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No full textMills concept of labor is multi-dimensional: it treats work as an activity, as mechanism of social stratification, as education, and as an object for social reform. This paper shows the structure, the strength and weaknesses of this conception between utilitarian, romantic and socialist ideas.
Teacher modelling as a way to foster <i>Bildung</i> in vocational education: a multi-method curriculum study
No full textThis study presents an inquiry into the relevance of Bildung for students in (pre-) vocational education. While Bildung has seen a remarkable revival in international educational theory, its relevance for educational practice(s) remains under-investigated, particularly in vocational education. This paper presents the insights offered by a multi-method curriculum study, conducted as part of a larger project in which (pre)vocational teachers in the Netherlands experimented with their own role as a model of and for their students’ Bildung. Building on a thematic analysis of teacher observations, teacher interviews and student focus groups, we explore how six teachers enacted and perceived their modelling role, and how their students experienced it. While all teachers modelled elements of what they found important for their students’ Bildung, the teachers actually perceived as models of Bildung by their students were those who shared their own experiences and stories with students, and who related to them on a personal level by offering them support, trust and inspiration to pave their own paths in life. Based on our findings, we suggest implications for broadening common understandings of Bildung and modelling, as well as practical implications for teachers, teacher education and policy to foster vocational students’ Bildung
Understanding Epistemic Justice through Inclusive Research about Intellectual Disability and Sexuality
No full textFormal language: This paper discusses inclusive research and epistemic justice by using an example of a published study the authors conducted on intellectual disability and sexuality in supported living environments. Our study addressed taboos and pushed boundaries in content and methodology through two ways of inclusive research: (1) the second author of this paper who has an intellectual disability was a main researcher in the study; and (2) we interviewed people with intellectual disabilities about their own experiences as well as their desired solutions to obstacles they face in their supported living environments. Their input was centralized in the final research report. This method challenged the epistemic injustice of who have historically not been ‘allowed’ to produce knowledge in research. This paper offers historical insight into epistemic injustice as well as relational approaches from critical disability studies and non-Western understandings of disability that ‘rethink’ disability and that can thus promote epistemic justice in academic theory. By addressing both practice and theory in this paper, we aim to contribute to the growing body of inclusive research and to the epistemic justice of people with intellectual disabilities. Plain language: (1) Epistemology = thinking about knowledge, producing knowledge, sharing knowledge. (2) In history, people with intellectual disabilities have often been excluded from participating in this. This is called epistemic injustice. It is caused by the discrimination of people with intellectual disabilities (ableism). (3) Performing inclusive research with people with intellectual disabilities challenges this. It contributes to epistemic justice. Researchers and interviewees with intellectual disabilities can bring knowledge from lived experience into research. (4) Knowledge from lived experience has not always been valued in traditional research. That means we also need to think differently about ‘knowledge’, and about ‘disability’ and its ‘value’. (5) Discrimination based on disability has a long history. For instance: during colonialism by European countries (starting in the 15th century), false ideas about ‘poor health’ and ‘low intelligence’ were already used to justify slavery. People with disabilities have often been locked away or even killed because they have been seen as ‘less valuable’. These ways of thinking still exist. They influence our understanding of ‘epistemology’ because they decide whose way of thinking and way of life is valuable or not valuable. We need to change this way of thinking. (6) Some academic fields that help are critical disability studies, indigenous studies, and feminist posthumanism. These fields challenge ableist ways of thinking. They can help us understand disability as something that is not negative or less valuable, but simply part of what makes us human
Perspectives on the essential skills of healthcare decision making in children and adolescents with intellectual disability
No full textAbstract Background Involvement in healthcare decisions is associated with better health outcomes for patients. For children and adolescents with intellectual disability, parents and healthcare professionals need to balance listening to a child’s wishes with the responsibility of keeping them safe. However, there is a scarcity of literature evaluating how to effectively involve them in decision making. In this context, we review the concept of health literacy, focusing on the skills of healthcare decision making for children and adolescents with intellectual disability. Methods We describe the concept of health literacy and models explaining shared decision making (individuals and healthcare professionals collaborate in decision making process) and supported decision making (when a trusted person supports the individual to collaborate with the healthcare professional in the decision-making process), and a rapid review of the literature evaluating their efficacy. We discuss healthcare decision making for children and adolescents with intellectual disability in the context of relevant recommendations from the recent Disability Royal Commission into Violence, Abuse, Neglect, and Exploitation of People with Disability in Australia. Results Health literacy skills enable individuals to access, understand, appraise, remember and use health information and services. Shared decision making has been described for children with chronic conditions and supported decision making for adults with intellectual disability. Decision-making contributes to how individuals appraise and use healthcare. The rapid review found very limited evidence of outcomes where children and adolescents with intellectual disability have been supported to contribute to their healthcare decisions. Recommendations from the Disability Royal Commission highlight current needs for greater efforts to support and build the capacity of individuals with disability to be involved in the decisions that affect their life, including healthcare decision making. Conclusions Existing rights frameworks and healthcare standards confirm the importance of providing all people with the opportunities to learn and practise health literacy skills including decision making. There is little literature examining interventions for healthcare decision making for children with intellectual disability. Childhood is a critical time for the development of skills and autonomy. Evidence for how children and adolescents with intellectual disability can learn and practice healthcare decision-making skills in preparation for adulthood is needed to reduce inequities in their autonomy
Hospice Care Access: a national cohort study.
