Using intentional emergence to dethrone the sage on the stage.

Intentional emergence (IE) as a pedagogy centers students in learning and calls for the educator or facilitator to take a different role. It is important for educators to mindfully regulate their presence in the classroom to allow students to notice the role of authority in leadership practice. This article provides recommendations for productive learning when authority is de-centered and learners are encouraged to take up their authority. Facilitators who reflect and consider their identities and the identities of their participants will be more prepared for what emerges in the classroom. Finally, educators center student learning by intentionally creating a safe container before giving back the work to students in meaningful ways, allowing themselves to take a backseat and observe students exercising leadership.

Climate change adaptation and the back of the invisible hand.

A good deal of contemporary work in cultural evolutionary theory focuses on the adaptive significance of culture. In this paper, we make the case that scientifically accurate and politically feasible responses to the climate crisis require a complex understanding of human cultural practices of niche construction that moves beyond the adaptive significance of culture. We develop this thesis in two related ways. First, we argue that cumulative cultural practices of niche construction can generate stable equilibria and runaway selection processes that result in long-term existential risks within and across cultural groups. We dub this the back of the invisible hand. Second, we argue that the ability of cultural groups to innovate technological solutions to environmental problems is highly constrained in ways that are exacerbated by sustained intergroup conflict, inequality and by inherently unpredictable cascades in climate change and human migration patterns. After developing these theoretical points about human cultural practices of niche construction in detail, we conclude our discussion with some tentative practical suggestions about the way that cultural evolutionary history can more fruitfully be used in efforts to remit the climate crisis and contribute to sustainable practices of human climate change adaptation. This article is part of the theme issue 'Climate change adaptation needs a science of culture'.

Effects of Intravenous Ketamine Infusions in a Neuropathic Pain Patient with Lichen Sclerosus et Atrophicus.

A patient reported to the Florida Spine Institute (Clearwater, Fla., USA) with severe lichen sclerosus of the anogenital region and legs. The patient's pain presentation was neuropathic with hypersensitivity, allodynia, swelling, and weakness. The patient had failed multiple pain management modalities including opioid therapy, anticonvulsants, and antidepressants. The patient completed a standard intravenous ketamine infusion regimen developed at the Florida Spine Institute and reported complete abolishment of her pain syndrome. For the first time, we report that ketamine infusions also dramatically improved a patient's lichen sclerosus. That ketamine is known to have immunomodulatory properties, and given the clinical observations described in this case report, suggests that ketamine should be explored as a possible new therapeutic option for managing lichen sclerosus, especially in cases that are refractory to conventional therapies.