 But what do they signify?
 But what do they signify?
Kevin J. Mitchell, Ph.D., "Sex on the Brain" published by Aeon Magazine, https://aeon.co/essays/the-gender-wars-will-end-only-with-a-synthesis-of-research
Published by Aeon Magazine https://aeon.co/essays/the-gender-wars-will-end-only-with-a-synthesis-of-research
By Kevin Mitchell is a neurogeneticist. He is associate professor at the Smurfit Institute of Genetics and the Institute of Neuroscience at Trinity College Dublin. His latest book is Innate: How the Wiring of Our Brains Shapes Who We Are (2018). He lives in Portmarnock, Ireland.
Edited by Marina Benjamin
Sex differences really do exist. Men and women, boys and girls, really do behave differently. The question – and difficultly – lies in establishing where these differences come from. Are the sexes wired differently? Or does culture explain observed behavioural differences? The answers are yes and yes; but, unfortunately, biological and cultural explanations are so often seen as mutually exclusive that a middle ground can be hard to discern. Instead, the debate about the origins of sex differences tends to get polarised into extreme positions, with straw persons being erected and toppled by each camp, while epithets of ‘neurosexism’ and ‘sex-difference denier’ are lobbed across the divide.
The debate is especially contentious at the moment, with proponents of nature or nurture each claiming that the latest brain science proves their position. Results from neuroimaging studies are pointed to as ‘proof at last’ that the brains of men and women really are innately different, and that these differences explain the differences we see in behaviour. Yet the very same results are held up as evidence that there really is no such thing as a ‘male brain’ or ‘female brain’, and that any observable differences between the sexes are not innate in origin, but owe to the effects of growing up in a gendered environment. Either way, important implications for social policy are drawn, based on the favoured interpretation of the evidence.
In her recent book, The Gendered Brain (2019), the English neuroscientist Gina Rippon argues against the ‘myth’ of innate biological differences and claims that brain and behavioural differences arise instead from cultural forces. She provides compelling evidence that much of the historical research in this area has been (and, in some cases, continues to be) driven by an overtly or implicitly sexist agenda, intent on finding scientific proof of female inferiority.
In the other corner, the Canadian psychologist Jordan Peterson contends on Twitter that: ‘Sex differences are large and biological/innate. The science is clear. The opposing sociology is delusional.’ In a now-infamous memo, the Google employee James Damore argued in 2017 that innate sex differences in interests and aptitudes partly explain observed differences in occupational choices, especially the relative lack of women in STEM fields (and at Google). Damore was promptly fired for his intemperate comments, and roundly excoriated by many commentators. Yet in other quarters, he was celebrated as a brave proponent of free speech and scientific truth.
Both sides can end up arguing for rather blinkered positions. Peterson, for example, maintains that the pay gap can be explained by women scoring higher, on average, in the personality trait of agreeableness: training women to be less agreeable, he contends, would improve their financial success in the workplace. Meanwhile, the Canadian cognitive scientist Steven Pinker recently decried an article in The New York Times – which looked at why women do more than their share of the housework – for not considering biological sex differences as a possible factor. Even if he had a point, his apparent disregard for entrenched patriarchal norms scotched any sympathy he might have found on social media.
Meanwhile, the American psychologist Michael Reichert argued, also in The New York Times, that ‘violence springs from what boys learn about what it means to be a man’ – as opposed to any inborn tendencies towards physical aggression. This despite the scientific evidence showing that sex differences in physical aggression are universal across human societies, have a cogent evolutionary rationale, manifest in most other mammalian species, and have well-worked-out biological mechanisms.
Much of the cultural discussion around sex differences amounts, in the words often attributed to the American philosopher William James, to people simply ‘rearranging their prejudices’ so as to privilege evidence that supports their position, while focusing the full glare of a skeptical spotlight on contradictory findings. Rippon, for example, rightly critiques shoddy early neuroimaging work that claimed to have found biologically driven brain differences directly accountable for observed sex differences in behaviour.
We are all human, of course: all subject to this kind of confirmation bias. At least a researcher’s position on the primary question of the origins of sex differences is typically made explicit. But people working in different disciplines and reading various literatures will also entertain a host of underlying subsidiary beliefs that are less overt, and that strongly influence how they weigh various types of evidence or argument. They might have strong prior positions on whether individuals have any innate psychological predispositions and if such traits are influenced by genetics; whether findings in animals are relevant to human psychology; whether human minds have been shaped by their recent evolutionary past; if experience can reshape brain structure, or personality traits play a larger role in explaining behaviour.
These deep but usually unstated differences in starting positions leave scientists and commentators talking past each other, and the general public none the wiser. They can even lead to the same data being interpreted in diametrically opposed ways – which raises the question of where the solid scientific ground actually lies. Nowhere is this more apparent than in the interpretation of results from neuroimaging studies.
In a 2015 study that has given rise to the ‘mosaic brain’ hypothesis, the psychologist Daphna Joel at Tel Aviv University and colleagues analysed brain scans from more than 1,400 people, looking for regions of the brain where there was a statistically significant difference in volume between the sexes. They found 10 regions showing such differences, some larger in males, some in females. On the face of it, their findings seemed to support the idea that male and female brains are structurally distinct. However, each of the 10 regions under scrutiny varies in volume across individuals anyway, with the distribution simply shifted slightly higher or lower in the other sex. Joel’s team found that very few individuals showed extreme ‘male’ or ‘female’ values for all 10 regions; instead, most showed a pattern of values falling mainly in the overlapping zones, with only a general trend towards one end or the other.
The authors concluded that the brains of males and females are not categorically distinct. In other words, there is no such thing as a ‘male brain’ or a ‘female brain’. Rather, they suggest that each individual’s brain is a ‘mosaic’ of masculinised and feminised regions, the implication being that we should not expect biologically driven sex differences in behaviour. Yet, within months, multiple other researchers showed that the same data could very reliably be used to categorise individual brains as male or female. While the volume of any individual area is a terrible predictor of sex, a multivariate analysis gives very good discrimination. On this reading, the brains of males and females are not dimorphic, with two completely different forms, like genitalia; instead, they show a correlated set of shifts in the size of various features, similar to what is observed for male and female faces, which are also readily distinguished.
Another neuroimaging study that drew media attention for the contrary readings it spawned was undertaken in 2014 by the neuroscientist Madhura Ingalhalikar and colleagues at the University of Pennsylvania. They measured the connections between brain regions, and found some sex differences in organisation, with females tending to have more connections between the two hemispheres, and males having slightly more running front-to-back within each hemisphere. The data seemed pretty robust, and fit with prior findings of greater cross-hemispheric connectivity in females. Still, the authors were criticised for how they interpreted the findings. They speculated – rather freely – that ‘male brains are structured to facilitate connectivity between perception and coordinated action, whereas female brains are designed to facilitate communication between analytical and intuitive processing modes’. In the press release for their paper, they claimed that the differences could explain why ‘men are more likely better at learning and performing a single task at hand, like cycling or navigating directions, whereas women have superior memory and social cognition skills, making them more equipped for multitasking and creating solutions that work for a group’.
In the absence of any causal link between the observed differences in brain structure and those in behaviour, such claims are purely speculative. Nor were the chosen examples of supposed sex differences in behaviour particularly convincing (are men really psychologically more suited to cycling?). Claims like these rely on unsupported inferences of there being close links between the size of bits of the brain and performance of complex human behaviours.
As it happens, there is good evidence that male and female brains are structurally different at the macroscopic scale. A number of recent, largescale neuroimaging studies have found numerous small but correlated differences that collectively distinguish male and female brains in the samples studied. However, just observing such differences doesn’t prove that they are driven by innate biological factors. Indeed, a prominent argument – advanced by Rippon, among others – is that they are caused by our brains reacting to the differing experiences of males and females in a culture that is pervasively gendered.
The focus on neuroimaging is a bit of a red herring in the sex-difference wars
Our brains are, of course, highly plastic and designed to respond to experience. But most of that plasticity happens on a microscopic scale – changing the weights of connections between neurons. The idea that culturally loaded experience can drive macroscopic differences in the size of bits of the brain is something else entirely. That claim relies on a small number of studies, such as the one from 2000 showing that London taxi drivers have a larger posterior hippocampus, which seems to have acquired an almost mythic lore, despite the collective evidence base being quite limited.
The idea that brain areas might grow with use, or that levels of neural activity might change in regionally specific ways as a result of the quality of experience is both vague and speculative. Despite myths to the contrary, we are effectively using all of our brain all of the time, while awake at least. If brain tissue were really like muscle, our brains would be busting out of our skulls. And if growth of one area occurred at the expense of neighbouring regions (which would seem like a design flaw), then you’d expect a complementary pattern of brain differences – each bit that is relatively bigger in males would be adjacent to a bit that is relatively smaller – which is not observed.
Given that neuroanatomical sex differences are consistently observed in children – even reported in infants as young as one month old – and are ubiquitous across other animal species (with well-worked-out developmental mechanisms in many cases), it seems likely that observed neuroanatomical sex differences in humans are the result of conserved programmes of masculinisation or feminisation of brain development. But here’s the thing – we don’t know what these differences mean. Really, we have no clue. This is not unique to sex differences: we don’t know what any differences in the size of little bits of the brain mean. And this is despite countless efforts to link variation in size of this or that brain region or this or that nerve tract to a corresponding variation in psychological or behavioural traits, and no shortage of reports of such correlations in the literature.
