The spirits of capitalism and christianity and their impact on the formation of healthcare leaders

In this article, I portray how the ethos of Christianity, broadly speaking, and the mores of capitalism intersect in the formation of healthcare leaders and the difficult decisions they make in insuring the viability of healthcare institutions. More particularly, I argue that healthcare leaders in Christian healthcare institutions are largely formed by and dependent on a capitalistic ethos in making decisions and less so by a Christian ethos. There are key differences in these two meaning systems, and these differences, in part, reveal an incompatibility between them. This incompatibility does not imply a rejection of capitalism, if that is even possible, but rather a recognition of its effects and limits vis-à-vis the formation of healthcare leaders and their decision-making process. Finally, I offer an approach that deals with the spirits of capitalism and Christianity in forming healthcare leaders and their decision-making.

Depression and suicidality in modern life

This paper describes the relationship between depression and the difficulties experienced in the postmodern world for human beings who must reconcile their consciousness of their own death and the feelings of powerlessness in the face of inevitable consequences. Depression and suicide are closely linked, and the consequences in terms of philosophy and psychology are described.

[Incorporation and adaptation of the postmodern belief system]

Every society develops a particular system of beliefs that summarizes its vision of socio-political organization, culture and interpersonal relationships. Each of these three basic dimensions has different forms, depending on the spatial and temporal context of societies. The belief system of the service societies is characterized by a democratic vision of social and political organization, rejection of radical social changes and high levels of interpersonal trust. This paper empirically examines the incorporation and adaptation of the postmodern belief system in a sample of university students. The participants belong to a country that is slowly integrating into the service societies. We used a scale of postmodernity to analyze the incorporation of the postmodern belief system. The results indicate that there is a peculiar combination of the three basic dimensions of the postmodern belief system, where the postmodern conceptions of culture and social relationships have lower acceptance.

Disability advocacy and reproductive choice: engaging with the expressivist objection

This professional issues paper outlines the experience and value of engagement with disability advocates, philosophy scholars and bioethicists for spirited debate of issues such as modern eugenics, the expressivist objection and reproductive choice. This process for one group of individuals, undoubtedly prompted deeper examination and questioning of some long held personal and professional views, for all participants. For this author, engagement in the "Disability Rights-Genetic Counseling Interest Group" over a full year resulted in several positive changes in genetic counselling practice as well as the development of meaningful, robust philosophical defence of the dual roles in genetic counseling; advocacy for those with disabilities, and facilitation of a full range of reproductive choices.

Ethical reflections: examining reflexivity through the narrative paradigm

Being reflexive and providing these reflections for public scrutiny is often considered a key element of ethical, rigorous qualitative research. Prevalent conceptualizations of reflexivity, however, need interrogating and sharpening. We aim to contribute to this by examining reflexive practice, and in particular researchers' reflexive accounts, through the lens of the narrative paradigm. Our aim is to demonstrate that acknowledging the role of narrative reconstruction in reflexivity creates more ethical research, and that it is therefore crucial for researchers to more explicitly recognize this. Both authors present an analysis of one particular exchange between interviewer and participant. This analysis highlights that despite our best efforts at "doing reflexivity," both immediately following and when reflecting back on an interview, there are influential factors that escape our gaze. Reflections of the past are particularly imperfect. Without fully recognizing this, we are not utilizing all the tools available for ensuring honest, ethical research.

Re-presenting the future of medicine's past: towards a politics of survival

The ‘death’ of the social history of medicine was predicated on two insights from postmodern thinking: first, that ‘the social’ was an essentialist category strategically fashioned in the course of the nineteenth and twentieth centuries; and second, that the disciplines of medicine and history-writing grew up together, the one (medicine) seeking to objectify the body, the other (history-writing) seeking to objectify the past. Not surprisingly, in the face of these revelations, historians of medicine retreated from the critical and ‘big-picture’ perspectives they entertained in the 1970s and 1980s. Their political flame went out, and doing the same old thing increasingly looked more like an apology for, than a critical inquiry into, medicine and its humanist project. Unable to face the present, let alone the future, they retreated from both, suffering the same paralysis of will as other historians stymied by the intellectual movement of postmodernism. Ironically, this occurred (occurs) at a moment when ‘medicine’ – writ large to include the biosciences and biotechnology – could easily be said to be the most relevant and compelling subject for understanding contemporary life and politics (global, local, and individual) and, as such, the place to justify the practice of history-writing as a whole. God knows, legitimacy has never been more urgent. But how can this be effected? Political action seems more likely than prayer. But let us begin by reviewing the nature of the problem that demands this response.

