Storylines of family medicine V: ways of thinking-honing the therapeutic self

Storylines of Family Medicine is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.

Living a Threatening Circumstance from a Nursing Perspective

This introduction reminds nurses to use a nursing perspective in their work with other clinicians and researchers. In this introduction, the humanbecoming perspective is used to help nurses see a group of persons with specific challenges or threatening circumstances as a case study of an important phenomenon, so as to remain as humane as possible in their practice, teaching, and research.

Leading-Following Interpretations: Living Quality and Working, the Musical

It is important to explore the ways that the working lives of persons provides meaning in personal, professional, and organizational ways. In this paper, the author utilized the processes of Parse's (2021a) humanbecoming hermeneutic sciencing (discoursing with penetrating engaging, interpreting with quiescent beholding, and understanding with inspiring envisaging) and the leading-following model to further understanding of the meaning of "working" through Stephen Schwarz's Broadway show, Working, the Musical (Browning & Schwartz, 1982/2002). Although not a formal sciencing project, this interpretive reflection provided a way to "see" how work is "lived out" uniquely.

The Humanbecoming Concept Inventing Model: Feeling Sad

In this paper, the scholar explored the universal humanuniverse living experience of feeling sad with the humanbecoming concept inventing model. The now-truth of feeling sad is penetrating discomfort arising with contemplating joy-sorrow of affiliations amid envisioning new possibilities. The theoretical statement as the ingenuous proclamation of feeling sad is imaging the connecting-separating of transforming with the scholar's chosen artform, Melancholy by Albert Gyorgy. The scholar aimed to advance nursing knowledge of the universal humanuniverse living experience of feeling sad.

Paradoxes in Humanbecoming Hermeneutic Sciencing

The author explores humanbecoming hermeneutic sciencing and provides exemplars of paradoxes that are used by scholars in this mode of inquiry.

Standardized training nurses's humanistic care practice ability: A cross-sectional survey in western China during COVID-19

AIM

This study aims to investigate the current status and determinants of humanistic care practice abilities among standardized training nurses in China during the post-COVID-19 era, as well as to propose management strategies.

DESIGN

A cross-sectional study.

METHODS

Deliberately chosen were 517 standardized training nursing students from a provincial-level training facility in western China.

RESULTS

The respondents had a mean ± SD age of 21.23 ± 1.34 years, and 92.0% of them voluntarily opted for the nursing profession. Almost all (99.8%) respondents had at least a college degree. The standardized training nurses scored an average of (130.31 ± 14.18) on humanistic care ability, which was significantly related to some sociodemographic variables. The average scores for the five dimensions of nursing communication ability, psychological adjustment ability, moral and legal application ability, nursing aesthetic ability, and care practice ability were 30.78, 17.61, 32.23, 18 and 31.67, respectively. All these dimensions showed positive correlations with the overall score of humanistic care practice ability.

Notes on [post]human nursing: What It MIGHT Be, What it is Not

With this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman-sometimes even critically so-and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation.

A Humanbecoming Perspective on Art and Sciencing

The author in this paper explores the connections between art and sciencing in the humanbecoming paradigm. Relevant examples of artforms used by Parse scholars are illustrated. A brief discussion on art sciencing is illuminated. Finally, an example of feeling overwhelmed through the lens of the performing arts is shared.

The heart of anaesthesiology: revitalising humanism in the age of technology

Technological innovation has greatly aided modern medicine, and anaesthesiology in particular, but also contributes to dehumanising influences that promote physician burnout and dissatisfaction among patients. Here we advocate for a profound reaffirmation of humanistic principles-empathy, compassion, and communication-in perioperative medicine. We propose adaptable strategies to bolster humanism in practice, such as curricular offerings, simulation training, role modelling, and recognition. As perioperative technologies continue to evolve, the threat of depersonalisation in anaesthetic care looms, making commitments to humanism a crucial precondition for healing in the communities in which we work and live.

