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Huebner DR. Language as social action: Gertrude Buck, the "Michigan School" of rhetoric, and pragmatist philosophy. J Hist Behav Sci 2024; 60:e22307. [PMID: 38607694 DOI: 10.1002/jhbs.22307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
In the late 19th and early 20th centuries, Gertrude Buck and collaborators developed a sociologically and pragmatist-informed approach to language that has been neglected in later scholarship. Buck approached the study of language from the standpoint of pragmatist functional psychology, which is indebted to John Dewey's pragmatism at the University of Michigan, and which views language as a normal, dynamic action of human organisms engaged in necessary cooperative relations with one another. Her approach overcomes the small-minded pragmatism that would criticize figurative or poetic language as impractical, and instead shows how figuration is essential to the particular ways in which language is action that conveys meaning to others and serves broader social functions. Buck's forgotten work helps overcome criticisms of the application of pragmatic action theory to language and literature, sketching how language structure may be explained on the basis of language as a natural social-communicative act, how figurative language is inherent in the normal act of communicating situated bodily experiences to others, and how rhetorical speech and writing contributes to participation in democratic social processes. This paper also indicates how Buck's work has been partially rediscovered in Composition Studies, as well as prefigures later reader-response esthetics and feminist analyses of language.
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Affiliation(s)
- Daniel R Huebner
- Department of Sociology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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2
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Racine E, D'Anjou B, Dallaire C, Dumez V, Favron-Godbout C, Hudon A, Montreuil M, Olivier C, Quintal A, Chenel V. Developing a living lab in ethics: Initial issues and observations. Bioethics 2024; 38:153-163. [PMID: 38105613 DOI: 10.1111/bioe.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 12/19/2023]
Abstract
Living labs are interdisciplinary and participatory initiatives aimed at bringing research closer to practice by involving stakeholders in all stages of research. Living labs align with the principles of participatory research methods as well as recent insights about how participatory ways of generating knowledge help to change practices in concrete settings with respect to specific problems. The participatory, open, and discussion-oriented nature of living labs could be ideally suited to accompany ethical reflection and changes ensuing from reflection. To our knowledge, living labs have not been explicitly trialed and reported in ethics literature. In this discussion paper, we report and discuss four initial issues that marked the process of setting up a living lab in ethics: (1) determining the goals and expected outcomes of an ethics living lab; (2) establishing operational procedures; (3) selecting communities and defining pilot projects; and (4) adopting a lens to tackle emerging questions and challenges. We explain these four issues and present the paths taken based on the novel and specific orientation, that is, living ethics, at the basis of this project. In alignment with living ethics and É-LABO, we approach challenges as learning opportunities to ask not only "how" questions but also "why" questions. We hope that this discussion paper informed by our experience helps to clarify the theoretical, methodological, and practical approaches necessary to successfully adopt and employ living labs in ethics.
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Affiliation(s)
- Eric Racine
- Unité de recherche en éthique pragmatique de la santé, Institut de recherches cliniques de Montréal, Université de Montréal et Université McGill, Montreal, Canada
| | - Bénédicte D'Anjou
- Unité de recherche en éthique pragmatique de la santé, Institut de recherches cliniques de Montréal, Université McGill, Montreal, Canada
| | - Clara Dallaire
- CEPPP, Université de Montréal, CRCHUSJ, Montreal, Canada
- CRCHUSJ, Montreal, Canada
| | - Vincent Dumez
- CEPPP, Université de Montréal, CRCHUSJ, Montreal, Canada
| | - Caroline Favron-Godbout
- Unité de recherche en éthique pragmatique de la santé, Institut de recherches cliniques de Montréal, Université de Montréal, Montreal, Canada
| | - Anne Hudon
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Marjorie Montreuil
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Université McGill, Montreal, Canada
| | | | - Ariane Quintal
- Unité de recherche en éthique pragmatique de la santé, Institut de recherches cliniques de Montréal, Université de Montréal, Montreal, Canada
| | - Vanessa Chenel
- School of Rehabilitation at the University of Montreal, University of Sherbrooke, Research Ethics Board at the CIUSSS de l'Est-de-l'Île-de-Montréal, Montreal, Canada
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3
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Mangat PK, Garrett-Mayer E, Perez JK, Schilsky RL. The Targeted Agent and Profiling Utilization Registry Study: A pragmatic clinical trial. Clin Trials 2023; 20:699-707. [PMID: 37489819 DOI: 10.1177/17407745231182013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
The conceptual framework of pragmatism in clinical trials is explored using the American Society of Clinical Oncology's pragmatic, non-randomized, phase II, multi-center basket clinical trial, the Targeted Agent and Profiling Utilization Registry Study (NCT02693535) as a model. The Targeted Agent and Profiling Utilization Registry Study aims to identify signals of drug activity when Food and Drug Administration approved drugs are matched to pre-specified genomic targets in patients with advanced cancer outside of their approved indication(s). The objectives of the study are to generate evidence of potential signals of activity in targeted therapies prescribed in an off-label setting as well as to expose and educate community cancer centers to genomic testing and precision medicine through the study protocol. The principles of pragmatic trial design can be applied across a broad spectrum of evidence-generation strategies, from explanatory trials to real-world evidence studies, and are briefly discussed. American Society of Clinical Oncology's Targeted Agent and Profiling Utilization Registry Study falls closer to the pragmatic end of this spectrum as it seeks to assess the efficacy of Food and Drug Administration approved drugs used outside their approved indications under usual care conditions, yielding results generalizable to the population that would likely receive the intervention in practice, while still adhering to rigorous data quality standards. The Targeted Agent and Profiling Utilization Registry Study's pragmatic objectives, characteristics, strengths, and limitations in its implementation are discussed and demonstrate that a large, multi-center, precision medicine basket trial can be mounted in the context of community practice and can generate clinically useful information with minimal burden to patients and clinical trial sites.
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Affiliation(s)
- Pam K Mangat
- American Society of Clinical Oncology, Alexandria, VA, USA
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Martin H. [Architecture as experience, living differently with the philosophy of John Dewey]. Soins 2023; 68:60-63. [PMID: 37932001 DOI: 10.1016/j.soin.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
If architecture can be considered an art form, it is at the cost of reconfiguring what we consider to be an aesthetic experience. Thus conceived as processes, not finished objects, refuting the separation between the active creator and the passive spectator and between ideas, actions and affects, the architectural projects accompanied and documented by the urban and architectural experiments laboratory la Preuve par 7 engage a collective, experimental, sensitive and political understanding of their discipline.
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Affiliation(s)
- Hugo Martin
- La Preuve par 7, 27 passage Courtois, 75011 Paris, France.
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5
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Guraya SS, Harkin DW, Yusoff MSB, Guraya SY. Paradigms unfolded - developing, validating, and evaluating the Medical Education e-Professionalism framework from a philosophical perspective. Front Med (Lausanne) 2023; 10:1230620. [PMID: 37928467 PMCID: PMC10620701 DOI: 10.3389/fmed.2023.1230620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/07/2023] [Indexed: 11/07/2023] Open
Abstract
In order to ensure a strong research design, literature stresses the adoption of a research paradigm that is consistent with the researcher's beliefs about the nature of reality. In this article we provide an overview of research paradigm choices in relation to the creation of a Medical Education e-Professionalism (MEeP) framework discussing the research design, research methods, data collection and analysis to enhance the transparency of our previously published research. The MEeP framework was conceived to help Health Care Professionals (HCPs) safeguard the construct of professionalism in the digital context. This entire process was heavily informed by wider readings and deliberations of published literature on e-professionalism. Although the MEeP framework research journey has been published, the paradigms approach was not discussed in any detail. Considering that one of the duties of medical educator is to balance the service and science by bringing the theoretical underpinnings of one's research to public attention and scrutiny so as to nullify the notion of 'weak' research. We were compelled to unfold this paradigm story of the MEeP framework in a detailed manner. In an effort to make our research both robust and effective, this study portrays a philosophical approach to guide future research designs and methodological choices by detailing our rationale for pragmatism as a choice of paradigm.