[Introduction to epistemology in nursing sciences]

The development of nursing research is one of the stages in the process for the professionalization of nurses. An epistemological reflection which took place gradually became necessary. Today, three traditions derived from the positivist, interpretative and critical approaches orientate reflections on nursing sciences, not without some controversy and debate.

Introduction: commentaries and author's response to "The rise and fall of the autochthonous self: from Italian Renaissance Art and Shakespeare to Hediegger, Lacan, and Intersubjectivism" by Richard D. Chessick

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the Renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient (p. 625).

[The mixed design in nursing sciences or when a question of research calls for qualitative and quantitative strategies]

The use of a mixed method research design raises many questions, especially regarding the paradigmatic position. With this paradigm, we may consider the mixed method design as the best way of answering a research question and the latter orients to one of the different subtypes of mixed method design. To illustrate the use of this kind of design, we propose a study such as conducted in nursing sciences. In this article, the challenges raised by the mixed method design, and the place of this type of research in nursing sciences is discussed.

A constructivist model for teaching evidence-based practice

The Institute of Medicine has reported that it takes roughly 17 years for evidence generated through research to move into clinical practice. Bridging that gap is an urgent need and will require educators to rethink how nurses are prepared for evidence-based practice. The constructivist theory for learning--in which it is assumed that students construct knowledge and meaning for themselves as they learn--may provide a framework for a redesigned baccalaureate curriculum, one that supports evidence-based practice throughout a nursing student's education.

Valuing the gap: a dialectic between theory and practice in graduate nursing education from a constructive educational approach

Within nursing education, graduate pedagogies are relatively unexplored, with research commonly focused upon undergraduate and continuing education. In order to address the increasingly complex organisational challenges in the workplace, mid-career nurses and midwives are turning to graduate education. In one graduate course on cultures of learning in the workplace, a constructivist approach to learning was adopted. Post-course analysis of data, from the feedback on the course from students, student choice of assignment topics, and reflections of the course facilitators, revealed three pedagogies unique to graduate education. The pedagogies were labelled 'keeping the space open', 'theoretical concepts as tools', and 'resonance and action as praxis'. The intended outcome of the course is revealed in a fourth theme, 'developing practice in the workplace'. This evaluation suggests that constructivist pedagogies used with graduate students may be different to those pedagogies used with undergraduate and continuing education students. We argue that graduate pedagogies move nursing education beyond strategies that seek integration of theory and practice, towards a dialectic between theory and practice.

Current trends in feminist nursing research

Despite an increasing number of feminist studies in nursing, few reviews on current trends in feminist nursing research have been published. This article aims to explore the current trends in feminist nursing research and provide recommendations for future feminist studies in nursing. In multiple database searches, 207 articles were retrieved. These were reviewed based on 5 criteria: (1) epistemological background, (2) research questions, (3) research participants, (4) research methods, and (5) implications for changes. The review indicated that feminist nurse researchers with diverse epistemological backgrounds adopted new research methods to ask new questions; expanded their focus to include differences in ethnicity, class, sexual preference, and disability; and incorporated these diversities among women in a global context in their research. Based on these findings, recommendations for future feminist research in nursing are outlined.