The relationship between bits of the brain and cognitive functions or behaviours is simply not so modular. This is only a modern version of phrenology, where the size and shape of depressions and bumps on the skull was supposed to reveal the size of underlying brain areas and the consequent psychology of individuals. The complexity of the cellular circuitry and connectivity of any given region is too great for its function to be straightforwardly mapped to the amount of neural real estate it occupies.
What we do know is that most of the known sex differences in the brains of other animals are found in small but important populations of cells, themselves located in tiny brain regions with exotic names such as the ‘interstitial nucleus of the hypothalamus’ or the ‘bed nucleus of the stria terminalis’. These structures mainly control the subconscious organisation of behaviour and physiology, with important roles in mating, reproductive physiology, social behaviours, threat monitoring, aggression, fear, energy balance, and the like. By contrast, while the cerebral cortex is easy to assay with neuroimaging, it’s not necessarily the business end of the brain when it comes to the kind of behavioural differences we are interested in.
The focus on neuroimaging is thus a bit of a red herring in the sex-difference wars. The technology is simply not able to detect all the differences that might exist in neural circuitry between men and women, nor are scientists able to interpret those differences it can detect, let alone resolve the issue of whether any purportedly associated differences we observe in male and female behaviour are due to biological or cultural factors.
 If such traits – thought to reflect some basic brain processes – differ consistently between males and females, then that would seem to favour a biological explanation for differences in behaviour. But, as with neuroanatomical differences, merely observing differences in such traits is not sufficient to settle the debate as to their origins or effects. What is observed is a spectrum – from traits where sex differences have a clear, conserved biological basis and strongly drive behaviours, to traits whose origins are murkier and the link to behaviour far more tenuous. The traits with strongest evidence of biological origins are, not surprisingly, the ones most closely linked to reproduction and mating strategies.
Sexual preference is the most obvious. So obvious that it is often overlooked, as if it just happens by default that some human beings are attracted to males and some to females. Those states don’t just happen. They are the outcome of a programme of masculinisation or feminisation of neural circuits that mediates sexual attraction, with principles and mechanisms well-worked-out in other mammals.  Human males are far more physically violent than females, across all cultures, committing the vast majority of serious assaults and homicides, and making up the vast majority of the victims. A similar sex difference is observed in many mammals, including most primates, in accord with the ecological pressures of competition for mates.
These differences in sexuality and aggression relate closely to reproductive strategies and behaviours; they are expected from an evolutionary perspective, have direct correlates in other species, and are associated with specific neural mechanisms that are beginning to be well-elucidated in model organisms. There is no good reason why a biological origin for these differences should be controversial.
But then such differences are also not really the things that much of the debate hangs on. Of much more relevance are possible differences in cognitive abilities, personality traits, aptitudes and interests.
Much has been written, over the centuries, about women’s supposedly inferior cognitive abilities. In fact, modern IQ tests show no difference in mean scores between men and women (though men show higher variance), and in many countries girls now regularly outperform boys in academic exams. There are, however, measurable differences in very specific cognitive abilities, such as a male advantage in mental rotation of three-dimensional objects, and a female advantage in verbal fluency. The difference in mental rotation shows up early, by age four or five, is moderate in size, and universally observed across cultures. Much is made of these differences. An OECD report in 2017 reviewed evidence that ‘students with higher scores on tests of spatial ability were substantially more likely to enter careers in science and mathematics’, yet the same report summarised data showing that spatial ability was fundamentally malleable, and could be improved by training and experience, suggesting an interplay of nature and nurture.
Even in the most individualistic societies, there are limits on the extent to which we independently create ourselves
There are other consistent sex differences in personality traits. In particular, females average slightly higher on the broad traits of neuroticism, agreeableness and conscientiousness. More specifically, males tend to score higher on traits such as assertiveness, sensation-seeking and dominance, while females average higher on gregariousness, sociability and nurturance. In psychometric analyses of interests, females consistently show a greater interest in people, on average, while males show a greater interest in things. Unlike sexual behaviours and aggression, most of these cognitive and personality traits are not so convincingly linked to reproductive success or to ecological roles. And, since they don’t have direct correlates in other species, we know much less about their biological underpinnings. They might have biological origins (since genetic differences influence these traits in a general sense), but there is also plenty of scope for cultural effects to have an important influence.
If the origins of these differences remain unclear, so too do their consequences. And yet arguing about the kinds of effects that these small average differences in psychological traits have on patterns of real-world behaviour and societal outcomes are the real flashpoints in this debate: are women suited to careers in STEM areas or not? Is the pay gap due to differences in traits such as agreeableness? Generally speaking, correlations between personality traits and a variety of consequential social outcomes – happiness, educational attainment, job performance, health, longevity – are weak, and the predictive power for individuals is very low. And that’s when we look at the full range of trait values across the whole population. But the sex differences discussed here are tiny relative to that range, meaning that any predictive value for outcomes will be correspondingly reduced.
When scientific findings are interpreted for media consumption or popular debate, the complexity and dynamism underlying the relationship between personality traits is typically underplayed. Our behaviour is not simply determined on a moment-to-moment basis by the tuning of these parameters. Innate predispositions provide a baseline – some initial tendencies to behave in one general way or another. And these initial tendencies influence how we interact with the world and subjectively experience it, as well as the kinds of environments we select and build. They can have a cumulative effect on how our individual habits and characters emerge, how we adapt to our environments, and the expectations we set of ourselves. But the idea that this just happens without any outside influence is naive.
Even in the most individualistic societies, there are limits on the extent to which we independently create ourselves. Societal outcomes are not simply an expression of the free choices of individuals, as some commentators seem to imply. With regard to sex differences, we have to consider the wider factors in play, including group dynamics, gender affiliation, the presence or absence of role models, societal norms and expectations, outright sexual discrimination and other systematic effects of culture.
For some behaviours, these forces can collectively act to amplify small group-average differences in psychology and habit-formation by setting expectations that become self-reinforcing. For example, aggressiveness (of a nonviolent nature) might be rewarded in males, while being discouraged in females. For other differences, such as choice of professions, culture might impose arbitrary norms and expectations that don’t reflect innate biological differences at all.
 We don’t have a ‘get out of evolution free’ card, but we are also not meat robots whose behaviour is determined by the positions of a few knobs and switches, independent of any societal forces. One thing is clear: we’ll never get to grips with the complexity of the interactive mechanisms in play if the debate remains polarised. We need a synthesis of findings and perspectives from genetics, neuroscience, psychology and sociology, not a war between them.


Chapter outline
5.1 [Chapter title goes here]
5.2 [Chapter title goes here]
5.3 [Chapter title goes here]
5.4 [Chapter title goes here]
5.5 [Chapter title goes here]
5.6 [Chapter title goes here]
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The Underground Railroad
Crossing the Bay in a Skiff
WILLIAM THOMAS COPE, JOHN BOICE GREY, HENRY BOICE AND ISAAC WHITE.
These young bondmen, whilst writhing under the tortures heaped upon them, resolved, at the cost of life, to make a desperate trial for free land; to rid themselves of their fetters, at whatever peril they might have to encounter. The land route presented less encouragement than by water; they knew but little, however, concerning either way. After much anxious reflection, they finally decided to make their Underground Rail Road exit by water. Having lived all their lives not far from the bay, they had some knowledge of small boats, skiffs in particular, but of course they were not the possessors of one. Feeling that there was no time to lose, they concluded to borrow a skiff, though they should never return it. So one Saturday evening, toward the latter part of January, the four young slaves stood on the beach near Lewes, Delaware, and cast their longing eyes in the direction of the Jersey shore. A fierce gale was blowing, and the waves were running fearfully high; not daunted, however, but as one man they resolved to take their lives in their hands and make the bold adventure.
With simple faith they entered the skiff; two of them took the oars, manfully to face uncertain dangers from the waves. But they remained steadfast, oft as they felt that they were making the last stroke with their oars, on the verge of being overwhelmed with the waves. At every new stage of danger they summoned courage by remembering that they were escaping for their lives.
Late on Sunday afternoon, the following day, they reached their much desired haven, the Jersey shore. The relief and joy were unspeakably great, yet they were strangers in a strange land. They knew not which way to steer. True, they knew that New Jersey bore the name of being a Free State; but they had reason to fear that they were in danger. In this dilemma they were discovered by the captain of an oyster boat whose sense of humanity was so strongly appealed to by their appearance that he engaged to pilot them to Philadelphia. The following account of them was recorded:
William Thomas was a yellow man, twenty-four years of age, and possessing a vigorous constitution. He accused Shepherd P. Houston of having restrained him of his liberty, and testified that said Houston was a very bad man. His vocation was that of a farmer, on a small scale; as a slave-holder he was numbered with the “small fry.” Both master and mistress were members of the Methodist Church. According to William Thomas’ testimony his mistress as well as his master was very hard on the slaves in various ways, especially in the matter of food and clothing. It would require a great deal of hard preaching to convince him that such Christianity was other than spurious.
John stated that David Henry Houston, a farmer, took it upon himself to exercise authority over him. Said John, “If you didn’t do the work right, he got contrary, and wouldn’t give you anything to eat for a whole day at a time; he said a ‘nigger and a mule hadn’t any feeling.'”   John firmly believed that his brother had been the victim of a monstrous outrage, and that he too was liable to the same treatment.
John was only nineteen years of age, spare built, chestnut color, and represented the rising mind of the slaves of the South.
Henry was what might be termed a very smart young man, considering that he had been deprived of a knowledge of reading. He was a brother of John, and said that he also had been wrongfully enslaved by David Houston, alluded to above. He fully corroborated the statement of his brother, and declared, moreover, that his sister had not long since been sold South, and that he had heard enough to fully convince him that he and his brother were to be put up for sale soon.
