Letteratura scientifica selezionata sul tema "Nelson College for Girls (Nelson, N.Z.)"

This study aims to apply rational emotive behavior counseling as an effort to reduce cheating behavior of high school students. The design of this study was conducted using a quasi experimental method approach with a pretest-posttest non-equivalent control group design research design. Data analysis techniques using Wilcoxon mached-pairs signed test, with the Asymp.Sig (2-Tailed) 0.028 <0.05, which shows a significant difference. The Z test value is -0.730 with the Asymp.Sig (2-Tailed) number 0.466, because of the Asymp.Sig (2-Tailed) value> 0.05, it can be concluded that there is no significant difference between the posttest value and the experimental group value with the control group, Ho is rejected and Ha is accepted which means that rational emotive behavior counseling is effective in reducing student cheating behavior. The study was carried out starting from January to March 2018, which took place at Darul Hikmah High School. Based on the results of the study, the researchers proposed several suggestions, among others (1) BK teachers, counseling rational emotive behavior can be applied by BK teachers to reduce student cheating behavior practically and can be easily applied; (2) for researchers furthermore, this research uses the pretest and posttest control group design research models, for the next researcher can use other research designs such as action research in BK, or other experimental research. References Andrestia, M. (2010). Pengaruh locus of control goal orientation terhadap cheating mahasiwa Fakultas Psikologi UIN Syarif Hidayatullah Jakarta. Skripsi. Jakarta: UIN Syarif Hidayatullah Jakarta. Anitasari, L. (2012). Hubungan stres dan perilaku merokok pada remaja. Skripsi. Malang: Universitas Negeri Malang. Arabzadeh, S., Ameli, N., Zeinoddini, A., Rezaei, F., Farokhnia, M., Mohammadinejad, P., Ghaleiha, A., & Akhondzadeh, S. (2015). Celecoxib adjunctive therapy for acute bipolar mania: A randomized, double-blind, placebo-controlled trial. Bipolar Disorders, 17(6), 606-614. doi:https://doi.org/10.1111/bdi.12324 Bond, F. W., & Dryden, W. (1996). Why two central REBT hypotheses appear untestable. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 14(1), 29-40. Corey, G. (2015). Theory and practice of counseling and psychotherapy. Canada: Nelson Education. Corey, G. (2012). Case approach to counseling and psychotherapy. Canada: Nelson Education. Dessy, D. A., Suranata, K. S., & Setuti, N. M. (2013). Penerapan konseling rasional emotif dengan teknik kognitif untuk meningkatkan self disclosure siswa kelas X. 6 SMA Negeri 1 Sukasada tahun pelajaran 2012/2013. Jurnal Ilmiah Bimbingan Konseling Undiksha, 1(1), 1-10. https://ejournal.undiksha.ac.id/index.php/JJBK/issue/view/91 Dryden, W. (2014). Rational emotive behaviour therapy: Distinctive features. London: Routledge. Dryden, W. (2003). Reason to change: A rational emotive behaviour therapy (REBT) workbook. London: Routledge. Fraenkel, J. R., Wallen, N. E., & Hyun, H. H. (1993). How to design and evaluate research in education (Vol. 7). New York: McGraw-Hill. Habsy, B. A. (2017a). Model konseling kelompok cognitive behavior untuk meningkatkan self esteem siswa SMK. Perspektif Ilmu Pendidikan, 31(1), 21-35. doi: https://doi.org/10.21009/PIP.311.4 Habsy, B. A. (2017b). Filosofi ilmu bimbingan dan konseling indonesia. Jurnal Pendidikan (Teori dan Praktik), 2(1), 1-11. doi: http://dx.doi.org/10.26740/jp.v2n1.p1-11 Habsy, B. A. (2018a). Konseling rasional emotif perilaku: Sebuah tinjauan filosofis. Indonesian Journal of Educational Counseling, 2(1), 13-30. doi:https://doi.org/10.30653/001.201821.25 Habsy, B. A. (2018b). Model bimbingan kelompok PPPM untuk mengembangkan pikiran rasional korban bullying siswa SMK Etnis Jawa. Jurnal Pendidikan (Teori dan Praktik), 2(2), 91-99. doi:http://dx.doi.org/10.26740/jp.v2n2.p91-99 Hartanto, D. (2012). Bimbingan & konseling menyontek: Mengungkap akar masalah dan solusinya. Jakarta: Indeks. Hetherington, E. M., & Feldman, S. E. (1964). College cheating as a function of subject and situationalvariables. Journal of Educational Psychology, 55(4), 212. McCabe, M., & Ricciardelli, L. (2001). Parent, peer and media influences on body image and strategies to both increase and decrease body size among adolescent boys and girls. Adolescence, 36(142), 225-240. https://www.questia.com/library/journal/1G1-79251794/parent-peer-and-mediainfluences-on-body-image-and Nurmayasari, K., & Murusdi, H. (2015). Hubungan antara Berpikir Positif dan Perilaku Menyontek pada Siswa Kelas X SMK Koperasi Yogyakarta. Empathy: Jurnal Fakultas Psikologi, 3(1), 8-15. http://journal.uad.ac.id/index.php/EMPATHY/ article/view/3009/1748 Santrock, J. W., & Curl, R. M. (2003). Adolescence (9th ed.). New York: McGraw-Hill. Setyani, U. (2007). Hubungan antara konsep diri dengan intensi menyontek pada siswa SMA Negeri 2 Semarang. Disertasi. Semarang: Universitas Diponegoro. Sujana, Y. E., & Wulan, R. (1994). Hubungan antara kecenderungan pusat kendali dengan intensi menyontek. Jurnal Psikologi, 21(1994). http://i-lib.ugm.ac.id/jurnal/download.php?dataId=4298 Taylor, K.R. (2003). Bracing for cheating and plagiarism. Diakses melalui https://www.eddigest.com/sub.php Permatasari, D., & Muka, J. R. (2017). Correlation between self–efficacy and cheating behavior onvocational high school students. Prosiding 8th ICLICE 2017. Valiente, C., Eisenberg, N., Haugen, R., Spinrad, T. L., Hofer, C., Liew, J., & Kupfer, A. (2011). Children’s efforftul control and academic achievement: Mediation through social functioning. Early Education and Development, 22(3), 411-433. doi: https://doi.org/10.1080/10409289.2010.505259

INFLUÊNCIA DA COMPACTAÇÃO E DO CULTIVO DE SOJA NOS ATRIBUTOS FÍSICOS E NA CONDUTIVIDADE HIDRÁULICA EM LATOSSOLO VERMELHO Amauri Nelson BeutlerJosé Frederico CenturionCassiano Garcia RoqueZigomar Menezes de SouzaDepartamento de Solos e Adubos, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Jaboticabal, SP. CEP 14870-000. E-mail: amaurib@yahoo.com.br, jfcentur@fcav.unesp.br 1 RESUMO Este estudo teve como objetivo determinar a influência da compactação e do cultivo de soja nos atributos físicos e na condutividade hidráulica de um Latossolo Vermelho de textura média. O experimento foi conduzido na Universidade Estadual Paulista – Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal (SP). Os tratamentos foram: 0, 1, 2, 4 e 6 passadas de um trator, uma ao lado da outra perfazendo toda a superfície do solo, com quatro repetições. O delineamento experimental foi inteiramente casualizado para a condutividade hidráulica e, em esquema fatorial 5 x 2 para os atributos físicos. Foram coletadas amostras de solo nas faixas de profundidades de 0,02-0,05; 0,07-0,10 e 0,15-0,18 m, por ocasião da semeadura e após a colheita para determinação da densidade do solo, porosidade total, macro e microporosidade do solo. A condutividade hidráulica do solo foi determinada após a colheita. O tempo entre a semeadura e a colheita de soja foi suficiente para aumentar a compactação do solo apenas na condição de solo solto. A compactação do solo reduziu a condutividade hidráulica em relação a condição natural (mata) e a condição de solo solto, sendo que esta não foi reduzida, após a primeira passagem, com o aumento no número de passagens. UNITERMOS: Densidade do solo, porosidade do solo, infiltração de água, soja. BEUTLER, A. N.; CENTURION, J. F.; ROQUE, C. G.; SOUZA, Z. M. COMPACTION AND SOYBEAN GROW INFLUENCE ON PHYSICAL ATTRIBUTES AND HYDRAULIC CONDUCTIVITY IN RED LATOSSOL SOIL 2 ABSTRACT The purpose of this study was to determine the influence of compaction and soybean grow on physical attributes and hydraulic conductivity of a Red Latossol, medium texture soil. The experiment was carried out in the experimental farm at the Paulista State University – Agricultural Science College, Jaboticabal – São Paulo state. The treatments were 0, 1, 2, 4 and 6 side-by-side tractor strides on the soil surface with four replications. The experimental design was completely randomized for hydraulic conductivity and a 5 x 2 factorial design for soil physical attributes. Soil samples have been collected at 0.02-0.05, 0.07-0.10 and 0.15-0.18 m depth at sowing season and after harvest in order to determine soil bulk density, total porosity, macro and micro porosity. Soil hydraulic conductivity was determined after harvest. The time period between the soybean sowing and harvesting was enough to increase soil compaction only in loose soil condition. Soil compaction reduced hydraulic conductivity compared to the natural (forest) and loose soil condition KEYWORDS: Bulk density, soil porosity, water infiltration, soybean.

