The spirit of palliative practice:A qualitative inquiry into the spiritual journey of palliative care physicians

Objective: Much is known about the important role of spirituality in the delivery of multidimensional care for patients at the end of life. Establishing a strong physician-patient relationship in a palliative context requires physicians to have the self-awareness essential to establishing shared meaning and relationships with their patients. However, little is known about this phenomenon and therefore, this study seeks a greater understanding of physician spirituality and how caring for the terminally ill influences this inner aspect. Method: A qualitative descriptive study was used involving face-to-face interviews with six practicing palliative care physicians. Results: Conceptualized as a separate entity from religion, spirituality was described by participants as a notion relating to meaning, personal discovery, self-reflection, support, connectedness, and guidance. Spirituality and the delivery of care for the terminally ill appeared to be interrelated in a dynamic relationship where a physician's spiritual growth occurred as a result of patient interaction and that spiritual growth, in turn, was essential for providing compassionate care for the palliative patient. Spirituality also served as an influential force for physicians to engage in self-care practices. Significance of results: With spirituality as a pervasive force not only in the lives of palliative care patients, but also in those of healthcare providers, it may prove to be beneficial to use this information to guide future practice in training and education for palliative physicians in both the spiritual care of patients and in practitioner self care. Copyright © Cambridge University Press 2010.

Cities and The Spirit Level: Reasserting the Public Interest in Planning Governance

Urban planning in Europe has its roots in social reform movements for reform of the 18th and 19th centuries and in the UK evolved into the state-backed comprehensive planning system established as a pillar of the welfare state in 1947. This new planning system played a key role in meeting key social needs of the early post-war period, through, for example, an ambitious new town programme. However, from the late 1970s onwards the main priorities of the planning system have shifted as the UK state has withdrawn support for welfare and reasserted market values. One consequence of this has been an increased inequality in access to many of the resources that planning seeks to regulate, including affordable housing, local services and environmental quality.
Drawing on evidence from recent literature on equality, including Wilkinson and Pickett’s The Spirit Level this paper will question the role of planning in an era of post-politics and a neo-liberal state. It will review some of the consequences for the governance and practice of planning and question what this means for the core values of the planning profession. Finally, the paper will discuss the rise of the Healthy Urban Planning Movement in the US and Europe and ask whether this provides any potential for reasserting the public interest in planning process.

Caged birds and cloning machines: how student imagery 'speaks' to us about cultures of schooling and student participation

With the advent of the United Nations Convention on the Rights of the Child (CRC), there is an increasing requirement that schools ensure children and young people's views are voiced, listened to and taken seriously on matters of significance. Encouraging these shifts by law is one thing; changing the culture in schools is another. For a significant proportion of schools, actively engaging students' voices on how they experience education poses a significant challenge and crucial gaps may exist between the rhetoric espoused and a school's readiness for genuine student involvement. This ethnographic study illuminates tensions that persist between headteachers' espoused views of how students are valued and students' creative images of their actual post-primary schooling experience. If cultures of schooling are to nurture the true spirit of democratic pupil participation implied by changes in the law, there is a need to develop genuine processes of student engagement in which students and staff can collaborate towards greater shared understandings of a school's priorities.

Rarity, pseudodiagnosticity and Bayesian reasoning

Three experiments investigated the effect of rarity on people's selection and interpretation of data in a variant of the pseudodiagnosticity task. For familiar (Experiment 1) but not for arbitrary (Experiment 3) materials, participants were more likely to select evidence so as to complete a likelihood ratio when the initial evidence they received was a single likelihood concerning a rare feature. This rarity effect with familiar materials was replicated in Experiment 2 where it was shown that participants were relatively insensitive to explicit manipulations of the likely diagnosticity of rare evidence. In contrast to the effects for data selection, there was an effect of rarity on confidence ratings after receipt of a single likelihood for arbitrary but not for familiar materials. It is suggested that selecting diagnostic evidence necessitates explicit consideration of the alternative hypothesis and that consideration of the possible consequences of the evidence for the alternative weakens the rarity effect in confidence ratings. Paradoxically, although rarity effects in evidence selection and confidence ratings are in the spirit of Bayesian reasoning, the effect on confidence ratings appears to rely on participants thinking less about the alternative hypothesis.

The anonymity of the hunt: A critique of hunting as sharing

Hunter-gatherers are often ascribed a “monistic” worldview at odds with the nature-society dichotomy. The centerpiece of this claim is that they view hunting as similar to sharing within the band and prey animals as part of a common sphere of sociality. This article challenges this thesis. An examination of the work of its main proponents shows that it conflates two different senses of “animal”—the flesh-and-blood animals of the hunt and the animal Spirit that is said to control the animals. The sharing motif in hunting makes sense with respect to the anthropomorphic Spirit but not to the animals hunted. The conditions of the hunt as a spatiotemporal event provide further grounds for skepticism toward the idea of hunting-as-sharing. Drawing on biologist Robert Hinde’s model of relationships, I argue that hunting represents an anonymous one-off interaction that cannot develop into a personal relationship, in stark contrast to the durable forms of personalized sociality associated with the hunter-gatherer band. This is not to deny the possibility of human-animal cosociality in the form of personal relationships but rather to redirect the search away from the hunt to the interface with domesticated animals.