The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of (...) potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a ‘report’ button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them. (shrink)

Constructive Neutral Evolution is an evolutionary mechanism that can explain much molecular inter-dependence and organismal complexity without assuming positive selection favoring such dependency or complexity, either directly or as a byproduct of adaptation. It differs from but complements other non-selective explanations for complexity, such as genetic drift and the Zero Force Evolutionary Law, by being ratchet-like in character. With CNE, purifying selection maintains dependencies or complexities that were neutrally evolved. Preliminary treatments use it to explain specific genetic and molecular structures (...) or processes, such as retained gene duplications, the spliceosome, and RNA editing. Here we aim to expand the scope of such explanation beyond the molecular level, integrating CNE with Multi-Level Selection theory, and arguing that several popular higher-level selection scenarios are in fact instances of CNE. Suitably contextualized, CNE occurs at any level in the biological hierarchy at which natural selection as normally construed occurs. As examples, we focus on modularity in protein–protein interaction networks or “interactomes,” the origin of eukaryotic cells and the evolution of co-dependence in microbial communities—a variant of the “Black Queen Hypothesis” which we call the “Gray Queen Hypothesis”. (shrink)

Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke patients (...) who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug treatment. (...) Design: Eleven patients who had been informed about thrombolytic drug treatment and had been through the process of deciding whether or not to participate in a thrombolytic drug trial went through repeated qualitative, semistructured interviews. Results: Many patients showed a limited perception of the risks connected with thrombolytic drug treatment. Some perceived the risk as not relevant to them and were reluctant to accept that treatment could cause harm. Others seemed to be aware that treatment would mean exposure to risk. The patients’ willingness to take a risk also varied substantially. Several statements revealed ambiguity and confusion about being involved in a decision about treatment. The patients’ reasoning about risk was put into the context of their health-related experiences and life histories. Several patients wanted the doctor to be responsible for the decisions. Conclusion: Acute stroke patients’ difficulties in perceiving and processing information about risk may reduce their ability to be involved in clinical decisions where risks are involved. (shrink)

What is the reason for the continued interest in Newman’s theology? This article’s reply that Newman was a contextual theologian is based on a consideration of three questions:Was Newman a theologian? What was the context of his theology? What are the reasons for Newman’s theological longevity?

One of the major benefits of the Internet is that numerous books and essays that have long been out of print are now readily accessible—including the following booklet.

The author argues that since previous ecumenical approaches—conflict, conversion, collaboration, compromise—have been minimally effective, the new one of convergence may be more successful.

© 2014 Taylor Francis. The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus testing of every client presenting for services in venues where HIV prevalence is high. Because older adults have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent and ever HIV testing in a probability sample of at-risk (...) adults seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months or ever. Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis. (shrink)

Newman was a prolific writer, but one who usually wrote on “call”; sometimes these calls were unexpected, but at other times they were a pastoral responsibility. Such was the case with his sermons, which exhibit four characteristics: biblically based, theologically grounded, circumstantially relevant, and spiritually insightful. As such, his sermons still appeal to readers today.

This essay examines the complementarity between Newman’s Apologia pro Vita Sua (1864), which provided an autobiographical account of his conversions, and his Grammar of Assent (1870), which described three types of inference—formal, natural, informal—that provide three paradigms for different types of religious conversion.

This essay examines Newman’s Dublin lecture on the relationship between Theology and Science—their inevitable intersections and their circumstantial collisions. What lessons can be learned from Newman’s “view” of Theology and Science in considering the confrontations between Theology and Science in the twenty-first century?

Newman was a prolific writer, but one who usually wrote on “call”; sometimes these calls were unexpected, but at other times they were a pastoral responsibility. Such was the case with his sermons, which exhibit four characteristics: biblically based, theologically grounded, circumstantially relevant, and spiritually insightful. As such, his sermons still appeal to readers today.

This essay, which was originally presented at the first Coloquio Internacional at the Guadalajara Campus of the Universidad Panamericana, Mexico, October 8-10, is a short introduction to Newman’s writings in six areas—autobiography, philosophy, theology, literature, education and spirituality—along with some suggestions for additional reading, particularly for those beginning Newman studies.

This essay examines Newman’s Dublin lecture on the relationship between Theology and Science—their inevitable intersections and their circumstantial collisions. What lessons can be learned from Newman’s “view” of Theology and Science in considering the confrontations between Theology and Science in the twenty-first century?

This essay examines the complementarity between Newman’s Apologia pro Vita Sua (1864), which provided an autobiographical account of his conversions, and his Grammar of Assent (1870), which described three types of inference—formal, natural, informal—that provide three paradigms for different types of religious conversion.