Cardiovascular diseases (CVDs) are the fastest-growing cause of death around the world, and atherosclerosis plays a major role in the etiology of CVDs. The most recent figures show that the total number of CVD patients worldwide surged from 271 million in 1990 to 523 million in 2019. Furthermore, globally, the number of fatalities caused by coronary artery disease (CAD) went up from 1.2 million in 1990 to 18.6 million in 2019.1 The morbidity and mortality rates for patients with heart failure (HF) are still too high, despite being given the therapy according to the recommended guidelines.2 HF strains the public health system, so better treatment options are required. According to different studies, in HF, the manifestation of ventricular and vascular remodeling, as well as the progression of the illness, may be influenced by elevated oxidative stress.3,4 The most prevalent form of inflammatory arthritis in the world, gout, correlates with CVDs and is a standalone predictor of all-cause death.5,6 An important therapeutic target and potential contributor to oxidative stress is the enzyme xanthine oxidase (XO). Oxidative stress is a state in which there is excessive production of reactive oxygen species (ROS). The key generators of ROS are oxidant-producing enzymes, which are increased in various disease conditions.7 Superoxide and uric acid (UA) are produced due to increased XO activity during purine metabolism. In addition to being the primary cause of gout, elevated xanthine oxidase is also to blame for several clinical illnesses linked to hyperuricemia, such as cardiovascular disorders, diabetes, chronic wounds, and Alzheimer's disease. Numerous studies have shown a direct connection between high urate levels and CVDs. The generation of urate crystals is a complicated process. Since the same enzyme that makes urate also causes the creation of ROS. According to some research, the urate molecule can scavenge in vitro free radicals and acute urate infusions help at-risk population restore their endothelial function.8,9 More and more evidence suggests that XO activity plays a significant role in target organ damage and tissue destruction rather than UA itself. The formation of UA requires the xanthine oxidoreductase (XOR) enzyme, and XOR is composed of XO and xanthine dehydrogenase (XDH). By posttranslational modification, XDH is transformed into XO, which catalyzes the final two steps of the processes that change hypoxanthine into xanthine and xanthine into UA. During this process, superoxide and hydrogen peroxide are produced. As a result, ROS can be produced when XO is activated, which might cause tissue damage. Nitric oxide (NO) and circulating XO can directly interact when the latter binds to vascular cells, causing NO levels to drop and peroxynitrite levels to rise. On the other hand, uric acid transporters (UATs) have been identified to mediate the effects of serum UA on vascular endothelial cells or smooth muscle cells, as URAT1 is only expressed on these cells and provides a route for UA to access these cells. By delaying NO generation and accelerating its breakdown, UA reduces NO levels when it enters endothelial cells.4 The organic anion transport inhibitor probenecid prevents UA-induced vascular smooth muscle cell proliferation. It reduces the generation of NO in human umbilical vein endothelial cells, suggesting that UATs are the mechanism via which UA exerts its impact.5 These findings pose the concern of whether the reduction in serum UA or the suppression of XO activity is more crucial for preventing cardiovascular and other tissue damage. However, in in vivo studies, UA performs pro- and antioxidant functions. When serum UA concentrations rise beyond 6 mg/dL, UA is taken up by vascular endothelial cells, which then triggers nicotinamide adenine dinucleotide phosphate oxidase to produce reactive oxygen species (ROS). Additionally, UA causes the apoptosis of vascular endothelial cells at levels of 9 mg/dL and higher. In other words, an excessively significant increase in the serum UA level might cause oxidative stress, alter the equilibrium between oxidation and antioxidants, and result in damage to vascular endothelial cells.10 Previous studies have shown that severe hyperuricemia, which lowers ejection fraction and is related to symptoms even worse, exercise intolerance, and decreased survival, is present in about 25% of individuals with heart failure (HF).11,12 Serum UA levels must be considered when calculating HF risk scores and may be used to identify high-risk patients for potential XO inhibition therapy.13,14 The approved treatment regimens for gout have significant implications for individuals with cardiovascular disease (CVD) due to varied levels of cardiovascular and HF benefits and risks. Therefore, it is essential to treat acute gout flares while reducing the risk of severe cardiovascular events and managing hyperuricemia using urate-lowering treatment.15 Allopurinol is a powerful XO inhibitor that can potentially reverse several HF pathophysiological processes, including impaired calcium sensitivity, accelerated anaerobic metabolism, mechanoenergetic uncoupling, and energy depletion. Allopurinol has been found in studies to improve cardiac efficiency and decrease oxygen consumption in both animals and humans with HF.16,17 Allopurinol, febuxostat, and topiroxostat, the commonly prescribed xanthine oxidase inhibitors used in clinical practice, suffer from fatal side effects that constitute a severe dilemma for the healthcare system and have sparked a global emergency to find novel, potent, and safer xanthine oxidase inhibitors.9 Herbal medications are utilized worldwide due to their effectiveness, affordability, accessibility, and safety.18 The conventional medical community holds colchicine in the highest regard. Colchicine's uses have been expanded from the treatment of gout to CVDs due to its special anti-inflammatory qualities and recent knowledge of chronic inflammation's role in several human diseases.1 According to contemporary therapeutic jargon, Colchicine's recent use in the setting of CVDs is an example of successful pharmacological repurposing. Pericarditis is now considered to be included in routine treatment, and its impact on coronary artery disease, postpericardiotomy syndrome, and percutaneous coronary interventions has been the subject of numerous clinical studies. Several effective clinical trials have expanded our understanding of reducing inflammation in the management of cardiovascular disease and given us new perspectives on how inflammation affects CVDs.19 Future research towards safer and more efficient ways to treat CVDs is encouraged. Herbal remedies are a viable choice since they are accessible, safe, and efficient; however, further research is required to determine whether they can be used to treat CVDs in gout and hyperuricemia patients.18 Conflict of interest: Authors declared no conflict of interest. References Zhang F-S, He Q-Z, Qin CH, Little PJ, Weng J-P, Xu S-W. Therapeutic potential of colchicine in cardiovascular medicine: a pharmacological review. Acta Pharma Sinica. 2022;43(9):2173-90. Chen J, Normand S-LT, Wang Y, Krumholz HM. National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries, 1998-2008. JAMA. 2011;306(15):1669-78. Tsutsui H, Kinugawa S, Matsushima S. Oxidative stress and heart failure. Am J Physiol Heart Circ Physiol. 2011;301(6):H2181-H90. Ashiq K, Ashiq S, Shehzadi N. Hyperuricemia and its association with hypertension: risk factors and management. Pak Heart J. 2022;55(2):200-1. Abhijit D, Bhaskar G, Jitendra ND. Traditional phytotherapy against skin diseases and in wound healing of the tribes of Purulia district, West Bengal, India J Med Plants Res. 2012;6(33):4825-483. A comprehensive review on gout: The epidemiological trends, pathophysiology, clinical presentation, diagnosis and treatment. J Pak Med Assoc. 2021;71(4):1234-8. Bergamini C, Cicoira M, Rossi A, Vassanelli C. Oxidative stress and hyperuricaemia: pathophysiology, clinical relevance, and therapeutic implications in chronic heart failure. Eur J Heart Fail. 2009;11(5):444-52. George J, Struthers AD. The role of urate and xanthine oxidase inhibitors in cardiovascular disease. Cardiovascular Drug Rev. 2008;26(1):59-64. Singh A, Singh K, Sharma A, Kaur K, Chadha R, Bedi PMS. Past, Present and Future of Xanthine Oxidase Inhibitors: Design Strategies, Structural and Pharmacological Insights, Patents and Clinical Trials. RSC Med Chem. 2023;14(11):2155-91. Sekizuka H. Uric acid, xanthine oxidase, and vascular damage: potential of xanthine oxidoreductase inhibitors to prevent cardiovascular diseases. Hypertension Res. 2022;45(5):772-4. Karantalis V, Schulman IH, Hare JM. Nitroso-redox imbalance affects cardiac structure and function. American College of Cardiology Foundation Washington, DC; 2013. p. 933-5. Kittleson MM, St John ME, Bead V, Champion HC, Kasper EK, Russell SD, et al. Increased levels of uric acid predict haemodynamic compromise in patients with heart failure independently of B-type natriuretic peptide levels. Heart. 2007;93(3):365-7. Ky B, French B, Levy WC, Sweitzer NK, Fang JC, Wu AH, et al. Multiple biomarkers for risk prediction in chronic heart failure. Circulation: Heart Failure. 2012;5(2):183-90. Levy WC, Mozaffarian D, Linker DT, Sutradhar SC, Anker SD, Cropp AB, et al. The Seattle Heart Failure Model: prediction of survival in heart failure. Circulation. 2006;113(11):1424-33. Mouradjian MT, Plazak ME, Gale SE, Noel ZR, Watson K, Devabhakthuni S. Pharmacologic management of gout in patients with cardiovascular disease and heart failure. Am J Cardiovasc Drugs. 2020;20(5):431-45. Cappola TP, Kass DA, Nelson GS, Berger RD, Rosas GO, Kobeissi ZA, et al. Allopurinol improves myocardial efficiency in patients with idiopathic dilated cardiomyopathy. Circulation. 2001;104(20):2407-11. Murphy R, Dutka T, Lamb G. Hydroxyl radical and glutathione interactions alter calcium sensitivity and maximum force of the contractile apparatus in rat skeletal muscle fibres. J Physiol. 2008;586(8):2203-16. Ashiq K, Hussain K, Islam M, Shehzadi N, Ali E, Ashiq S. Medicinal plants of Pakistan and their xanthine oxidase inhibition activity to treat gout: a systematic review. Turkish J Bot. 2021;45(8):723-38. Deftereos SG, Beerkens FJ, Shah B, Giannopoulos G, Vrachatis DA, Giotaki SG, et al. Colchicine in cardiovascular disease: in-depth review. Circulation. 2022;145(1):61-78.

