Person, People, Planet: Eco-Systematic Analysis of Older Adults' Experiences of Engagement with Nature and Discourse About Nature

This study combined ecological, environmental, nature-based, and epistemic interpretations of older adulthood to gain a previously unresearched look at how older adults feel that their relations with nature are treated by others. Sixty older adults were interviewed in-depth, and data was analyzed using the Eco-Appreciation framework and Thematic Content Analysis. The results indicate the concurrence of processes of withdrawal of older adults from spaces of nature and discourse about nature. These processes obstruct older adults' wellbeing; entail the infliction of existential epistemic injustices and "eco-ageism" toward them; and emphasize the crucial role social work can play in responding thereto.

Shining a light on the road towards conducting principle-based co-production research in rehabilitation

Moving from participatory approaches incorporating co-design to co-production in health research involves a commitment to full engagement and partnership with people with lived experience through all stages of the research process-start to finish. However, despite the increased enthusiasm and proliferation of research that involves co-production, practice remains challenging, due in part to the lack of consensus on what constitutes co-production, a lack of guidance about the practical steps of applying this approach in respect to diverse research methods from multiple paradigms, and structural barriers within academia research landscape. To navigate the challenges in conducting co-produced research, it has been recommended that attention be paid to focusing and operationalising the underpinning principles and aspirations of co-production research, to aid translation into practice. In this article, we describe some fundamental principles essential to conducting co-production research (sharing power, relational resilience, and adopting a learning mindset) and provide tangible, practical strategies, and processes to engage these values. In doing so, we hope to support rehabilitation researchers who wish to engage in co-production to foster a more equitable, ethical, and impactful collaboration with people with lived experience and those involved in their circle of care.

What really is nontokenistic fully inclusive patient and public involvement/engagement in research?

Patient and public involvement and engagement (PPIE) is critically important in healthcare research. A useful starting point for researchers to understand the scope of PPIE is to review the definition from the National Institute for Health and Care Research (NIHR) as, 'research being carried out "with" or "by" members of the public rather than "to", "about" or "for" them'. PPIE does not refer to participation in research, but to actively shaping its direction. The 'Effectiveness of a decision support tool to optimise community-based tailored management of sleep for people living with dementia or mild cognitive impairment (TIMES)' study is funded through the NIHR programme grant for applied research. TIMES has thoroughly embraced PPIE by ensuring the person's voice is heard, understood, and valued. This editorial showcases how the TIMES project maximised inclusivity, and we share our experiences and top tips for other researchers. We base our reflections on the six key UK standards for public involvement; Inclusive Opportunities, Working Together, Support and Learning, Communications, Impact and Governance. We present our work, which had been co-led by our PPIE leads, academics and partners including, together in dementia everyday, Innovations in Dementia, The UK Network of Dementia Voices (Dementia Engagement & Empowerment Project) and Liverpool Chinese Wellbeing. We have a Lived Experience Advisory Forum on Sleep, which includes people with dementia, family carers, representatives of the South Asian Community and the Chinese community.

Epistemic domination by data extraction: questioning the use of biometrics and mobile phone data analysis in asylum procedures

In a growing number of destination countries state authorities have started to use various digital devices such as analysis of data captured from mobile phones to verify asylum seekers' claimed country of origin. This move has prompted some critics to claim that asylum decision-making is increasingly delegated to machines. Based on fieldwork at a reception centre in Germany, this paper mobilises insights from science and technology studies (STS) to develop a framework that allows for more nuanced analyses and modes of critiques of the digitisation of asylum procedures. Rather than thinking human and non-human forms of agency as external to one another in order to juxtapose them in a zero-sum game, I comprehend the introduction of digital technologies as a reconfiguration of existing human-machine configurations. This conception highlights how the use digital technologies enables caseworkers to retain their position as an epistemic authority in asylum decision-making by assembling clues about asylum seekers' country of origin generated by digital technologies into hard juridical evidence. Subsequently, I develop an alternative critique that focuses on epistemic implications of the digitisation of asylum procedures. I identify a particular version of data colonialism that enables epistemic domination by means of data extraction.