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Affiliation(s)
- Shaista Salman Guraya
- Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain, Bahrain
- Department of Medical Education, School of Medicine, University Sains Malaysia, Kelantan, Malaysia
| | - Denis W Harkin
- Faculty of Medicine and Health Sciences, Royal College of Surgeons Ireland, Dublin, Ireland
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Daly T. If deprivation worsens dementia outcomes, stimulation should improve them. Curr Med Res Opin 2023; 39:1391-1394. [PMID: 37725088 DOI: 10.1080/03007995.2023.2260741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023]
Abstract
It is still not known what causes Alzheimer's Disease (AD). In this period of uncertainty, an emerging literature on risk factors suggests that the concept of "stimulation" is a useful pragmatic tool both before and after diagnosis to improve cognitive health. Before diagnosis of AD, stimulation of the brain through education, exercise, and social stimulation provides fortification against later cognitive decline. After diagnosis, specific electrical stimulation of brain circuits may protect cognitive function, and non-specific stimulation through different kinds of environmental enrichment may help to compensate for cognitive decline. Pragmatic guidelines are offered here to maximise enabling stimulation (physical, cognitive, and social activity) and minimise disabling stimulation across the lifetime (e.g. stress, pollution, and poor diet). However, much deeper structural changes in society are needed to struggle against socioeconomic and environmental deprivation and the inaccessibility of education for women across the globe.
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Affiliation(s)
- Timothy Daly
- Bioethics Program, FLACSO Argentina, Buenos Aires, Argentina
- Science Norms Democracy UMR 8011, Sorbonne Université, Paris, France
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Schuurmans J, Stalenhoef H, Bal R, Wallenburg I. All the good care: Valuation and task differentiation in older person care. Sociol Health Illn 2023; 45:1560-1577. [PMID: 37169732 DOI: 10.1111/1467-9566.13654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/17/2023] [Indexed: 05/13/2023]
Abstract
Task reallocation is increasingly foregrounded as a promising solution for capacity problems. Numerous studies show, however, that task reallocation between medical professionals is a highly contested issue and difficult to institutionalise. Conflicts are omnipresent and often arise from 'intraprofessional competition': Zero-sum games between professionals from different disciplinary backgrounds where one party's gains require another party's losses. In this article, we build on calls to enrich the sociology of professions with new concepts and theories. We analyse a case of task reallocation between medical professionals in a nursing home using concepts from empirical ethics and valuation studies. We argue that modes of good care offer a valuable framework for analysing the reorganisation of professional work because they provide an empirically grounded and fine-grained conceptual toolkit for understanding the dynamics among professionals and between professionals and managers. Enactment of different modes of good care inspires innovation in service provision but at the same time creates new tensions between those involved. We show how, in times of scarcity, a dynamic emerges between professionals attempting to stave off and reallocate work, thereby restricting their professional domains.
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Affiliation(s)
- Jitse Schuurmans
- Healthcare Governance, Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
| | - Hanna Stalenhoef
- Healthcare Governance, Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
| | - Roland Bal
- Healthcare Governance, Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
| | - Iris Wallenburg
- Healthcare Governance, Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
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GREENHALGH TRISHA, ENGEBRETSEN EIVIND, BAL ROLAND, KJELLSTRÖM SOFIA. Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review. Milbank Q 2023; 101:646-674. [PMID: 37219239 PMCID: PMC10509518 DOI: 10.1111/1468-0009.12656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/26/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Policy Points The concept of value complexity (complexity arising from differences in people's worldviews, interests, and values, leading to mistrust, misunderstanding, and conflict among stakeholders) is introduced and explained. Relevant literature from multiple disciplines is reviewed. Key theoretical themes, including power, conflict, language and framing, meaning-making, and collective deliberation, are identified. Simple rules derived from these theoretical themes are proposed.
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Thomas SJ. Critically Appraising Pragmatist Critiques of Evidence-Based Medicine: Is EBM Defensible on Pragmatist Grounds? J Med Philos 2023; 48:73-83. [PMID: 36519764 DOI: 10.1093/jmp/jhac037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Significant contributions to debates in the philosophy of evidence-based medicine (EBM) have come from a variety of different philosophical quarters, yet mainstream discourse in the field has been largely devoid of contributions from scholars working in the pragmatist tradition. This is a particularly conspicuous omission, given pragmatism's commitment to the melioristic view that philosophy both can, and should, be about the business of concretely bettering the human estate. Two exceptions to this oversight come from Brian Walsh and Maya Goldenberg. Unfortunately, in both cases, the misapplication of pragmatist thinking leads to the mistaken view that EBM is committed to some form of pernicious objectivism. This article aims to revise these pragmatist critiques in order to bring them more consistently in line with pragmatist values and commitments. Doing so shows that EBM is defensible on pragmatist grounds against objectivist attacks.
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Florczak K. Pragmatism in Evidence-Based Practice - Not to the Extreme, Please. Nurs Sci Q 2023; 36:11-15. [PMID: 36571314 DOI: 10.1177/08943184221131960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Over the years, I have written many articles on the subject of evidence-based practice (EBP). At times, the writing has been entirely derogatory; at others, it has been a bit more forgiving. In attempting to crystalize my notion of evidence in practice, I have concluded that pragmatism is a central driver of the process and that such pragmatism may attempt to whitewash the problem of bias in order to make findings useful for clinicians. To further clarify my position, the ideas of pragmatism, EBP, and bias are considered here.
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Buys T, Casteleijn D, Heyns T, Untiedt H. A Reflexive Lens on Preparing and Conducting Semi-structured Interviews with Academic Colleagues. Qual Health Res 2022; 32:2030-2039. [PMID: 36194785 DOI: 10.1177/10497323221130832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In qualitative research, researchers often conduct semi-structured interviews with people familiar to them, but there are limited guidelines for researchers who conduct interviews to obtain curriculum-related information with academic colleagues who work in the same area of practice but at different higher education institutions. Using a pragmatic constructivist stance, we address the practicalities of conducting semi-structured interviews with fellow educators who work in the same area of professional practice, where the researcher has to address the dual roles of "insider" and "outsider" as well as that of researcher and participant. Interviewing academic colleagues offers a unique opportunity for rich data collection, but researchers should adopt a flexible conversational style during interviewing within research parameters and be acutely aware of their positionality and fluidity of roles. This article contributes to existing knowledge by drawing on the work of previous scholars in various areas of research and research methodology thereby offering a practical and theoretical perspective on conducting qualitative research interviewing in higher education institutions where the role of researcher and participant can become blurred. These guidelines and insights will also benefit researchers who conduct research with peers who work together in the same area of expertise, in similar contexts and with whom there are varying levels of working relationships.
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Affiliation(s)
- Tania Buys
- Department of Occupational Therapy, Faculty of Health Sciences, 72042University of Pretoria, Arcadia, South Africa
- Department of Occupational Therapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tanya Heyns
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Arcadia, South Africa
| | - Hannelie Untiedt
- Department of Education Innovation, Faculty of Health Sciences, 72042University of Pretoria, Arcadia, South Africa
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Abstract
The cause of deterioration is often unclear, so it is vitally important that we spot the sick and deteriorating patient from all causes. As a result, warning scores must cater for all conditions, and - where possible - be standardised across all healthcare settings. This article summarises the importance of an 'unblinkered' approach to acute illness assessment, comparing and examining the evidence for different historical scoring systems and looking at the early impact of national alignment to NEWS2 in patients admitted to hospital with suspected bacterial infections.
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Affiliation(s)
- Matt Inada-Kim
- Hampshire Hospitals NHS Foundation Trust, Winchester, UK; professor, University of Southampton, Southampton, UK; national clinical director for infection, antimicrobial resistance and deterioration and national specialty advisor on sepsis, NHS England; clinical director for digital innovation, Wessex Academic Health Science Network.