Photo by niu niu on Unsplash ABSTRACT Shackling prisoners has been implemented as standard procedure when transporting prisoners in labor and during childbirth. This procedure ensures the protection of both the public and healthcare workers. However, the act of shackling pregnant prisoners violates the principles of ethics that physicians are supposed to uphold. This paper will explore how shackling pregnant prisoners violates the principle of justice and beneficence, making the practice unethical. INTRODUCTION Some states allow shackling of incarcerated pregnant women during transport and while in the hospital for labor and delivery. Currently, only 22 states have legislation prohibiting the shackling of pregnant women.[1] Although many states have anti-shackling laws prohibiting restraints, these laws also contain an “extraordinary circumstances” loophole.[2] Under this exception, officers shackle prisoners if they pose a flight risk, have any history of violence, and are a threat to themselves or others.[3] Determining as to whether a prisoner is shackled is left solely to the correctional officer.[4] Yet even state restrictions on shackling are often disregarded. In shackling pregnant prisoners during childbirth, officers and institutions are interfering with the ability of incarcerated women to have safe childbirth experiences and fair treatment. Moreover, physicians cannot exercise various ethical duties as the law constrains them. In this article, I will discuss the physical and mental harms that result from the use of restraints under the backdrop of slavery and discrimination against women of color particularly. I argue that stereotypes feed into the phenomenon of shackling pregnant women, especially pregnant women of color. I further assert that shackling makes it difficult for medical professionals to be beneficent and promote justice. BACKGROUND Female incarceration rates in the United States have been fast growing since the 1980s.[5] With a 498 percent increase in the female incarceration population between 1981 and 2021, the rates of pregnancy and childbirth by incarcerated people have also climbed.[6],[7] In 2021, over 1.2 million women were incarcerated in the United States.[8] An estimated 55,000 pregnant women are admitted to jails each year.[9],[10] Many remain incarcerated throughout pregnancy and are transported to a hospital for labor and delivery. Although the exact number of restrained pregnant inmates is unclear, a study found that 83 percent of hospital prenatal nurses reported that their incarcerated patients were shackled.[11] I. Harms Caused by Shackling Shackling has caused many instances of physical and psychological harm. In the period before childbirth, shackled pregnant women are at high risk for falling.[12] The restraints shift pregnant women’s center of gravity, and wrist restraints prevent them from breaking a fall, increasing the risk of falling on their stomach and harming the fetus.[13] Another aspect inhibited by using restraints is testing and treating pregnancy complications. Delays in identifying and treating conditions such as hypertension, pre-eclampsia, appendicitis, kidney infection, preterm labor, and especially vaginal bleeding can threaten the lives of the mother and the fetus.[14] During labor and delivery, shackling prevents methods of alleviating severe labor pains and giving birth.[15] Usually, physicians recommend that women in labor walk or assume various positions to relieve labor pains and accelerate labor.[16] However, shackling prevents both solutions.[17] Shackling these women limits their mobility during labor, which may compromise the health of both the mother and the fetus.[18] Tracy Edwards, a former prisoner who filed a lawsuit for unlawful use of restraints during her pregnancy, was in labor for twelve hours. She was unable to move or adjust her position to lessen the pain and discomfort of labor.[19] The shackles also left the skin on her ankles red and bruised. Continued use of restraints also increases the risk of potentially life-threatening health issues associated with childbirth, such as blood clots.[20] It is imperative that pregnant women get treated rapidly, especially with the unpredictability of labor. Epidural administration can also become difficult, and in some cases, be denied due to the shackled woman’s inability to assume the proper position.[21] Time-sensitive medical care, including C-sections, could be delayed if permission from an officer is required, risking major health complications for both the fetus and the mother.[22] After childbirth, shackling impedes the recovery process. Shackling can result in post-delivery complications such as deep vein thrombosis.[23] Walking prevents such complications but is not an option for mothers shackled to their hospital beds.[24] Restraints also prevent bonding with the baby post-delivery and the safe handling of the baby while breast feeding.[25] The use of restraints can also result in psychological harm. Many prisoners feel as though care workers treat them like “animals,” with some women having multiple restraints at once— including ankles, wrists, and even waist restraints.[26] Benidalys Rivera describes the feeling of embarrassment as she was walking while handcuffed, with nurses and patients looking on, “Being in shackles, that make you be in stress…I about to have this baby, and I’m going to go back to jail. So it’s too much.”[27] Depression among pregnant prisoners is highly prevalent. The stress of imprisonment and the anticipation of being separated from their child is often overwhelming for these mothers.[28] The inhumane action has the potential to add more stress, anxiety, and sadness to the already emotionally demanding process of giving birth. Shackling pregnant prisoners displays indifference to the medical needs of the prisoner.[29] II. Safety as a Pretense While public safety is an argument for using shackles, several factors make escape or violence extremely unlikely and even impossible.[30] For example, administering epidural anesthesia causes numbness and eliminates flight risk.[31] Although cited as the main reason for using shackles, public safety is likely just an excuse and not the main motivator for shackling prisoners. I argue that underlying the shackling exemplifies the idea that these women should not have become pregnant. The shackling reflects a distinct discrimination: the lawmakers allowing it perhaps thought that people guilty of crimes would make bad mothers. Public safety is just a pretense. The language used to justify the use of restraint of Shawanna Nelson, the plaintiff in Nelson v. Correctional Medical Services, discussed below, included the word “aggressive.”[32] In her case, there was no evidence that she posed any danger or was objectively aggressive. Officer Turnesky, who supervised Nelson, testified that she never felt threatened by Nelson.[33] The lack of documented attempts of escape and violence from pregnant prisoners suggests that shackling for flight risk is a false pretense and perhaps merely based on stereotypes.[34] In 2011, an Amnesty International report noted that “Around the USA, it is common for restraints to be used on sick and pregnant incarcerated women when they are transported to and kept in hospital, regardless of whether they have a history of violence (which only a minority have) and regardless of whether they have ever absconded or attempted to escape (which few women have).”[35] In a 2020 survey of correctional officers in select midwestern prisons, 76 percent disagreed or strongly disagreed with restraining pregnant women during labor and delivery.[36] If a correctional officer shackles a pregnant prisoner, it is not because they pose a risk but because of a perception that they do. This mindset is attributed to select law enforcement, who have authority to use restraints.[37] In 2022, the Tennessee legislature passed a bill prohibiting the use of restraints on pregnant inmates. However, legislators amended the bill due to the Tennessee Sherriff Association’s belief that even pregnant inmates could pose a “threat.”[38] Subjecting all prisoners to the same “precautions” because a small percentage of individuals may pose such risks could reflect stereotyping or the assumption that all incarcerated people pose danger and flight risk. To quell the (unjustified) public safety concern, there are other options that do not cause physical or mental harm to pregnant women. For example, San Francisco General Hospital does not use shackles but has deputy sheriffs outside the pregnant women’s doors.[39] III. Historical Context and Race A. Slavery and Post-Civil War The treatment of female prisoners has striking similarities to that of enslaved women. Originally, shackling of female slaves was a mechanism of control and dehumanization.[40] This enabled physical and sexual abuses. During the process of intentionally dehumanizing slaves to facilitate subordination, slave owners stripped slave women of their feminine identity.