Latin America at the margins? Implications of the geographic and epistemic narrowing of 'global' health

To explore the narrowing of the concept of 'global' in global health, this article traces how Latin America has held a place of both privilege and power as well as marginalisation in the field. We employ a modified extended case method to examine how Latin America has been 'seen' and 'heard' in understandings of global health, underscoring the region's shifting role as a key site for research and practice in 'tropical medicine' from the mid-nineteenth century through World War II, to a major player and recipient of development assistance throughout the 'international health' era after World War II until the late twentieth century, to a region progressively marginalised within 'global health' since the mid-1980s/1990s. We argue that the progressive marginalisation of Latin America and Southern theory has not only hurt health equity and services, but also demonstrates the fundamental flaws in contemporary 'global' thinking. The narrowing of global health constitutes coloniality of power, with Northern institutions largely defining priority regions and epistemic approaches to health globally, thus impoverishing the field from the intellectual resources, political experience, and wisdom of Latin America's long traditions of social medicine and collective health.

The global development of community psychology as reflected in the American Journal of Community Psychology

This commentary presents a virtual special issue on the global growth of community psychology (CP), particularly, but not exclusively, as reflected in the American Journal of Community Psychology (AJCP). CP exists in at least 50 countries all over the world, in many of those for over 25 years. Yet, aside from several early Israeli articles, AJCP rarely published work from or about countries outside the US and Canada until the early 2000s, when the number of international articles began to rise sharply. The focus of CP developed differently in different continents. CP in Australia and New Zealand initially followed North America's emphasis on improving social service systems, but has since focused more on environmental and indigenous cultural and decolonial issues that are as salient in those countries as in North America, but have drawn much more attention. CP came later to most of Asia, where it also tended to follow the North American path, but starting in Japan, India, and Hong Kong and now in China and elsewhere, it is establishing its own way. The other two global hotspots for CP for over 40 years have been Europe and Latin America. The level and focus of CP in Europe varies in each country, with some focused on applied developmental psychology and/or community services and others advancing critical and liberation psychology. CP in Latin America evolved from social psychology, but like CP in Sub-Saharan Africa, is also more explicitly political due to a history of political oppression, social activism, and the limitations of individualistic psychology to focus on social change, overcoming poverty, and interventions by (not just for) community members. Despite those differences, CP literature over the past 23 years suggests an increasingly common interest in social justice, multinational collaborations, and decoloniality. There is still a need for more truly (bidirectional) cross-cultural, comparative work for mutual learning, sharing of ideas, methods, and intervention practices, and for CP to develop in countries and communities throughout the globe where it could have the greatest impact.

A Framework for Transparency in Precision Livestock Farming

As precision livestock farming (PLF) technologies emerge, it is important to consider their social and ethical dimensions. Reviews of PLF have highlighted the importance of considering ethical issues related to privacy, security, and welfare. However, little attention has been paid to ethical issues related to transparency regarding these technologies. This paper proposes a framework for developing responsible transparency in the context of PLF. It examines the kinds of information that could be ethically important to disclose about these technologies, the different audiences that might care about this information, the challenges involved in achieving transparency for these audiences, and some promising strategies for addressing these challenges. For example, with respect to the information to be disclosed, efforts to foster transparency could focus on: (1) information about the goals and priorities of those developing PLF systems; (2) details about how the systems operate; (3) information about implicit values that could be embedded in the systems; and/or (4) characteristics of the machine learning algorithms often incorporated into these systems. In many cases, this information is likely to be difficult to obtain or communicate meaningfully to relevant audiences (e.g., farmers, consumers, industry, and/or regulators). Some of the potential steps for addressing these challenges include fostering collaborations between the developers and users of PLF systems, developing techniques for identifying and disclosing important forms of information, and pursuing forms of PLF that can be responsibly employed with less transparency. Given the complexity of transparency and its ethical and practical importance, a framework for developing and evaluating transparency will be an important element of ongoing PLF research.

