Marginalization has been used as a guiding concept for nursing research, theory and practice. Its properties have been identified and updated in 1994 and 1999, respectively. This article re-examines marginalization, considering it to be a concept that changes with pivotal historical events. The events of September 11, 2001, and the war between the US/UK and Iraq are such pivotal events. The notion of the linguistic habitus and symbolic violence as outlined by Bourdieu provide new insights about the dynamics of marginalization. (...) Specifically noted is the marginalization of persons and cultures based on their designation by the current US administration, and as interpreted through mainstream media, as actual or potential ‘terrorists’. A parallel situation in nursing is discussed, beginning with nursing's own marginality, related to the dynamics of symbolic violence. Nursing is argued to be vulnerable to having essential words and practices co-opted by dominant institutions and altered in meaning, that is, made incongruent with the discipline's emphasis on core values of confidentiality, equity and care. In response to marginalization and exteriorization those affected can use voice and testimony to ‘recreate the centre’. Suggestions for protecting our practices and philosophy are included. (shrink)

How well do scientists communicate to members of the mass media? A communication scholar reviews potential barriers to the essential dialogue necessary between those in the sciences and journalists who report science to the public. Suggestions for improving communication within this relationship, in spite of professional process differences, are offered, emphasizing adherence to shared ethical standards.

This commentary focuses on evidence from autism concerning the relation between metacognition and mindreading. We support Carruthers' rejection of models 1 (independent systems) and 3 (metacognition before mindreading), and provide evidence to strengthen his critique. However, we also present evidence from autism that we believe supports model 2 (one mechanism, two modes of access) over model 4 (mindreading is prior).

Understanding Animal Abuse and How to Intervene with Children and Young People offers a positive, compassion-based and trauma-informed approach to understanding and intervening in animal abuse. It provides an accessible cross-disciplinary synthesis of current international evidence on animal abuse, and a toolkit for professionals working with people and/or animals to help them understand, prevent, and intervene in cases of animal abuse. With contributions from experts in the field, this essential text offers ten user-friendly chapters with questions for reflection and key (...) summary points. It offers a definition of animal abuse, synthesises the latest research on children, young people and animal abuse, and explores the link between animal abuse and other forms of abuse, and legal perspectives on animal abuse. The second half of the book presents a practical toolkit for professionals, offering guidance and strategies for prevention of and intervention in cases of animal abuse. It provides multidisciplinary perspectives on interventions; from teachers' and social workers roles in detection and intervention of childhood animal abuse, to the roles of enforcement agencies and veterinarians in legal cases of adult animal abuse. Together with a final chapter proposing new directions for research, policy, and practice, this guide is for all who work with children, young people and/or animals, including psychologists, social workers, veterinarians, education professionals, and animal welfare educators. It is also key reading for those involved in legal and policy issues relating to animal welfare. (shrink)

Decompressive craniectomy is a technically straightforward procedure whereby a large section of the cranium is temporarily removed in cases where the intracranial pressure is dangerously high. While its use has been described for a number of conditions, it is increasingly used in the context of severe head injury. As the use of the procedure increases, a significant number of patients may survive a severe head injury who otherwise would have died. Unfortunately some of these patients will be left severely disabled; (...) a condition likened to the RUB, an acronym for the Risk of Unacceptable Badness. Until recently it has been difficult to predict this outcome, however an accurate prediction model has been developed and this has been applied to a large cohort of patients in Western Australia. It is possible to compare the predicted outcome with the observed outcome at 18 months within this cohort. By using predicted and observed outcome data this paper considers the ethical implications in three cases of differing severity of head injury in view of the fact that it is possible to calculate the RUB for each case. (shrink)

Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or ‘rescue’ procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely (...) disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other ‘rescue situations’, the utility of the procedure cannot be rationalised on a mere cost–benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation. (shrink)

IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

Volume 20, Issue 8, August 2020, Page W12-W13.

The position advocated in the target article should be called “absurd environmentalism.” Literature showing that general intelligence is related to musical ability is not cited. Also ignored is the heritability of musical talent. Retrospective studies supporting practice over talent are incapable of showing differences in talent, because subjects are self-selected on talent. Reasons for the popularity of absurd environmentalism are discussed.

Invited media scholars and journalists examine the general issue of nuclear waste, risk and the sicentific promises that were made, but not kept, about safe disposal. The mass media uncovered and reported on nuclear waste problems at Rocky Flats in Colorado and Hanford in Washington. Two environmental journalists review efforts to expose problems at these sites, how secrecy hampered reporting, and the effects of media coverage on nearby residents. An environmental communications scholar evaluates media coverage, the role of the U.S. (...) Department of Energy, and the impact of secrecy on public risk perceptions and attitudes toward government nuclear waste policies. (shrink)

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)

The liver was used widely in early studies of polarised transport but has been largely overlooked in recent years, mostly because of the development of epithelial cell lines which provide more tractable experimental systems. The majority of membrane proteins and lipids reach the hepatocyte apical membrane by transcytosis and it remains unclear whether there is a direct route for apical targeting, although the pathways present have yet to be fully characterised. The recent development of systems that allow hepatocyte transport processes (...) to be studied in culture and the observation that transcytosis can be significantly stimulated under physiological conditions suggest that hepatocytes have a role to play in future studies of polarised transport. This review discusses the known features of polarised membrane traffic in hepatocytes and contrasts them with the characteristics of vesicular transport in other epithelial cell types. (shrink)

