Resumen: Entre 1842 y 1870, la narrativa chilena presenta un paulatino proceso de desarrollo que oscila entre la novela -cuando no el cuento- y el folletín. Lastarria califica su cuento “El mendigo” como “novela histórica”. A su vez, Alberto Blest Gana luego de publicar folletines en diversos periódicos de la época toma nítida distancia de ese tipo de “novela popular cuando en 1862 reflexiona acerca de la novela propiamente tal y al declarar -en 1864- que solo pretende ser un novelista (...) al estilo de Balzac. No obstante, el folletín de filiación europea presentará -hacia 1870- una precisa fórmula como es la denominada “novela indiana” que critica Zorobabel Rodríguez. Por lo mismo, proponemos que en las instancias fundacionales de la narrativa nacional se anticipa la tendencia de recurrir al folletín poniendo de relieve el motivo del amor imposible que no puede superar obstáculos de diversa índole, sean ellos sentimentales, estamentales, políticos o historiográficos. Nuestra hipótesis es que en el curso de la novela chilena liberal, de sello romántico sentimental, esta estructura modélica no es ajena a la narrativa nacional, hecho que permite dar curso a la narración -entre otros- de acontecimientos propios de la conquista, la independencia y la República.: Between 1842 and 1870, the Chilean narrative presents a gradual development process that oscillates between the novel -if not the short story- and the folletin. Lastarria describes his story “El mendigo” as an “historical novel”. At the same time, Alberto Blest Gana wins after publishing brochures in various newspapers of the time, he takes a clear distance from that type of "popular novel” when in 1862 he reflects on the novel itself and in declaring -in 1864- that it only pretends to be a Balzac-style novelist. However, the European affiliation booklet will present -by 1870- a precise formula such as the so-called “Indian novel” criticized by Zorobabel Rodríguez. For the same reason, we propose that in the foundational instances of the national narrative the tendency to resort to the newsletter is anticipated, highlighting the reason for impossible love that cannot overcome obstacles of various kinds, whether they are sentimental, social class, political or historiographic. Our hypothesis is that in the course of the liberal Chilean novel, with a sentimental romantic stamp, this model structure is no stranger to the national narrative, a fact that allows the narration -among others- of events of the conquest, independence and the Republic. (shrink)

Aim: To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.Method: Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union the leaflets (...) were assessed for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed.Results: All the units’ leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50–75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high.Conclusion: Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets. (shrink)

Package leaflets belong to the complex communication system related to the minimization and prevention of pharmaceutical risk. Their legal nature is not exhausted by safety regulation though: as a privileged form of product instruction, they are also subject to liability regulation with a consequent reallocation of damage responsibility through risk disclosure. This article presents the results of a doctoral dissertation devoted to the legal and communicative analysis of PL information. After illustrating the articulation of pharmaceutical risk through risk prevention (...) norms, the paper goes on with a discussion of the PL role within the therapeutic decision as a complementary vehicle to doctor’s information. It results that the liability framework in which both information channels are embedded determines a communication model, which far from promoting a shared decision process, radicalizes the two-step communication structure typical of the informed consent model inherited by surgery judicature. The second part investigates PL information as a source of knowledge updating through the methodological tools provided by Bayesian decision theory. Finally, an empirical study conducted over a sample of 55 drug consumers investigates the impact of PL information on drug risk perception and its perceived value to therapeutic decision. (shrink)

This study explores society's attitudes towards medicine, as reflected in the language of Patient Information Leaflets, and attempts to explicate how they have changed over the last century. For this purpose, Halliday's transitivity model is employed as a method of discourse analysis in order to carry out a systematic, comparative investigation of the language of early 20th-century PILs and that of their modern equivalents. The study demonstrates how the transitivity choices in the respective samples cumulatively realize a particular `world-view', (...) and considers the implications this has for the construal of the wider social/cultural context and the projection of particular ideologies. The analyses show significant differences in transitivity patterns between the two samples, which reflect changes in the way medicine is viewed in Western culture. (shrink)

The problem of non-compliance with treatment and its repercussions on the clinical evolution of different conditions has been widely investigated.1–4 Non-compliance has also been shown to have significant economic implications, not only as a result of product loss but also indirectly through the complication of disease management and its subsequent healthcare and social costs.5–7Non-compliance as a health problemThe term “non-compliance” might be taken to refer both to the failure to follow a drug regimen and to the failure to adopt other (...) measures that contribute to improvement in health—for example, changes in lifestyle or diet. This letter focuses on the former.Non-compliance with a drug regimen can be the result of a number of different factors9–11 and a variety of techniques have been developed in an attempt to control it.12,13 Of these, the few techniques that have been shown to be effective have only managed to solve the problem in specific situations over short periods of time. The use of such techniques to control non-compliance, particularly where these are effective, raises interesting ethical questions about the extent to which their application constitutes an infringement of the patient’s right to decide on how to manage their own health.8 Here we suggest that in some cases one factor that leads to non-compliance is the tendency to provide extensive and exhaustive information on side effects in …. (shrink)