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13
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Mayumi N, Ota K. Implications of philosophical pragmatism for nursing: Comparison of different pragmatists. Nurs Philos 2022; 24:e12414. [PMID: 36205082 DOI: 10.1111/nup.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/13/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
Pragmatism emphasizes practical consequences and empirical explanations rather than introspective contemplations. However, the arguments of pragmatists are not uniform, as shown by the four prominent pragmatists presented in this article. The major difference between them is that Peirce and Haack acknowledge an objective truth, whereas James and Rorty do not. Thus, for a fuller understanding of the pragmatist view of our knowledge, both camps must be consulted. In the nursing field, pragmatism is occasionally referred to as a guiding philosophy. However, the influence of James and Rorty has been greater than that of Peirce and Haack on pragmatists, which may risk leading to a skewed understanding of pragmatism by nursing scholars. Still, the four pragmatists share naturalism, which rejects a metaphysics that defines the nature of knowledge before our enquiry and emphasizes experience and practice. Pragmatic naturalism can help ensure that nursing theory does not deviate from clinical practice. This article also explores the broad adaptability of the ideas of all four pragmatists to philosophical issues in nursing, such as mixed-methods research, epistemic relativism and realism. By showing that pragmatism can be relevant and stimulating to each of these topics, the article demonstrates that the different approaches to pragmatism can provide more inspiration for nurses and nursing researchers in the future.
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Affiliation(s)
- Naoya Mayumi
- Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | - Katsumasa Ota
- Faculty of Human Care at Numazu, Tohto University, Numazu, Shizuoka, Japan
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Dolan S, Nowell L, McCaffrey G. Pragmatism as a philosophical foundation to integrate education, practice, research and policy across the nursing profession. J Adv Nurs 2022; 78:e118-e129. [PMID: 35854667 DOI: 10.1111/jan.15373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 06/22/2022] [Accepted: 07/05/2022] [Indexed: 12/01/2022]
Abstract
AIM A discussion of the philosophy of pragmatism and how it can underpin and integrate nursing education, practice, research and policy across the nursing profession. BACKGROUND Although the concepts of plurality, truth, fallibilism, subjectivity and meliorism have been discussed across foundational philosophical literature, the relation of these concepts across various facets of the nursing profession have not been thoroughly articulated in the nursing literature. DESIGN Critical theoretical reflection. DATA SOURCES In this article, we draw from literature written on the philosophy of pragmatism from 1907 through to 2021. IMPLICATIONS FOR NURSING We propose an integrative approach for the nursing profession where education, practice, research and policy speak and contribute to each other through a lens of pragmatism. In this approach, education has a relationship with practice and practice has a direct line to research where nurses on the front lines can engage with pragmatic inquiry. Researchers in return can inform frontline nurses and policymakers of evidence emerging in areas pertinent to practice. These relationships are made possible through integrated knowledge translation by including all stakeholders at every point of knowledge generation. Each facet of the nursing profession is filled with stakeholders of nursing knowledge, who are invested in its utility. Although it requires focused effort to integrate knowledge across the profession, pragmatism calls for action in the face of challenges in hope for a stronger body of nursing knowledge and ultimately profession. CONCLUSION Pragmatism is an apt philosophy to underpin and integrate nursing education, practice, research and policy across the nursing profession.
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Affiliation(s)
- Sara Dolan
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Lorelli Nowell
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Graham McCaffrey
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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Moore J. Conceptual Foundations: Teaching the Historical Development of Radical Behaviorism as a Philosophy of Science. Perspect Behav Sci 2022; 45:711-42. [PMID: 36618558 DOI: 10.1007/s40614-022-00335-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 01/11/2023] Open
Abstract
This article outlines a graduate-level course on the philosophical, conceptual, and historical (PCH) foundations of radical behaviorism, which is the philosophy of science that underlies behavior analysis. As described, the course is for a 15-week semester, and is organized into weekly units. The units in the first half of the course are concerned with the influences of other viewpoints in the history of psychology on the development of behavior analysis and radical behaviorism. The units in the second half are concerned with the PCH foundations of eight basic dimensions of radical behaviorism. Throughout, a course examining the foundations of radical behaviorism is seen as compatible with related courses in the other three domains of behavior analysis-the experimental analysis of behavior, applied behavior analysis, and service delivery-and as integral to the education of all behavior analysts.
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Schöllhorn WI, Rizzi N, Slapšinskaitė-Dackevičienė A, Leite N. Always Pay Attention to Which Model of Motor Learning You Are Using. Int J Environ Res Public Health 2022; 19:711. [PMID: 35055533 PMCID: PMC8776195 DOI: 10.3390/ijerph19020711] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 12/22/2022]
Abstract
This critical review considers the epistemological and historical background of the theoretical construct of motor learning for a more differentiated understanding. More than simply reflecting critically on the models that are used to solve problems-whether they are applied in therapy, physical education, or training practice-this review seeks to respond constructively to the recent discussion caused by the replication crisis in life sciences. To this end, an in-depth review of contemporary motor learning approaches is provided, with a pragmatism-oriented clarification of the researcher's intentions on fundamentals (what?), subjects (for whom?), time intervals (when?), and purpose (for what?). The complexity in which the processes of movement acquisition, learning, and refinement take place removes their predictable and linear character and therefore, from an applied point of view, invites a great deal of caution when trying to make generalization claims. Particularly when we attempt to understand and study these phenomena in unpredictable and dynamic contexts, it is recommended that scientists and practitioners seek to better understand the central role that the individual and their situatedness plays in the system. In this way, we will be closer to making a meaningful and authentic contribution to the advancement of knowledge, and not merely for the sake of renaming inventions.
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Affiliation(s)
- Wolfgang I. Schöllhorn
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany;
| | - Nikolas Rizzi
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany;
| | - Agnė Slapšinskaitė-Dackevičienė
- Department of Sports Medicine, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Tilžės g. 18, 47181 Kaunas, Lithuania;
| | - Nuno Leite
- Reseach Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Department of Sport Sciences, Exercise and Health, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal;
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Schleim S. Why mental disorders are brain disorders. And why they are not: ADHD and the challenges of heterogeneity and reification. Front Psychiatry 2022; 13:943049. [PMID: 36072457 PMCID: PMC9441484 DOI: 10.3389/fpsyt.2022.943049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Scientific attempts to identify biomarkers to reliably diagnose mental disorders have thus far been unsuccessful. This has inspired the Research Domain Criteria (RDoC) approach which decomposes mental disorders into behavioral, emotional, and cognitive domains. This perspective article argues that the search for biomarkers in psychiatry presupposes that the present mental health categories reflect certain (neuro-) biological features, that is, that these categories are reified as biological states or processes. I present two arguments to show that this assumption is very unlikely: First, the heterogeneity (both within and between subjects) of mental disorders is grossly underestimated, which is particularly salient for an example like Attention Deficit/Hyperactivity Disorder (ADHD). Second, even the search for the biological basis of psychologically more basic categories (cognitive and emotional processes) than the symptom descriptions commonly used in mental disorder classifications has thus far been inconclusive. While philosophers have discussed this as the problem of mind-body-reductionism for ages, Turkheimer presented a theoretical framework comparing weak and strong biologism which is more useful for empirical research. This perspective article concludes that mental disorders are brain disorders in the sense of weak, but not strong biologism. This has important implications for psychiatric research: The search for reliable biomarkers for mental disorder categories we know is unlikely to ever be successful. This implies that biology is not the suitable taxonomic basis for psychiatry, but also psychology at large.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands
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18
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Vackerberg N, Andersson AC. Commentary: Bridging the silos: A comparative analysis of Implementation Science and Improvement Science. Front Health Serv 2022; 2:964489. [PMID: 36925877 PMCID: PMC10012783 DOI: 10.3389/frhs.2022.964489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Nicoline Vackerberg
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Qulturum, Center for Learning and Innovation in Healthcare, Jönköping, Sweden
| | - Ann-Christine Andersson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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19
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Abstract
OBJECTIVE To discuss narrow pragmatism, manifest as digital and technical solutionism, in mental healthcare and psychiatric practice. Pragmatism is a view of the field of psychiatry as an instrument or tool for the purpose of providing psychiatric care for people with a mental illness. Solutionism, as proposed by Morozov, can be considered a special case of pragmatism that valorises an approach to solving real-world problems based on computation, algorithms and digital technology,1 which we extend to discuss other technical solutions such as medication, non-invasive brain stimulation and psychotherapy. CONCLUSIONS Digital or technical solutionism may unnecessarily constrain approaches to mental healthcare and psychiatric practice. Psychiatrists can consider, and should advocate for, appropriate adaptation of technology and technical solutions toward collaborative and effective mental healthcare.
