In social systems or spaces, distance between the centre and the periphery breeds epistemic injustice. There are growing accounts of epistemic injustice in health-related fields, as in the article by Pratt and de Vries.1 The title of the article asks: ‘Where is knowledge from the global South?’ Like me, you may answer by saying: ‘Knowledge from the global South is in the global South’. That answer says a lot about how we right epistemic injustice done to actors in the global (...) South or the periphery, including in health ethics. Pratt and de Vries identified four sets of actors (individuals, institutions, journals and funders) responsible for righting epistemic injustice. For three of the four sets of actors, they recognised the need for—or the possibility of—symmetry between global North and global South. Except journals. They did not seriously consider that journals are either present in or could belong to the global South; to the periphery. Platforms for knowledge exchange, circulation, cultivation and curation—such as journals, conferences, publishers, blogs, archives, seminars, books and the media, social or traditional—are neither physically nor epistemically neutral. They are situated. The BBC cannot do for Nigeria or Australia what it does for Britain; neither can the BMJ. Many of us take our position at the centre or periphery as neutral, natural, necessary or permanent. But the African American writer Toni Morrison proved the opposite with her career: ‘I stood at the border, stood at the edge and claimed it as central. l claimed it as central, and let the rest of the world move over to where I was.’2 Although physically in the USA, Toni Morrison was writing …. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial (...) clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

_This article examined the accounts of diplomatic relations between Russia and Syria. It interrogated a significant aspect of global politics, where the interaction of geopolitical interests, ideological affinities, and regional influences played defining roles in shaping this diplomatic association from the height of the Cold War in the 1960s and 1970s to the Syrian Civil War that began in 2011. This scope allowed extensive research into the changing nature of Russo-Syrian relations, providing a diverse revelation into their historical evolution. This (...) article relies on a wide array of primary sources, including diplomatic records, as well as secondary sources offering useful context and perspective. The primary aim was to reveal the motivations and strategies that steered diplomatic exchanges between them and the real-political considerations that formed the basis of their engagement. Moreover, this article considered the ramifications of Russo-Syrian relations on the broader Middle East region and how partnership affected regional stability, conflict, and the distribution of power such as the Soviet Union's support for the Ba'athist regime in 1963, Syria's involvement in the Arab-Israeli conflict in 1967, and Russia's military intervention in the Syrian civil war in 2015. Through historical evaluation, this article contributes to an understanding of international relations and their implications for security and stability._. (shrink)

Over the last 4 or so decades, Dudley Shapere has developed a rich and interesting alternative to the Kuhnian “relativist” account of science and its development. This paper is a review of this alternative viewpoint. It is a critical evaluation of Shapere’s arguments in support of the claim that radical methodological change can be allowed in science without thereby embracing relativism (and without ending with an irrational account of scientific change).

This Viewpoint calls attention to the pervasive wrongs related to knowledge production, use, and circulation in global health, many of which are taken for granted. We argue that common practices in academic global health (eg, authorship practices, research partnerships, academic writing, editorial practices, sensemaking practices, and the choice of audience or research framing, questions, and methods) are peppered with epistemic wrongs that lead to or exacerbate epistemic injustice. We describe two forms of epistemic wrongs, credibility deficit and interpretive marginalisation, which (...) stem from structural exclusion of marginalised producers and recipients of knowledge. We then illustrate these forms of epistemic wrongs using examples of common practices in academic global health, and show how these wrongs are linked to the pose (or positionality) and the gaze (or audience) of producers of knowledge. The epistemic injustice framework shown in this Viewpoint can help to surface, detect, communicate, make sense of, avoid, and potentially undo unfair knowledge practices in global health that are inflicted upon people in their capacity as knowers, and as producers and recipients of knowledge, owing to structural prejudices in the processes involved in knowledge production, use, and circulation in global health. (shrink)

_The goal of this study is to investigate the ethnic conflict in southern Kaduna in connection to eastern Ukraine, which has now spread internationally as a result of major countries' action on Ukraine's behalf. The Hausa-Fulani are Muslims, whereas indigenous Christian communities make up the bulk of the population in southern Kaduna. Although the root causes of the situation in southern Kaduna are multifaceted given their theological and sociopolitical undertones, they are primarily cultural and patriotic in the case of Ukraine. (...) The special status of the Russian language is a subject of heated debate among those on the side of Ukraine's government and opposition nationalists who are pro-Russia. The study's purpose dictated that premordialism theory be used as a working model. Ethnic activists and nationalists commonly employ primordialist ideas to explain and defend ethnic wars, like the ones under study (in southern Kaduna and eastern Ukraine). In addition to hoping that the United Nations is permitted to fulfil the purpose for which it was established so that peace can return to Ukraine, we also hope that the same can be achieved in southern Kaduna if the recommendations of the state and federal governments assigned to investigate the crisis are dusted off and implemented._ _In conclusion, it is hard to discuss peace in an environment rife with injustice and nepotism. More peace advocacy is needed from the main international political powers, but they can only do that if they allow the United Nations (UN) to function freely. Primordialist theories are frequently used by ethnic activists and nationalists to explain and justify ethnic conflicts, such as those in southern Kaduna and eastern-southern Ukraine, which is why this research supports the use of the primordial theory of ethnic conflict despite its flaws._. (shrink)