Of their mistress John said that she was a “pretty easy kind of a woman, only she didn’t want to allow enough to eat, and wouldn’t mend any clothes for us.”
Isaac was twenty-two, quite black, and belonged to the “rising” young slaves of Delaware. He stated that he had been owned by a “blacksmith, a very hard man, by the name of Thomas Carper.” Isaac was disgusted with his master’s ignorance, and criticised him, in his crude way, to a considerable extent. Isaac had learned blacksmithing under Carper. Both master and mistress were Methodists. Isaac said that he “could not recommend his mistress, as she was given to bad practices,” so much so that he could hardly endure her. He also charged the blacksmith with being addicted to bad habits. Sometimes Isaac would be called upon to receive correction from his master, which would generally be dealt out with a “chunk of wood” over his “no feeling” head. On a late occasion, when Isaac was being chunked beyond measure, he resisted, but the persistent blacksmith did not yield until he had so far disabled Isaac that he was rendered helpless for the next two weeks. While in this state he pledged himself to freedom and Canada, and resolved to win the prize by crossing the Bay.
While these young passengers possessed brains and bravery of a rare order, at the same time they brought with them an unusual amount of the soil of Delaware; their persons and old worn-out clothing being full of it. Their appearance called loudly for immediate cleansing. A room—free water—free soap, and such other assistance as was necessary was tendered them in order to render the work as thorough as possible. This healthy process over, clean and comfortable clothing were furnished, and the change in their appearance was so marked, that they might have passed as strangers, if not in the immediate corn-fields of their masters, certainly among many of their old acquaintances, unless subjected to the most careful inspection. Raised in the country and on farms, their masters and mistresses had never dreamed of encouraging them to conform to habits of cleanliness; washing their persons and changing their garments were not common occurrences. The coarse garment once on would be clung to without change as long as it would hold together. The filthy cabins allotted for their habitations were in themselves incentives to personal uncleanliness. In some districts this was more apparent than in others. From some portions of Maryland and Delaware, in particular, passengers brought lamentable evidence of a want of knowledge and improvement in this direction. But the master, not the slave, was blameworthy. The master, as has been intimated, found but one suit for working (and sometimes none for Sunday), consequently if Tom was set to ditching one day and became muddy and dirty, and the next day he was required to haul manure, his ditching suit had to be used, and if the next day he was called into the harvest-field, he was still obliged to wear his barn-yard suit, and so on to the end. Frequently have such passengers been thoroughly cleansed for the first time in their lives at the Philadelphia station. Some needed practical lessons before they understood the thoroughness necessary to cleansing. Before undertaking the operation, therefore, in order that they might be made to feel the benefit to be derived therefrom, they would need to have the matter brought home to them in a very gentle way, lest they might feign to fear taking cold, not having been used to it, etc.
It was customary to say to them: “We want to give you some clean clothing, but you need washing before putting them on.  Nothing that could be done for you would make you feel better after the fatigue of travel than a thorough bath. Probably you have not been allowed the opportunity of taking a good bath, and so have not enjoyed one since your mother bathed you. Don’t be afraid of the water or soap—the harder you rub yourself the better you will feel. Shall we not wash your back and neck for you? We want you to look well while traveling on the Underground Rail Road, and not forget from this time forth to try to take care of yourself,” &c., &c. By this course the reluctance where it existed would be overcome and the proposition would be readily acceded to, if the water was not too cool; on the other hand, if cool, a slight shudder might be visible, sufficient to raise a hearty laugh. Yet, when through, the candidate always expressed a hearty sense of satisfaction, and was truly thankful for this attention.


9 Chapter 9- Getting to Know Mrs. Henry
After the winter break, Ruby and her teacher, Mrs. Henry, found a good routine. At first, Ruby felt strange because she was the only student in her class at the Frantz School. But soon, she saw it as a unique opportunity. Mrs. Henry was not just a teacher to Ruby; she was like a best friend. They did everything together, like reading, solving word puzzles, and learning spelling and math. They even sang songs and played games inside because Ruby couldn’t play outside.
Sometimes, Mrs. Henry got special permission for them to walk in the schoolyard. Ruby felt it was odd being outside without other children and noticed men, who she later found out were detectives, watching from a distance.
Ruby spent so much time with Mrs. Henry that she began to talk like her. Mrs. Henry came from Boston, Massachusetts, and didn’t speak with a Southern accent. She had a Boston accent. Ruby didn’t understand why she started to sound different from her family, but she liked the way Mrs. Henry spoke.
Over the year, Mrs. Henry’s kindness and polite ways deeply influenced Ruby. She learned to behave and speak like her teacher. Ruby grew to love Mrs. Henry very much, and they became very close.
Watch the video about how Mrs. Henry and Ruby Bridges reunited after 35 years and then answer the questions.
Listen to the different accents around the US and then answer the questions.


59
Simple Prayer of Reparation
Most Sacred Heart of Jesus, I believe, I adore, I trust, and I love Thee
and I beg pardon for those who do not believe, do not adore, do not trust, and do not love Thee.
Daily Offering of Reparation
O Jesus, through the Immaculate Heart of Mary, I offer you all my prayers, works, joys, and sufferings of this day,
for all the intentions of your Sacred Heart, in union with the Holy Sacrifice of the Mass throughout the world,
in reparation for my sins, for the intentions of all my relatives and friends, and in particular for the intentions of the Holy Father.
*
Heart of Jesus, Help Me
O most holy Heart of Jesus, fountain of every blessing,
I adore you, I love you and will a lively sorrow for my sins.
I offer you this poor heart of mine.
Make me humble, patient, pure, and wholly obedient to your will.
Grant, good Jesus, that I may live in you and for you.
Protect me in the midst of danger; comfort me in my afflictions;
give me health of body, assistance in my temporal needs,
your blessings on all that I do, and the grace of a holy death.
Within your heart I place my every care.
In every need let me come to you with humble trust saying,
Heart of Jesus, help me.
Amen.
*
Prayer of Trust to the Sacred Heart
Holy Heart of Jesus, Sweet Sanctuary of rest,
bring peace to my soul and settle my spirit,
especially in the matter of […]
I vow to place all of my worries and fears
into the wound of your Sacred Heart,
there to be tended to in accordance with your perfect will,
which desires only the best and highest good.
Your love alone is enough, and I surrender to it;
clinging to the hope of a swift resolution
and trusting with confidence in all of your promises.
Amen.
*
Prayer to the Sacred Heart in Times of Loss or Betrayal
Sweet Jesus, your heart beats for the brokenhearted,
and you know their pain.
You experienced loss when your friend Lazarus died,
and betrayal when your friends abandoned and rejected you
in your darkest hours.
I ask you for relief and release right now in this time of grief.
I cry out to your heart, seeking comfort and consolation.
Take this present heartache and unite it to your own
for the good of others, especially […]
Ease my sorrow, and fill my heart with hope and light to face another day.
Amen.
*
Prayer to the Sacred Heart for Help to Forgive
Lord Jesus, my heart feels like an impenetrable stone
as I am struggling to forgive […].
Please trade my hardened heart
for one that flows with mercy like your own.
Give me the grace to let go of bitterness,
a desire for revenge, and the need for an apology.
Set me free from the captivity of my unforgiving heart
and fill me with your healing love.
Amen.
Prayer to the Sacred Heart for Someone Who Is Addicted
Lord, my heart is filled with concern for […], who is addicted.
You know and see the disorder and chaos that the addiction is causing,
and your heart grieves over the distortion of personality and danger to the soul
that results when someone is in the throes of addiction.
I pray that you will please give me the wisdom and spiritual
fortitude to detach with love and trust in your tender mercies
and that you will give […] the humility and strength to seek recovery.
I ask this through the saving grace of your Sacred Heart.
Amen.
*
Prayer to the Sacred Heart When Health Is Failing
Sweet Heart of Jesus,
my health is failing, and I am hurting.
Thank you for my body, which is a great and marvelous gift
and a temple where the Holy Spirit chooses to dwell.
I offer up my current suffering for […],
accepting whatever you permit to happen to me.
I believe in your healing power and claim your promises of peace,
help in all my afflictions, and the grace of final perseverance.
Help me to resist all fear, and hide me, Lord,
in the haven of your precious heart.
Give me the strength to accept this current state of my health with joy,
holy resignation, and lively hope for the future.
Amen.
*
Prayer of Thanksgiving and Praise to the Sacred Heart
Lord, you deserve all honor and praise,
because your love is perfect and your heart sublime.
My heart is filled to overflowing with gratitude
for the many blessings and graces you have bestowed upon me and those
whom I love.
Forever undeserving, may I always be attentive
and never take for granted the gifts of mercy and love
that flow so freely and generously from your Sacred Heart.
Heart of Jesus, I adore you.
Heart of Jesus, I praise you.
Heart of Jesus, I thank you.
Heart of Jesus, I love you forever and always.
Amen.


Preparing for the Session
Key Learning Points
This training opens up the conversation about suicide to reduce the negative stigma surrounding suicide and decrease anxiety about talking to others about suicide. Key learning points of the training include the following:
- We can all play a role in supporting students’ mental health.
- By knowing the signs of suicide risk and understanding the needs of a person at risk of suicide, we can support others.
- Conversations about suicide are never comfortable, but it is possible to develop skills for talking to someone about suicide and to increase our confidence.
- There are practical steps to take in starting a conversation about suicide with another student.