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Affiliation(s)
- Jeffrey C L Looi
- Academic Unit of Psychiatry and Addiction Medicine, the Australian National University Medical School, Canberra Hospital, ACT, Australia
| | - Daniel Bonner
- Academic Unit of Psychiatry and Addiction Medicine, the Australian National University Medical School, Canberra Hospital, ACT, Australia
| | - Paul Maguire
- Academic Unit of Psychiatry and Addiction Medicine, the Australian National University Medical School, Canberra Hospital, ACT, Australia
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20
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Allemang B, Sitter K, Dimitropoulos G. Pragmatism as a paradigm for patient-oriented research. Health Expect 2021; 25:38-47. [PMID: 34748689 PMCID: PMC8849373 DOI: 10.1111/hex.13384] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Mixed methods research studies continue to pervade the field of health care, where pragmatism as a research paradigm and patient-oriented research (POR) as an engagement strategy are combined to strengthen the process and outcomes of the research. Pragmatists use the most appropriate research methods to address issues at hand, where complex social problems need multipronged approaches. As an emerging healthcare research strategy, POR actively engages individuals with lived experience across all stages of the research process. While POR continues to garner attention within mixed-methods research designs, there is a paucity of literature that considers POR in relation to pragmatism. OBJECTIVE As POR grows in popularity within the field of health care, there is a need to explore the theoretical and epistemological alignment with pragmatism and the implications to research. METHODS To address this need, we provide a critical review of the literature to examine the synergies between POR and pragmatism, and argue for the adoption of pragmatism as a paradigm for conducting POR. MAIN RESULTS This article begins with a discussion of the philosophical underpinnings informing the pragmatic paradigm. It then identifies key alignments between POR and pragmatism across three intersecting concepts: democratic values, collaborative approaches to problem-solving and the pursuit of social justice. DISCUSSION AND CONCLUSIONS Reflecting on our experiences engaging with patient partners in a mixed-methods POR study titled READY2Exit, we illustrate the relevance of pragmatism to POR by applying these concepts to practice. Implications and considerations for conducting POR within the pragmatic paradigm are also described. PATIENT OR PUBLIC CONTRIBUTION This paper provides a critical review of the literature and did not directly involve patients or the public. The authors reflected on their experiences collaborating with five young adult patient partners in the READY2Exit study (case exemplar described in this article) to demonstrate the relevance of the pragmatic paradigm to POR. We acknowledge and thank the young adult patient partners for their contributions to the research, for encouraging us to think critically about patient engagement in research, and for sharing their experiences.
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Affiliation(s)
- Brooke Allemang
- Department of Social Work, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen Sitter
- Department of Social Work, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Gina Dimitropoulos
- Department of Social Work, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada.,Department of Psychiatry, Mathison Centre for Mental Health Research & Education, Calgary, Alberta, Canada
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21
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Chen RX, Ge ZM, Hu SL, Tang WZ. Supportive or Confining? The Impact of War Metaphors From the COVID-19 Pandemic on Persons With Disabilities in Mainland China. Front Public Health 2021; 9:720512. [PMID: 34616706 PMCID: PMC8488130 DOI: 10.3389/fpubh.2021.720512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Ensuring the well-being of persons with disabilities (PWDs) is a priority in the public sector during the coronavirus disease 2019 (COVID-19) pandemic. To contain this unprecedented public crisis in China, a set of nationwide anti-epidemic discourse systems centered on war metaphors has guided the epidemic's prevention and control. While the public is immersed in the joy brought by the stage victory, most ignore the situation of the disadvantaged PWDs. Accordingly, this study adopts and presents a qualitative research method to explore the impact of war metaphors on PWDs. The results showed that while there was some formal and informal support for PWDs during this period, they were increasingly marginalized. Owing to the lack of a disability lens and institutional exclusion, PWDs were placed on the margins of the epidemic prevention and control system like outsiders. Affected by pragmatism under war metaphors, PWDs are regarded as non-contributory or inefficient persons; therefore, they are not prioritized and are thus placed into a state of being voiceless and invisible. This research can provide inspiration for improving public services for PWDs in the context of COVID-19.
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Affiliation(s)
- Ren-Xing Chen
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Zhong-Ming Ge
- Department of Social Work, School of Philosophy and Social Development, Shandong University, Jinan, China
| | - Shu-Ling Hu
- Department of Social Work, School of Philosophy and Social Development, Shandong University, Jinan, China
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22
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Caine V, Steeves P, Berendonk C, Blix BH, Jean Clandinin D. Narrative care: Unpacking pandemic paradoxes. Nurs Inq 2021; 29:e12462. [PMID: 34541743 DOI: 10.1111/nin.12462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/30/2021] [Accepted: 09/04/2021] [Indexed: 11/29/2022]
Abstract
During the coronavirus disease 2019 pandemic, public health has issued three interrelated dominant narratives through social media and news outlets: First, to care for others, we must keep physically distant; second, we live in the same world and experience the same pandemic; and third, we will return to normal at some point. These narratives create complexities as they collide with the authors' everyday lives as nurses, educators, and women. This collision creates three paradoxes for us: (a) learning to care by creating physical distance, (b) a sense of togetherness erases inequities, and (c) returning to normal is possible. To inquire into these three paradoxes, we draw on our experiences with Ingrid, an older adult who requires in-home physical care, and Matthew, a man with multiple disabilities including severe oral dyspraxia and developmental delays. We outline how narrative care is a counterstory to the dominant narratives and enables us to find ways to live our lives within the paradoxes. Narrative care allows us, through attention to embodiment, liminality, and imagination, to create forward looking stories. Understanding narrative care within these paradoxes allows us to offer more complex understandings of the ways narrative care can be embodied in our, and others', lives.
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Affiliation(s)
- Vera Caine
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Pamela Steeves
- Centre for Research for Teacher Education and Development, Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | | | - Bodil H Blix
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - D Jean Clandinin
- Centre for Research for Teacher Education and Development, Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
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23
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Abstract
This interview with Peter Zachar, PhD, discusses his 2014 book 'A Metaphysics of Psychopathology', and explores his application of the philosophy of scientifically-inspired pragmatism to psychiatric classification, his critique of essentialistic thinking in psychiatry, and his notion of the imperfect community model with regards to psychiatric disorders. The imperfect community is a non-essentialist idea, namely, that the various members of the class of psychiatric disorders have many things in common, but there is no one thing (an essence) that they all have in common that distinguishes them as a group from non-disorders. The resulting domain is, however, not random or arbitrary - new constructs have been introduced for reasons that reflect our scientific goals and pragmatic interests. Zachar is sceptical about the possibility of a single correct and privileged psychiatric classification, but he recognises that the ways in which psychiatric symptoms empirically cluster together places constraints on psychiatric classification that, for instance, don't apply to organising libraries. Classifications are contingent on multiple factors, including our scientific knowledge and goals. Epistemic and evaluative commitments, once identified, work together in a non-arbitrary way to constrain what counts as a good solution to the question of classification.
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Affiliation(s)
- Awais Aftab
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA.,Northcoast Behavioral Healthcare (Ohio Department of Mental Health and Addiction Services), Northfield, OH, USA
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24
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Chase M, Lloyd CEM, Peters BJ, Chase E, Lee K. Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care. Health Soc Care Community 2021; 29:1061-1071. [PMID: 32812286 DOI: 10.1111/hsc.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/28/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
Despite the increasing policy focus on integrated dementia care in the UK, little is known about the opportunities and challenges encountered by practitioners charged with implementing these policies on the ground. We undertook an extensive, mixed-methods analysis of how a contemporary multidisciplinary dementia pathway in the UK was experienced and negotiated by service providers. Our pragmatic mixed methods design incorporated three types of research interaction with practitioners: (a) Semi-structured interviews (n = 31) and focus group discussions (n = 4), (b) Practitioner 'shadowing' observations (n = 19), and (c) Service attendance and performance metrics reviews (n = 8). Through an abductive analysis of practitioner narratives and practice observations, we evidenced how inter-practitioner prejudices, restrictive and competitive commissioning frameworks, barriers to effective data sharing and other resource constraints, all challenged integrative dementia care and led to unintended consequences such as practice overlap and failure to identify and respond to people's needs. In order to more successfully realise integrated dementia pathways, we propose innovative commissioning frameworks which purposefully seek to diffuse power imbalances, encourage inter-provider respect and understanding, and determine clear lines of responsibility.
