary teams of researchers on the topics of self, motivation, and virtue. Nine chapters bringing together scholars from the fields of philosophy, psychology, neuroscience, and sociology advance our substantive understanding of these important topics, and showcase a variety of research methods of interdisciplinary interest. Essays on Buddhism and the self in the context of romantic relationships, the development of personal projects and virtue, the notion of self-distancing and its moral impact, virtues as self-integrated (...) traits, humility and the self in loving encounter, the importance of nation and faith in motivating virtue in western and non-western countries, roles for the self and virtue in eudaimonic growth, overcoming spiritual violence and sacramental shame in Christian communities, and an investigation into the moral self highlight the range and diversity of topics explored in this volume. The concept of deep integration also characterizes this work: each member of the interdisciplinary teams was fully and equally invested in their project from inception to completion. This approach invites teams to examine their disciplinary assumptions, rethink familiar concepts, and adjust methodologies in order to view their topics with fresh eyes. The result is not only new findings of substantive and methodological interest, but also an interesting glimpse into the thinking of the researchers as they sought interdisciplinary common ground in their research. Self, Motivation, and Virtue will be of interest to scholars in philosophy, moral psychology, neuroscience, and sociology who are working on these topics. (shrink)

This collection of original essays examines innovations in both the theory and practice of classical philology. The chapters address interdisciplinary methods in a variety of ways. Some apply theoretical insights derived from other disciplines, such as folklore studies, performance theory, feminist criticism, and the like, to classical texts. Others examine the relationships between classics and cultural studies, popular literature, film, art history, and other related disciplines. Others, again, look to the evolution of theoretical methods within the discipline of classics. Taken (...) together, the essays offer a spectrum of new approaches in the classics and their place within the profession. (shrink)