- We can make a difference to a person who is thinking about suicide by knowing how to recognize the signs of distress, responding empathetically, and knowing how to refer them to campus and community resources.
- Listening without judgment is key when talking to someone who may be at risk of suicide.
- Participants are not expected to act as counsellors and should not attempt to diagnose a person’s mental health problems.
- Participants need to be aware of their own boundaries and need for self-care. If they are overwhelmed by the session, they may want to talk to a counsellor.
Consider Who Is Attending the Session
This session is intended for students who are interested in learning more about mental health and working to build an inclusive and resilient community at their post-secondary institution. Many students who are interested in this training will be in leadership roles (e.g., residence assistants, peer group leaders, and teaching assistants) and will have to follow procedures that are specific to your post-secondary institution. You will need to know your institution’s protocols for student employees helping students in crisis. Student employees will be obligated to report their concerns if they become aware of a student who is in crisis and mentions suicide, but the procedures may vary from campus to campus. Students who are not employees do not have the same obligation. However, you will need to reinforce boundaries for these students.
Think about the student population at your institution. It may not be possible to know in advance who is attending, but if you do, these are some things to consider:
- Will there be international students in the session or students who work with international students?
- Are there specific cultural differences to consider? For example, in some cultures, such as South Asian cultures, mental illness is still stigmatized, and students may be uncomfortable talking about it. A helpful resource on South Asian students and mental health is South Asian Mental Health (SOCH) website. SOCH was one of the producers of The Pardesi Project, a film on the mental health of South Asian international students.
Keep in mind that the mental health words we use in English may not exist in other languages, as mental health and suicide are rarely discussed in some cultures. You may want to do some research on the specific issues that marginalized groups face. (See the Resources on Suicide for Further Reading and Preparation, and Marginalized Groups.)
Know the Procedures and Contacts at Your Campus and in Your Community
Consider your post-secondary institution’s resources, procedures, or policies for helping students in distress and make sure you are familiar with who to notify during the day, when the campus is open, and at night or on weekends, when the campus is closed. If the situation is not an emergency, the procedures will vary from institution to institution and will also depend on whether a student is an employee of the institution or is a student concerned about a friend or classmate. For example, if a student is a residence assistant or teaching assistant, do they contact their supervisor? Is there an alert form they should fill out? Who do they contact if they are concerned about a student but it’s not an emergency?
Complete Handout 1: Quick Reference: Responding to Students in Crisis, with contact information for your campus, create your own contacts sheet to share with participants, or have the appropriate web page ready for viewing on screen.
Preparing for In-Person and Online Sessions: Practical Considerations
- Before giving a session, read through the Guidelines and Tips for Facilitation section and reflect on your own experiences and feelings about suicide.
- Download the slide deck and make any needed modifications.
- Read through the facilitator’s guide and handouts to familiarize yourself with the content. You may want to download the guide as a PDF file and print it.
- Consider sending participants a link to the video on the Live Through This website to give them a chance to hear suicide survivors’ stories before the training. Alternatively, you could show the video during the session, or bookmark the video and have it ready to play in a browser before the session.
- Prepare to give a territory acknowledgement to open the session. Also consider ways in which to Indigenize the content. (See Indigenous Considerations.)
- Read through the scenarios and think about which scenarios you want students to discuss. There are 10 scenarios to choose from, but it’s unlikely you’ll have time to cover them all. Handout 2.1 has just the scenarios, with no responses; Handout 2.2 has the scenarios with suggested responses.
- Consider how many participants you expect to attend. The facilitator’s guide assumes a small to medium number of participants (approximately 6 to 30); if your group is very large, you may need to modify some of the small group and reflection activities.
- Add relevant examples and additional insights that are based on your own experience or are relevant to the student population at your institution.
- Prepare the handouts. Either have them ready to hand out for an in-person session or have the links to the PDFs ready for an online session. Determine how you will share handouts and other resources, particularly when you are facilitating an online session. You can put PDFs in the chat, share a link in the chat, or email participants after the session.
- Have your institution’s workshop evaluation form ready to give to participants after the session.
- Consider providing participants with group guidelines before the session so people can prepare and create guidelines together. This will save time during the session. See Group Guidelines for more information.
Preparing for an In-Person Session
In addition to booking a room and letting participants know the location of the session, you will need to ensure that you have the following tools and materials for the session:
- Laptop
- Projector
- Flipchart or whiteboard and markers
- Copies of Handouts 1, 2.1, 2.2, and 3
Support for participants who get overwhelmed during an in-person session
You will also need to consider where participants can go if they need to leave the session for a while. Is there a place where they can sit that is close to the classroom? Arrange in advance for someone to check on anyone who leaves the session, whether a co-facilitator, an assistant, or another participant.
Preparing for an Online Session
If you are offering the session online, there are a few additional things to do in advance:
- Schedule a meeting time in your post-secondary institution’s preferred video-conferencing platform.
- Make sure that the screen-share function is enabled for sharing slides.
- If you will be using the chat or breakout rooms, make sure they are enabled.
- Share the meeting link and any passwords with participants before the session. (Consider sending the meeting information at least twice, including once the day before the session.)
- You may also want to share suggestions for online meeting etiquette for creating a safe learning space (e.g., sharing supportive comments, respecting confidentiality).
- Consider assigning someone to be the monitor responsible for responding to technical issues and questions posted in the chat.
- As noted above, make sure you have a plan for distributing any resources, such as the handouts, online. Remember to let participants know how and when they can expect to receive these resources.
Support for participants who get overwhelmed during an online session
Before an online session, you’ll need to decide on a protocol for following up with participants who have strong emotional responses and need to leave the online session. In an in-person session, someone can follow a participant out of the room, but it is more complex if a participant just drops out of an online session. It may be helpful to have participants share in advance their phone numbers and physical locations at the time of the session so crisis resources can be called in if needed. It is also very helpful to have a co-facilitator or assistant available to call someone who suddenly leaves the session.
Working in small groups online
If your video-conferencing software allows you to create breakout rooms, you can have participants work together in smaller groups. Take some time before the session to get comfortable with the process for setting up breakout rooms. It can be helpful to have someone assist you with setting up the breakout rooms during the session, so you can facilitate while they handle the technical issues.
Breakout rooms will work well for discussing the scenarios, but you will need to do some preparation. It may be easiest to put the scenarios in the chat; if you are doing this, have the scenarios ready to add to the chat before the session. During the session, you can then assign each group to a specific breakout room to discuss the different scenarios. Alternatively, you could move participants into breakout rooms and then visit each room to verbally provide each group with a scenario.


Formal Elements of Poetry
Learning to read how a poem is lineated is an important skill to develop for understanding poetry. Lineation controls where lines of verse begin and end in a poem. These artistic choices can significantly impact the rhythm of a poem and in some cases can be used to create dramatic or thematic tension, as in the use of an enjambed line . Enjambment is a French word that means â€˜to step over.’ In poetry, the shifting from one line to the next without concluding a thought or without the use of closing punctuation creates a sense of connection and movement that can increase the pacing of the meter of a poem and/or can productively complicate the meaning of the ideas or images between one line and another.
The grouping of lines into organizational units in poetry is known as a stanza . Some poetic forms, such as the couplet , are identified by how many lines constitute a stanza. (A couplet has two lines per stanza; many poems are composed of a series of couplets rather than a single couplet.)
Rhythm is the pattern of stressed and unstressed syllables in a line of poetry. Everyday speech has rhythm, yet poets make conscious choices to arrange and highlight particular rhythms and rhythm patterns to create meter. Meter refers to specific syllabic patterns in the rhythm of a line of poetry. Learning to scan the rhythm and meter of a poem, a process referred to as scansion , focuses analysis on the line-by-line structure. A foot is the basic unit of rhythm, usually composed of two or three syllables, used in scansion. Four major types of feet are found in most verse: anapest , dactyl , iamb , and trochee :
| Foot Names | Syllable Arrangements | Examples |
|---|---|---|
| Anapest | X X / | X X / X X / X X / |
| dactyl | / X X | / X X / X X Take her up tenderly |
| iamb | X / | X / X / X / X / The falling out of faithful friends. X / X / X / renewing is of love |
| trochee | / X | / X / X / X / X |
Less frequently occurring types of feet in poetry are: pyrrhic and spondee .
| Foot Names | Syllable Arrangements | Examples |
|---|---|---|
| pyrrhic | X X | / / X X / / X X X / X My way is to begin with the beginning |
| spondee | / / | X X / / X X / / |
The number of feet in a line of poetry determine its length. Although a line may be of any length, common line lengths in verse include: tetrameter , pentameter and octameter .
| Line Length Names | Number of Feet | Number of Syllables | Examples |
|---|---|---|---|
| tetrameter | four | eight | How dreary to be somebody! How drear | y to | be some | body |
| pentameter | five | ten | Shall I compare thee to a summer’s day? Shall I | compare | thee to | a sum | mer’s day? |
| octameter | eight | sixteen | And the silken sad uncertain rustling of each purple curtain. And the | silken | sad un | certain | rustling | of each | purple | curtain. |
William Shakespeare is renowned for his use of iambic pentameter. Read and listen to his poem “Shall I Compare Thee to a Summer’s Day (Sonnet 18)” and pay close attention to how his rhythm and meter enhance the auditory effects of his poetry. As a famous playwright, Shakespeare was especially concerned with the verbal performance of poetic language. Some scholars have even argued that Shakespeare’s use of iambic pentameter resembles the lub-dub rhythm of the human heartbeat. (1)
“Shall I Compare Thee to a Summer’s Day (Sonnet 18)” (19)
Shall I compare thee to a summer’s day? Thou art more lovely and more temperate. Rough winds do shake the darling buds of May, And summer’s lease hath all too short a date. Sometime too hot the eye of heaven shines, And often is his gold complexion dimmed; And every fair from fair sometime declines, By chance, or nature’s changing course, untrimmed; But thy eternal summer shall not fade, Nor lose possession of that fair thou ow’st, Nor shall death brag thou wand’rest in his shade, When in eternal lines to Time thou grow’st. So long as men can breathe, or eyes can see, So long lives this, and this gives life to thee.