Dance and sexuality: many moves

This literature review of dance and sexual expression considers dance and religion, dance and sexuality as a source of power, manifestations of sexuality in Western theater art and social dance, plus ritual and non-Western social dance. Expressions of gender, sexual orientation, asexuality, ambiguity, and adult entertainment exotic dance are presented. Prominent concerns in the literature are the awareness, closeting, and denial of sexuality in dance; conflation of sexual expression and promiscuity of gender and sexuality, of nudity and sexuality, and of dancer intention and observer interpretation; and inspiration for infusing sexuality into dance. Numerous disciplines (American studies, anthropology, art history, comparative literature, criminology, cultural studies, communication, dance, drama, English, history, history of consciousness, journalism, law, performance studies, philosophy, planning, retail geography, psychology, social work, sociology, and theater arts) have explored dance and sexual expression, drawing upon the following concepts, which are not mutually exclusive: critical cultural theory, feminism, colonialism, Orientalism, postmodernism, poststructuralism, queer theory, and semiotics. Methods of inquiry include movement analysis, historical investigation, anthropological fieldwork, autoethnography, focus groups, surveys, and self-reflection or autobiographical narrative. Directions for future exploration are addressed.

Philosophical aspects of dual use technologies

The term dual use technologies refers to research and technology with the potential both to yield valuable scientific knowledge and to be used for nefarious purposes with serious consequences for public health or the environment. There are two main approaches to assessing dual use technologies: pragmatic and metaphysical. A pragmatic approach relies on ethical principles and norms to generate specific guidance and policy for dual use technologies. A metaphysical approach exhorts us to the deeper study of human nature, our intentions, goals, values ideals and social relations when considering dual use technology. Use of science and technology (S and T) is determined by two components of human nature: human intentions and choices. We have drawn a distinction between specific measures, goals and intentions with respect to technologies in order to show that moral judgment about technologies must precede their use. Understanding of our intentionality and values, and our moral ideals, as a measurable, tangible part of the real world is important for the prevention of any possible harm from S and T. In the context of dual use technologies, we stress the importance of three main understandings of human nature: vulnerability, responsibility and narrative identity. These can become a strong ontological "antidote" to technology's poisoning of modern man. Each new technology can be measured and compared with man's values, traditions and societal norms. This can be done bearing in mind the concept that human nature is not dualistic, but pluralistic. A system of ethical principles that includes the principles of good intentions, the correspondence of goals and means, the balancing of risks and benefits, simplicity, and contextuality, will help ensure that technologies are more humanistic and friendly to human beings.

Beyond division: convergences between postmodern qualitative research and family therapy

Starting from examples of postmodern research and therapeutic practice, we raise the question on the role of the research-therapy dichotomy within these approaches. The article aims to show the profound convergence between postmodern ethnographic research and constructionist, collaborative therapeutic approaches on a double, epistemological and practice level. First, we point out their converging development toward narrative and constructionist epistemologies. Second, an inquiry into the core features of these disciplinary activities' goal, process, and expert role reveals their profound convergence into a dialogical practice in which the boundaries between research and therapy are radically transgressed. We conclude by questioning the implications and acceptability of this convergence for researchers' and therapists' understanding of their practices.

The rise and fall of the autochthonous self: from Italian Renaissance art and Shakespeare to Heidegger, Lacan, and intersubjectivism

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient.

The use of innovative pedagogies in nursing education: an international perspective

The purpose of this global study was to explore the types of innovative pedagogies used in nursing education worldwide; transformative learning theory served as the theoretical basis for the study. A descriptive, mixed-method design with a researcher-developed instrument was used to conduct the electronic survey. Respondents were 946 nurse educator members of Sigma Theta Tau International; more than 93 percent were Caucasian women. Respondents indicated that the conventional teacher-centered approach remains the most prevalent pedagogical style (56 percent); fewer than 20 percent of respondents used feminist or postmodern approaches. Ninety percent of respondents reported using instruments to evaluate the effectiveness of their teaching. The majority viewed their faculty role as facilitator (88 percent) or information provider (65 percent). Greater efforts are needed to create an evidence base for nursing education through research that focuses on the effectiveness of innovative pedagogical strategies. This study, by describing the current patterns of teaching/learning strategies and approaches used by nurse educators, provides a beginning research base for improving nursing education.