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Affiliation(s)
- Mike Chase
- Psychology, Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | | | | | - Elaine Chase
- Department of Education, Practice & Society, University College London, London, UK
| | - Kellyn Lee
- Ageing & Dementia, School of Health Sciences, University of Southampton, Southampton, UK
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25
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Bradway M, Årsand E. Exploring Real-World mHealth Use for Diabetes Consultations: Pros and Pitfalls of a Pragmatic Mixed-Methods Approach. Stud Health Technol Inform 2021; 281:875-9. [PMID: 34042799 DOI: 10.3233/SHTI210304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Intervention research is often highly controlled and does not reflect real-world situations. More pragmatic approaches, albeit less controllable and more challenging, offer the opportunity of identifying unexpected factors and connections. As the introduction of mHealth into formal diabetes care settings is relatively new and less often explored from the perspectives of patients and providers together, such an opportunity for exploration should be embraced. In this paper we demonstrate our experiences and results in designing and administering a pragmatic mixed-methods feasibility study to understand the impacts of a diabetes data-sharing system on patients and providers. In doing so, we aim to provide a realistic account of the pros and pitfalls of this approach to diabetes mHealth intervention research.
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26
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Poechhacker N, Kacianka S. Algorithmic Accountability in Context. Socio-Technical Perspectives on Structural Causal Models. Front Big Data 2021; 3:519957. [PMID: 33693408 PMCID: PMC7931883 DOI: 10.3389/fdata.2020.519957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
The increasing use of automated decision making (ADM) and machine learning sparked an ongoing discussion about algorithmic accountability. Within computer science, a new form of producing accountability has been discussed recently: causality as an expression of algorithmic accountability, formalized using structural causal models (SCMs). However, causality itself is a concept that needs further exploration. Therefore, in this contribution we confront ideas of SCMs with insights from social theory, more explicitly pragmatism, and argue that formal expressions of causality must always be seen in the context of the social system in which they are applied. This results in the formulation of further research questions and directions.
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Affiliation(s)
- Nikolaus Poechhacker
- Institute for Public Law and Political Science, University of Graz, Graz, Austria
| | - Severin Kacianka
- Department of Computer Science, Chair of Software and Systems Engineering, Technical University of Munich, Munich, Germany
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27
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Abstract
Within the last two decades, it has been commonly agreed that patient safety and error management in healthcare organizations can best be attained by adopting a systems approach via re-engineering efforts and the introduction of industrial safety technologies and methodologies. This strategy has not delivered the expected result. Based on John Dewey's pragmatism, we propose another vocabulary for understanding, inquiring into and learning from safety situations in healthcare. Drawing especially on Dewey's understanding of transaction as the inseparability between human and environment, we develop an analytical approach to patient safety understood as a transactional accomplishment thoroughly dependent on the quality of situated and shared habits and collaborative practices in healthcare. We further illustrate methodologically how a transactional attitude can be situationally practised through video-reflexive ethnography, a method that allows for inquiry into mundane safety practices by letting interprofessional teams see, reflect upon and possibly modify their shared practices and safety habits.
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Affiliation(s)
- Kirstine Z Pedersen
- Department of Organization, Copenhagen Business School, Frederiksberg, Denmark
| | - Jessica Mesman
- Society Studies, Faculty of Arts and Social Sciences, Maastricht Universit, Maastricht, Netherlands
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28
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Guyon H, Nôus C. Quantification in Experimental Psychology and Pragmatic Epistemology: Tension Between the Scientific Imperative and the Social Imperative. Front Psychol 2021; 11:603617. [PMID: 33519610 PMCID: PMC7838504 DOI: 10.3389/fpsyg.2020.603617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hervé Guyon
- Université de Bretagne Occidentale, AMURE Laboratory, Brest, France
| | - Camille Nôus
- Université de Bretagne Occidentale, Cogitamus Laboratory, Brest, France
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29
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du Plessis E, Chevrier C, Lazarus L, Reza-Paul S, Rahman SHU, Ramaiah M, Avery L, Lorway R. Pragmatic women: negotiating sex work, pregnancy, and parenting in Mysore, South India. Cult Health Sex 2020; 22:1177-1190. [PMID: 31549914 DOI: 10.1080/13691058.2019.1662946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
Persisting inequities in maternal health pose a particular burden for marginalised populations such as sex workers. However, current literature on pregnancy and sex work is limited to mostly quantitative studies focusing on contraception use, unplanned and/or undesired pregnancies and unsafe abortions. Additionally, emphasis has been placed on the prevention, treatment and care of STIs and HIV with less attention accorded to women's pregnancy desires and implications to work. In this paper, we explore sex workers' conflicted experiences surrounding pregnancy, parenthood, and work. Forty-six women participated in in-depth interviews as part of a qualitative exploratory study conducted in close collaboration with a sex worker collective in the city of Mysore (South India). Our analysis focuses on women's pragmatic responses to pregnancy desires, workplace challenges during and after pregnancy, strategies for managing risk and approaches to managing work and childcare. We show that women confront various intersecting challenges with respect to pregnancy and sex work. Women's complex decision-making balances multiple considerations while highlighting the temporal dimension of pragmatism as women respond not only to the immediacy of an encounter but also in anticipation of a better future.
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Affiliation(s)
- Elsabé du Plessis
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Claudyne Chevrier
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa Lazarus
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sushena Reza-Paul
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Lisa Avery
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Robert Lorway
- Centre for Global Public Health, Rady Faculty of Health Sciences, Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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30
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Deering K, Williams J, Stayner K, Pawson C. Giving a voice to patient experiences through the insights of pragmatism. Nurs Philos 2020; 22:e12329. [PMID: 32951310 DOI: 10.1111/nup.12329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
Abstract
As a philosophical position, pragmatism can be critiqued to distinguish truth only with methods that bring about desired results, predominantly with scientific enquiry. The article hopes to dismiss this oversimplification and propose that within mental health nursing, enquiry enlightened by pragmatism can be anchored to methods helping to tackle genuine human problems. Whilst pragmatists suggest one reality exists, fluctuating experiences and shifting beliefs about the world can inhabit within; hence, pragmatists propose reality has the potential to change. Moreover, pragmatism includes being cognisant of what works to whom reality concerns, making reality context-driven, with a view to understand how actions shape experiences so what is generated has usefulness. Hence, it somewhat follows pragmatism can inform mental health nursing, after all, nursing is a discipline of action, and awareness is needed in how actions produce experiences that patients find helpful. Given the principles of recovery are preferably adopted in mental health care, the paper will explore how pragmatism can help nurses move towards that goal; specifically, with patients voicing their experiences. This is because like pragmatism, recovery subscribes to hope that reality can progress, and through meaningful experiences and beliefs, patients have expertise about personal difficulties alongside how life may flourish, despite mental illness.