Rhyme is created when two words are similar in sound, as found in the words â€˜dog’ and â€˜fog.’ End rhyme occurs when the last words in two lines of poetry rhyme. Rhyming between two words within the same line is called internal rhyme . Slant rhyme (or approximate rhyme) is the term used to refer to the suggestion of a rhyme that is not exact, as found in the words â€˜laugh’ and â€˜taught.’
The larger pattern of rhyme in a poem is referred to as the rhyme scheme . Rhyme schemes are commonly indicated by a letter pattern where a different represents a new rhyme, as in abab cdcd efef gg . The effectiveness of a poem’s rhyme scheme is shaped not only by the repetition of, but the variation between, the types of rhyme and meter. Analysis of poetry frequently looks at the occurrence of â€˜repetition and variation’ as a linked literary device.
Besides rhyme, poets also may make use of other sound patterns including assonance , consonance , and alliteration . Assonance is the repetition of vowel sounds, usually two or more times in short succession, whereas consonance is the repetition of consonant sounds. Alliteration is the repetition of the identical initial consonant in neighboring or consecutive words. (1)
Reading in Context
While it is important to ground our analysis of poetry in a close reading based on a detailed understanding of formal elements and poetic structure, we should not become so carried away that we neglect the roles history and cultural circumstance can play in shaping a poem. Likewise, as Edward Hirsch suggests, it is also important to recognize the contribution that you make as a reader to the construction of a poem’s meaning.
Consider, once more, “Dulce et Decorum est” by Wilfred Owen. The content of the poem is moving enough, yet the added emotional weight of understanding the poem’s context — the mass casualties in Europe during World War I — lends a potent specificity to the imagery in Owen’s poem. The poem’s effect is made all the more palpable by the knowledge that he was killed in action one week before the Armistice that ended the fighting in Western Europe. With this historical context in mind, it might be possible then to consider what your own experience or views on war might be. What is your response to Owen’s portrayal of the battlefield? What knowledge or insight can be gained from the way that the poem attempts to make the violence of war intelligible to its reader?
The context of a poem can play a major role in what gives it a lasting literary value. However, when a powerful historical context meets masterful formal execution, it can be tempting to assume everything in the poem is a direct line to the poet’s heart and mind. But when analyzing a poem, the speaker of the poem, the “I” voice, should not be conflated with the author of the poem. In written analysis we refer to “the author” when speaking of his or her craftsmanship and authorial choices, as in “the author repeats the symbol of the bird at the beginning and the end of the poem.” We use “the speaker” when discussing the point-of-view of the “I” speaking in the poem, as in “the speaker longs to be free” or “the speaker bemoans the impending loss of her child.” In our analysis we can suggest that “the poet” is closely aligned with “the speaker,” but we should not assume they are one in the same. The conventions of poetry veil a direct connection in contrast to a literary form, such as autobiography.
Even more than historical periods, we can connect the analysis of one particular poem to a wider literary movement. In our course readings, for example, are two writers whose poems exemplify the modernist movement known as Imagism: H.D. (Hilda Doolittle) and William Carlos Williams. Imagism valued precision and clarity of both image and language; it rejected the sentimentality of the previous generation of poets and sought to create poems around single, powerful images that might speak of the essential nature of a thing, person, or place. Understanding a poem’s historical and literary context is important, but it is equally important to acknowledge the active role that the reader plays in the construction of meaning, as Edward Hirsch suggests. (1)


20 Plant Growth Characteristics
Learning Objectives
- Recognize and describe plant growth characteristics.
Plant form and growth habit are among the most noticeable and important features for identification purposes as well as for landscape plant selection. Plant form, the three-dimensional shape or silhouette outline of a plant, is determined by the habit or branching pattern. For example, plants with an excurrent growth habit have single, undivided trunks and lateral branches that typically produce an overall cone or pyramid-shaped form. This plant form and growth habit is characteristic of many gymnosperms such as Thuja plicata (western red cedar) and Pseudotsuga menziesii (Douglas fir). In contrast, decurrent, or sometimes called deliquescent growth habit exhibits several roughly equal branches arising from the trunk or stem that become the main structural system of the plant. This habit results in the typical rounded or spreading form of deciduous trees such as Acer macrophyllum (big leaf maple) or Acer platanoides (Norway maple) as well as many shrubs. Depending on the branching pattern, additional descriptive terms such as upright or horizontal, arching or weeping, open, twiggy or dense may be used for shrubs as well as for trees.
Stem, Bark, and Bud Morphology
In addition to plant form and habit, the winter identification of deciduous trees and shrubs depends on the morphology of stems, bark, and buds. Stem color, surface texture and the presence of lenticels, small cork-like spots for gas exchange between plant tissues and air are characteristic for some species of Prunus (cherry). A cross section taken through a stem or shoot reveals soft plant tissue, the pith. The color and texture of the pith may be used for distinguishing between similar plant types, such as species of Cornus (dogwood). Pith may be brown or white, variably shaped, and uniformly solid, chambered or hollow as illustrated in Figure 20.1.
Bark, the dead outer protective tissue of woody plants can vary greatly in appearance, thickness, and texture as a tree or shrub matures. In addition to plant identification, plant bark may have highly ornamental value in the landscape. Color change, peeling and exfoliation, and smooth, or furrowed (grooved), ridged or plate-like are some common descriptors used for bark. For example, Figure 20.2 shows the bark of Platanus × acerifolia[New Tab] . In addition to its ornamental value, the bark is a key identification feature for this tree.
Buds, condensed shoots containing a new leaf, leaf cluster, or flower are located in leaf axils and at tips of stems. In general, a flower bud appears somewhat larger and rounder than a vegetative bud. While bud shape, size, color, and surface texture vary by species, bud arrangement will be alternate, opposite or whorled on the stem. Bud scales, the protective covering of buds may be single, few, or many, and imbricated (overlapping) or not as shown in the Figure 20.3. The shape of a leaf scar, where a leaf falls off a twig, and the arrangement of vascular bundles within the leaf scar may also provide distinct identification characteristics as in Juglans spp. (walnut).
The dichotomous key below differentiates bud characteristics for some common deciduous trees and shrubs. Plant information is available at the KPU Plant Database [New Tab].
Dichotomous Key to Buds of Common Deciduous Trees and Shrubs
- 1.a. buds opposite or whorled on the stem ……………………………………………………. go to 2
- 1.b. buds not opposite on the stems ……………………………………………………………… go to 7
- 2.a. leaf scars oval or round, vein scars forming a ring ……………………. Catalpa speciosa [New Tab]
- 2.b. leaf and vein scars not as above ……………………………………………………………… go to 3
- 3.a. buds valvate, appressed, brownish black ………………… Cornus kousa var. chinensis [New Tab]
- 3.b. buds acute or swollen, red or green ……………………………………………………….. go to 4
- 4.a. buds small or narrow, with few obvious scales, the scales more or less valvate (i.e., meeting at the edges) …………………………………………………………………………….. go to 5
- 4.b. buds large, with several imbricate (overlapping) scales ………………………….. go to 6
- 5.a. buds conical, the outer scales shiny red, the bud with a short fringe of hairs at its base…………………………………………………………………………………………………. Acer circinatum [New Tab]
- 5.b. buds conical, the outer bud scales green or red, hairs extending half the height of the bud…………………………………………………….. Acer palmatum Atropurpureum Group [New Tab]
- 6.a. buds brown large, ovoid, and varnished with sticky gum ……………………………………………………………………………………………. Aesculus hippocastanum [New Tab]
- 6.b. buds smooth, leaf scars small, with a single vein scar………………… Syringa vulgaris [New Tab]
- 7.a. buds narrowly conical and bud scales imbricate ………………………… Fagus sylvatica [New Tab]
- 7.b. the bud scales imbricate or valvate, or the buds covered by a single scale …………………………………………………………………………………………………………………….. go to 8
- 8.a. buds stalked ……………………………………………………………………………………. Alnus rubra [New Tab]
- 8.b. buds not stalked ……………………………………………………………………………………. go to 9
- 9.a. twigs yellow, the buds flattened, appressed to stems and covered by a single, silky-downy bud scale…………………………………………… Salix sepulcralis var. chrysochoma [New Tab]
- 9.b. twigs not yellow, buds not covered by a single scale ……………………………. go to 10
- 10.a. lateral buds superposed, slightly hairy; leaf scars v-shaped, prominent; pith chambered ………………………………………………………………………………………….. Juglans nigra [New Tab]
- 10.b. buds not superposed; leaf scars not v-shaped; pith not chambered …………………………………………………………………………………………………………………… go to 11
- 11.a. buds 2 mm long, rounded to shortly acute, with several reddish-brown scales ……………………………………………………………………………………………………… Cotinus coggygria [New Tab]
- 11.b. buds 2 mm long, ovoid to acute, with several rows of imbricate scales …………………………………………………………………………………………………………………… go to 12
- 12.a. buds of 2 sizes, bud scales glabrous, leaf scars triangular with 3 vein scars ……………………………………………………………………………………………………….. Prunus ‘Kanzan’ [New Tab].