The truth project- paper two- using staff training and consultation to inculcate a testimonial sensibility in non-specialist staff teams working with survivors of child sexual abuse

This paper explores how trauma informed training and consultation for non-specialist staff at the Independent Inquiry into Child Sexual Abuse in England and Wales enabled them to work with survivors of non-recent child sexual abuse in the Truth Project and other areas of the Inquiry. The paper draws on data gathered from 32 semi-structured interviews with a range of Inquiry staff, including civil servants, legal professionals, senior operational managers, and researchers. The interview questions mapped on to the trauma informed principles embedded in the Inquiry and considered the efficacy and implementation of this training for engaging with survivors' voices, working with challenging testimonies and materials, and contributing to epistemic change. Findings included all staff having an awareness of what it meant to be trauma informed in an Inquiry context, talking about the principles in terms of value-based positions. Staff described an awareness of needing to attend to the idiosyncratic experiences of the individual survivor, and there was recognition that previous damage to survivor trust, through institutional failure, meant that demonstrating trustworthiness was a central task. Staff talked about the impacts of participation on some survivors, and the impacts it had on them to be exposed to trauma-related materials. There was acknowledgment of the limitations of the trauma informed approach but also recognition of the wider applications of this learning for other areas of their personal and professional lives. There is some support for the therapeutic culture developed at the Inquiry leading to what Fricker refers to as a testimonial sensibility, a quality of listening necessary for the establishment of epistemic justice. The discussion focuses on how this way of working can be applied to other public service settings and how epistemic justice concepts can be included in more traditional trauma informed care models to encourage an ethic of listening that has political and social, in addition to therapeutic, outcomes.

The truth project paper one-how did victims and survivors experience participation? Addressing epistemic relational inequality in the field of child sexual abuse

The last 30 years has seen an exponential increase in Historical Institutional Abuse Inquiries. One feature of these has been to place adult survivor voices at the center of Inquiry work, meaning that child abuse victims and survivors are engaging with Inquiries, sharing their experiences, with this participation often presented as empowering and healing. This initiative challenges long held beliefs that child sexual abuse survivors are unreliable witnesses, which has led to epistemic injustice and a hermeneutical lacunae in survivor testimony. However to date there has been limited research on what survivors say about their experiences of participation. The Truth Project was one area of work of the Independent Inquiry into Child Sexual Abuse in England and Wales. It invited survivors of Child Sexual Abuse to share their experiences including the impacts of abuse and their recommendations for change. The Truth Project concluded in 2021 and heard from more than 6,000 victims of child sexual abuse. The evaluation of the Trauma Informed Approach designed to support survivors through their engagement with the project was a mixed methods, two phase methodology. A total of 66 survey responses were received. Follow-up interviews were conducted with seven survey respondents. The Trauma Informed Approach was found to be predominantly helpful in attending to victim needs and minimizing harm. However, a small number of participants reported harmful effects post-session. The positive impacts reported about taking part in the Truth Project as a one-off engagement challenges beliefs that survivors of child sexual abuse cannot safely talk about their experiences. It also provides evidence of the central role survivors should have in designing services for trauma victims. This study contributes to the epistemic justice literature which emphasizes the central role of relational ethics in the politics of knowing, and the importance of developing a testimonial sensibility when listening to marginalized groups.

Being, Knowing, and Doing: Importing Theoretical Toolboxes for Autism Studies

The aim of this article was to think with and elaborate on theories developed outside of autism research and the autistic community, and through this support the production of new autistic-led theories: theories and concepts based on autistic people's own embodied experiences and the social worlds we inhabit. The article consists of three different sections all of part of the overall umbrella, Being, knowing, and doing: Importing theoretical toolboxes for autism studies. In each section, we import useful concepts from elsewhere and tailor them to autism studies. Throughout, we mingle our own autoethnographic accounts and shared discourse in relation to research accounts and theories. Illustrating being, we explore and discuss the possibilities of critical realism in autism studies. Illustrating knowing, we explore and discuss the possibilities of standpoint theory in autism studies. Finally, illustrating doing, we explore and discuss the possibilities of neurocosmopolitics including epistemic (in)justice in autism studies. Our proposal here is for an epistemic shift toward neurodiverse collaboration. We are inviting nonautistic people to work with, not on, us, aiming at to make autism research more ethical, breaking down bureaucratic structures, and questioning poor theory and shoddy methodology. Acknowledging intersecting axes of oppression in which an individual seeks to renegotiate and reimagine what it means to belong also means to understand what needs changing in society, as it is and how we might do things differently.

