Park rangers hold a unique set of knowledge—of science, of publics, of institutional structures, of place, and of self—that should be recognised as valuable. For too long, models of the knowledge of scientists and publics have set people like rangers in an inbetweener position, seeing them as good at communicating, translating or negotiating from one side to the other, but not as making knowledge that is powerful in its own right. In this paper we argue that focus groups with park (...) rangers across regional and conservation parks in Aotearoa/New Zealand reveal the complexity and multiplicity of rangers’ knowledge-making that shows the science-public model as incomplete. We argue further that the model is flawed for its focus on the making and holding of knowledge and not also on how it is enacted. Rangers, we argue, are responsible every day for making knowledgeable decisions for the health and well-being of parks and people. Making good decisions, though, requires not just knowledge but also care. An understanding of the many ways rangers know and enact their knowledge is important for biosecurity practice, especially in models of adaptive governance. (shrink)

This volume examines some of the most contentious social justice issues present in the corpus of Augustine's writings. Whether one is concerned with human trafficking and the contemporary slave trade, the global economy, or endless wars, these essays further the conversation on social justice as informed by the writings of Augustine of Hippo.

It has been known for 20 years that the ribosomal protein S6 is rapidly phosphorylated when cells are stimulated to grow or divide. Furthermore, numerous studies have documented that there is a strong correlation between increases in S6 phosphorylation and protein synthesis, leading to the idea that S6 phosphorylation is involved in up‐regulating translation. In an attempt to define a mechanism by which S6 phosphorylation exerts translational control, other studies have focused on characterizing the sites of phosphorylation of this protein (...) and its location within the ribosome. Recent data show that S6 is a protein which may have diverse cellular functions and is essential for normal development, and that it may be involved in the translational regulation of a specific class of messages. (shrink)

The Buddhist Art of Nagarjunakonda. Elizabeth Rosen Stone. Buddhist Tradition Series 25, ed. Alex Wayman. Motilal Banarsidass, Delhi 1994. 143 pp. Rs.600. ISBN 81-208-0828-2.

It is widely thought that genetic counselors should work with parents “nondirectively”: they should keep parents informed and support their decisions. But this view misconceives human decisionmaking by failing to recognize that value choices are constructed within and constrained by a community. Acknowledging that decisions involve interaction with and responsibility toward others leads to a “dialogical” model of counseling, in which genetic counselors may question and guide parents’ decisions.

The Caves at Aurangabad: Early Buddhist Tantric Art in India. Carmel Berkson. Mapin Publishing Pvt. Ltd., Ahmedabad 1987. Distributed by University of Washington Press, Seattle. xvi, 238 pp. $32.50.

Background:Moving into the last phase of life comprises a developmental transition with specific needs and risks. Facilitating transitions is an important component of the work of nurses. When curative interventions are no longer helpful, nurses enact key roles in caring for patients and families.Aim:The aim of this study was to examine the experiences of registered nurses in acute care settings as they worked with patients and families to facilitate transition to comfort-focused care.Research design:Sampling, data collection, and data analysis were guided (...) by constructivist grounded theory, chosen because of its strength in identifying and explicating social processes.Participants and context:A purposeful sample of 26 registered nurses working in acute care hospitals in one community in the northeastern United States participated in this study through semi-structured interviews.Ethical considerations:The study received approval from the university’s Institutional Review Board for the Protection of Human Subjects. Participants provided informed consent.Findings:Nurses facilitated transition to comfort-focused care by enacting their moral commitments to patients and families. They focused on building relationships, honoring patient self-determination, and maintaining respect for personhood. In this context, they discerned a need for transition, opened a discussion, and used diverse strategies to facilitate achieving consensus on the part of patients, family members, and care providers. Regardless of how the process unfolded, nurses offered support throughout.Discussion:Achievement of consensus by all stakeholders is critical in the transition to comfort-focused care. This study deepens our understanding of how nurses as moral agents utilize specific strategies to assist progress toward consensus. It also offers an example of recognizing the moral agency of nurses through listening to their voices.Conclusion:Increased understanding of effective nursing strategies for facilitating transition to comfort-focused care is essential for developing needed evidence for excellent care and strengthening end-of-life nursing education. (shrink)

The increase in the scope of international collaborative medical research involving human subjects is raising the problem of whether and how to maintain Western ethical standards when research is conducted in countries with very different social and ethical values. Existing international ethical guidelines for research largely reflect Western concepts of human rights, focusing on the bioethical principles of respect for persons, beneficence, and justice. However, in countries and societies where these values are understood differently or are not expressed in local (...) cultures and institutions, it may be impossible or of no practical value to insert them into the research setting.In the United States, individual informed consent is considered ethically imperative for research involving human subjects. However, this imperative may be difficult to instill in societies that define persons by their relations to others, and important decisions are commonly made by heads of households or group leaders rather than by individuals. The baseline economic and health care conditions in foreign communities may also create ethical conflicts. (shrink)

D.T. Suzuki. A Biography. A. Irwin Switzer III. Edited and enlarged by John Snelling. The Buddhist Society, London 1985. 63 pp. I11.