- 12.b. buds of 1 kind; buds scales fringed with hair; leaf scars with 5 or more vein scars …………………………………………………………………………………………………. Quercus robur [New Tab]


Pain and Mobility
10.8 Adjuvant Analgesics
Medications used as adjuvant analgesics were developed for other purposes but were later found to be effective to treat pain. Examples of adjuvant medications include gapapentin (an anticonvulsant) and amitriptyline (a tricyclic antidepressant). Additional information about these specific medications can be found in Chapter 8. Muscle relaxants are also considered an adjuvant analgesic and are used for various musculoskeletal disorders such as multiple sclerosis. Three different types of muscle relaxants will be discussed below baclofen, cyclobenzaprine, and tizanidine.
Baclofen
Mechanism of Action
Baclofen inhibits reflexes at the spinal level.
Indications for Use
Baclofen is used to treat muscle symptoms, such as spasms, pain, and stiffness, caused by multiple sclerosis, spinal cord injuries, or other spinal cord disorders.
Nursing Considerations Across the Lifespan
Baclofen is safe for clients 12 years and older.
Adverse/Side Effects
Adverse effects include drowsiness, dizziness or lightheadedness, confusion, nausea, constipation, and muscle weakness.
Abrupt Drug Withdrawal: Hallucinations and seizures have occurred on abrupt withdrawal of baclofen. Therefore, except for serious adverse reactions, the dose should be reduced slowly when the drug is discontinued.
Impaired Renal Function: Because baclofen is primarily excreted unchanged through the kidneys, it should be given with caution, and it may be necessary to reduce the dosage.
Signs and symptoms of overdose include vomiting, muscular hypotonia, drowsiness, accommodation disorders of the eye, coma, respiratory depression, and seizures.
Client Teaching & Education
The medication should be taken as directed and abrupt withdrawal of the medication should be avoided. It may cause dizziness or drowsiness. Clients should be advised to change positions slowly because of the potential orthostatic changes that may occur. Additionally, clients should avoid concurrent use with alcohol or other CNS depressants.
Baclofen Medication Card
Now let’s take a closer look at the medication card for baclofen[1] Medication cards like this are intended to assist students to learn key points about each medication. Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication. Basic information related to each class of medication is outlined below. Prototype or generic medication examples are also hyperlinked to a free resource at Daily Med. On the home page, enter the drug name in the search bar to read more about the medication.
Medication Card 10.8.2: Baclofen
Generic Name: baclofen
Prototype/Brand Name: APO-Baclofen
Mechanism: inhibits reflexes at the spinal level.
Therapeutic Effects
- Inhibition of spasticity and muscle stiffness
- Reduction of pain
Administration
- Baclofen is safe for clients 12 years and older.
- Do not take this drug during pregnancy.
- PO and intrathecal routes
- Excretion: Kidneys
Indications
- Muscle symptoms (such as spasm, pain, and stiffness, caused by multiple sclerosis, spinal cord injuries, or other spinal cord disorders).
Contraindications
- Hypersensitivity. Active peptic ulcer disease.
- Caution for use with renal impairment.
Side Effects
- Drowsiness, dizziness or light-headedness, confusion, nausea, constipation, sedation, and muscle weakness.
- Potentially Fatal: Respiratory or CV depression, seizures.
- SAFETY WARNING: Abrupt discontinuation can cause serious reactions.
Nursing Considerations
- Assess for allergies, and S&S of MI
- Avoid abrupt withdrawal
- Avoid use with alcohol or other CNS depressants.
- Report frequent or painful urination, constipation, nausea, headache, insomnia, or confusion that persists or is severe.
A client just started taking baclofen for muscle spasticity due to multiple sclerosis.
What teaching should the nurse provide?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.
Cyclobenzaprine
Mechanism of Action
Cyclobenzaprine reduces tonic somatic muscle activity at the level of the brainstem. It is structurally similar to tricyclic antidepressants.
Indications for Use
Cyclobenzaprine is used to treat acute muscle spasms.
Nursing Considerations Across the Lifespan
Cyclobenzaprine is safe for clients 15 years and older. Use cautiously with geriatric clients. In the elderly, the frequency and severity of adverse events associated with the use of cyclobenzaprine, with or without concomitant medications, are increased. In elderly clients, cyclobenzaprine should be initiated with a 5 mg dose and titrated slowly upward.
Should not be used by breastfeeding women.
Adverse/Side Effects
Adverse effects include dizziness (may cause orthostatic hypotension) drowsiness, dry mouth, urinary retention, serotonin syndrome with antidepressant use, or increased sedation with other CNS depressants.
Because of its atropine-like action, cyclobenzaprine hydrochloride should be used with caution in clients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in those taking anticholinergic medication.
Serotonin Syndrome
The development of a potentially life-threatening serotonin syndrome has been reported with cyclobenzaprine hydrochloride when used in combination with other drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), tramadol, bupropion, meperidine, verapamil, or MAO inhibitors (MAOIs). The concomitant use of cyclobenzaprine hydrochloride with MAO inhibitors is contraindicated.
Serotonin syndrome symptoms may include mental status changes (e.g., confusion, agitation, hallucinations), autonomic instability (e.g., diaphoresis, tachycardia, labile blood pressure, hyperthermia), neuromuscular abnormalities (e.g., tremor, ataxia, hyperreflexia, clonus, muscle rigidity), and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea). Treatment with cyclobenzaprine hydrochloride and any concomitant serotonergic agents should be discontinued immediately if the above reactions occur, and supportive symptomatic treatment should be initiated. If concomitant treatment with cyclobenzaprine hydrochloride and other serotonergic drugs is clinically warranted, careful observation is advised, particularly during treatment initiation or dose increases.
Impaired Hepatic Function
The plasma concentration of cyclobenzaprine is increased in clients with hepatic impairment. Cyclobenzaprine, especially when used with alcohol or other CNS depressants, may impair mental and/or physical abilities required for the performance of hazardous tasks, such as operating machinery or driving a motor vehicle.
Client Teaching & Education
The medication should be taken as directed and clients should be informed about what to be aware of related to serious side effects of the medication. Clients should be advised to change positions slowly because of the potential orthostatic changes that may occur. Additionally, clients should avoid concurrent use with alcohol or other CNS depressants. Clients should be aware that constipation may occur as a side effect of medication therapy and increased fluid intake may assist in preventing complications.
Cyclobenzaprine Medication Card
Now let’s take a closer look at the medication card for cyclobenzaprine[2]
Medication Card 10.8.3: Cyclobenzaprine
Generic Name: cyclobenzaprine
Prototype/Brand Name: Flexeril, Novo-Cycloprine
Mechanism: reduces tonic somatic muscle activity at the level of the brainstem. It is structurally like tricyclic antidepressants. Precise mechanism not known
Therapeutic Effects
- Reduction of pain and muscle spasms
Administration
- Use cautiously with geriatric clients, and those who take antidepressants and other CNS depressants.
- Safety and efficacy in clients under 15 years are not established.
- Caution with urinary retention, glaucoma, lactation, mild hepatic impairment
Indications
- Used to treat acute muscle spasms.
Contraindications
- Hypersensitivity to cyclobenzaprine
- Acute recovery phase of MI, arrhythmias, heart block or conduction disturbances, CHF
- Hyperthyroidism.
Side Effects
- Antimuscarinic effects, neurological adverse effects, GI disorders, orthostatic hypotension, tachycardia, hypersensitivity reactions.
- Increased appetite/wt. gain
- Increased sedation with other CNS depressants
- Serotonin Syndrome
- SAFETY: Orthostatic hypotension.
Nursing Considerations
- Assess for allergies, and S&S of CV disease
- Inform clients about serious side effects
- Avoid concurrent use with alcohol or other CNS depressants.
- Report urinary retention or difficulty voiding, pale stools, yellow skin, or eyes.
A client asks if they can drive their car while taking cyclobenzaprine.
What is the nurse’s best response?
Note: Answers to the Critical Thinking activities can be found in the “Answer Key” sections at the end of the book.
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
Drugs with a primary indication other than pain that have analgesic properties in some painful conditions. The group includes numerous drugs in diverse classes such as gabapentin (an anticonvulsant) or amitriptyline (a tricyclic antidepressant).


School of Medicine
71 Investigating the Role of Microglia Function in the Brain
Emily Rhodes
Faculty Mentor; Naveen Nagarajan (Human Genetics, University of Utah)
Background
The purpose of this study is to investigate the physiological function in the microglia in response to behavior induction in mice. Grooming is a normal behavior among most animal species. The gene Hoxb8 is required for normal grooming behavior in mice. A mutation in this gene results in pathological over-grooming behaviors in mice that can be related to OCD behaviors in humans. Hox genes are primarily involved in body patterning. Microglia functions as the brain’s monitor and responder of immune activity. It was then discovered in 2010 by Capecchi and Chen that the cell in the brain that implements grooming behavior are microglia cells derived from Hoxb8. The findings of this research shed light on how the brain generates complex behaviors such as OCD. Such mechanistic insight is necessary to understand other neuropsychiatric and neurodegenerative diseases such as Autism, Dementia, and Alzheimer’s disease.