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Affiliation(s)
- Kris Deering
- Nursing and Midwifery Department, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Jo Williams
- Nursing and Midwifery Department, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Kay Stayner
- Southmead Hospital, Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - Chris Pawson
- Psychology Department, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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31
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Younas A. Operationalist and inferentialist pragmatism: Implications for nursing knowledge development and practice. Nurs Philos 2020; 21:e12323. [PMID: 32755025 DOI: 10.1111/nup.12323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 11/28/2022]
Abstract
Philosophical inquiries in nursing are useful for analysing and critiquing existing practices, exploring contextual factors affecting practice, adapting to and sustaining ongoing changes in knowledge development, and facilitating the linkages between theory, research and practice. Nurse scholars used several philosophical schools of thought to guide knowledge development and practice. Pragmatism has been described as essential for bridging the theory-practice gap, for engaging in the inquiry-based practice and for translating knowledge into practice. The existing descriptions of pragmatism rely on rudimentary descriptions of "what works" and "inquiry-based action" aspects. However, the operationalist and inferentialist aspects of pragmatism and their worth for nursing knowledge development and practice are yet to be discussed. This paper explores the operationalist and inferentialist pragmatism and highlights the implications of these aspects for nursing knowledge development and practice. It has been argued that the dual aspect of pragmatism offers an approach to develop practical lines of action, evaluate actions in terms of their usefulness and assimilate already learned actions with the new actions. I suggested that moving beyond the rudimentary understanding of pragmatism and embracing and utilizing the dual aspect of pragmatism can bring more significant benefits for nursing. Embracing the dual aspect of pragmatism can enable nurses in developing philosophical reflexivity, emphasizing the experiential context of nursing, generating actionable and ready to use knowledge, and utilizing nursing theories to their fullest potential.
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Affiliation(s)
- Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada.,Swat College of Nursing, Mingora, Pakistan
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32
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Dittrich A. Who Has the Last Word? Radical Behaviorism, Science, and Verbal Behavior about Verbal Behavior. Perspect Behav Sci 2020; 43:343-59. [PMID: 32647786 DOI: 10.1007/s40614-020-00249-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
A radical behaviorist epistemology recognizes the recursivity inherent in behavior analysis: as behaving organisms, we not only take behavior as our subject matter but we are also part of it. Such a naturalization of epistemology, however, is not without its critics. In this article, my aim is to assess some of the arguments that were directed against this approach by the American philosopher Thomas Nagel in his book The Last Word (1997). In particular, I address Nagel's arguments regarding (1) the shortcomings of naturalistic explanations of scientific knowledge and (2) the impossibility of circumventing a realistic, representational epistemology. Regarding (1), I argue that although Nagel is right in arguing that there is no neutral or external viewpoint from which we can understand scientific knowledge, the naturalistic explanation of such knowledge proposed by radical behaviorists is not only possible, but have important practical advantages, insofar as it allows the identification of the variables that control scientific behavior. Regarding (2), I argue that although behavior scientists will frequently talk and write in descriptive ways, the function of descriptive verbal behavior in science is not to represent reality but to coordinate our collective behavior in dealing with the environment. I conclude that instead of avoiding an evolutionary account of rationality, as Nagel suggests, we have every reason to further pursue it.
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33
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Hartman L, Metselaar S, Widdershoven G, Molewijk B. Developing a 'moral compass tool' based on moral case deliberations: A pragmatic hermeneutic approach to clinical ethics. Bioethics 2019; 33:1012-1021. [PMID: 31339182 PMCID: PMC6852469 DOI: 10.1111/bioe.12617] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 12/13/2018] [Accepted: 03/02/2019] [Indexed: 05/25/2023]
Abstract
Although moral case deliberation (MCD) is evaluated positively as a form of clinical ethics support (CES), it has limitations. To address these limitations our research objective was to develop a thematic CES tool. In order to assess the philosophical characteristics of a CES tool based on MCDs, we drew on hermeneutic ethics and pragmatism. We distinguished four core characteristics of a CES tool: (a) focusing on an actual situation that is experienced as morally challenging by the user; (b) stimulating moral inquiry into the moral concepts, questions and routines in the lived experience of the CES tool user; (c) stimulating moral learning by exploring other perspectives; and (d) incorporating contextual details. We provide an example of a CES tool developed for moral dilemmas over client autonomy. Our article ends with some reflections on the normativity of the CES tool, other application areas and the importance of evaluation studies of CES tools.
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Affiliation(s)
- Laura Hartman
- Department of Medical Humanities, University of Amsterdam, the Netherlands
| | - Suzanne Metselaar
- Department of Medical Humanities, University of Amsterdam, the Netherlands
| | - Guy Widdershoven
- Department of Medical Humanities, University of Amsterdam, the Netherlands
| | - Bert Molewijk
- Department of Medical Humanities, University of Amsterdam, the Netherlands
- Centre for Medical Ethics, University of Oslo, Norway
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34
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Abstract
In this article, we present a pragmatic approach to neuroethics, referring back to John Dewey and his articulation of the “common good” and its discovery through systematic methods. Pragmatic neuroethics bridges philosophy and social sciences and, at a very basic level, considers that ethics is not dissociable from lived experiences and everyday moral choices. We reflect on the integration between empirical methods and normative questions, using as our platform recent bioethical and neuropsychological research into moral cognition, action, and experience. Finally, we present the protocol of a study concerning teenagers’ morality in everyday life, discussing our epistemological choices as an example of a pragmatic approach in empirical ethics. We hope that this article conveys that even though the scope of neuroethics is broad, it is important not to move too far from the real life encounters that give rise to moral questions in the first place.
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Abstract
Common understandings of neuroethics, that is, of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics, and (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism whereas the second relies on debatable assumptions about the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill founded and should give way to pragmatist reconstructions; namely, that neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations, but does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions.
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Abstract
The authors of this column consider the subject of collaboration in terms of healthcare practice, research, and education. To that end, the concept of pragmatism is discussed as a precursor to collaboration followed by consideration of specific instances of collaboration in practice, research, and education. Additionally, the consequences of collaboration are discussed.
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Abstract
This article explores the pragmatic sensibilities that are implicit in idioms of distress among family caregivers for Alzheimer's disease in Teotitlán del Valle, a rural Zapotec-speaking community in Oaxaca, Mexico. Through analysis of caregivers' perceptions of progressive memory loss and related etiological understandings, this article emphasizes the pragmatism inherent to local health perspectives. In so doing, the article revisits Nichter's earliest formulation of idioms of distress as providing an alternative epistemological framework to appreciate how illness is varyingly understood. Such a framework is useful for understanding how idioms of distress are not aimed towards attaining accuracy about what illness is in an objective sense, but rather put into focus how such descriptions are both constitutive of-and themselves pragmatic responses to-broader social circumstances. This article concludes with a consideration of how idioms of distress empower individuals as agents of action.
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Affiliation(s)
- Jonathan Yahalom
- US Department of Veterans Affairs; University of California, Los Angeles
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Kubu CS, Ford PJ, Wilt JA, Merner AR, Montpetite M, Zeigler J, Racine E. Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes following DBS. NEUROETHICS-NETH 2019; 2019. [PMID: 32952741 PMCID: PMC7500511 DOI: 10.1007/s12152-019-09418-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gilbert and colleagues (2018) point out the discrepancy between the limited empirical data illustrating changes in personality (and related concepts of identity, agency, authenticity, autonomy, and self, i.e., PIAAAS) following implantation of deep brain stimulating (DBS) electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities (representing the conceptual publications) and the sciences (representing the empirical work). This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences.
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Affiliation(s)
- Cynthia S Kubu
- Center for Neurological Restoration, Cleveland Clinic, P57, 9500 Euclid Ave, Cleveland, OH 44195.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
| | - Paul J Ford
- Center for Neurological Restoration, Cleveland Clinic, P57, 9500 Euclid Ave, Cleveland, OH 44195.,Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
| | - Joshua A Wilt
- Department of Psychological Sciences, Case Western Reserve University
| | - Amanda R Merner
- Center for Neurological Restoration, Cleveland Clinic, P57, 9500 Euclid Ave, Cleveland, OH 44195.,Department of Psychological Sciences, Case Western Reserve University
| | - Michelle Montpetite
- Center for Neurological Restoration, Cleveland Clinic, P57, 9500 Euclid Ave, Cleveland, OH 44195
| | - Jaclyn Zeigler
- Center for Neurological Restoration, Cleveland Clinic, P57, 9500 Euclid Ave, Cleveland, OH 44195
| | - Eric Racine
- Institut de recherches cliniques de Montréal
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Jiao S. Harm reduction: Philosophical drivers of conceptual tensions and ways forward. Nurs Inq 2019; 26:e12286. [PMID: 30773745 DOI: 10.1111/nin.12286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/12/2019] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
Abstract
Of the various debates surrounding harm reduction, a conceptual tension that perhaps has the most relevance for the provision of services is that of harm reduction as a technical solution versus a contextualized social practice. The aim of this paper was to examine this conceptual tension. First, the two perspectives will be presented through the use of examples. Second, philosophical drivers that serve to underpin and justify each perspective will be explicated at the level of the knowledge that we privilege; the ideologies that we subscribe to; and the interests that we stand to serve. In this paper, I argue that the existing tension between technical and social approaches to harm reduction is embedded within discord pertaining to ways of knowing, paradigms of inquiry, prevailing ideologies, and notions of harm and risk. Building on these sources of tension, I suggest a means of philosophical reconciliation between the two approaches and ways forward, namely through acknowledging multiple sources of knowledge, through embracing paradigmatic incommensurability, through considering alternative conceptions of people who use drugs as political subjects, through involving service providers and end-users in shared decision-making, and lastly through reaffirming people who use drugs as the intended beneficiaries of services.