Imaging Wisdom, Seeing and Knowing in the Art of Indian Buddhism. Jacob N. Kinnard. Curzon Press, Richmond 1999. xi, 210 pp., 16 figures. £40.00. ISBN 0-7007-1083-3.

The increase in the scope of international collaborative medical research involving human subjects is raising the problem of whether and how to maintain Western ethical standards when research is conducted in countries with very different social and ethical values. Existing international ethical guidelines for research largely reflect Western concepts of human rights, focusing on the bioethical principles of respect for persons, beneficence, and justice. However, in countries and societies where these values are understood differently or are not expressed in local (...) cultures and institutions, it may be impossible or of no practical value to insert them into the research setting.In the United States, individual informed consent is considered ethically imperative for research involving human subjects. However, this imperative may be difficult to instill in societies that define persons by their relations to others, and important decisions are commonly made by heads of households or group leaders rather than by individuals. The baseline economic and health care conditions in foreign communities may also create ethical conflicts. (shrink)

Within the rarefied world of art collecting, connoisseurship signifies esoteric knowledge used to judge the quality, exclusivity, desirability and even authenticity of art. As this collection of essays demonstrates, however, connoisseurship is not confined to the art world but rather practised in a variety of settings by elites and consumers alike. This volume presents a fresh approach to connoisseurship, creating a broad international dialogue about its meaning and application. It ranges across such diverse fields as consumer history, sociology and ethnography, (...) earth science, forensic science and art history. It demonstrates that connoisseurship can be both intuitive and scientific, utilizing comparison and tied to measures of value and market dynamics. (shrink)

BackgroundDelirium is highly prevalent in the general hospital patient population, characterized by acute onset, fluctuating levels of consciousness, and global impairment of cognitive functioning. Mental capacity, its assessment and subsequent consent are therefore prominent within this cohort, yet under-explored.AimThis study of patients with delirium sought to determine the processes by which consent to medical treatment was attempted, how capacity was assessed, and any subsequent actions thereafter.MethodA retrospective documentation review of patients identified as having a delirium for the twelve months February (...) 2013 to January 2014 was undertaken. Inclusion and exclusion criteria were used; demographic and descriptive data collected. A total of n=1153 patients were identified with n=310 meeting inclusion criteria.ResultA random sample of one hundred patients were subsequently reviewed. One third of patients had documentation relating to consent, while four patients had documentation relating to capacity. Median delirium duration was three days, with treatment refusal occurring in twenty-two patients and “duty of care” being used as an apparent beneficent related treatment framework in twelve patients.ConclusionsWhile impaired decision-making was indicated, the review was unable to indicate what patient characteristics flag the need for capacity assessment. Documentation relating to consent processes appeared deficient for this cohort. (shrink)

In recent years, the growth of interest in global health among medical students and residents has led to an abundance of short‐term training opportunities in low‐resource environments. Given the disparities in resources, needs and expectations between visitors and their hosts, these experiences can raise complex ethical concerns. Recent calls for best practices and ethical guidelines indicate a need for the development of ethical awareness among medical trainees, their sponsoring and host institutions, and supervising faculty. As a teaching tool to promote (...) this awareness, we developed a scenario that captures many common ethical issues from four different perspectives. Each perspective is presented in case format followed by questions. Taken together, the four cases may be used to identify many of the elements of a well‐designed global health training experience. (shrink)

This article describes the spiritual formation training program for counseling students at Richmont Graduate University, an evangelical institution providing Master’s-level instruction for counselors and ministers. This model of spiritual formation has a dual foundation which includes the centrality of love to the Christian life and the importance of attachment to the development of persons. The training is intentionally designed to invite students to pursue a more secure attachment to God, healthier relationships with others, and a more grace-based self-awareness. Integrative and (...) clinical instruction, and experiences that foster establishment of secure attachment are described. Co-curricular efforts in research and student advisement focus on grace and wellness, as well as opportunities for service, and these serve to further contribute to a supportive environment for spiritual formation. (shrink)

A series of structural constitutional arguments lodged in multiple cases against Centers for Medicare and Medicaid Services’ (CMS) authorities to negotiate prescription drug prices via the 2022 Inflation Reduction Act threaten the legitimacy of CMS program and federal agency powers.