Methods
The mice in this study are composed of a specific genetic cross between Hoxb8-IRESCre (male) and GCaMP5 (female). The results of this cross will produce a new generation of offspring that will exhibit GCaMP5 expressed in Hoxb8-positive cells. There are two methods being used to induce specific behaviors in the mice: the first method is a micro water sprinkle assay to induce grooming behaviors and the second method is a visual looming assay to induce anxiety behaviors. Microglia uses calcium to communicate with neurons to drive behaviors. To measure the fluctuations in calcium levels during the behavioral shifts, a calcium sensor called GCaMP will be used. A miniature lens will be inserted into the brain and attached to a miniaturized integrated microscope that will be used to inspect the calcium fluctuation changes mediated by the GCAMP sensor. Using this procedure, there will be 5 minutes of prestimulation, 10 minutes of during behavioral stimulation, and 10 minutes of post-stimulation recording.
Results
This is an ongoing study, however, it is expected that microglia will produce calcium transients in response to the behavioral shifts in the mice. The nature of calcium transients is dependent on the intensity of the behavior; if there is more grooming happening, there is an expectation of having more calcium transients.
Conclusions
Genetic lineage tracing identified that the Hoxb8 gene is turned on only in microglia (approximately 30%) in the brain. In conducting the proposed study, we anticipate measuring calcium transients in microglia during behavioral shifts. However, hypothetically, there can be an unexpected limitation to this experiment in that anxiety behavior can shut the calcium transients down.


3 Audience
Getting to Know Your Audience
Learning Objectives
Upon completing this chapter, you should be able to:
- categorize specific elements of a given communication scenario to the stages of the acronym AUDIENCE;
- write a complete audience analysis detailing each part of AUDIENCE for a given communication scenario by briefly describing the purpose of a communication and the characteristics of an audience;
- write a complete audience analysis detailing each part of AUDIENCE for a specific communication task (e.g., letter writing, presentation, etc.).
Framing the Audience Analysis
The communications landscape changes rapidly over time, but one criterion for successful communication remains the same: the importance of knowing who your audience is and understanding their needs. Imagine you want to give a presentation to people in your department at work. You likely know your colleagues’ personalities and what they expect of you. You might know their education levels and you are sure they understand all of your company-specific jargon. You think delivering your message should be easy, except many of them are so comfortable with you, they decide to skip your presentation because you took for granted that they would be interested. On the other hand, if you had to present to the board of directors, you might need to do more homework on who they are and what they expect from you. In other words, it is always important to get to know your audience as much as possible to give yourself the best chance at communicating successfully.
In this chapter you will begin to examine differences between primary, secondary, and hidden audiences. Then, using the AUDIENCE acronym as a tool, you will participate in activities that will help you flesh out information you need to know about your audience in order to persuade, inform, or entertain them. You will have at least three chances to practise your audience analysis skills and get peer feedback. Then, near the end of this chapter, you will craft a message that considers your audience’s needs and expectations. This process will lay the foundation for you to become a communicator who is effective in persuading, informing, or entertaining an audience because you have done your best work in getting to know them, their needs, and expectations first.
Identifying Your Primary, Secondary, and Hidden Audiences
Your audience is the person or people you want to communicate with. By knowing more about them (their wants, needs, values, etc.), you are able to better craft your message so that they will receive it the way you intended.
Your success as a communicator partly depends on how well you can tailor your message to your audience.
 However, when analyzing your audience you must also beware of your secondary audience. These are other people you could reasonably expect to come in contact with your message. For example, you might send an email to a customer, who, in this case, is your primary audience, and copy (cc:) your boss, who would be your secondary audience. Beyond these two audiences, you also have to consider your hidden audience, which are people who you may not have intended to come in contact with your audience (or message) at all, such as a colleague who gets a forwarded copy of your email.
Check Your Understanding
A Tool for Analyzing Your Audience
To help you get to know your audience even more, we will begin by working through a set of steps that, together, spell the acronym AUDIENCE. These steps will give you an idea of what questions to ask and what information can be useful in better connecting with your audience.
| A | Analyze | Who is/are the recipients of your message? |
| U | Understand | What is their knowledge about your intended message? |
| D | Demographics | What is their age, gender, education level, position? |
| I | Interest | What is their level of interest/investment in your message (What’s in it for them?) |
| E | Environment | What setting/reality is your audience immersed in, and what is your relationship to it? What is their likely attitude to your message? Have you taken cultural differences into consideration? |
| N | Need | What information does your audience need? |
| C | Customize | How do you adjust your message to your audience? |
| E | Expectations | What are your audience’s expectations? |
These categories of information have been assembled into a job aid to help you conduct your very own audience analyses. As you review the tool, list the traits that apply to you for each section. If you would like to expand this reflection, consider how you might fill this tool out with traits that apply to you in your personal life versus your worklife. What are some methods you might use to find out more about an audience?
For your audience analysis, choose one of the scenarios and fill out the following form. Submit it according to your instructor’s directions.
Now let us take a look at putting this tool to use in a scenario. Read the following news story about an executive at a company [http://bit.ly/1Qyqdyy]. Reflect on these questions regarding his email:
- Who was the primary audience for his original email?
- Who was the secondary audience?
- Who was the hidden audience?
- Assuming he did an audience analysis, was it effective? Why or why not?
- What elements of AUDIENCE might he have considered in advance to get a better outcome?
| Category of Analysis | Description/Notes |
| Example:To further answer the questions above, we can use the AUDIENCE form to analyze the audience in this scenario and provide a revised message. | |
| AnalyzeWho will receive your message? | Primary: Yahoo employees working on the Daily Fantasy Football development team.Secondary: Other Yahoo employees.
Hidden: Anyone the email could be forwarded to. |
| UnderstandWhat do they already know or understand about your intended message? | Primary: Understands the technical details of Fantasy football.Secondary: May have heard of the project.
Hidden: Knows little of the technical details. |
| DemographicsWhat is their age, gender, education level, occupation, position? | Primary: 20s, 30s, 40s, White/Asian male, educated with bachelors’ or technical degrees and above; mostly IT developers.Secondary: Various ages, gender, mostly educated, and in various positions.
Hidden: Likely an American resident |
| InterestWhat is their level of interest/ investment in your message? (What’s in it for them?) | Primary: Very invested (I’m their boss!).Secondary: Mild interest if they like Fantasy football or the technology behind it.
Hidden: Not very invested. |
| EnvironmentWhat setting/reality is your audience immersed in, and what is your relationship to it? What is their likely attitude to your message? Have you taken cultural differences into consideration? | Primary: Developer setting. Can speak the same IT and corporate culture jargon. Likely to be open to my message because of my position.Secondary: Corporate setting; professionalism expected because of my position. Some may find it funny, others may find it offensive. There may be different corporate cultures in different departments.
Hidden: Could be anyone in the world. Some Americans might find it offensive, others might find it funny. Could potentially include Ice Cube, or other Black people. |
| NeedWhat information does your audience need? How will they use the information? | Primary: Links to get others to participate in the contest staging.Secondary: Instructions on how to get to the staging area for the fantasy football preseason contest staging and explanation of deposit bonus.
Hidden: Information consistent with what they already know about Yahoo’s brand values. |
| CustomizeHow do you adjust your message to better suit your audience? | Primary: Revise to create a more professional tone by removing all references to Ice Cube, hip hop culture, and racially charged elements like Ebonics and the N-word.Secondary: Ensure the contest speaks to the widest variety of employees who can help test the system.
Hidden: Ensure Yahoo’s brand is not damaged, by being above reproach. |
| ExpectationsWhat does your audience expect from you or your message? | Primary: Expects me to be professional and my message to be relevant to their work.Secondary: Expects me to be professional, be competent, and embody company values.
Hidden: Expects me to be professional. |
Revised Message:
Subject: Daily Fantasy Football goes live!
Greetings, folks.
Jerry here. I am proud to announce my team is now ready to bring you what you have all been waiting for: Daily Fantasy Football! Starting today, we are going to have NFL preseason contests on staging. Here is how to play:
1) On Desktop: link
2) On iOS: Download the latest dogfood app, which will point to the staging environment.
3) On Android: not yet available
4) Join the Daily Fantasy Football contest before 4 p.m. today: [link]
Please join contests, create contests, invite your friends, and make sure to alert the team at [link] if you find any technical problems.
One more thing: The team is also testing out deposit bonuses! For every dollar you put in, we give you another dollar. If you signed up for Fantasy Football, we give you two dollars. It’s easy money! When you spend money on a contest that runs, your deposit bonus becomes real money at a rate of 4 percent. That means, if you enter a $1 contest, you get 4¢ from your bonus. So try that out and make sure your investment gets returns!
So let’s go for the win-win. Play dogfood Daily Fantasy football so we can all have fun and make some money while we’re at it.
Cheers,
Jerry
The Purpose of Your Message
When you communicate with an audience, you are normally trying to achieve one or more of the three following broad outcomes:
- Persuade – convince your audience to do something or take some action
- Inform – raise their awareness and/or understanding about a situation or issue
- Entertain – capture their attention in order to distract and delight
Check Your Understanding
Here are two possible use cases where analyzing your audience will help you improve your communication:
- You can complete an analysis to make sure you understand your audience comprehensively before you begin crafting your message. This ensures your message has the best chance at landing properly with your audience.
- Take an existing message and use your analysis to better customize the message.
Can you think of others? In both of our suggested use cases, the AUDIENCE tool provides a framework to identify key factors you should consider when creating, revising, or reviewing communications.
Below you will find three scenarios that you can use to practise your ability to identify your audience. Using this Audience Analysis Form, complete an audience analysis for each of the three scenarios below.
Fill in the Audience Analysis template below and submit it according to your instructor’s directions.
https://h5p.org/h5p/embed/265399
Conclusion
In this chapter you have learned what an audience is and why an awareness of your audience’s needs and expectations is important to communicating your intended message.