No full textObjectives Hospice care in the Netherlands is provided in three different types of hospice facilities: volunteer-driven hospices (VDH), standalone hospices (SAHs) and hospice unit nursing homes (HU). The organisational structures range from care directed by trained volunteers in VDH to care provided by multiprofessional teams in SAH and HU units. This study aims to characterise the patient populations who access Dutch hospices and describe the patient profiles in different hospice types. Methods A retrospective cohort study using clinical records of adult hospice inpatients in 2017–2018 from a random national sample of hospices. Results In total 803 patients were included from 51 hospices, mean age 76.1 (SD 12.4). 78% of patients had a primary diagnosis of cancer, 3% identified as non-Dutch cultural background and 17% were disorientated on admission. At admission, all patients were perceived to have physical needs. Psychological needs were reported in 37%, 36% and 34%, social needs by 53%, 52% and 62%, and existential needs by 23%, 30% and 18% of patients in VDH, SAH, HU units, respectively. 24%, 29% and 27% of patients from VDHs, SAHs and HUs had care needs in three dimensions, and 4%, 6% and 3% in all four dimensions. Conclusions People who access Dutch hospices predominantly have cancer, and have a range of physical, psychological, social and existential needs, without substantial differences between hospice types. Patients with non-malignant disease and non-Dutch cultural backgrounds are less likely to access hospice care, and future policy would ideally focus on facilitating their involvement
Blurring the Lines between Imitation and Emulation in Moral Development
No full textThis article investigates the roles of imitation and emulation in the development of virtue by questioning the way these learning mechanisms are distinguished in the literature. Conventional views distinguish a deliberate kind of emulation, necessary for the acquisition of practical wisdom and virtue, from the unconscious and automatic imitation of virtuous actions. In this article, this binary is challenged through an analysis of two (autobiographical) novels by the French author Edouard Louis. Eddy, the main character in both novels, adopts behaviours from his friends and teachers on purpose, driven by personal goals rather than the models’ virtuous motives. The novels help us to imagine a new category of moral learning, called ‘deliberate imitation’: it is goal-driven but not fully aligned with the virtuous intentions of the role models. This type of imitation blurs the distinction between imitation and emulation and may serve as a transitional phase. The article ends with a discussion of the implications this type of imitation may have for moral education. It is suggested that teachers may have less control over which of their actions students take to be exemplary and which ones not
Chaplains’ Professional Identity and a Structured Approach to Chaplaincy: Mutually Exclusive or Complementary?
No full textThe trend towards evidence-based health care challenges chaplains to work with structured—predefined and standardized—interventions that lead to measurable outcomes. However, chaplaincy literature raises various objections against using a structured approach. These include compromising the chaplain-client relationship, standardizing and limiting chaplaincy content, and the instrumentalization of the spiritual dimension. Based on a thematic analysis of 20 interviews and 33 workbooks, the current study investigates the experiences of chaplains in the Netherlands who participated in a structured intervention provided in palliative clients’ homes. The results show that most chaplains did indeed struggle with developing a healing relationship with their clients in which they are attuned to their specific needs. At the same time, the participating chaplains reported that a structured approach enriches and broadens the content of their care, improves the impact on clients, and grasps the spiritual dimension of their work. We found that the chaplains’ experiences differed depending on the professional role they emphasized. When they integrate and balance the roles of companion, counselor, and spiritual guide evenly, a structured approach can complement chaplains’ professional identity
Samenloop Wlz en Wzd
No full textMeneer Pietersen, woonachtig op een locatie voor chronische somatische zorg, is de afgelopen twee jaar cognitief flink achteruitgegaan. Een woonplek op een locatie voor psychogeriatrische verpleeghuiszorg lijkt beter voor hem. Hiervoor is een nieuwe aanvraag Wet langdurige zorg noodzakelijk. Wat speelt allemaal mee in deze casus? En is de Wet zorg en dwang van toepassing