[41] Slave women were unable to exhibit the Victorian model of “good mothering” and people thought they lacked maternal feelings for their children.[42] In turn, societal perception defeminized slave women, and barred them from utilizing the protections of womanhood and motherhood. During the post-Civil War era, black women were reversely depicted as sexually promiscuous and were arrested for prostitution more often than white women.[43] In turn, society excluded black women; they were seen as lacking what the “acceptable and good” women had.[44] Some argue that the historical act of labeling black women sexually deviant influences today’s perception of black women and may lead to labeling them bad mothers.[45] Over two-thirds of incarcerated women are women of color.[46] Many reports document sexual violence and misconduct against prisoners over the years.[47] Male guards have raped, sexually assaulted, and inappropriately touched female prisoners. Some attribute the physical abuse of black female prisoners to their being depicted or stereotyped as “aggressive, deviant, and domineering.”[48] Some expect black women to express stoicism and if they do not, people label them as dangerous, irresponsible, and aggressive.[49] The treatment of these prisoners mirrors the historical oppression endured by black women during and following the era of slavery. The act of shackling incarcerated pregnant women extends the inhumane treatment of these women from the prison setting into the hospital. One prisoner stated that during her thirty-hour labor, while being shackled, she “felt like a farm animal.”[50] Another pregnant prisoner describes her treatment by a guard stating: “a female guard grabbed me by the hair and was making me get up. She was screaming: ‘B***h, get up.’ Then she said, ‘That is what happens when you are a f***ing junkie. You shouldn’t be using drugs, or you wouldn’t be in here.”[51] Shackling goes beyond punishing by isolation from society – it is an additional punishment that is not justified. B. Reproductive Rights and “Bad Mothers” As with slaves not being seen as maternal, prisoners are not viewed as “real mothers.” A female prison guard said the following: “I’m a mother of two and I know what that impulse, that instinct, that mothering instinct feels like. It just takes over, you would never put your kids in harm’s way. . . . Women in here lack that. Something in their nature is not right, you know?”[52] This comment implies that incarcerated women lack maternal instinct. They are not in line with the standards of what society accepts as a “woman” and “mother” and are thought to have abandoned their roles as caretakers in pursuit of deviant behaviors. Without consideration of racial discrimination, poverty issues, trauma, and restricted access to the child right after delivery, these women are stereotyped as bad mothers simply because they are in prison. Reminiscent of the treatment of female black bodies post-civil war and the use of reproductive interventions (for example, Norplant and forced sterilization) in exchange for shorter sentences, I argue that shackles are a form of reproductive control. Justification for the use of shackles even includes their use as a “punitive instrument to remind the prisoner of their punishment.”[53] However, a prisoner’s pregnancy should have no relevance to their sentence.[54] Using shackles demonstrates to prisoners that society tolerates childbirth but does not support it.[55] The shackling is evidence that women are being punished “for bearing children, not for breaking the law.”[56] Physicians and healthcare workers, as a result, are responsible for providing care for the delivery and rectifying any physical problems associated with the restraints. The issues that arise from the use of restraints place physicians in a position more complex than they experience with regular healthy pregnancies. C. Discrimination In the case of Ferguson v. City of Charleston, a medical university subjected black woman to involuntary drug testing during pregnancy. In doing so, medical professionals collaborated with law enforcement to penalize black women for their use of drugs during pregnancy.[57] The Court held the drug tests were an unreasonable search and violated the Fourth Amendment. Ferguson v. City of Charleston further reveals an unjustified assumption: the medical and legal community seemed suspicious of black women and had perhaps predetermined them more likely to use drugs while pregnant. Their fitness to become mothers needed to be proven, while wealthy, white women were presumed fit.[58] The correctional community similarly denies pregnant prisoners’ medical attention. In the case of Staten v. Lackawanna County, an African American woman whose serious medical needs were treated indifferently by jail staff was forced to give birth in her cell.[59] This woman was punished for being pregnant in prison through the withholding of medical attention and empathy. IV. Failure to Follow Anti-Shackling Laws Despite 22 states having laws against shackling pregnant prisoners, officers do not always follow these laws. In 2015, the Correctional Association of New York reported that of the 27 women who gave birth under state custody, officers shackled 23 women in violation of the anti-shackling laws.[60] The lawyer of Tracy Edwards, an inmate who officers shackled unlawfully during her twelve-hour labor stated, “I don’t think we can assume that just because there’s a law passed, that’s automatically going to trickle down to the prison.”[61] Even with more restrictions on shackling, it may still occur, partly due to the stereotype that incarcerated women are aggressive and dangerous. V. Constitutionality The Eighth Amendment protects people from cruel and unusual punishment. In Brown vs. Plata, the court stated, “Prisoners retain the essence of human dignity inherent in all persons.”[62] In several cases, the legal community has held shackling to be unconstitutional as it violates the Eighth Amendment unless specifically justified. In the case of Nelson v. Correctional Medical Services, a pregnant woman was shackled for 12 hours of labor with a brief respite while she pushed, then re-shackled. The shackling caused her physical and emotional pain, including intense cramping that could not be relieved due to positioning and her inability to get up to use a toilet.[63] The court held that a clear security concern must justify shackling. The court cited a similar DC case and various precedents for using the Eighth Amendment to hold correctional facilities and hospitals accountable.[64] An Arkansas law similarly states that shackling must be justified by safety or risk of escape.[65] If the Thirteenth Amendment applied to those convicted of crimes, shackling pregnant incarcerated people would be unconstitutional under that amendment as well as the Eighth. In the Civil Rights Cases, Congress upheld the right “to enact all necessary and proper laws for the obliteration and prevention of slavery with all its badges and incidents.”[66] Section two of the Thirteenth Amendment condemns any trace or acts comparable to that of slavery. Shackling pregnant prisoners, stripping them of their dignity, and justification based on stereotypes all have origins in the treatment of black female slaves. Viewed through the lens of the Thirteenth Amendment, the act of shackling would be unconstitutional. Nonetheless, the Thirteenth Amendment explicitly excludes people convicted of a crime. VI. Justice As a result of the unconstitutional nature of shackling, physicians should have a legal obligation, in addition to their ethical duty, to protect their patients. The principle of justice requires physicians to take a stand against the discriminatory treatment of their patients, even under the eye of law enforcement.[67],[68] However, “badge and gun intimidation,” threats of noncompliance, and the fear of losing one’s license can impede a physician’s willingness to advocate for their patients. The American College of Obstetricians and Gynecologists (ACOG) finds the use of physical restraints interferes with the ability of clinicians to practice medicine safely.[69] ACOG, The American Medical Association, the National Commission on Correctional Health Care, and other organizations oppose using restraints on pregnant incarcerated people.[70] Yet, legislators can adopt shackling laws without consultation with physicians. The ACOG argues that “State legislators are taking it upon themselves to define complex medical concepts without reference to medical evidence. Some of the penalties [faced by OBGYNs] for violating these vague, unscientific laws include criminal sentences.”[71] Legislation that does not consider medical implications or discourages physicians’ input altogether is unjust. In nullifying the voice of a physician in matters pertaining to the patient’s treatment, physicians are prevented from fulfilling the principle of justice, making the act of shackling patients unethical. VII. Principle of Beneficence The principle of beneficence requires the prevention of harm, the removal of harm, and the promotion of good.