Living the Art of Nursing

The article that follows reflects on the importance, the precision, and the guidance provided through theoretical foundations, science, and art of nursing as directed by these paradigmatic theoretical frameworks and their corresponding practice methodologies. The mainstay element common across all frameworks is the precise essentials contained within the nursing theoretical frameworks that, in turn, guide the contributions of the nursing discipline. The humanbecoming paradigm serves as the primary highlighted focus of the article.

Toward an ontology of the mutant in the health sciences: Re/defining the person from Cronenberg's perspective

Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the 'person' or 'patient' that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken-for-granted definitions and assumptions of the 'person' from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the 'person' in nursing and beyond. Cronenberg's work explores bodily transformation and mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of 'the person'. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming-mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles.

Policy Crafting: Humanbecoming and the Rainbow PRISM Model

It is important that nurses guide practice with crafted policies based in nursing knowledge that is distinctive and specific to the values and beliefs of all persons, such as humanbecoming. As policy crafters in nursing, a nursing theory or model must serve as the foundation in service to others. In this article, the author explores crafting policy with the Rainbow PRISM model (Cody, 2003; Ortiz, 2018), in light of Parse's (2021a) humanbecoming paradigm, the humanbecoming community change concepts (Parse, 2003, 2021a), and Parse's (1987, 2021a) principles of inquiry construction.

Thinking through critical posthumanism: Nursing as political and affirmative becoming

As a rejection and continuous reframing of theoretical humanism, critical posthumanism questions and imagines the human condition in the current context, aligning it with nonhuman and more than human entities, past and future. While this philosophical approach has been referenced in many academic disciplines since the 1990s, it has been gradually garnering interest among nursing scholars, leading to questions such as what it means to be human and what it means to be a nurse in the here and now. As a deeply ethical and political project, posthumanism, which we associate with poststructuralist concepts of power and resistance, questions the formation of posthuman subjects who more accurately reflect complex times, characterized by capitalistic commodification of life-human and nonhuman. In this article, we aim to explore how the ontological and epistemological underpinnings of critical posthumanism, specifically through Rosi Braidotti's works, can be useful to understand a posthuman subjectivity that favors affirmative actions aimed at actualizing our world in becoming. Through examples in nursing practice, education, and research, we will explore not only how critical posthumanism allows us to frame transformations in the current situation that we are embedded in as nurses and more generally as beings but also how these examples allow us to move beyond critique to the actualization of affirmative actions that correspond to the creation of new worlds.

A Parsesciencing Inquiry on Feeling Ashamed

Feeling ashamed is a universal humanuniverse living experience. According to humanbecoming, all persons choose to feel ashamed or not from moment to moment. Therefore, it is significant to discover the newknowings of the phenomenon of feeling ashamed. The investigation method was Parsesciencing, a unique mode of inquiry within the humanbecoming paradigm. The investigation included 10 historians between the ages of 18 and 65 years, who were willing to share their experiences of feeling ashamed. The inquiry stance was: What is the discerning extant moment of the universal humanuniverse living experience of feeling ashamed? The major discovery of this Parsesciencing inquiry was the discerning extant moment: Feeling ashamed is profound agonizing regretfulness with persistent unwelcome recollections arising with desired concealment with distancing affiliations.

Humanuniverse Emerging

The author presents poetry that expands understanding of the humanuniverse experience at a lake.

Conceptual Foreknowings: Integrative Review on Having Courage

Having courage is a humanuniverse living experience that is common to all humans. Individuals experience courage in one way or another at different times. Hence, it is imperative to understand having courage from various standpoints. To explore the different perspectives on the phenomenon of courage, the scholar dwelled with printed material across the disciplines of theology, psychology, philosophy, sociology, social work, education, business, and nursing. Two themes were crafted from the literature as (a) courage is steadfastness in the midst of fear and (b) unfaltering commitment to the cherished.