Mapping Queer Relationalities: An Exploration of Communication at the Edges of Cultural Unintelligibility

Focusing on queer relationality, broadly conceptualized as minoritarian subjects' modes of relating, engaging, and connecting with others in a symbolic and material landscape of erasure and cultural unintelligibility, this special issue highlights their communication practices and relational experiences. In so doing, it attempts to mitigate epistemic injustice, a wrong perpetrated against minoritarian subjects in their capacity as knower and legitimate source of their own experiences, by making their practices and experiences known and legible in mainstream heteronormative culture. The purpose of our article is to offer a preliminary mapping of queer relationalities, ranging from communication practices to modes of sociality and relational formations that exist at the edges of mainstream cultural unintelligibility. To do so, we first explore the vast domain of queer relationality. Next, we identify and examine multiple ways of thinking, doing, and imagining queer relationality. We conclude with a discussion of theoretical, methodological, and political implications of current work on queer relationality assembled in this issue and explore future directions for research.

Integrating autistic perspectives into autism science: A role for autistic autobiographies

LAY ABSTRACT

Autism science faces challenges in how to think about autism and what questions to focus on, and sometimes contributes to stigma against autistic people. We examine one way that non-autistic researchers may start to combat these challenges: by reading and reflecting on autistic people's descriptions of their personal experiences (e.g. autobiographies) of what it is like to be autistic. In this article, we review some of the advantages and challenges of this approach and how it may help combat some of the challenges currently facing autism science by focusing studies on the questions autistic people find most important, counteracting stereotypes, and increasing understanding of autistic experiences.

Epistemic justice in public involvement and engagement: Creating conditions for impact

Introduction

Patient and public involvement in research is anchored in moral and epistemological rationales. Moral rationales relate to the public having a right to influence how knowledge about them is generated. Epistemological rationales relate to how research design and implementation can improve when informed by experiential, as well as technical, knowledge. In other words, public involvement can increase the epistemological resources of researchers, and contribute to research that is fit for purpose and has high external validity.

Methods

This article presents an analysis of 3 meetings and 11 interviews with public collaborators and researchers in three UK‐based health research studies. Data comprised transcripts of audio‐recorded research meetings and interviews with public collaborators and researchers. Data were first analysed to develop a data‐informed definition of experiential knowledge, then thematically to investigate how this experiential knowledge was considered and received within the research space.

Results

At meetings, public collaborators shared their experiential knowledge as stories, comments, questions, answers and when referring to their own roles. They were aware of crossing a boundary from everyday life, and some adapted their contributions to fit within the research space. Although researchers and public collaborators made efforts to create an inclusive climate, obstacles to impact were identified.

Conclusions

Considering experiential knowledge as a boundary object highlights that this knowledge has a different form to other kinds of knowledge that contribute to research. To enable impact from experiential knowledge, researchers need to create a space where public collaborators experience epistemic justice.

Patient and Public Contribution

The Peninsula Public Engagement Group (PenPEG) was involved in the planning and conceptualization of the study, including the development of the ethics application and the interview schedules. One member of this group (Richard Fitzgerald) and one from outside the group (Leon Farmer), were full members of the author team and were involved in the data analysis. Leon Farmer has since become a member of PenPEG. Richard Fitzgerald and Leon Farmer were not involved in the three research studies sampled for this study. Sadly Richard Fitzgerald died during the course of this study.

Making the road caminando de otra manera: Co-constructing decolonial community psychologies from the Global South

Current discussion on coloniality dismantles structures embedded in neoliberal capitalism that maintain and perpetuate social pathologies. Theories and praxes emerging from Abya Yala (North, Central, and South America) provide academic and nonacademic contributions to co-construct community psychologies de otra manera (otherwise). These accountable ways of knowing and acting in cultural context and local place, become ways of making counterculture to inform decolonial community psychologies. The epistemologies of the Global South have produced invaluable teachings for transformative revisions of community psychology within frameworks that go beyond liberation and toward decoloniality. Activist women and decolonial feminists from the Global South, contest patriarchal rationality and universalism and co-construct new ways of being, thinking-feeling, sentipensar, and acting. Decolonial paradigms weave networks of solidarity with communities in their struggles to sustain Indigenous cosmovisions, delinking from western-centric ideologies that are not anthropocentric and promote sustainability, epistemic and ecological justice, and Sumak Kawsay/Buen Vivir (wellbeing) that includes the rights of the Earth. This paper deepens into decolonial community psychologies from Abya Yala that are making the road caminando (walking) de otra manera by applying methodologies of affective conviviality with communities, sentipensando, and co-authoring collective stories that weave pluriversal solidary networks within ecologies of praxes into colorful tapestries of liberation. These are the proposed coordinates to sketch pathways toward decoloniality.