[72] Beneficence demands the physician not only avoid harm but benefit patients and promote their welfare.[73] The American Board of Internal Medicine Foundation states that physicians must work with other professionals to increase patient safety and improve the quality of care.[74] In doing so, physicians can adequately treat patients with the goal of prevention and healing. It is difficult to do good when law enforcement imposes on doctors to work around shackles during labor and delivery. Law enforcement leaves physicians and healthcare workers responsible not only to provide care for the delivery, but also rectify any ailments associated with the restraints. The issues arising from using restraints place physicians in a position more complex than they experience with other pregnancies. Doctors cannot prevent the application of the shackles and can only request officers to take them off the patient.[75] Physicians who simply go along with shackling are arguably violating the principle of beneficence. However, for most, rather than violating the principle of beneficence overtly, physicians may simply have to compromise. Given the intricate nature of the situation, physicians are tasked with minimizing potential harm to the best of their abilities while adhering to legal obligations.[76] It is difficult to pin an ethics violation on the ones who do not like the shackles but are powerless to remove them. Some do argue that this inability causes physicians to violate the principle of beneficence.[77] However, promoting the well-being of their patients within the boundaries of the law limits their ability to exercise beneficence. For physicians to fulfill the principle of beneficence to the fullest capacity, they must have an influence on law. Protocols and assessments on flight risks made solely by the officers and law enforcement currently undermine the physician’s expertise. These decisions do not consider the health and well-being of the pregnant woman. As a result, law supersedes the influence of medicine and health care. CONCLUSION People expect physicians to uphold the four major principles of bioethics. However, their inability to override restraints compromises their ability to exercise beneficence. Although pledging to enforce these ethical principles, physicians have little opportunity to influence anti-shackling legislation. Instead of being included in conversations regarding medical complexities, legislation silences their voices. Policies must include the physician's voice as they affect their ability to treat patients. Officers should not dismiss a physician's request to remove shackles from a woman if they are causing health complications. A woman's labor should not harm her or her fetus because the officer will not remove her shackles.[78] A federal law could end shackling pregnant incarcerated people. Because other options are available to ensure the safety of the public and the prisoner, there is no ethical justification for shackling pregnant prisoners. An incarcerated person is a human being and must be treated with dignity and respect. To safeguard the well-being of incarcerated women and the public, it is essential for advocates of individual rights to join forces with medical professionals to establish an all-encompassing solution. - [1] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [2] S983A, 2015-2016 Regular Sessions (N.Y. 2015). https://legislation.nysenate.gov/pdf/bills/2015/S983A [3] Chris DiNardo, Pregnancy in Confinement, Anti-Shackling Laws and the “Extraordinary Circumstances” Loophole, 25 Duke Journal of Gender Law & Policy 271-295 (2018) https://scholarship.law.duke.edu/djglp/vol25/iss2/5 [4] Chris DiNardo (2018) [5] U.S. Bureau of Justice Statistics. 1980. " Prisoners in 1980 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/content/pub/pdf/p80.pdf). [6] U.S. Bureau of Justice Statistics. 2022. " Prisoners in 2021 – Statistical Tables”. Retrieved April 20, 2023 (https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/p21st.pdf). [7] U.S. Bureau of Justice Statistics (1980) [8] Sufrin C, Jones RK, Mosher WD, Beal L. Pregnancy Prevalence and Outcomes in U.S. Jails. Obstet Gynecol. 2020;135(5):1177-1183. doi:10.1097/AOG.0000000000003834 [9] Kramer, C., Thomas, K., Patil, A., Hayes, C. M., & Sufrin, C. B. (2022). Shackling and pregnancy care policies in US prisons and jails. Maternal and Child Health Journal, 27(1), 186–196. https://doi.org/10.1007/s10995-022-03526-y [10] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [11] Goshin, L. S., Sissoko, D. R., Neumann, G., Sufrin, C., & Byrnes, L. (2019). Perinatal nurses’ experiences with and knowledge of the care of incarcerated women during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic &amp; Neonatal Nursing, 48(1), 27–36. https://doi.org/10.1016/j.jogn.2018.11.002 [12] Shackling and separation: Motherhood in prison. (2013). AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [13] King, L. (2018). Labor in chains: The shackling of pregnant inmates. Policy Perspectives, 25, 55–68. https://doi.org/10.4079/pp.v25i0.18348 [14] King, L. (2018). [15] AMA Journal of Ethics (2013) [16] Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour. Cochrane database of systematic reviews, (8). [17] Association of Women’s Health, Obstetric and Neonatal Nurses. (2011). AWHONN position statement: Shackling incarcerated pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 40(6), 817–818. doi:10.1111/j.1552-6909.2011.01300.x [18] Ferszt, G. G., Palmer, M., & McGrane, C. (2018). Where does your state stand on shackling of Pregnant Incarcerated Women? Nursing for Women’s Health, 22(1), 17–23. https://doi.org/10.1016/j.nwh.2017.12.005 [19] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [20] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [21] Griggs, Claire Louise. "Birthing Barbarism: The Unconstitutionality of Shackling Pregnant Prisoners." American University Journal of Gender Social Policy and Law 20, no. 1 (2011): 247-271. [22] American Civil Liberties Union. (2012, October 12). ACLU briefing paper: The shackling of pregnant women & girls in U.S ... American Civil Liberties Union (ACLU). https://www.aclu.org/wp-content/uploads/legal-documents/anti-shackling_briefing_paper_stand_alone.pdf [23] King.L (2018) [24] Griggs, Claire Louise (2011) [25] American Civil Liberties Union. (2012) [26] Clarke, J. G., & Simon, R. E. (2013). Shackling and separation: Motherhood in prison. AMA Journal of Ethics, 15(9), 779–785. https://doi.org/10.1001/virtualmentor.2013.15.9.pfor2-1309 [27] Berg, M. D. (2014, April 18). Pregnant prisoners are losing their shackles - The Boston Globe. BostonGlobe.com. Retrieved March 12, 2023, from https://www.bostonglobe.com/magazine/2014/04/18/taking-shackles-off-pregnant-prisoners/7t7r8yNBcegB8eEy1GqJwN/story.html [28] Levi, R., Kinakemakorn, N., Zohrabi, A., Afanasieff, E., & Edwards-Masuda, N. (2010). Creating the bad mother: How the U.S. approach to pregnancy in prisons violates the right to be a mother. UCLA Women's Law Journal, 18(1). https://doi.org/10.5070/l3181017816 [29] Chris DiNardo (2018) [30] Griggs, Claire Louise (2011). [31] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [32] Nelson v. Correctional, 533 F.3d 958 (8th Cir. 2009) [33] Nelson v. Correctional(2009) [34] House, K. T., Kelley, S., Sontag, D. N., & King, L. P. (2021). Ending restraint of incarcerated individuals giving birth. AMA Journal of Ethics, 23(4). https://doi.org/10.1001/amajethics.2021.364 [35] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/ [36] Pendleton, V., Saunders, J. B., & Shlafer, R. (2020). Corrections officers' knowledge and perspectives of maternal and child health policies and programs for pregnant women in prison. Health & justice, 8(1), 1. https://doi.org/10.1186/s40352-019-0102-0 [37] Elizabeth Alexander, Unshackling Shawanna: The Battle Over Chaining Women Prisoners during Labor and Delivery, 32 U. ARK. LITTLE ROCK L. REV. 435 (2010). Available at: https://lawrepository.ualr.edu/lawreview/vol32/iss4/1 [38] Hernandez, J. (2022, April 22). More states are restricting the shackling of pregnant inmates, but it still occurs. NPR. Retrieved March 12, 2023, from https://www.npr.org/2022/04/22/1093836514/shackle-pregnant-inmates-tennessee [39] Sufrin, C. (2012, June 24). End practice of shackling pregnant inmates. SFGATE. Retrieved March 12, 2023, from https://www.sfgate.com/opinion/openforum/article/End-practice-of-shackling-pregnant-inmates-3176987.php [40] Mullings, L. (1997). On our own terms: Race, class, and gender in the lives of African American women. Routledge [41] Ocen, Priscilla A., (2011). [42] Ladd-Taylor, M. (1998). "Bad" mothers: The politics of blame in Twentieth-century America. New York Univ. Press. [43] Hine, D. C. (1998). Hine Sight: Black women and the re-construction of American history. Indiana University Press. [44] Baldwin, L. (2019). Excluded from good motherhood and the impact of prison: Motherhood and Social Exclusion, 129–144. https://doi.org/10.2307/j.ctvk12qxr.13 [45] Ocen, Priscilla A., Punishing Pregnancy: Race, Incarceration, and the Shackling of Pregnant Prisoners (October 3, 2011). California Law Review, Vol. 100, 2012, Available at SSRN: https://ssrn.com/abstract=1937872 [46] Johnson, P. C. (2004). Inner lives: Voices of african american women in prison. New York University Press. [47] Thomas, D. Q. (1996). All too familiar: Sexual abuse of women in U.S. state prisons. Human Rights Watch. [48] Ocen, Priscilla A., (2011). [49] Ashley W. The angry black woman: the impact of pejorative stereotypes on psychotherapy with black women. Soc Work Public Health. 