What Families of Children With Medical Complexity Say They Need: Humanism in Care Delivery Change

There is growing consensus that centering lived experience is needed to meaningfully transform the burdensome systems of care for children with medical complexity (CMC) and their families. The Collaborative Improvement and Innovation Network to Advance Care for Children with Medical Complexity quality improvement initiative, co-led with family colleagues, illuminates a critical real-world view of systems change to address unintended bias and demystify the medical model of care. We share candid themes in which families describe the need for systems to counteract widespread misconceptions and bias to achieve meaningful system change. We held family-designed, family-led focus groups (N = 127 across 27 groups) within 10 diverse state teams. Families were asked about CMC quality of life and family wellbeing. We transcribed and coded the responses to uncover salient themes. We uncovered 2 major themes from families with direct applicability to systems of care: "What's Missing - Human Dignity" and "What Families Really Need and Recommend in Care." Families shared that valuing each child and creating opportunities for the child and family to enjoy their lives were most important in addressing human dignity in systems of care. They recommended centering the whole child, building relationships of trust and communication, and valuing family-to-family supports to transform the system of care aligned to humanism in care. Families express an urgency for systems to uphold dignity, valuing their child as a whole human being whose quality of life holds meaning and joy, not just as a diagnosis. The highly untenable cost of navigating dehumanizing systems of care reduces quality of life and wellbeing and must be transformed.

Critical ethnography and its others: Entanglement of matter/meaning/madness

Beginning with a critical examination of the humanist assumptions of critical ethnography, this article interrogates and surfaces problems with the ontological and epistemological orientations of this research methodology. In drawing on exemplar empirical data from an arts-based project, the article demonstrates the limitations in the humanist-based qualitative research approach and advances a postdualist, postrepresentationalist direction for critical ethnography called entangled ethnography. Using data from a larger study that examined the perspectives of racialized mad artists, what is demonstrated in this inquiry is that the entanglement of bodies, objects, and meaning-making practices is central to working with the ontologically excluded, such as those who find themselves in various states of disembodiment and/or corporeal and psychic distribution. We propose the redevelopment of critical ethnography, extended by entanglement theory (a critical posthuman theory), and suggest that for it to be an inclusive methodology, critical ethnography must be conceptualized as in the process of becoming and always in regeneration, open to critique, extension, and redevelopment.

The Art of Teaching-Learning the Humanbecoming Paradigm

In this column, the author argues that art, literary, visual, and performing should be requisite concepts in nurse curricula, and describes her personal journey teaching-learning the humanbecoming paradigm.

Presence of good humanization practices in the healthcare of patients with rare diseases in Pharmacy Services

OBJECTIVE

To analyze the presence of Good Humanization Practices in the care of patients with rare diseases in Hospital Pharmacy Services and to identify the strengths and prevalent areas for improvement in the humanization of healthcare.

METHODS

Online questionnaire structured in two parts was developed using Google Form®. The first one was designed to collect identifying data and the second one included questions related to compliance with the 61 standards of the Manual of Good Humanization Practices in the healthcare of patients with rare diseases in Hospital Pharmacy Services. Access to the questionnaire was sent by email to the Heads of the Hospital Pharmacy Service of 18 hospitals. The study period was from October 2021 to October 2022. The analyzed variables were the number of criteria that were considered met, total compliance (percentage of criteria met), by strategic line and by type or level of standard, globally and grouped by regions of Spain.

RESULTS

18 Hospital Pharmacy Services were included. The overall mean of standards met was 31.1 (95% CI: 24.8-37.6) and mean total compliance was 52.1% (95% CI: 44.4-59.7). The mean compliance by strategic line was line 1 Humanization culture: 46.5% (95% CI: 35.3-57.7), line 2 Patient empowerment: 47.4% (95% CI: 37.1- 57.8), line 3 Professional care: 49.7% (95% CI: 39.8-59.1), line 4 Physical spaces and comfort: 55.6% (95% CI: 46.3-64.8) and line 5 Organization of healthcare: 63.8% (95% CI: 55.8-71.9).

CONCLUSION

The average compliance with the standards is between 40 and 60%, which indicates that humanization is present in the Hospital Pharmacy Services, but there is a wide margin for improvement. The main strength in the humanization of Hospital Pharmacy Services is a patient-centered care organization, and the area with the greatest room for improvement is the culture of humanization.