Organizing a transnational solidarity for social change through participatory practices: The case of People Powered-Global Hub for Participatory Democracy

In the context of global democratic crises and pervasive neoliberal policies, civil society organizations (CSOs) play a critical role in promoting democratic processes and advancing social change on local, national, and transnational scales. However, such organizations also (need to) grapple with how they themselves put social justice and democratic principles into practice, and resist coloniality within. This article examines these questions in the case of People Powered-Global Hub for Participatory Democracy, a recently found transnational CSO that advocates globally for participatory democracy as a mechanism for social change and employs these principles in its own governance and operations. The analysis focusses on the creation of People Powered and its first year of practice. Drawing upon decolonial frameworks-and based on our own experiences as founding members of People Powered and our reading of interviews and documents-we identify concrete practices through which the organization seeks to enact epistemic justice, shift power, and emphasize relationality. We argue that People Powered's decolonial roots, collectively articulated values and commitments, radical transparency, and its consistent employment of meaningful participation and reflexivity have built and are likely to sustain this transnational solidarity for social change. At the same time and perhaps critical for fostering solidarity and social change in the long term, People Powered embraces, rather than evades, tensions and contradictions that emerge in these efforts.

Dissident women's letter writing as decolonial plurilogues of relational solidarities for epistemic justice

Braiding our words, "dissi-dance," and desires, this article engages how various social actors, and communities-which we are a part of and belong to-challenge structural violence, oppression, inequity, and social, racial, and epistemic injustice. We thread these reflections through our written words, in subversive letters which we offer in the form of a written relational conversation among us: a plurilogue that emerges in response to our specific locations, commitments, and refusals, as well as dissents. Our stories and process of dissent within the various locations, relationships, and contexts that we occupy served as the yarn and needle to thread our stories, posed questions and reflections. Braiding, threading and weaving together, we animate deep decolonial inquiries within ourselves, and our different cultural contexts and countries. Refusing individualism-the illusions of objectivity as distance, the academic as expert, and the exile of affect and emotion on academic pages-we choose to occupy academic writing and ask: What if academic writing were stitched with blood and laughter, relationships and insights, rage and incites? What if, at the nexus of critical psychology and decolonizing feminism, we grew an "embodied praxis?" Unlike academic writing, traditionally designed to camouflage affect, connection, relationality and subjectivity, these letters are unapologetically saturated in care and wisdom toward a narrative-based embodied practice: decolonial plurilogues of relational solidarities for epistemic justice. Our plurilogue of dissent offers a view to advance community research and action with goals of liberation, decoloniality, and community wellness.

Navigating Voice, Vocabulary and Silence: Developing Critical Consciousness in a Photovoice Project with (Un)Paid Care Workers in Long-Term Care

Photovoice is a widely used approach for community participation in health promotion and health promotion research. However, its popularity has a flip-side. Scholars raise concerns that photovoice drifts away from its emancipatory roots, neglecting photovoice’s aim to develop critical consciousness together with communities. Our four-year photovoice project aimed to unravel how the health of (un)paid care workers was shaped at the intersection of gender, class and race. This article springs from first, second and third-person inquiry within our research team of (un)paid care workers, academic researchers and a photographer. We observed that critical consciousness emerged from an iterative process between silence, voice and vocabulary. We learned that photovoice scholars need to be sensitive to silence in photovoice projects, as silence can be the starting point for finding voice, but also a result of silencing acts. Social movements and critical theories, such as intersectionality, provide a vocabulary for participants to voice their critical perspectives to change agents and to support collective action. We discuss our experiences using Frickers’ concept of ‘epistemic justice’, arguing that critical consciousness not only requires that communities are acknowledged as reliable knowers, but that they need access to interpretative tropes to voice their personal experiences as structural.