You learned to define primary, secondary, and hidden audiences, and thought about ways to persuade, inform, and/or entertain them. You also used the AUDIENCE tool to examine an audience and begin to recognize when the audience and message are mismatched.
You should now be able to create messages that more effectively match your objective to successfully persuade, inform, or entertain. You are also well-positioned to get more practice and/or move on to the next module topic.
Key Takeaways and Check In
Learning highlights
- When you craft a message, it is important to (1) distinguish between your primary and secondary audiences and (2) identify a potentially hidden audience for your message.
- To better understand your audience and plan your communications, you can use the AUDIENCE job aid to reveal audience characteristics that either facilitate or impede the communication of a message.
- There are generally three purposes of a message:
- to persuade
- to inform
- to entertain
Further Reading
- YouTube video about audience analysis to prepare for a speech or other verbal presentation: https://www.youtube.com/watch?v=WQ3wJ2A_4UI
- Audience Analysis web page by David McMurray with a focus on Technical Writing. Provides good guidance on how to effectively adapt (customize) your message to suit your audience. https://www.prismnet.com/~hcexres/textbook/aud.html
- Article about getting to know less obvious elements of your audience, such as culture and thought patterns. The focus here is on presentation and provides good activities at the end to test your knowledge using individual and peer exercises. http://2012books.lardbucket.org/books/communication-for-business-success/s07-04-getting-to-know-your-audience.html
- Supplementary information for primary, secondary, and hidden audiences, along with more information about the AUDIENCE tool, can be found here: Audience Analysis: Primary, Secondary and Hidden Audiences
References and Attributions
Wollert Hickman, D. (2014). Audience analysis: Primary, secondary, and hidden audiences. Retrieved from http://writingcommons.org/index.php/2013-12-30-04-56-15/2014-02-04-20-46-53/audience-analysis-primary-secondary-and-hidden-audiences
Attribution Statement
This chapter is a remix containing content from a variety of sources published under a variety of open licenses, including the following:
Chapter Content
- Original content contributed by the Olds College OER Development Team, of Olds College to Professional Communications Open Curriculum under a CC-BY 4.0 license
Check Your Understandings
- Original assessment items contributed by the Olds College OER Development Team, of Olds College to Professional Communications Open Curriculum under a CC-BY 4.0 license
- Assessment items created by The Saylor Foundation for a Saylor.org course BUS210: Corporate Communication, previously shared at https://www.oercommons.org/courses/business-administration-corporate-communication-unit-1-quiz under a CC BY 3.0 US license
- Assessment items created by The Saylor Foundation for a Saylor.org course BUS210: Corporate Communication, previously shared at https://www.oercommons.org/courses/business-administration-corporate-communication-unit-2-quiz under a CC BY 3.0 US license
- Assessment items created by The Saylor Foundation for a Saylor.org course BUS210: Corporate Communication, previously shared at https://www.oercommons.org/courses/business-administration-corporate-communication-unit-4-quiz under a CC BY 3.0 US license
- Assessment items created by The Saylor Foundation for a Saylor.org course BUS210: Corporate Communication, previously shared at https://www.oercommons.org/courses/business-administration-corporate-communication-unit-6-quiz under a CC BY 3.0 US license


Accessibility Statements and Further Resources
Faculty can use extended syllabus statements to reflect on how access and accommodation will be addressed in their specific classes beyond your institution’s official policies. Developing your own extended statement can help make clear your approach to accessibility to students and empower them to determine how they will navigate your class in advance of making accommodation requests (if needed.)
See here for a compilation of different university and faculty syllabus accessibility statements.
Accessibility and Accommodation Statement
Below we have included how an extended Accessibility Statement looks when added to a syllabus. Feel free to use or adapt this statement to your teaching needs.
Sample Statement
Within the constraints of the resources available, I will work with students to develop sustainable accommodations when possible, and in response to the diverse and complex ways that barriers arise and access needs can change. Students are strongly encouraged to speak with me as soon as they become aware of accommodation needs (which may be ongoing or unexpected) and discuss alternative forms of accessibility beyond the services already provided by the university.
Important note on disclosure: Please note that you are not expected to disclose the nature of your circumstances to me. You may simply state the aspect of coursework for which you need accommodation and any specific requests for me to consider as we discuss the terms of the accommodation.
We have also included a downloadable PDF version, available here: Extended Accessibility and Accommodation Statement [PDF]
Beyond the Syllabus
More than just a statement, accessibility and accommodation can be incorporated into the classroom as a collective project rather than simply a service provision. This can help make accessibility a collaborative responsibility laterally across faculty, students, staff, and university services. In the classroom, this can be accomplished by making access and accessibility statements part of course development, inviting students to co-create statements, policies, and practices for the course, or sharing your own teaching philosophy documents on accessibility.
See Appendix: Cultivating a Culture of Accessibility, Accommodation, and Respect for an example of one such document.
Resources
Accessibility and Disability
- CAST. Universal Design Guidelines.
- Centre for Teaching Support and Learning, Teaching Assistants’ Training Program. Access Checks. University of Toronto.
- Centre for Excellence in Learning and Teaching. 10 Tips for Creating Accessible Course Content [PDF]. Iowa State University.
- Dolmage, Jay. 2017. “Academic Ableism: Disability and Higher Education.” In Corporealities. Ann Arbor: University of Michigan Press.
- Fritsch, Kelly. 2024. “Desiring Disability in Our Learning Communities: Fostering a Crip Culture of Access.” In Reading the Room: Lessons on Pedagogy and Curriculum from the Gender and Sexuality Studies Classroom, edited by Natalie Kouri-Towe. Montreal: Concordia University Press.
- Hamraie, Aimi. 2016. “Beyond Accommodation: Disability, Feminist Philosophy, and the Design of Everyday Academic Life.” philoSOPHIA. 6(2): 259-271.
- Hamraie, Aimi. 2020. Critical Access Studies. Harvard Graduate Studies in Design.
- Hamraie, Aimi. 2020. Accessible Teaching in the Time of COVID-19. Critical Design Lab.
- Jama, Sarah. 2019. “Dismantling Ablism in Ontario.” Filmed August 29, 2019, in Ontario, The Agenda with Steve Paikin and Nan Kiwanuka, TVO, 0:26:39.
- Laureano, Bianca I. and Aiesha Turman. Crip Camp Curriculum.
- Rello, Luz and Ricardo Baeza-Yates. 2013. Good Fonts for Dyslexia [PDF].
- Tshuma, Gift and Shayna Hadley. 2020. The Centre for Gender Advocacy, Revision Recommendations of Concordia University’s Student Accessibility Policy [PDF]. October 7.
- Tshuma, Gift and Shayna Hadley. 2020. The Centre for Gender Advocacy: Mapping Project Report. October 7.
- UTSC Campus Curriculum Review Resource Hub. Pedagogical Development with Universal Design for Learning. University of Toronto.
- Waggoner, Jess, Hailee Yoshizaki-Gibbons, Ashley Mog, Krystal Cleary, and Margaret Price. 2017. “Disability Access as Feminist Praxis at NWSA and Beyond Workshop.” Workshop Presented at the National Women’s Studies Conference, Maryland, USA, November 2017.
- CAST. Universal Design Guidelines.
- Centre for Teaching Support and Learning, Teaching Assistants’ Training Program. Access Checks. University of Toronto.
- Centre for Excellence in Learning and Teaching. 10 Tips for Creating Accessible Course Content [PDF]. Iowa State University.
- Dolmage, Jay. 2017. “Academic Ableism: Disability and Higher Education.” In Corporealities. Ann Arbor: University of Michigan Press.
- Fritsch, Kelly. 2024. “Desiring Disability in Our Learning Communities: Fostering a Crip Culture of Access.” In Reading the Room: Lessons on Pedagogy and Curriculum from the Gender and Sexuality Studies Classroom, edited by Natalie Kouri-Towe. Montreal: Concordia University Press.
- Hamraie, Aimi. 2016. “Beyond Accommodation: Disability, Feminist Philosophy, and the Design of Everyday Academic Life.” philoSOPHIA. 6(2): 259-271.
- Hamraie, Aimi. 2020. Critical Access Studies. Harvard Graduate Studies in Design.
- Hamraie, Aimi. 2020. Accessible Teaching in the Time of COVID-19. Critical Design Lab.
- Jama, Sarah. 2019. “Dismantling Ablism in Ontario.” Filmed August 29, 2019, in Ontario, The Agenda with Steve Paikin and Nan Kiwanuka, TVO, 0:26:39.
- Laureano, Bianca I. and Aiesha Turman. Crip Camp Curriculum.
- Rello, Luz and Ricardo Baeza-Yates. 2013. Good Fonts for Dyslexia [PDF].
- Tshuma, Gift and Shayna Hadley. 2020. The Centre for Gender Advocacy, Revision Recommendations of Concordia University’s Student Accessibility Policy [PDF]. October 7.
- Tshuma, Gift and Shayna Hadley. 2020. The Centre for Gender Advocacy: Mapping Project Report. October 7.
- UTSC Campus Curriculum Review Resource Hub. Pedagogical Development with Universal Design for Learning. University of Toronto.
- Waggoner, Jess, Hailee Yoshizaki-Gibbons, Ashley Mog, Krystal Cleary, and Margaret Price. 2017. “Disability Access as Feminist Praxis at NWSA and Beyond Workshop.” Workshop Presented at the National Women’s Studies Conference, Maryland, USA, November 2017.