Background: Black, Asian and minority ethnic groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising community-based research (...) involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; hospital-based research examining staff practices and influences on family consent through ethics discussion groups with staff, a study on intensive care units and interviews with bereaved ethnic minority families; and development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts. Participants: Community studies: 228 focus group participants; hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication. Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. (shrink)

The challenge of pursuing sustainability in agriculture is often viewed as mainly or wholly technical in nature, requiring the reform of farming methods and the development and adoption of alternative technologies. Likewise, the purpose of sustainability is frequently cast in utilitarian terms, as a means of protecting a valuable resource (i.e., soil) and of satisfying market demands for healthy, tasty food. Paul B. Thompson has argued that the embrace of these views by many in the consumer/environmental movement enables easy co-optation (...) by agribusiness. It also reflects a critical weakness in this movement: a lack of commitment to philosophical principles that depart from the utilitarian premises of the industrial model of agriculture. This paper draws on the writings of Thomas Berry and Liberty Hyde Bailey to identify the philosophical principles of what we call planetary agrarianism. From the perspective of planetary agrarianism, the pursuit of sustainability is a broad and challenging moral, educational, and political task. Berry helps us see that it is fundamentally a project of worldview transition, which requires a new cultural narrative that must rival, in form and appeal, the mythic power of the utilitarian industrial vision. Liberty Hyde Bailey, author of The Holy Earth (1915) and a leader in the land-grant education and nature-study movements, took up the project of worldview transition in his life work. While in some ways dated and flawed, Bailey’s writings are a valuable source of guidance for developing and pursuing a viable philosophy of agriculture for the 21st century. (shrink)

A method of developing a relational semantics and relational proof systems for many-valued logics based on finite algebras of truth values is presented. The method is applied to Rosser-Turquette logic, logics based on symmetric Heyting algebras with operators and a Post-style logic.

Previous meta-analyses support a female advantage in decoding non-verbal emotion (Hall, 1978, 1984), yet the mechanisms underlying this advantage are not understood. The present study examined whether the female advantage is related to greater female attention to the eyes. Eye-tracking techniques were used to measure attention to the eyes in 19 males and 20 females during a facial expression recognition task. Women were faster and more accurate in their expression recognition compared with men, and women looked more at the eyes (...) than men. Positive relationships were observed between dwell time and number of fixations to the eyes and both accuracy of facial expression recognition and speed of facial expression recognition. These results support the hypothesis that the female advantage in facial expression recognition is related to greater female attention to the eyes. (shrink)

Throughout his life, John Tyler Bonner contributed to major transformations in the fields of developmental and evolutionary biology. He pondered the evolution of complexity and the significance of randomness in evolution, and was instrumental in the formation of evolutionary developmental biology. His contributions were vast, ranging from highly technical scientific articles to numerous books written for a broad audience. This historical vignette gathers reflections by several prominent researchers on the greatness of John Bonner and the implications of his work.

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

Endosex, in contrast to intersex, refers to innate physical sex characteristics judged to fall within the broad range of what is considered normative or typical for ‘binary’ female or male bodies by the medical field, or to persons with such characteristics1 (p. 437). In this short contribution, we explain the origins and increasing use of this little-known term and discuss its practical and ethical relevance to medicine as well as to scholarship from a range of disciplines concerned with individuals’ sexed (...) embodiment. There is growing awareness in many quarters of the term intersex— used within some discourses to refer to clusters of bodily attributes (as in ‘intersex traits’, also termed differences of sex development or variations of sex characteristics)1 or more broadly to persons (as in ‘intersex persons’) whose bodily attributes differ from the dominant clinical, biological, or legal paradigms that categorise and differentiate female and male bodies. Intersex traits have historically been stigmatised as monstrous, morbid or tragic, justifying surgical and hormonal ‘fixing’.2 Persons born with the attributes named with these terms, even if physically healthy, therefore risk unnecessary pathologisation and medicalisation, prompting interventions, often non-voluntary, into their bodies to make them appear or function in ways that are deemed more typically female or male. In addition, some legal and social systems automatically associate persons with these traits with third categories of sex—neither female nor male—which may or may not align with their sex designation at birth, sex of rearing, personal experience or self-conception (see Coda). Being seen as intersex or being judged to have …. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

"A Handbook of Traditional Living" consists of two texts originally published by the Italian cultural organization Raido, translated here for the first time: "The World of Tradition," a comprehensive summary of the principle ideas of Julius Evola; and "The Front of Tradition," a more practical guide for living as a traditionalist.

The explicit ambition of this collection is to move `beyond' the Universal Pragmatics of Jurgen Habermas.

Over the past two decades, the understanding of the roles of vitamin D has expanded to include many nonskeletal effects such as reduced risk of acute respiratory tract infections, autoimmune diseases, cancer, cardiovascular disease, diabetes mellitus, neurological diseases, and adverse pregnancy and birth outcomes. The role of vitamin D for optimal health is well known in Western developed countries but less so in Central Asian countries. This narrative review compares the status of vitamin D between Central Asian countries and Northern (...) European countries. The analysis also summarizes the evidence for the beneficial effects of vitamin D and recommendations for Central Asian countries. (shrink)

Several prominent voices have called for a democratization of science through deliberative processes that include a diverse range of perspectives and values. We bring these scholars into conversation with extant research on democratic deliberation in political theory and the social sciences. In doing so, we identify systematic barriers to the effectiveness of inclusive deliberation in both scientific and political settings. We are particularly interested in what we call misidentified dissent, where deliberations are starkly framed at the outset in terms of (...) dissenting positions without properly distinguishing the kinds of difference and disagreement motivating dissent. (shrink)

Aims and background: Little is known about how participants perceive prevention trials, particularly trials designed to prevent mental illness. This study examined participants’ motives for participating in a trial and their views of randomisation and the ability to withdraw from a randomised controlled trial for prevention of depression. Methods: Participants were older adults reporting elevated depression symptoms living in urban and regional locations in Australia who had consented to participate in an RCT of interventions to prevent depression. Participants rated their (...) agreement with various statements describing motivations for enrolment in the trial and opinions regarding randomisation and withdrawal. Results: The majority of participants expressed a triad of altruistic motivation for participation, relative lack of concern about randomisation and commitment to the trial. Certain subgroups of participants, such as women and those with higher depression scores, reported higher levels of concern about specific issues. Conclusions: The findings suggest that participants enrolled in prevention trials for mental illness are likely to hold positive attitudes towards research trials. The identification of relationships between key person factors and trial-related attitudes enabled profiling of participant groups, which can inform recruitment strategies and interactions of participants and research projects in future prevention trials. (shrink)

In this essay I set out to problematize the concepts of intersubjectivity and interaction in the theories of Germany's two foremost social philosophers: Jiirgen Habermas and Niklas Luhmann. To do so, I shall briefly reconstruct Husserl's phenomenological concept of intersubjectivity and its relationship with rational horizons and lifeworlds. I shall then demonstrate the importance of Husserl's thought in the theory of (rational) communicative action in Habermas. The third section deals with the radical rethinking of the subject (and hence intersubjectivity) in (...) the theory of Niklas Luhmann. My principal question will then be: is it possible to reconcile critical theory with systems theory? Or, alternatively: is intersubjectivity a reality or a useful fiction? (shrink)

In bringing intentions, understandings, meanings and interactions down to earth this book invites its readers to account for the complex communications between ...