Perspective: Decolonizing postmodernist approaches to mental health discourse toward promoting epistemic justice

Currently, it is possible to observe a slowly (but surely) growing volume of claims seeking to disprove Foucauldian ideas about knowledge and power as overlapping basic theories of epistemic justice. Prompted by these claims, alongside adopting tenets of Critical Race Theory to address injustices inflicted upon people facing mental health challenges, I propose applying decolonizing deconstruction to Foucault's terminology, toward identifying opportunities to enhance epistemic justice, primarily in direct interventions in mental health services.

Portraying the ‘Chinese international students’: a review of English-language and Chinese-language literature on Chinese international students (2015–2020)

The Chinese international students are often portrayed in a monolithic manner in popular discourse. To offer a more comprehensive and critical representation of the Chinese international students, this paper conducts a thematic narrative review of 128 English-language and 74 Chinese-language peer-reviewed articles published between 2015 and 2020. Drawing on post-colonial theories, this review identifies four subject positions portrayed of the Chinese international students: the (1) neoliberal, (2) political, (3) pedagogic and (4) racialised subjects. This paper celebrates heartening developments in the literature which affirms Chinese international students’ epistemic contributions, legitimate pedagogic needs, notable heterogeneity and wide-ranging political, cultural and pedagogic agencies. It also highlights how aspects of these subject positions have exercised epistemic injustice on the Chinese international students. Meanwhile, it pinpoints the Chinese international students’ acquiescence in exacerbating global education inequalities. Among the first to bring the dominant English-language and ‘local’ perspectives of Chinese-language literature in dialogue, this article notes divergent focuses and indicates unique contributions to historicising research on Chinese international students made by the latter. This article challenges popular perceptions of Chinese international students, questions production of knowledge, and pinpoints future research directions.

"Poster girl": The discourse constructing the image of "girls in distress" as existential epistemic injustice

The present study is focused on understanding how the image of the girl designated "in distress" in official regulations guiding the provision of public social services to girls in Israel can be structured. The study takes a qualitative approach, and employs the critical-feminist paradigm to the analysis and interpretation of discourse, combining thematic content analysis and deductive critical discourse analysis. Its main findings disclose an organized process of establishing the normative authorities dominating the discourse on public social services for girls; classifying groups of service recipients to which a girl can belong; constructing their forms; and ultimately circumscribing the girls thereto, determining the performative acts on which receiving state assistance is conditional. Through discursive maneuvers of construction, the image of the girl is "born" as an undisputed "truth" deriving from the deviance attached to her every move. In this trajectory, basic epistemic injustices are perpetuated and solidified, and a new form of epistemic injustice-existential epistemic injustice-is revealed. This process's implications are proposed.

Decolonizing health care: Challenges of cultural and epistemic pluralism in medical decision-making with Indigenous communities

The Truth and Reconciliation Commission of Canada made it clear that understanding the historical, social, cultural, and political landscape that shapes the relationships between Indigenous peoples and social institutions, including the health care system, is crucial to achieving social justice. How to translate this recognition into more equitable health policy and practice remains a challenge. In particular, there is limited understanding of ways to respond to situations in which conventional practices mandated by the state and regulated by its legal apparatus come into direct conflict with the values and autonomy of Indigenous individuals, communities, and nations. In this paper, we consider two cases of conflict between Indigenous and biomedical perspectives to clarify some of the competing values. We argue for the importance of person- and people-centered approaches to health care. These value conflicts must be understood at multiple levels to clarify their personal, social, cultural, and political dimensions. Taking into account the divergence between epistemic cultures and communities allows us to understand the multiple narratives deployed in decision-making processes in clinical, community, and juridical contexts. Recognizing the knowledge claims of Indigenous peoples in health care can help clinicians avoid reinforcing the divides created by the structural and institutional legacy of colonialism. This analysis also provides ways to adjudicate conflicts in health care decision-making by disentangling cultural, political, medical, and pragmatic issues to allow for respectful dialogue. Insofar as the engagement with cultural pluralism in health care rights is conducted with reciprocal recognition, the medical community and Indigenous peoples can address together the difficult question of how to integrate different epistemic cultures in the health care system.