2014;29(1):27-34. doi: 10.1080/19371918.2011.619449. PMID: 24188294. [50] CBS Interactive. (2019, March 13). Shackling pregnant inmates is still a practice in many states. CBS News. Retrieved March 12, 2023, from https://www.cbsnews.com/news/shackling-pregnant-inmates-is-still-a-practice-in-many-states/ [51] Guardian News and Media. (2020, January 24). Pregnant and shackled: Why inmates are still giving birth cuffed and bound. The Guardian. Retrieved March 25, 2023, from https://www.theguardian.com/us-news/2020/jan/24/shackled-pregnant-women-prisoners-birth [52] Oparah, J. C. (2015). Birthing justice: Black women, pregnancy, and childbirth. Routledge. [53] Chris DiNardo (2018) [54] Griggs, Claire Louise (2011). [55] Chris DiNardo (2018) [56] Griggs, Claire Louise (2011). [57] Song, Ji Seon, Policing the Emergency Room (June 10, 2021). 134 Harvard Law Review 2646 (2021), Available at SSRN: https://ssrn.com/abstract=3864225 [58] Ocen, Priscilla A., (2011). [59] Staten v. Lackawanna Cnty., No. 4:07-CV-1329, 2008 WL 249988, at *2 (M.D. Pa. Jan. 29, 2008) [60] Lovett, K. (2018, April 9). Pregnant inmates at New York prisons will no longer be shackled under new law. New York Daily News. Retrieved March 12, 2023, from https://www.nydailynews.com/new-york/new-york-pregnant-inmates-no-longer-shackled-article-1.2474021 [61] Thompson, E. (2022, August 30). Woman sues NC state prison system for mistreatment while pregnant. North Carolina Health News. Retrieved March 12, 2023, from https://www.northcarolinahealthnews.org/2022/05/25/woman-sues-nc-state-prison-system-for-mistreatment-while-pregnant/ [62] Brown v. Plata, 563 U.S. 493 (2011) [63] Nelson v. Correctional Medical Serices, et al., Nelson v. Correctional Med. Servs, 583 F.3d 522 (8th Cir. 2009) [64] Nelson citing Women Prisoners of D.C. Dep't of Corr. v. District of Columbia, 877 F.Supp. 634, 668-69 (D.D.C. 1994), modified in part on other grounds, 899 F.Supp. 659 (D.D.C. 1995). [65] Ark. Dep't of Corr. Admin. Reg. 403 § V (1992) [66] Civil Rights Cases, 109 U.S. 3 (1883) [67] Physician charter. ABIM Foundation. (2022, October 18). Retrieved March 10, 2023, from https://abimfoundation.org/what-we-do/physician-charter#:~:text=Principle%20of%20social%20justice.&text=Physicians%20should%20work%20actively%20to,or%20any%20other%20social%20category. [68] Riddick FA Jr. The code of medical ethics of the american medical association. Ochsner J. 2003 Spring;5(2):6-10. PMID: 22826677; PMCID: PMC3399321. [69] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). Reproductive Health Care for Incarcerated Pregnant, Postpartum, and Nonpregnant Individuals: ACOG Committee Opinion, Number 830. Obstetrics and gynecology, 138(1), e24–e34. https://doi.org/10.1097/AOG.0000000000004429 [70] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [71] American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women (2021). [72] Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press. [73] Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119 [74] Medical professionalism in the new millennium: A physician charter. (2002). Annals of Internal Medicine, 136(3), 243. https://doi.org/10.7326/0003-4819-136-3-200202050-00012 [75] Allen, J. E. (2010, October 21). Shackled: Women Behind Bars Deliver in Chains. ABC News. https://abcnews.go.com/Health/WomensHealth/pregnant-shackled-women-bars-deliver-chains/story?id=11933376&page=1 [76] Jonsen, A. R. (2010). The Birth of Bioethics. Oxford University Press. [77] Beauchamp, T. L., & Childress, J. F. (2019). [78] Amnesty International USA. (1999, March). “Not part of my sentence” Violations of the Human Rights of Women in Custody. Amnesty International USA. Retrieved March 12, 2023, from https://www.amnestyusa.org/reports/usa-not-part-of-my-sentence-violations-of-the-human-rights-of-women-in-custody/

The objective of this article is to explore how suitable Team-Based Learning (TBL) is for students with social and communication disabilities, such as those on the autism spectrum or with social anxiety. TBL is a structured form of Active Collaborative Learning, combining a flipped classroom approach with students working in permanent teams to apply concepts, models and theories into practice. The design of the study was based on an idiographic case study approach at Anglia Ruskin University, UK, treating each student as an individual rather than a representative sample. Towards the end of the academic year 2017/18, an electronic questionnaire was sent out to all students who had taken TBL modules at ARU during the preceding academic year, asking about various aspects of TBL experience. The questionnaire was repeated towards the end of the first semester of 2018/19. The questionnaire was analysed with a focus on questions relating to inclusivity, and the responses related to students who had declared a disability. The questionnaire was followed by semi-structured interviews with students with disabilities who had experienced TBL. We focused primarily on disabilities broadly related to communication, notably with dyslexia, dysgraphia, social phobia and autism that may impair students’ abilities to work in teams. Interviews were audio recorded and then transcribed. Transcriptions were thematically analysed by the research team using NVivo. The results of the study provide anonymized case studies for each of the students who took part in an interview, explaining their disability or condition, their coping strategies for studying in HE, and their experiences, both positive and negative, of the TBL modules they had taken. References Active Collaborative Learning. (2019). Scaling Up Active Collaborative Learning for Student Success. Project website. https://aclproject.org.uk. ARU. (2017). Equality, Diversity and Inclusion at our University. Annual Report. Anglia Ruskin University.https://web.anglia.ac.uk/anet/student_services/public/AngliaRuskinReport_2017_AW_ACCESSIBLE.pdf. ARU. (2018). Student Snapshots. Anglia Ruskin University. https://aru.ac.uk/about-us/equality-diversity-and-inclusion/equality-diversity-and-inclusion-for-students/aru-student-snapshots. ARU. (2020). Disability Support. Anglia Ruskin University. https://aru.ac.uk/student-life/support-and-facilities/study-skills/disability-support. ARU. (2020b). Inclusive Practices. Anglia Ruskin University. https://aru.ac.uk/about-us/equality-diversity-and-inclusion/equality-diversity-and-inclusion-for-students/inclusive-practices. Berkson, R., & Richter, U.M. (2019). Can Active Collaborative Learning Improve Equality? The European Conference on Education 2019 Official Conference Proceedings. https://papers.iafor.org/submission51859/. Berkson, R.G., & Richter, U.M. (2020). Barriers to scaling up active collaborative learning. IN S. Pratt-Adams, U.M. Richter & M. Warnes (Eds.), Innovations in Active Learning in Higher Education, Ch 7. Anglia Ruskin University (in press). Chenail, R. J. (2009). Interviewing the Investigator: Strategies for Addressing Instrumentation and Researcher Bias Concerns in Qualitative Research. The Qualitative Report, 13(4): 14-21. https://nsuworks.nova.edu/tqr/vol13/iss4/14/. Dearnley, Ch., Rhodes, Ch., Roberts, P., Williams, P., & Prenton, S. (2018). Team based learning in nursing and midwifery higher education; a systematic review of the evidence for change. Nurse Education Today, 60: 75-83. http://dx.doi.org/10.1016/j.nedt.2017.09.012. Eksteen, M.J. (2019). Does team-based learning develop essential generic skills in pharmacy students? South African Journal of Higher Education, 33(1). https://www.journals.ac.za/index.php/sajhe/article/view/1332. http://dx.doi.org//10.20853/33-1-1332. Haidet, P., Kubitz, K., & McCormack, W. T. (2014). Analysis of the team-based learning literature: TBL comes of age. Journal on Excellence in College Teaching, 25(3-4): 303-333. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643940/. Hefce. (2018). Differences in student outcomes. The effect of student characteristics. Data Analysis report March 2018/05. https://dera.ioe.ac.uk/31412/1/HEFCE2017_05%20.pdf HM Government. (2017). Industrial Strategy. Building a Britain fit for the future. UK Government White Paper. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/664563/industrial-strategy-white-paper-web-ready-version.pdf. Kent, S., Wanzek, J., Swanson, E.A., & Vaughn, S. (2015). Team-Based Learning for Students with High-Incidence Disabilities in High School Social Studies Classrooms. Learning Disabilities Research & Practice, 30(1): 3-14. https://onlinelibrary.wiley.com/doi/abs/10.1111/ldrp.12048. Koles, P.G., Stolfi, A., Borges, N.J., Nelson S., & Parmelee, D.X. (2010). The impact of team-based learning on medical students' academic performance. Academic Medicine: Journal of the Association of American Medical Colleges, 85(11): 1739-1745. https://pubmed.ncbi.nlm.nih.gov/20881827/ http://dx.doi.org/: 10.1097/ACM.0b013e3181f52bed. Michaelsen, L. K., Davidson, N., & Major, C. H. (2014). Team-based learning practices and principles in comparison with cooperative learning and problem-based learning. Journal on Excellence in College Teaching, 25(3&4): 57-84. https://www.lhthompson.com/uploads/4/2/1/1/42117203/team_based_learning_-_group_work.pdf. Michaelsen, L. K., Knight, A. B., & Fink, L. D. (2004). Team-based learning: A transformative use of small groups in higher education. Sterling, VA: Stylus. McNeil, J., Borg, M., Kennedy, E., Cui, V., Puntha, H., Rashid, Z., Churchill, T., Howitt, E. and Trivedy, K., (2019a). SCALE-UP Handbook 2019-20 (3rd ed). Centre for Academic Development and Quality, Nottingham Trent University. https://www.ntu.ac.uk/__data/assets/pdf_file/0033/906927/FINAL-SCALE-UP-Handbook-2019-20.pdf. McNeil, J., Borg, M., Kerrigan, M., Waller, S., Richter, U., Berkson, R., Tweddell, S., & McCarter, R. (2019b). Addressing barriers to student success. Scaling up Active Collaborative Learning for Student Success. Final Report, 28 March 2019, Updated 28 October 2019. https://aclproject.org.uk/wp-content/uploads/2019/07/NTU-ABSS-Final-Report-revised-Oct-2019.pdf. OECD. (2019). OECD Future of Education and Skills 2030. OECD Learning Compass 2030. A Series of Concept Notes. OECD. http://www.oecd.org/education/2030-project/contact/OECD_Learning_Compass_2030_Concept_Note_Series.pdf. Office for Students. (2019a). Addressing Barriers to Student Success programme. https://www.officeforstudents.org.uk/advice-and-guidance/promoting-equal-opportunities/addressing-barriers-to-student-success-programme/ Office for Students. (2019b). Beyond the bare minimum: Are universities and colleges doing enough for disabled students? OfS Insight Brief 4. https://www.officeforstudents.org.uk/publications/beyond-the-bare-minimum-are-universities-and-colleges-doing-enough-for-disabled-students/#participation. Roulston, K., & Shelton, St. A. (2015). Reconceptualizing Bias in Teaching Qualitative Research Methods. Qualitative Inquiry, (21)4: 332-342. https://journals.sagepub.com/doi/10.1177/1077800414563803. Sangwan, P., & Sangwan, S. (2011). Inclusive Education: A Developmental Approach in Special Education. Journal of Indian Education, 36(4): 18-32. http://www.ncert.nic.in/publication/journals/pdf_files/iea/JIE_FEB2011.pdf#page=20 Sibley, J., & Ostafichuk, P. (2014). Getting Started with Team-Based Learning. Sterling, VA, USA: Stylus. Sisk, R. J. (2011). Team-based learning: systematic research review. Journal of Nursing Education, 50(12): 665–669. https://pubmed.ncbi.nlm.nih.gov/22007709/. Vaccaro, A., Daly-Cano, M., & Newman, B. M. (2015). A sense of belonging among college students with disabilities: An emergent theoretical model. Journal of College Student Development, 56(7): 670-686. https://muse.jhu.edu/article/597267 Vaughn, S., Danielson, L., Zumeta, R., & Holdheide, L. (2015). Deeper Learning for Students with Disabilities. Students at the Center. Deeper Learning Research Series. Boston, MA: Jobs for the Future. https://files.eric.ed.gov/fulltext/ED560790.pdf. Wanzek, J., Vaughn, S., Kent, S.C., Swanson, E.A., Roberts, G., Haynes, M., & Solis, M. (2014). The Effects of Team-Based Learning on Social Studies Knowledge Acquisition in High School. Journal of Research on Educational Effectiveness. 7(2): 183-204. https://www.tandfonline.com/doi/abs/10.1080/19345747.2013.836765. Williams, M., Pollard, E., Helena Takala, H., & Houghton, A-M. (2019). Review of Support for Disabled Students in Higher Education in England. Report to the Office for Students by the Institute for Employment Studies and Researching Equity, Access and Participation. IES Report. Institute for Employment Studies and Researching Equity, Access and Participation. https://www.officeforstudents.org.uk/media/a8152716-870b-47f2-8045-.fc30e8e599e5/review-of-support-for-disabled-students-in-higher-education-in-england.pdf World Economic Forum. (2018). The Future of Jobs 2018. Insight Report. Centre for the New Economy and Society. http://www3.weforum.org/docs/WEF_Future_of_Jobs_2018.pdf.

¿Qué sabemos sobre evolución? ¿Por qué deberíamos conocer sobre ella? ¿Qué aporta a la comprensión del conocimiento biológico? ¿Qué controversias instala su argumentación?En el presente año se conmemora el 150 aniversario de la publicación “El Origen de las Especies” (El origen de las especies mediante la selección natural o la conservación de las razas favorecidas en la lucha por la vida), y los 200 años del nacimiento de su autor Charles Darwin. Cuando indagamos en la obra de Darwin, la teoría nos resulta asombrosamente simple y deslumbrantemente obvia para explicar la diversidad orgánica y la notable adaptación de los organismos: en la naturaleza las poblaciones tienden a crecer geométricamente, pero los recursos que necesitan para sobrevivir y reproducirse (alimento, refugio) actúan como limitantes ya que tienen un crecimiento aritmético. De esta manera, el ambiente impone una presión por la cual no todos los que nacen van a sobrevivir y reproducirse. Agreguemos que los organismos de una población muestran variabilidad entre ellos (poseen variantes en los rasgos que los hacen diferentes a unos de otros). Esas diferencias en los rasgos en el momento de tener que obtener los recursos para sobrevivir los posiciona a unos mejor que a otros en la competencia. Aquellos organismos que posean rasgos que les permitan utilizar mejor los recursos y así sobrevivir o reproducirse mejor (están más adaptados o ajustados al ambiente) irán reemplazando a aquellos menos capaces, que se reproducen o sobreviven en menor grado. Hay así mortalidad o reproducción no aleatoria –o diferencial- con respecto a los caracteres (ocurre selección natural). De este modo, los individuos con el rasgo que fue seleccionado favorablemente se encontrarán en mayor frecuencia (estarán numéricamente más representados) que los restantes en las próximas generaciones, resultando en cambios que diferencian una generación de otra (evolución). Desde que Darwin concibió la teoría al hoy ha recibido aportes que han mejorado muchísimo su salud intelectual. En un amplio sector de la sociedad esta “simple” teoría cambió para siempre la visión del mundo, y el lugar del hombre en él. Sacudió las bases del pensamiento humano generando una verdadera revolución intelectual en los distintos campos de la ciencia y de la cultura. La profundidad de su aporte aún sigue siendo asunto de interés para biólogos, historiadores, sociólogos, antropólogos, filósofos, educadores y políticos. Es entonces bueno preguntarnos cómo algo tan aparentemente simple y de tan alto significado y trascendencia en la historia de la ciencia y de la cultura humana es ignorada, resistida o rechazada por algunos sectores de la comunidad, y en particular en los ámbitos de la educación. Podríamos intentar pensar en motivos que podrían participar en ello, considerando las más variadas combinaciones: ausencia de esos contenidos en las clases, docentes no informados, prohibiciones emanadas desde la autoridad escolar, poco incentivo institucional, textos y programas con contenidos evolutivos al final y poco o mal desarrollados, falso dilema ciencia versus religión, fundamentalismo religioso, desconocimiento de la posición de las religiones sobre el tema.En nuestro país, resulta llamativa, salvo excepciones, la ausencia del tratamiento o el tratamiento superficial de la cuestión de la evolución en institutos de formación docente, y por consiguiente en muchos establecimientos de enseñanza media a pesar de que aparezca como parte del currículo en los documentos oficiales. Es muy posible entonces que muchos docentes de escuelas no comprendan los conceptos que deberían enseñar. Alicia Massarini y otros colaboradores (2009) en una encuesta realizada a profesores de Biología entre 2004 y 2007 en la ciudad de Buenos Aires presentó datos reveladores. El 33% manifestó que los principales contenidos de la biología evolutiva estaban ausentes en los programas de su formación. El 77%, que no contaba con recursos apropiados para enseñarlos, y el 78% no tuvieron oportunidad de acceder a cursos de actualización sobre el tema. Así, para muchos ciudadanos que no han accedido a estudios superiores la teoría de la evolución podría resultar falsa y otros más no sabrían absolutamente nada de ella. Agreguemos también que para muchos la evolución es a menudo vista como contenciosa y problemática, y seguiremos sumando respuesta al por qué sus contenidos son resistidos en los programas escolares. El 14% de los docentes encuestados por Massarini y col. (2009) admitió que recibió recomendaciones o prohibiciones en contra de la enseñanza de la evolución. “Hay escuelas religiosas donde los directivos consideran que atenta contra el dogma de fe. Ocurre en escuelas católicas, pero también en escuelas