Lack of attribution and plagiarism can create a special problem for journalists. As numerous examples indicate, there is confusion about the sometimes fine line between lack of attribution and plagiarism. But there is even more confusion over how to solve the problem. Short of restructuring the journalism profession to create an overall governing body similar to the law bar, there is no way to create a set of national guidelines on when lack of attribution might become plagiarism. The only place (...) to deal with the ambiguity of this issue is at the level of the individual papers. (shrink)

In recent years, the growth of interest in global health among medical students and residents has led to an abundance of short-term training opportunities in low-resource environments. Given the disparities in resources, needs and expectations between visitors and their hosts, these experiences can raise complex ethical concerns. Recent calls for best practices and ethical guidelines indicate a need for the development of ethical awareness among medical trainees, their sponsoring and host institutions, and supervising faculty. As a teaching tool to promote (...) this awareness, we developed a scenario that captures many common ethical issues from four different perspectives. Each perspective is presented in case format followed by questions. Taken together, the four cases may be used to identify many of the elements of a well-designed global health training experience. (shrink)

Respect for patients’ self-determination has long been considered central to efforts to improve end-of-life care, yet efforts to promote advance directives or engage patients in end-of-life discussions are often unsuccessful. In this article, I contend that this is because the shared decision-making approach typically used in healthcare assumes patients’ capacity to make rational choices, which is not always possible in end-of-life decisions. Drawing on decision theory, behavioral psychology, and related studies of endof-life care, I present a growing body of evidence (...) that suggests the novelty, complexity, and uncertainty of end-of-life circumstances make rational and stable preferences difficult to establish. I argue that an effective decision-making approach for the terminally ill must recognize and respond to the unique characteristics of endof-life choices, including their nonrational dimensions. I conclude with a description of an initiative that appears to do so, resulting in increased patients’ satisfaction. (shrink)

This paper describes the development of two annual lantern parades as case examples of arts in community health, which the authors define as a distinct area of activity operating mainly outside of acute healthcare settings, characterised by the use of participatory arts to promote health. The parades took place in Gateshead 1994–2006 and later in Stockton-on-Tees from 2009 to the present, and the paper reflects on the factors that made for the success of the Gateshead parade and also the problems (...) that led to its demise. It then describes and assesses the Stockton parade, and the benefits and challenges of a workshop ethos of ‘positive regard’ with reference to interview data gathered from adult volunteers and school staff. It considers the potential of this annual ‘tradition’ to shape communal memories that identify with place, and it sets out its aspirations for future programme and research. (shrink)

This article is concerned with developing a philosophical approach to a number of significant changes to academic publishing, and specifically the global journal knowledge system wrought by a range of new digital technologies that herald the third age of the journal as an electronic, interactive and mixed-media form of scientific communication. The paper emerges from an Editors' Collective, a small New Zealand-based organisation comprised of editors and reviewers of academic journals mostly in the fields of education and philosophy. The paper (...) is the result of a collective writing process. (shrink)

Nondirective genetic counseling developed as a means of promoting informed and independent decision-making. To the extent that it minimizes risks of coercion, this counseling approach effectively respects client autonomy. However, it also permits clients to make partially informed, poorly reasoned or ethically questionable choices, and denies counselors a means of demonstrating accountability for the use of their services. These practical and ethical tensions result from an excessive focus on noncoercion while neglecting the contribution of adequate information and deliberative competence to (...) autonomous decision-making. A counseling approach that emphasizes the role of deliberation may more reliably produce thoroughly reasoned decisions. In such an approach, characterized by dialogue, counselors are responsible for ensuring that decisions are fully informed and carefully deliberated. Counseling remains nonprescriptive, but in the course of discussion counselors may introduce unsolicited information and/or challenge what they believe are questionable choices. By this means clients can be better assured that the decisions they make are fully considered, while counselors demonstrate a limited degree of professional accountability. (shrink)

A paper given at the Conference on “Issues Facing the New Administration”, Pepperdine University, January 1989. The nuclear family of much nostalgic conservative Christian rhetoric is a product of the industrial revolution making the father the absent bread winner. The family farm model where both parents shared parenting and providing roles is a better model for work patterns that enable boys and girls to relate to good role models of both genders in their childhood.

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 completed surveys and 54 partially completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

This paper argues that racist speech in public places ought to be regulable even with teh strict free speech protections of the First Amendment. McGowan argues that the same justification for regulating the hanging of a 'Whites Only' sign applies to racist utterances in public spaces.