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Affiliation(s)
- Sunny Jiao
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
This paper explores anthropomorphism in human–animal interactions from the theoretical perspectives of pragmatism and anthropology of human–animal communication. Its aim is to challenge the conception of anthropomorphism as the attribution/inference of human properties to a non-human animal – particularly as a special case of the theory of mind. The author’s goal is to articulate a plausible an alternative conception of anthropomorphism as a situated direct perception of human properties by someone who is engaged in a given situation and sensitive to what the animal is doing to them. Rooted in pragmatist theory as well as in contemporary anthropological studies, this paper offers an original perspective for in depth ethnographic and empirical studies of anthropomorphism-in-situation. Such studies could bring new insights in the study of how ordinary people make sense of animal behaviors in real-life situations.
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Affiliation(s)
- Véronique Servais
- Laboratory of Social and Cultural Anthropology, Faculty of Social Sciences, University of Liège, Liège, Belgium
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Schermer MHN, Richard E. On the reconceptualization of Alzheimer's disease. Bioethics 2019; 33:138-145. [PMID: 30303259 PMCID: PMC6585806 DOI: 10.1111/bioe.12516] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/25/2018] [Accepted: 07/31/2018] [Indexed: 05/24/2023]
Abstract
In the hope of future treatments to prevent or slow down the disease, there is a strong movement towards an ever-earlier detection of Alzheimer's disease (AD). In conjunction with scientific developments, this has prompted a reconceptualization of AD, as a slowly progressive pathological process with a long asymptomatic phase. New concepts such as 'preclinical' and 'prodromal' AD have been introduced, raising a number of conceptual and ethical questions. We evaluate whether these new concepts are theoretically defensible, in light of theories of health and disease, and whether they should be understood as disease or as an at-risk state. We introduce a pragmatic view on disease concepts and argue that an evaluation of the reconceptualization of AD should also take its aims and effects into account, and assess their ethical acceptability. The reconceptualization of AD is useful to coordinate research into preventive strategies, and may potentially benefit future patients. However, in the short term, early detection and labelling of 'preclinical AD' can potentially harm people. Since there is no treatment available and the predictive value is unclear, it may only create a group of 'patients-in-waiting' who may suffer from anxiety, uncertainty and stigmatization, but will never actually develop dementia. We conclude that only if the promise of preventive medication materializes, will the reconceptualization of AD turn out unequivocally to be for the better. Otherwise, the reconceptualization may do more harm than good.
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Affiliation(s)
- Maartje H. N. Schermer
- Department of Medical Ethics and Philosophy of MedicineUniversity Medical CenterRotterdamThe Netherlands
| | - Edo Richard
- Department of NeurologyRadboud University Medical CenterNijmegenThe Netherlands
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Racine E, Bracken-Roche D. Enriching the concept of vulnerability in research ethics: An integrative and functional account. Bioethics 2019; 33:19-34. [PMID: 30136737 DOI: 10.1111/bioe.12471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/22/2018] [Accepted: 05/20/2018] [Indexed: 05/25/2023]
Abstract
The concept of vulnerability is widely used in research ethics to signal attention to participants who require special protections in research. However, this concept is vague and under-theorized. There is also growing concern that the dominant categorical approach to vulnerability (as exemplified by research ethics regulations and guidelines delineating vulnerable groups) is ethically problematic because of its assumptions about groups of people and is, in fact, not very guiding. An agreed-upon strategy is to move from categorical towards analytical approaches (focused on analyzing types and sources of vulnerability) to vulnerability. Beyond this agreement, however, scholars have been advancing competing accounts of vulnerability without consensus about its appropriate operationalization in research ethics. Based on previous debates, we propose that a comprehensive account of vulnerability for research ethics must include four components: definition, normative justifications, application, and implications. Concluding that no existing accounts integrate these components in a functional (i.e., practically applicable) manner, we propose an integrative and functional account of vulnerability inspired by pragmatist theory and enriched by bioethics literature. Using an example of research on deep brain stimulation for treatment-resistant depression, we illustrate how the integrative-functional account can guide the analysis of vulnerability in research within a pragmatist, evidence-based approach to research ethics. While ultimately there are concerns to be addressed in existing research ethics guidelines on vulnerability, the integrative-functional account can serve as an analytic tool to help researchers, research ethics boards, and other relevant actors fill in the gaps in the current landscape of research ethics governance.
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Affiliation(s)
- Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), Montréal, QC, Canada
- Université de Montréal, Montréal, QC, Canada
- McGill University, Montréal, QC, Canada
| | - Dearbhail Bracken-Roche
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), Montréal, QC, Canada
- McGill University, Montréal, QC, Canada
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Abstract
Ecological Psychology is an embodied, situated, and non-representational approach pioneered by J. J. Gibson and E. J. Gibson. This theory aims to offer a third way beyond cognitivism and behaviorism for understanding cognition. The theory started with the rejection of the premise of the poverty of the stimulus, the physicalist conception of the stimulus, and the passive character of the perceiver of mainstream theories of perception. On the contrary, the main principles of ecological psychology are the continuity of perception and action, the organism-environment system as unit of analysis, the study of affordances as the objects of perception, combined with an emphasis on perceptual learning and development. In this paper, first, we analyze the philosophical and psychological influences of ecological psychology: pragmatism, behaviorism, phenomenology, and Gestalt psychology. Second, we summarize the main concepts of the approach and their historical development following the academic biographies of the proponents. Finally, we highlight the most significant developments of this psychological tradition. We conclude that ecological psychology is one of the most innovative approaches in the psychological field, as it is reflected in its current influence in the contemporary embodied and situated cognitive sciences, where the notion of affordance and the work of E. J. Gibson and J. J. Gibson is considered as a historical antecedent.
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Affiliation(s)
- Lorena Lobo
- Facultad de Ciencias de la Salud y de la Educación, Universidad a Distancia de Madrid, Madrid, Spain
| | - Manuel Heras-Escribano
- Department of Logic and Philosophy of Science, IAS-Research Centre for Life, Mind and Society, Universidad del País Vasco-Euskal Herriko Unibertsitatea, San Sebastian, Spain
| | - David Travieso
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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Pagnamenta F, Lhussier M. Viewing dressing evaluation through a pragmatic lens: The application of Dewey's experimentalism in the development of evidence for dressing selection. J Eval Clin Pract 2018; 24:988-994. [PMID: 30028065 DOI: 10.1111/jep.12989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/27/2018] [Accepted: 06/06/2018] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The aim of this paper is to (1) summarize the challenges with developing evidence for dressing selection in wound care, (2) discuss the limiting influence that the Evidence-Based Practice movement has had in this field, and (3) discuss the opportunities offered by Dewey's theory of experimentalism as a pragmatic solution to develop a structured body of evidence. FINDINGS Whilst the number of dressings available on the market continue to proliferate, limited progress has taken place to develop a methodology for dressing evaluation that is relevant to clinical practice. It is proposed that experimentalism can be operationalized with a mixed-methods approach that may include the following: (1) medical histories and patient's stories; (2) participant observation and informal interviews; (3) a comparative study between a new dressing and standard care; (4) a patient's satisfaction survey; (5) a staff survey; (6) a cost examination; (7) an evaluation of the packaging and procurement route; and finally (8) a clinical meeting to triangulate the data and reach a consensus. CONCLUSION Experimentalism offers a framework for the construction of evidence used for dressing selection. Central to this concept is the integration of experience to the data collected. The context of the evaluation has equal weight to the data thus collected.