Exploration and practice of humanistic education for medical students based on volunteerism

Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.

The Sun Also Rises: Tracing the evolution of humanistic values in anatomy pedagogy and research, including cadaveric acquisition practices

Anatomy has always been at the intersection of the socio-cultural and political landscape, where new ideas constantly replace older wisdom. From ancient Egyptians through the Greeks, and then the Romans, finally culminating into the European Renaissance-all the significant eras of human civilisation have left their insignia and distinct marks on the evolution of anatomical practices. Despite its utility as a tool for anatomy pedagogy and research that has proven its worth over millennia, cadaveric dissection has particularly been subject to political and social vicissitudes. A major debate about anatomical dissection lay with the ethical considerations, or its lack thereof, while acquiring corpses for demonstration in the dissection halls. From antiquity, anatomical dissection-often synonymous with medical studies-had typically been carried out on the dead bodies of executed criminals with certain laws, such as the Murder Act of 1752, facilitating such uses. Gradually, the uses of unclaimed bodies, resourced primarily from the impoverished sections of society, were also introduced. However, these body acquisition protocols often missed the crucial element of humanism and ethical considerations, while knowledge augmentation was taken as sufficient reasoning. Unfortunately, a gross disregard towards humanistic values promulgated heinous and illegal practices in acquiring corpses, including grave robbery and even murders like in the case of Burke and Hare murders of 1828. Follow-up legislation, such as the Anatomy Act of 1832, and comparable laws in other European nations were passed to curb the vile. What distils from such a historical discourse on humane values in anatomy dissection, or medical science in general, is that the growth and integration of humanism in anatomy have never been linear, but there were intermittent and, yet, significant disruptions in its timeline. For example, there were serious human rights violations in anatomical practices during the Third Reich in Germany that perpetrated the holocaust. The medical community has kept evolving and introducing new moral values and principles while using such egregious events as lessons, ultimately resulting in the Declaration of Helsinki in 1964. This article revisits the heterogeneous journey of integrating humanistic values in anatomy practice. Such humanistic traits that, like medical science, have also developed over centuries through the inputs of physicians, researchers, and philosophers-from Greece to modernity with an important stopgap at the Renaissance-are a fascinating lore that deserves to be re-envisioned through the lens of contemporary values and ethos. In parallel to human medicine, humanistic values continue to influence veterinary medicine, a welcome development, as our society condemns animal cruelty in any form. There are lessons to be learned from this historical journey of how humanism shaped many of the concepts that anatomists use now. Finally, and most importantly, it might prevent the medical community from repeating the same mistakes by cautioning against the traps that are there, and in a convoluted world where morality as such is eroding from our social fabric, will always be there. Such historical account acts as a righteous, ethical, and contextual compass to guide the existing and upcoming anatomists in discerning between light and dark, right and wrong, and roads-to be or not to be-taken.

Dementia as a material for co-creative art making: Towards feminist posthumanist caring

This article generates new understandings of dementia through feminist posthumanist and performative engagements with co-creative artmaking practices during a six-month study in a residential care home in Norway. Dementia emerges within multisensorial entanglements of more-than-human materials in three different artmaking sessions, which first materialized in the form of collective photographs and vignettes and culminated in a final exhibition, Gleaming Moments, in the care home. Drawing on these photographs, vignettes, and the author's engagement as a research artist in the sessions, this analysis examined how dementia was enacted as a spark of inspiration, felted warm seat pads, and a friendly more-than-human touch, that is, a touch of human and nonhuman art materials. These findings suggest new ontologies of dementia within multisensorial artmaking practices, in which dementia functions as a material for co-creative artmaking rather than a disease. These findings disrupt dominant biomedical ontologies of Alzheimer's disease and other dementias, as well as humanist person-centered practices in dementia care, which have concretized an individual, rather than relational, focus on dementia. In contrast, this study explores dementia as a phenomenon within the entanglements of human and nonhuman intra-active agencies. By highlighting the significance of these agencies (i.e., sponge holder-painting, wool-felting, choir-singing, chick-making) for different worlds-making with dementia, this study provides an entry point for imagining feminist posthumanist caring. Thus, dementia becomes a matter in life that is not to be managed and defeated to achieve successful aging, but to be interrogated and embraced.