The publication in 1959 of Russell and Burch's ThePrinciplesofHumaneExperimentalTechnique initiated a new era in the history of the debate between science and animal protection, the era of alternatives. Although Russell and Burch never used the word, and although the animal protection movement was somewhat moribund at the time in both England and the United States, within a decade of the book's publication a number of signs indicating a resurgence of public interest in the issue began to appear. At the same (...) time, increased knowledge and understanding of neurophysiology and ethology heightened scientific awareness of the significance of humane treatment in the laboratory and professionalized laboratory animal science. (shrink)

This study explored spatial navigation alongside several other cognitive abilities that are thought to share common underlying neurocognitive mechanisms (e.g., the capacity for self-projection, scene construction, or mental simulation), and which we hypothesised may be impaired in autism spectrum disorder (ASD). Twenty intellectually high-functioning children with ASD (with a mean age of ~8 years) were compared to 20 sex, age, IQ, and language ability matched typically developing children on a series of tasks to assess spatial navigation, episodic memory, episodic future (...) thinking (also known as episodic foresight or prospection), theory of mind, relational memory, and central coherence. This is the first study to explore these abilities concurrently within the same sample. Spatial navigation was assessed using the “memory island” task, which involves finding objects within a realistic, computer simulated, three-dimensional environment. Episodic memory and episodic future thinking were assessed using a past and future event description task. Theory of mind was assessed using the “animations” task, in which children were asked to describe the interactions between two animated triangles. Relational memory was assessed using a recognition task involving memory for items (line drawings), patterned backgrounds, or combinations of items and backgrounds. Central coherence was assessed by exploring differences in performance across segmented and unsegmented versions of block design. Children with ASD were found to show impairments in spatial navigation, episodic memory, episodic future thinking, and central coherence, but not theory of mind or relational memory. Among children with ASD, spatial navigation was found to be significantly negatively related to number of repetitive behaviours. In other words, children who showed more repetitive behaviours showed poorer spatial navigation. The theoretical and practical implications of the results are discussed. (shrink)

Although sustainable and responsible investment (SRI) has quite recently become a hot research topic, scarcely any systematic research has been paid to the performance of this non-conventional approach to investment during the financial crisis that emerged in mid-2008 when the resilience of the financial markets was sorely tested. Such real-world resilience in practice is the subject of the current research which tests whether environmental, social and governance screens provides ethical investors with adaptive resilience in bull and bear market conditions by (...) focussing on the SRI equity index of one of the most active markets in Europe in terms of ethical investment, the FTSE4Good-Ibex in Spain. Multivariate Generalized Autoregressive Conditional Heteroskedasticity (M-GARCH) analysis indicates that ethical investors in the equity market examined with evidence that greater resilience in severe business cycle shocks could be attributable to SRI by companies. Although limited to a single country study, the results have implications for investors seeking resilience in crisis: when individual values and beliefs towards sustainability tie with personal investment strategy, the end result is adaptive financial resilience, social well-being and environmental defence. (shrink)

This study uses the Locke and Okali gender analysis framework to explore gender relations surrounding grain storage management and marketing in Binga District of Zimbabwe. The study was conducted during one grain storage season and involved multiple visits to selected households, which were used as case studies. The main question that the study sought to address was: “What bargaining goes on between men and women in the area of stored grain management and marketing?” Data were collected from four households, fitting (...) into the following categories: simple monogamous, complex monogamous (two scenarios), and polygamous. Participatory rural appraisal tools and techniques were extensively used and formed the backdrop of all the data collection. The study established that much bargaining and strategizing occurs within the household in order for women to exercise control over the use of stored grain. The bargaining process was found to be a complex one of give-and-take without an immediately recognizable winner. There is evidence that women use this bargaining power to exert influence on their relative position in the household in terms of independent income generation and management, seniority, and overall household food security policies. While bargaining between and within gender remains shrouded in subtleness, individuals in a household consciously use their skills to manipulate the situation to their best advantage. This article is expected to initiate broader debate in the area of gender roles and bargaining in grain post-harvest management, an area often kept private by smallholder farmers in sub-Saharan Africa. (shrink)

Background: ICU patients’ family members are in a new, uncertain, and vulnerable situation due to the patient’s critical illness and complete dependence on the ICU nurses and physicians. Family members’ feeling of being cared for is closely linked to clinicians’ attitudes and behavior. Aim: To explore ICU nurses’ and physicians’ bedside interaction with critically ill ICU patients´ families and discuss this in light of the ethics of care. Research design: A qualitative study using participant observation, focus groups, and thematic narrative (...) analysis. Participants and research context: Data were gathered from July 2017 to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven focus groups with ICU nurses and physicians. Ethical considerations: The Regional Committee for Medical and Health Research Ethics and the Norwegian Centre for Research Data approved the study. Findings: Quality of ICU family care depends on nurses’ and physicians’ attitudes, behavior, and personality traits. Three main themes were identified: being attentive, an active approach, and degree of tolerance. Discussion: The findings are discussed in light of the ethics of care and empirical research from the intensive care environment. Conclusions: This study shows that attentive, active, and tolerant clinicians represent a culture of ethical care that gives families greater freedom of action and active participation in patient care. Clinicians must not bear sole responsibility for this culture; it must have a firm basis in the hospital and ICU and be established through training, interprofessional reflection, and support of clinicians. (shrink)