21 research outputs found
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Spiritual literacy and tacit knowledge
This article represents a critique of the 'spiritual literacy' approach to spiritual education developed by Andrew Wright (e.g. 2000a), with particular reference to the inclusion of Michael Polanyi's theory of 'tacit knowledge'. Wright's assessment of the current state of religious education is summarised and his proposed method is outlined. Polanyi's ideas are then described and assessed for their compatibility with the 'spiritual literacy' approach
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Cultivating ethical dispositions in early childhood practice for an ethic of care: a contemplative approach
The purpose of this paper is to argue that care ethics is part of an ongoing feminist challenge to a narrow kind of epistemology in higher education which separates mind from body and feeling from intellect. Care ethics imagines a self which is embodied and relational. Connecting this philosophical model with psychological research in attachment and moral development, I propose an experiential and contemplative approach to the ethical development of teachers in ECEC
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Compassionate pedagogy: the ethics of care in early childhood professionalism
This paper builds upon an earlier attempt (Taggart, 2011) to articulate a rationale for professional training in early childhood education and care (ECEC) which is ethical as opposed to one which is purely instrumental or rooted in a patriarchal notion of women’s supposed unique suitability. The argument proposes that a feminist approach to ethics, as both socially critical and psychologically affective or flexible, has a particular relevance to professional identity in ECEC. In particular, compassion, as a concept which has both sociological and psychological connotations, foregrounds the ethical dimension of the work whilst overcoming false dichotomies between discourses of ‘children’s rights’ and ‘care’. The implications for the training and professional identity of practitioners are discussed
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Mickey Mouse spirituality? Children’s worldviews and the culture industry
Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received
Background
The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy.
Objective
To report outcomes according to treatment received in men in randomised and treatment choice cohorts.
Design, setting, and participants
This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy.
Intervention
Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment.
Outcome measurements and statistical analysis
Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores.
Results and limitations
According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa.
Conclusions
Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group.
Patient summary
More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common
Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)
Objective
To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making.
Patients and Methods
Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores.
Results
Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL.
Conclusion
Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes
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Don't we care?: the ethics and emotional labour of early years professionalism
This paper argues that early childhood education and care (ECEC) has a legitimate aspiration to be a 'caring profession' like others such as nursing or social work, defined by a moral purpose. For example, practitioners often draw on an ethic of care as evidence of their professionalism. However, the discourse of professionalism in England completely excludes the ethical vocabulary of care. Nevertheless, it necessarily depends on gendered dispositions towards emotional labour, often promoted by training programmes as 'professional' demeanours. Taking control of the professionalisation agenda therefore requires practitioners to demonstrate a critical understanding of their practice as 'emotion work'. At the same time, reconceptualising practice within a political ethic of care may allow the workforce, and new trainees in particular, to champion 'caring' as a sustainable element of professional work, expressed not only in maternal, dyadic key-working but in advocacy for care as a social principle
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Religious and spiritual identity and citizenship education in the UK
If education is to be about ‘human flourishing’ (De Ruyter, 2004) as well as preparation for adulthood and work, then religious and citizenship education would seem to have a key contribution towards this goal, both offering opportunities for the exploration and development of a robust sense of identity. However, despite the opposition of most religious educators, religious education has been treated by successive UK governments simply as a form of inculcation into a homogenous notion of citizenship based on nominal church attendance. Moreover, the teaching of the relatively new subject of citizenship education, whilst recognising that the sense of identity and allegiance is complex, has not regularly included faith perspectives. I argue that the concept of ‘spiritual development’, which centres on an existential sense of identity, offers a justification for combining lessons in both religious and citizenship education. I conclude on a cautionary note, arguing that pupils need to be given a critical awareness of ways in which such identities can be provided for them by default, particularly since consumer culture increasingly makes use of ‘spiritual’ language and imagery
Revolutionary Love: Early Childhood Education as Counter-Culture
This paper places the pedagogies of love and care which typify the early years of practice in the context of evolution, arguing that, during an optimum window of development, young children are predisposed physiologically to benefit from the attention of multiple alloparents. This anthropological model of community stands in stark contrast to the individualistic and privatised notion of love in neoliberal cultures, indicating reasons why practitioners may be ambivalent about it. Moreover, it is argued that, whilst the notion of care is easily commoditised, the deeper concept of love, contextualised within wisdom and faith paths, is resistant to the money culture. In looking beyond neoliberalism at counter-cultural alternatives, alloparenting traditions suggest a way in which ECEC settings can establish themselves as models of social sustainability rooted in ‘philia’ and mutuality