A Parsesciencing Inquiry on Feeling Trusted

The purpose of this study was to investigate the universal humanuniverse living experience of feeling trusted using Parsesciencing, which is a unique mode of inquiry within the humanbecoming paradigm. The inquiry stance was: What is the discerning extant moment of the universal humanuniverse living experience of feeling trusted? Historians were 10 individuals who were age 18 and older living in the community. The discerning extant moment of feeling trusted, the major discovery of this Parsesciencing inquiry, was: Feeling trusted is serene uplifting recognition with dedicated affiliations arising with assuredness-unassuredness in venturing onward.

The New Mythology of the Body and the Transformation of the Therapeutic Space

BACKGROUND

The history of medicine has flowed in the wake of knowledge and social perceptions about the body and corporeality. There is no idea of health without reference to the notion of body (although "health" can have other meanings, figuratively). Considering the same history, the body was the subject of numerous segregations and categorizations due to which it was and is a "social object" and a "political object." In turn, the spatial and cultural framework was the environment and determinant of the medicine development which is not only a science but also an inter-human interactive practice.

AREAS OF UNCERTAINTY

In this article, we will analyze the current social (re)construction of the notions of body and space by referring to the technological and structural changes that are manifested in medicine and society and their ethical implications.

DATA SOURCES

A review of the specialized literature was performed in June-July 2023, using keywords like human enhancement, therapeutic enhancement, transhumanist medicine, ethics from PubMed, Scopus, Web of Science, and Google Scholar, and official documents issued at the international level (World Health Organization, European Commission).

ETHICS AND THERAPEUTIC ADVANCES

This literature review suggests that few practical solutions to human enhancement, both curative and preventive, whether cognitive or physical, have been approached entirely from an ethical point of view. The historical evolution of the concept of human enhancement has led to debates between "transhumanists" and "bioconservatives" depending on how they relate to the improvement of the human condition without or with reticence interventions to improve human capabilities being related to various interventions, from pharmacological, surgical ones to those in the field of genetics, nanomedicine, or cybernetics. In addition to the technical aspects, which are often the major concern of researchers and those applying new technologies, there are also ethical and legislative aspects, to better understand the impact that the dynamics and diffusion of these processes have on the evolution of the human species.

CONCLUSIONS

In interference with these technologies, the body is exposed to possibilities of change and evolution with colossal (expected) social impact that can change norms and values that have been stable for centuries. Social space and place are also proving to be "processes in the making'" for which we need to detect what developments are possible or have already imposed themselves as a trend in the social and medical world.

The Uniqueness of the Humanbecoming Paradigm

This article explores several unique constructs of the humanbecoming paradigm including truth for the moment. A dialogue with nurse theorist Rosemarie Rizzo Parse completes this exploration.

The Relational Virtual Nursing Practice Model: A Web-Based Nursing Intervention

This discussion paper aimed to reflect on the development of relational connections in the context of a web-based, tailored, asynchronous nursing intervention (VIH-TAVIETM) aimed at empowering people living with HIV in taking their antiretroviral treatment. Our reflection culminates in the Relational Virtual Nursing Practice Model. This paper builds on nurse-researchers and people living with HIV's experiences, nursing theories, and cross-disciplinary work on relational engagement. The model shows the disciplinary principles underpinning VIH-TAVIETM, engagement processes used to create humanistic and supportive relational environment and people's relational experiences and it contributes to the development of conceptual nursing knowledge on how generating meaningful relational nursing care in virtual environments.