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Affiliation(s)
- Fania Pagnamenta
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Wium AM, Louw B. Mixed-methods research: A tutorial for speech-language therapists and audiologists in South Africa. S Afr J Commun Disord 2018; 65:e1-e13. [PMID: 30035606 PMCID: PMC6111631 DOI: 10.4102/sajcd.v65i1.573] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 04/30/2018] [Accepted: 05/08/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Mixed-methods research (MMR) offers much to healthcare professions on clinical and research levels. Speech-language therapists and audiologists work in both educational and health settings where they deal with real-world problems. Through the nature of their work, they are confronted with multifaceted questions arising from their efforts to provide evidence-based services to individuals of all ages with communication disorders. MMR methods research is eminently suited to addressing such questions. Objective: The aim of this tutorial is to increase awareness of the value of MMR, especially for readers less familiar with this research approach. Method: A literature review was conducted to provide an overview of the key issues in MMR. The tutorial discusses the various issues to be considered in the critical appraisal of MMR, followed by an explanation of the process of conducting MMR. A critical review describes the strengths and challenges in MMR. Results: MMR is less commonly used or published in the fields of speech-language therapy and audiology. Conclusion: Researchers working in teams can draw on the strengths of different disciples and their research approaches. Such collaborative enterprises will contribute to capacity building. Researchers, SLTs and audiologists are encouraged to make use of MMR to address the complex research issues in the multicultural, multifaceted South African context. MMR makes an important contribution to the understanding of individuals with communication disorders, and in turn, researchers in the two disciplinary fields of speech-language therapy and audiology can contribute to the development of this research approach. MMR is well suited to the complexity of South African contexts and its populations, as it can provide multiple perspectives of a topic.
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Affiliation(s)
- Anna-Marie Wium
- Discipline Speech-Language Pathology and Audiology, Sefako Makgatho Health Sciences University.
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O'Reilly K, Peters K, Wilson N, Kwok C. Use of pragmatism to explore women's experiences of traumatic brain injury: a kaleidoscopic view of the world. Nurse Res 2018; 25:21-25. [PMID: 29546963 DOI: 10.7748/nr.2018.e1572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although more men than women sustain a traumatic brain injury (TBI), approximately one quarter of people with TBIs are women. The experiences of TBI reported in the literature are informed from the masculine perspective and do not adequately represent women's experiences. Pragmatism provides an overarching methodological framework to explore and critique a broader perspective of health, including psychosocial, cultural, spiritual, political and environmental factors, while attempting to address gender inequity. AIM To describe the philosophical background validating the use of pragmatism to research women's experiences of TBI. DISCUSSION Given the limited understanding of the interplay of socially constructed barriers with the complex impairments women have following TBI, a novel approach to research is required. Pragmatism offers a way to incorporate critical thinking and advocacy into research designs. CONCLUSION The critical feminist transformative framework presented in this paper demonstrates the strengths of using pragmatism as a framework to explore complex phenomena. IMPLICATIONS FOR PRACTICE This paper illustrates how methodology, which is influenced by various philosophical perspectives, can be woven throughout the design of a research project.
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Affiliation(s)
- Kate O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Penrith NSW, Australia
| | - Kath Peters
- Western Sydney University, Campbelltown NSW, Australia
| | - Nathan Wilson
- Western Sydney University, Hawkesbury NSW, Australia
| | - Cannas Kwok
- Western Sydney University, Parramatta NSW, Australia
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Lucero J, Wallerstein N, Duran B, Alegria M, Greene-Moton E, Israel B, Kastelic S, Magarati M, Oetzel J, Pearson C, Schulz A, Villegas M, White Hat ER. Development of a Mixed Methods Investigation of Process and Outcomes of Community-Based Participatory Research. J Mix Methods Res 2018; 12:55-74. [PMID: 29230152 PMCID: PMC5722275 DOI: 10.1177/1558689816633309] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This article describes a mixed methods study of community-based participatory research (CBPR) partnership practices and the links between these practices and changes in health status and disparities outcomes. Directed by a CBPR conceptual model and grounded in indigenous-transformative theory, our nation-wide, cross-site study showcases the value of a mixed methods approach for better understanding the complexity of CBPR partnerships across diverse community and research contexts. The article then provides examples of how an iterative, integrated approach to our mixed methods analysis yielded enriched understandings of two key constructs of the model: trust and governance. Implications and lessons learned while using mixed methods to study CBPR are provided.
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Affiliation(s)
| | | | | | | | | | | | - Sarah Kastelic
- National Indian Child Welfare Association, Portland, OR, USA
| | | | - John Oetzel
- University of Waikato, Hamilton, New Zealand
| | | | - Amy Schulz
- University of Michigan, Ann Arbor, MI, USA
| | - Malia Villegas
- National Congress of American Indians Policy Research Center, Washington, DC, USA
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Abstract
Analyst and patient occasionally arrive at moments of heightened meaning and aliveness. These moments can be transformative and lead to psychic change in the patient. They give life and arouse hope, and feel "real" in a new way, though often entailing emotional turbulence. Specific internal work must be done by the analyst to allow for and foster these experiences. This involves a kind of mourning process in the analyst that allows for "presence" and "availability" as described by Gabriel Marcel, and for the "at-one-ment" described by Bion. These transforming moments can be viewed in an aesthetic realm, along the lines of Keats's "Beauty is truth, truth beauty." This embodies the analytic value of emotional truth. These moments are shared and their emergence is an intersubjective creation. Clinical illustrations show how the internal work of mourning by the analyst through directed introspection allows for presence and availability, and then for shared moments of beauty with the patient.
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Abstract
Despite China's regulatory initiatives to promote its research accountability, it still needs to prove itself as a trusted player in life science research. In addition, in contrast to its huge investment, China is losing the race in delivering quality application of stem cells. The trial implementation of the 2015 ministerial regulations seemed to offer hope in ending this dual 'lost-in-translation'. Yet skepticism remains. By examining China's regulatory trajectory in the last 15 years, this paper illustrates that it is a post hoc pragmatic policy rationale and a soft centralization regulatory approach that have hampered China's governance. To improve China's governance of accountability, policy-makers need to get beyond an 'act-in-response' regulatory ethos and to engage with diverse stakeholders.
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Affiliation(s)
- Joy Y Zhang
- School of Social Policy, Sociology & Social Research, Cornwallis North East, University of Kent, Canterbury, Kent CT2 7NF, UK
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50
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Lefere S, De Rouck R, De Vreese L. What to expect from reliability and validity claims? A pragmatic conception of psychiatric nosology. J Eval Clin Pract 2017; 23:981-987. [PMID: 28032415 DOI: 10.1111/jep.12686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/21/2016] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
Abstract
The reliability and validity of psychiatric diagnoses have always been a major concern. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) reliability field trials yielded ambiguous results, with some diagnostic categories scoring well below par. We argue that the emphasis on the reliability of psychiatric diagnoses, which has dominated psychiatric nosology and guided the endeavor of improving the DSM in its consecutive editions, is misguided and lacks in structural validity. In this article, we defend a pragmatic view on psychiatric disease as the most fruitful approach to an understanding of what the categorical distinctions in the DSM (can) represent. Disorders in the DSM are descriptions of clinical pictures and do not necessarily correspond to an identified pathological substrate. Although this is a logical result of the nature of psychiatric disease, it bears important consequences. The various DSM disease categories are not uniform but should be regarded as representing different kinds of disorders, ranging from a separation from normal behavior based on practical grounds to the discrete kind of disorders envisioned by proponents of a strong realistic view. We argue that the explication of kinds of disorders outlined in this article provides interesting perspectives on the problems of reliability and validity that the DSM faces.
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Affiliation(s)
| | | | - Leen De Vreese
- Centre for Logic and Philosophy of Science, Ghent University, Ghent, Belgium
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