Refining the model for an emergency department‐based mental health nurse practitioner outpatient service The mental health nurse practitioner (MHNP) role based in the emergency department (ED) has emerged in response to an increase in mental health‐related presentations and subsequent concerns over waiting times, co‐ordination of care and therapeutic intervention. The MHNP role also provides scope for the delivery of specialised primary care. Nursing authors are reporting on nurse‐led outpatient clinics as a method of healthcare delivery that allows for enhanced access (...) to health‐care, particularly following hospital discharge. However, due to a lack of in‐depth substantiation, this mode of service delivery requires more thorough investigation. This study describes the refinement phase undertaken before the implementation and pilot evaluation of a formalised and structured MHNP outpatient service in the ED of a large inner‐city hospital in Sydney, Australia. An expert advisory panel (EAP) consisting of key local informants was convened to provide feedback on and refinement to the proposed model. This related to issues such as target population, structure and process considerations, outcome measures and interface within the overall health service. Findings from the EAP meeting are presented and discussed. The importance of linking methods with the appropriate methodology in evaluating a healthcare program is highlighted. (shrink)

Whether or not men have free choice is a question which arises within two distinct moral contexts. At issue in the one is their ability to decide among genuine alternatives; in the other their ability to do what they think they ought to do although their desire to perform their duty is weaker than their desire to do otherwise. The former has to do with moral decision; (he latter with moral effort. Although the two are distinct they are not unrelated. (...) For in any moral decision a fully conscious, or rather self-conscious agent, will always take into account the likelihood of his effort succeeding in action and this will have an important bearing on the decision he makes. (shrink)

Nurses practising in mental health are faced with challenging decisions concerning confidentiality if a patient is deemed a potential risk to self or others, because releasing pertinent information pertaining to the patient may be necessary to circumvent harm. However, decisions to withhold or disclose confidential information that are inappropriately made may lead to adverse outcomes for stakeholders, including nurses and their patients. Nonetheless, there is a dearth of contemporary research literature to advise nurses in these circumstances. Cognitive Continuum Theory presents (...) a single‐system intuitive‐analytical approach to examining and understanding nurse cognition, analogous to the recommended single‐system approach to decision‐making in mental health known as structured clinical judgement. Both approaches incorporate cognitive poles of wholly intuition and analysis and a dynamic continuum characterised by a ‘common sense’ blending of intuitive and analytical cognition, whereby cues presented to a decision‐maker for judgement tasks are weighed and assessed for relevance. Furthermore, Cognitive Continuum Theory promotes the importance of determining pattern recognition and functional relations strategies, which can be used to understand the operationalisation of nurse cognition. (shrink)

Fabi and Goldberg have helpfully shed some light on the wrongs perpetuated by the current funding architecture on research, sponsorship, and career development in the field of bioethics. The...

Consider a variant of the usual story about the iterative conception of sets. As usual, at every stage, you find all the (bland) sets of objects which you found earlier. But you also find the result of tapping any earlier-found object with any magic wand (from a given stock of magic wands). -/- By varying the number and behaviour of the wands, we can flesh out this idea in many different ways. This paper's main Theorem is that any loosely constructive (...) way of fleshing out this idea is synonymous with a ZF-like theory. -/- This Theorem has rich applications; it realizes John Conway's (1976) Mathematicians' Liberation Movement; and it connects with a lovely idea due to Alonzo Church (1974). (shrink)

There is a growing trend in European countries for childbearing to occur later in women’s lives. The recent increase in the use of ART, together with the long-term trend towards later childbearing, raises questions as to the acceptable age of childbearing in contemporary society. ART legislation varies considerably across Europe and age limits for access to fertility treatment are rarely defined. The legislation takes into account the preferences of potential parents; children’s preferences, however, are not ascertained. The article discusses a (...) research method used in a survey of older children and young adults. The objective of the survey was to answer the following questions: What age would children prefer their parents to be if they could choose? What are their reasons? Respondents were asked the following question: “How old would you like your mother and father to be when you are 20 (version for respondents younger than 16) or 25 (version for those older than 16) if you could wave a magic wand?” Furthermore, their reasons for wishing a change were identified through an open question, “Why would you like to change the age of your parents?”. (shrink)

Hub Zwart's latest book, "The Truth on the Wall: A Psychoanalysis of Knowledge," establishes compelling connections between the literary and the scientific imagination. The author explores how seemingly fantastical literary tropes can serve as reflections of scientific progress. A notable example is the vampire archetype, traditionally depicted as a nocturnal, undead entity that sustains itself by consuming the blood of the living. This imagery, Zwart argues, can be interpreted as a metaphorical representation of scientific developments. He analyzes the central motif (...) of blood exchange between vampire and victim as an allegory for the scientific discourse surrounding blood transfusion in the late 19th century. During this period, blood transfusion posed significant challenges due to the undiscovered nature of blood groups. Furthermore, Zwart draws parallels between vampire-hunting strategies and scientific efforts to combat mysterious, potentially epidemic diseases, viewing both as attempts to control unknown and threatening forces. -/- [In Dutch: In "De waarheid op de wand: psychoanalyse van het weten", het nieuwste boek van Hub Zwart, worden de literaire en de wetenschappelijke verbeelding op inspirerende wijze aan elkaar gekoppeld. Zo blijkt het schijnbaar fantastische beeld van de vampier, de levende dode die in de nachtelijke uren tevoorschijn komt om zich te voeden met het bloed van de levenden, gelezen te kunnen worden als een reflectie op wetenschappelijke ontwikkelingen. De eerste associatie die het beeld van de vampier oproept, de uitwisseling van bloed tussen prooi en slachtoffer, interpreteert Zwart als een verbeelding van het wetenschappelijke debat over bloedtransfusie aan het eind van de 19e eeuw. Bloedtransfusie was destijds nog zeer problematisch omdat men nog niet wist van het bestaan van bloedgroepen. De strategieën die worden ingezet bij het bestrijden van vampiers, ziet Zwart als een beeld voor het wetenschappelijke gevecht tegen onbekende, geheimzinnige ziektes die uit kunnen groeien tot een nauwelijks te bestrijden epidemie. (shrink)