Medical Humanism in the Posthuman Era: A Critical Examination of its Past, Present, and Future

This paper explores the historical and contemporary significance of medical humanism and its potential value in medical education. Medical humanities emerged as a response to the issues arising from science-driven modern medicine, most notably the marginalization of the individual in medical practice. Medical humanism has evolved to become a guiding ideology in shaping the theory and practice of medical humanities. However, the COVID-19 pandemic has brought about significant changes in medical humanities, challenging the foundations of humanism beyond medical humanism. The rise of posthumanism raises fundamental questions about humanism itself. The climate crisis, driven by human greed and capitalism's exploitation of nature, has led to the emergence of viruses that transcend species boundaries. The overflow of severely ill patients has highlighted the classic medical ethics problem of "who should be saved first" in Korea, and medical humanism is facing a crisis. Various marginalized groups have also pointed out the biases inherent in medical humanism. With this rapidly changing environment in mind, this paper examines the past and present of medical humanism in order to identify the underlying ideology of medical humanism and its future potential in medical education. This paper assumes that there are two axes of humanism: human-centeredness and anthropocentrism. Medical humanism has historically developed along the axis of human-centeredness rather than anthropocentrism, emphasizing the academic inquiry into human nature and conditions, as well as the moral element of humanity. Furthermore, this paper discusses the challenges that medical humanism faces from post-human centeredness and post-anthropocentrism, as well as the recent discourse on posthumanism. Finally, the implications of this shift in medical humanism for the education of the history of medicine are briefly explored.

Leading-Following and Living Quality: A Reflection

There are many moments within all collaborative leading-following relationships that form each constituent over time. In collaborative leading-following, it is important that there is a nursing theoretical framework that guides the professional relationship with a knowledge base that is distinctive and shared by all involved. In this paper, the author reflects on the humanbecoming core knowings of living quality in light of the essences of leading-following (Parse, 2021a, 2021b).

Race, class, caste, disability, sterilisation and hysterectomy

This interdisciplinary historical paper focuses on the past and current state of diverse forms of surgical hysterectomy as a global phenomenon relating to population control and sterilisation. It is a paper grounded in historical inquiry but is unconventional relative to the norms of historical scholarship both in its wide geographical scope informed by the methodologies of global and intercultural history, in its critique of current clinical practices informed by recent feminist, race, biopolitical and disability studies, and by its engagement with scholarship in health sociology and medical anthropology which has focused on questions of gender and healthcare inequalities. The first part of the paper surveys existing medical, social-scientific and humanistic research on the racial, class, disability and caste inequalities which have emerged in the recent global proliferation of hysterectomy; the second part of the paper is about the diverse global rationales underlying radical gynaecological surgeries as a form of sterilisation throughout the long twentieth century. Radical gynaecological surgeries have been promoted for several different purposes throughout their history and, of course, are sometimes therapeutically necessary. However, they have often disproportionately impacted the most disadvantaged groups in several different global societies and have frequently been concentrated in populations that are already maligned on the basis of race, ethnicity, age, criminality, disability, gender deviation, lower class, caste or poverty. This heritage continues to inform current practices and contributes to ongoing global inequalities of healthcare.

Look Up

This article highlights the findings of the 1998 humanbecoming inquiry considering tomorrow. The participants in this inquiry were women homeless in Chicago. Children's books, recent TV and newspaper articles focusing on the homeless in Pensacola, Florida, and various other humanbecoming inquiries involving homeless populations emphasize the importance of looking up and paying attention to what is occurring in humanuniverse so as to seize opportunities that present themselves with the emerging now.

Hydraulic Engineers and Antiquarians: Political Use of the Past in Nineteenth-Century Venice

The article analyzes the relationship between hydraulics and history in the nineteenth century, often described as a period when the humanities and the sciences split into "two separate cultures." Venice, amphibious city par excellence, is a good starting point for exploring the use of history in water management debates. In the early nineteenth century, humanists and hydraulic engineers came together through multiple disciplinary approaches and in constant confrontation with the Republic of Venice's water policies. In the following decades, while making extensive use of history, these engineers realized and emphasized the diversity of both disciplines' methodologies. This evolution-seen through the writings of renowned hydraulic engineer at the time Pietro Paleocapa-illustrates how history was no longer a source of empirical knowledge but came to be used for rhetorical and political purposes.