Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Commentary on “Can a good philosophical contribution be made just by asking a question?”

This paper explains some of the reasoning behind “Can a Good Philosophical Contribution Be Made Just by Asking a Question?,” a paper which consists solely in its title and which is published in the same issue of the journal as the present paper. The method for explaining that reasoning consists in making available a lightly edited version of a letter the authors sent to the editors when submitting the title-only paper. The editors permitted publication of that paper on the condition that the authors also separately publish a version of that letter; the present paper aims to fulfil that condition.     

Finding voice in a year of collective trauma: Case study of an online photovoice project with youth

In this article, we share findings from a qualitative case study of a virtual youth photovoice program implemented across three regions of the United States. The purpose of the program was to engage youth in research on a social issue relevant to them during an unprecedented year marked by two public health crises, COVID-19 and anti-Black racial violence. Results of an analysis of curriculum and archival program materials lend support for online strategies for youth engagement including individualized support and online audiovisual presentations with avatars. Racial justice and trauma-informed adaptations were designed to be responsive to youth needs for flexible programming and safe spaces. Themes captured in the first online gallery of youth photos include (1) tools for mental health, (2) meaningful connection, and (3) community advocacy, bringing attention to structural issues as well as family and community strengths. Findings suggest photovoice can be thoughtfully adapted for youth researchers and support individual and group storytelling in response to collective trauma.     

Awakening from Descartes' nightmare: On the love of ambiguity in phenomenological approaches to education

This paper is an exploration of the Cartesian paradigms of clarity and univocity and how these inform contemporary educational theory and practice. Phenomenology is discussed as a way of disrupting Descartes' visions of clarity and distinctness as paradigms of knowledge and as a return of inquiry to life as it is actually lived. Analogical discourse is examined as a way of giving a voice to this sort of inquiry. Heidegger's notions of inquiry as obedience and thanksgiving are discussed.     

Towards reflexive practice: Engaging participants as co-researchers or co-analysts in psychological inquiry

This paper considers some of the implications of reflexivity for the practice of psychological research. After a brief consideration of the theoretical background to a concern with reflexivity, the paper goes on to examine how various researchers have attempted to incorporate components of reflexivity in their research practice. While a group of sociologists of science have operationalized reflexivity by self-conscious concern for their own role in the construction of social—scientific knowledge, new paradigm co-operative inquirers interpret a need for reflexivity by including their participants as fully self-reflexive co-researchers. Mulkay's suggestion for a dialogic analytical exchange with one's participants is also considered. The second half of the paper illustrates an attempt at reflexive practice in the authors' own research. This was a project concerned with identity change during the transition to motherhood, and aimed to allow the women a strong hand in helping to shape the project's direction. Preliminary analysis of a woman's data was taken back to her for her comments, and her reflections on the data were incorporated in the final case study. A detailed example of the investigator and participant's discussion of a piece of data is provided.     

From “4Rs and 2Ss” to “Amaka Amasanyufu” (Happy Families): Adapting a U.S.-based Evidence-Based Intervention to the Uganda Context

In Uganda, one in five children presents mental health challenges, including disruptive behavior disorders (DBDs). DBDs can persist through adulthood and result in negative outcomes. Effective interventions for DBDs have been developed and tested in high-poverty communities in developed countries. Yet, most African countries, such as Uganda, lack such interventions. This paper describes the adaptation process of an evidence-based intervention of U.S. origin to optimize fit to context with intervention fidelity, as part of a randomized trial conducted with youth that exhibit behavioral challenges and their caregivers in 30 schools in Uganda. The process involved: initial meetings with headteachers and teachers to introduce the study and the main concepts of the intervention; initial manual review focusing on 4Rs and 2Ss content by the Uganda team; engagement of community stakeholders for additional feedback on content and cultural relevance; final revision of the manual; and collection of children’s drawings for the illustration of the manual. This paper describes both similarities and differences between the original and adapted intervention content and methods of delivery. The findings also highlight the importance of involving community stakeholders in the adaptation process.     