Poetry as Praxis + "Illumination": Toward an Epistemically Just Health Promotion for Resistance, Healing, and (Re)Imagination

Health promotion is facing a most challenging future in the intersections of structural racism, COVID-19 (coronavirus disease 2019), racialized police violence, and climate change. Now is a critical moment to ask how health promotion might become more responsive to and representative of people's daily realities. Also how it can become a more inclusive partner in, and collaborative conduit of, knowledge-one capable of both informing intellects and transforming hearts. It needs to feel the pulse of the "fierce urgency of now," and perhaps nothing can reveal this pulse more than the creative power of art-especially poetry. Drawing from critical and Black feminist theory, I use commentary in prose to conceptualize and call for an epistemically just health promotion guided by poetry as praxis-not just as method. I posit that, as praxis rooted in lived realities, poetry becomes experiential excavation and illumination; a practice of community, communion, and solidarity; a site and source of healing; and a space to create new narratives of health to forge new paths toward its promotion. I accordingly suggest a need to view and value poetry as a critical scholarship format to advance health promotion knowledge, discourse, and action toward a more humanized pursuit-and narrative-of health equity.

Observations on Use of the N-Word in Psychoanalytic Conferences

In a frequently repeated group phenomenon, a racial slur is spoken in psychoanalytic conferences, after which a range of defensive responses emerge to counter acknowledgment of the meanings of having done so. After a discussion of the literature relevant to the use of slurs in psychoanalytic professional settings, Freud's concept of Nachträglichkeit, or deferred action, is used to identify and explore these events as a series of discriminatory gestures that evoke racial trauma. The defensive responses that emerge to protect the use of these gestures indicate ties to the traumatic legacy of slavery and to white supremacy as it appears in contemporary psychoanalytic culture. "Gestures of the open hand" are proposed, and their profound reparative potential is discussed. The intimate link between epistemic justice and psychoanalytic endeavors is delineated.

What is "shared" in shared decision-making? Philosophical perspectives, epistemic justice, and implications for health professions education

BACKGROUND

Drawing from the philosophical work of Hans-Georg Gadamer and the perspectives of theorists Mikhail Bakhtin and Kenneth Burke, the aim of this paper is to critically reflect on the meaning of the word "shared."

METHOD

The authors draw on the concept of epistemic justice, which they argue permeates the clinical encounter, to discuss how various forms of, and claims to, knowledge may influence the attainement of shared decision-making in health care contexts. The specific objectives are twofold: first, the authors draw key concepts from key Gadamerian, Burkean, and Bakhtinian philosophical perspectives to consider shared decision-making in relation to two types of epistemic injustice: testimonial and hermeneutic epistemic injustice. Second, building on philosopher Paulo Freire's critical pedagogy, the authors emphasize that major changes in educational structures and systems are required to promote the critical reflexivity required to address issues of epistemic justice, in the broader pursuit of authentic shared decision-making.

RESULTS

They propose three main areas of focus for helath professions education: (a) changes in content (moving from a focus on biomedical knowledge to more content on social sciences) and methods of teaching (more dialogue and the creation of moments of dissonance); (b) a re-examination of teachers' role in promoting epistemic justice; and (c) inclusion of patients as partners.

CONCLUSIONS

Without major transformation in what, how, and with whom we teach, future clinicians may be unprepared to enact shared decision-making in a manner that does justice to the various ways of knowing.

Poles apart: does the export of mental health expertise from the Global North to the Global South represent a neutral relocation of knowledge and practice?

The World Health Organization's Mental Health Action Plan 2013-2020 identifies actions for all member states to alleviate the global burden of mental ill health, including an obligation for mental healthcare to be delivered in a 'culturally appropriate' manner. In this article we argue that such a requirement is problematic, not least because such pronouncements remain framed by the normative prepositions of Western medical and psychological practice and their associated ethical, legal and institutional standpoints. As such, when striving to export Western mental health expertise, different paradigms for evidence will be necessary to deliver locally meaningful interventions to low and middle income countries. Our discussion highlights a number of philosophical concerns regarding methodologies for future research practice, including those relating to representation and exclusion in the guise of epistemic injury, presumptive methodologies arising from Western notions of selfhood, and related ethical issues.