judías ortodoxas”. Se da también el caso de muchos estudiantes que tienen mayor dificultad para entender y aceptar los conceptos evolutivos que otros contenidos. ¿Por qué? En muchas familias la fuerte raigambre religiosa motiva que se considere que los contenidos de la biología evolutiva intersecta con valores religiosos. Ello les plantearía un dilema intelectual y espiritual que motivaría una elección entre convicciones religiosas y la credibilidad de la evolución (Sinclair y Pendarvis, 1997). Esta situación genera evidentemente preconceptos de raíz profunda en los alumnos provenientes de esos ámbitos, contra los cuales se hace necesario entablar una activa y tenaz lucha durante el proceso de enseñanza-aprendizaje (Alters y Nelson, 2002). Ellos traen explicaciones relacionadas al origen de la vida, a la diversidad y al cambio orgánico, teñidas con connotaciones finalistas e intencionales, dando a entender que los cambios biológicos se producen para alcanzar un fin, un objetivo (Bartov, 1978). Debemos ser cuidadosos entonces para que estas ideas no se generen o se refuercen en el contexto escolar a consecuencia del propio proceso de enseñanza-aprendizaje. Muchas, o la mayoría, de las personas desconocen en realidad que el supuesto conflicto entre ciencia y religión ofrece un debate que sólo existe en sus cabezas y en las prácticas sociales, no en la lógica, ya que se ocupan de temas completamente distintos. La función de ser de la ciencia es muy diferente al de la iglesia. Cada una tiene un ámbito específico, los cuales son tan diferentes por sus objetos y métodos de estudio que hace no factible establecer discusiones o comparaciones en un mismo terreno. La ciencia estudia los objetos propios de la naturaleza y tiende a la producción de conocimiento. La iglesia opera en el reino de los fines, los significados y los valores humanos (la moral y lo sobrenatural), y aborda las escrituras y la difusión de la palabra de Dios. Es importante entonces que las personas reconozcan que la ciencia y las creencias tienen dominios separados, y que hay muchos científicos que practican en forma activa alguna religión, y aceptan la teoría evolutiva como una explicación del mundo natural (Brickhouse et al., 2000; Antolin y Herbers, 2001). En la Iglesia Católica ha habido ya pronunciamientos por eminentes miembros del clero a favor de algunos de los postulados de la teoría de evolución. Pío XII había considerado a la evolución como una indagación adecuada en la encíclica Humani Generis publicada en 1950. Pío XII dice: “La autoridad de Enseñanza de la Iglesia no prohíbe que, de conformidad con el estado actual de las ciencias humanas y de la sagrada teología, investigación y discusiones, por parte de hombres experimentados en ambos campos, tengan lugar con respecto a la doctrina de la evolución, en tanto en cuanto éstas indaguen el origen del cuerpo humano en tanto que procedente de materia viva y preexistente; porque la fe católica nos obliga a sostener que las almas son creadas inmediatamente por Dios”. Así, los católicos pueden aceptar la evolución del cuerpo mientras acepten la creación del alma. Juan Pablo II empieza resumiendo la vieja encíclica de Pío, reafirmando la independencia de los magisterios, y diciendo que entre el pontificado de Pío y el suyo ha sido testigo de tal crecimiento de datos, y de tal refinamiento de la teoría, que las personas de buena voluntad y de intelecto sensible ya no pueden dudar de la evolución. El mismo Darwin negaba constantemente utilizar la evolución para cuestiones religiosas, excepto para refutar la vieja ilusión de que una naturaleza intrínsecamente benéfica registre la existencia y los atributos de Dios. Los estudiosos de la biología reconocen que la naturaleza está repleta de comportamientos que nuestras tradiciones morales calificarían de repulsivos y crueles que pondrían en duda la brillantez y hermosura de la “creación”. Gould (2000) retrata claramente esta situación: “El significado moral de la vida no está expuesto en la factualidad de la naturaleza. El mundo natural es absolutamente incapaz de proporcionarnos ninguna instrucción moral para la conveniencia humana. La naturaleza es amoral, no inmoral, construida sin referencia a este concepto estrictamente humano. Estaba mucho tiempo antes de que llegáramos nosotros, y no sabía que íbamos a venir, y no le importamos un comino. La naturaleza, simplemente, es... en toda su complejidad y diversidad, en toda su sublime indiferencia a nuestros deseos. Por tanto, no podemos utilizarla para nuestra educación moral. Las soluciones a cuestiones de moral y significados deben buscarse en el lugar adecuado: dentro de nosotros mismos”.Por otro lado, la controversia fundamentalista que se plantea en EEUU con la evolución, e importada graciosamente a nuestro país, aporta también al rechazo de la teoría. Esta situación no tiene sentido en ninguna nación predominantemente católica como la nuestra, donde no ha existido nunca tradición de leer la Biblia literalmente. Los fundamentalistas de movimientos religiosos protestantes como presbiterianos, bautistas, episcopales y los de otras denominaciones, creen que la Biblia es la palabra literal de Dios. La Biblia dice que Dios creó el mundo en seis días; por lo tanto, así debió suceder. Esta no es una posición del catolicismo en general. Las contradicciones en la Biblia no plantean ningún problema a la inmensa mayoría de personas religiosas que consideran a esta obra como un documento inspirado lleno de verdad moral, y no como una crónica precisa de la historia humana o un relato perfecto de los hechos acontecidos. Desde lo religioso, todo el mundo tiene derecho a tener la propia. Todo el mundo tiene derecho a pensar lo que quiera. Pero en el ámbito de la educación, particularmente al desarrollar contenidos provenientes de las ciencias factuales como la biología, uno está comprometido con una manera de razonar, tiene que seguir ciertas reglas, respetar ciertos juegos estrictos, no tiene derecho a mezclar y a imponer. No debemos caer en la vieja propensión humana de adoptar la esperanza y descartar la lógica, en creer lo que deseamos en lugar de lo que observamos. Debemos hacernos cargo de la confrontación apasionadas en temas que tienen carga pasional, y no adoptar la táctica completamente evasiva de no generar conflicto al no hablar de ciertos temas. El enemigo no es la ciencia o la religión, sino esa mezcla explosiva que resulta de la ignorancia, el dogmatismo y la intolerancia. La cabal comprensión de la teoría evolutiva es imprescindible para el profesor en ciencias biológicas, así como luego su desarrollo en la enseñanza con sus alumnos, tanto por sus implicaciones teóricas integradoras, como por su significación para hacer más efectivas las aplicaciones de la biología. La teoría de la evolución es la teoría más integradora de la biología, la que brindando el soporte conceptual permite la construcción de explicaciones a la mayoría de los hechos biológicos. Sin ella, la biología en su mayoría sería un conjunto de enunciados desagregados sobre hechos biológicos. Es una de las pocas “grandes ideas” que se refiere a profundas cuestiones que podrían fascinar a los jóvenes: ¿De dónde venimos? ¿Dónde surgió la vida? ¿Cómo se desarrolló? ¿De qué modo se hallan emparentados los organismos? ¿Cómo se explican las diferencias y las semejanzas entre los organismos? Indudablemente son preguntas fascinantes que obligan a pensar y podrían ser objeto de interesantes debates. Es importante que los educadores impartan esto, por ejemplo, con discusiones sobre excitantes aplicaciones modernas de la investigación evolutiva sobre biotecnología, biorremediación y salud ambiental para la emergencia de nuevas enfermedades. Vale la pena, entonces, que los docentes realicen un esfuerzo que asegure una mejor comprensión de su parte de las teorías evolutivas, y que dediquen mayor tiempo en las escuelas a impartir una de las más ingeniosas e impactantes ideas científicas.Referencias bibliográficas Alters, B. J. y C. E. Nelson. 2002. Perspective: teaching evolution in higher education. Evolution, 56, pp. 1891-1901. Antolín, M. F. y J. M. Herbers. 2001. Perspective: Evolution ?s struggle for existence in America ?s public schools. Evolution, 55, pp. 2379-2388. Bartov, H. 1978. Can students be taught to distinguish between teleological and causal explanations? Journal of Research in Sciences Teaching, 18, pp. 79-86. Brickhouse N. W., Z. R. Dagher, W. J. Letts y H. Shipman. 2000. Diversity of students ? views about evidence, theory, and the interface between science and religion in an Astronomy course. Journal of Research in Sciences Teaching, 37, pp. 340-362. Darwin, Ch. 1983. El Origen de las Especies. Sarpe. Madrid. Gould, S. J. 2000. Ciencia versus Religión. Un falso conflicto. Drakontos. Barcelona. Massarini, A. et al. 2009. Congreso de la Asociación de Docentes de Biología. Clarín, 19.01.09. Sinclair A. y M. P. Pendarvis. 1997. The relationship between college zoology students ? beliefs about evolutionary theory and religion. Journal of Research and Development in Education, 30, pp. 118-125.