Parental Involvement and Adolescents’ Academic Achievement: Latent Profiles of Mother and Father Warmth as a Moderating Influence

Parental involvement in their adolescents’ education plays an important role in promoting their children's academic outcomes. Yet, more research is needed to examine the relationship between parenting practices and parental warmth as well as to consider the potential joint contribution of warmth from both fathers and mothers. Thus, the primary purpose of the current study is to examine the extent to which patterns of parental warmth across fathers and mothers moderate the association between parental involvement and adolescents’ grade point average (GPA) and school engagement behaviors. Latent profile analysis was conducted to identify disparate profiles of fathers’ and mothers’ warmth within a nationally representative sample of 2,306 youths (51% male; mean age = 15.31 years, SD = 1.50; 77% non-Hispanic White) residing in opposite-sex, two-parent families from Wave I and II of the National Longitudinal Study of Adolescent to Adult Health. Latent-class enumeration processes support a five-profile solution characterized by differences in levels of parental warmth and congruency across parents: (a) Congruent High Warmth, (b) Congruent Moderate Warmth, (c) Congruent Low Warmth, (d) Incongruent High Mother/Low Father Warmth, and (e) Incongruent Low Father/Lower Mother Warmth. Subsequent multiple linear regression analyses reveal a moderating effect for Congruent Low Warmth on the relationship between parental involvement and adolescents’ GPA. Ultimately, the results show that variation in parental warmth exists across fathers and mothers with differing impact on adolescents’ outcomes. Excluding one parent without considering the joint effects of both parents will not produce an accurate and precise understanding of parenting in research or practice.     

Explaining the Asian American Youth Paradox: Universal Factors versus Asian American Family Process Among Filipino and Korean American Youth

This study used longitudinal survey data of Filipino American and Korean American youth to examine ways in which universal factors (e.g., peer antisocial behaviors and parent–child conflict) and Asian American (AA) family process variables (e.g., gendered norms) independently and collectively predict grade point average (GPA), externalizing, and internalizing problems. We aimed to explain the “Asian American youth paradox” in which low externalizing problems and high GPA coexist with high internalizing problems. We found that universal factors were extensively predictive of youth problems and remained robust when AA family process was accounted for. AA family process also independently explained youth development and, in part, the AA youth paradox. For example, gendered norms increased mental distress. Academic controls did the opposite of what it is intended, that is, had a negative impact on GPA as well as other developmental domains. Family obligation, assessed by family-centered activities and helping out, was beneficial to both externalizing and internalizing youth outcomes. Parental implicit affection, one of the distinct traits of AA parenting, was beneficial, particularly for GPA. This study provided important empirical evidence that can guide cross-cultural parenting and meaningfully inform intervention programs for AA youth.     

A Two-way Street: Mentor Stress and Depression Influence Relational Satisfaction and Attachment in Youth Mentoring Relationships

Over the past two decades, youth mentoring programs have increased in popularity as an intervention for children exposed to a range of stressful life circumstances. Such programs have been shown to promote positive youth development and reduce risk for emotional and behavioral problems; yet, the effect size of youth gains remains small. The current study examined the influence of college student mentors’ history of early life stress and baseline depressive symptoms on their effectiveness in youth mentoring relationships using 340 randomized mentor–youth pairs from College Mentors for Kids, a well-established mentoring program with chapters across the United States. Hierarchical linear models revealed that mentors with higher levels of depressive symptoms reported lower relationship satisfaction and increased avoidance in the mentoring relationship. In contrast, mentors who experienced higher levels of early life stress had youth who reported greater satisfaction in the mentoring relationship and decreased relational anxiety. These findings are some of the first to examine the impact of mentor characteristics on mentor–youth relationships and highlight the importance of considering factors relevant to psychosocial functioning and emotional distress when recruiting, training, and supporting college student mentors.