Examples of "anti-Soviet" behavior of schoolchildren in Ukraine during the 1960-1970s are analyzed in the article based on the materials of the State Archives Department of the Security Service of Ukraine and interviews conducted by the author. The ambivalence of family and school education as factors of upbringing of "Homo Sovieticus" is characterized. Communist education set an ambitious goal to form a generalized canonical image of the "respectable person". Standing out was not only condemned, but also attracted attention of the (...) Committee for State Security, regardless the child's age. Among the unauthorized actions there are the following: distribution of leaflets, inscriptions on the walls, anonymous letters, condemnation of the foreign policy of the USSR, display of Ukrainian symbols, stylisation, membership in religious communities, disruption or distortion of portraits of leaders and visual agitation, creation of unauthorized organizations, clubs, groups. The forms and methods of the Committee for State Security, in combating anti-Soviet behavior of schoolchildren are revealed in the article. The Committee for State Security, found various reasons to explain the students' anti-Soviet behavior, such as medical diagnoses, games of children, lack of ideological education at school, negative influence of family, watching foreign films, listening to prohibited media channels, influence of bourgeois propaganda, nationalist ideas and religious views. These motives would have to show that deviations from the norm associated with insignificant short-term influences, are not an indicator of the mistakes in the policy of juvenile communist education. However, each document of the Committee for State Security, about "anti-Soviet behavior" has personal resolution of the First Secretary of the Central Committee of the Communist Party of Ukraine, regardless the age of the child who committed the action. The utopia of attempts to educate appropriate Soviet schoolchild under the conditions of "Khrushchev Thaw" and "Era of Stagnation" is stipulated. It has been argued that anti-Soviet behavior of schoolchildren was not only manifestation of juvenile maximalism, but also evidence of more significant socio-political crisis in the Soviet society of the 1960 -1970s, including those related to national issues. (shrink)

Magazines, leaflets, weblogs, and a variety of other media incessantly spread messages advising us on how to achieve or maintain our health or well-being. In such messages, the iconic representation of the face is predominant, and reveals an interesting phenomenon: the “face of health” seems to be unattainable as such, and is generally represented in a differential way, that is to say, by making reference to its opposite – the “face of illness”, or at least of malaise. In fact, (...) the face is crucial in the medical domain: since ancient times, face observation has played an essential role in diagnostic practices, both in Western medicine (which resorts to the concept of facies, intended as the distinctive facial expression or appearance associated with a specific medical condition, for the description of pathological states) and Eastern preventive and healing techniques (within which the so-called Mian Xiang, or ‘face reading’, is fundamental, and connects the medical sphere with other aspects such as personality, talents, and dispositions). Drawing on the semiotic analysis of relevant case studies extending from classical iconography to present-day digital mediascapes, this paper investigates the representation of the face of health (and illness) across time and space, specifically focusing on the analogies and differences between the Western and the Eastern semiosphere. To this purpose, it relies on both literature concerning the representation and understanding of the face and studies on medical sign systems and discourses. (shrink)

OBJECTIVES: To study whether linguistic analysis and changes in information leaflets can improve readability and understanding. DESIGN: Randomised, controlled study. Two information leaflets concerned with trials of drugs for conditions/diseases which are commonly known were modified, and the original was tested against the revised version. SETTING: Denmark. PARTICIPANTS: 235 persons in the relevant age groups. MAIN MEASURES: Readability and understanding of contents. RESULTS: Both readability and understanding of contents was improved: readability with regard to both information leaflets (...) and understanding with regard to one of the leaflets. CONCLUSION: The results show that both readability and understanding can be improved by increased attention to the linguistic features of the information. (shrink)

Background: Informed consent in the modern era is a common and important topic both for the well-informed patient and to prevent unnecessary litigation. However, the effectiveness of informed consent in trauma patients is an under-researched area. This paper aims to assess the differences in patient recall of the consent process and desire for information by performing a comparative analysis between orthopaedic trauma and elective patients. Methods: Information from 41 consecutive elective operations and 40 consecutive trauma operations was collected on the (...) first post-operative day. Results: 100% of elective patients and 90% of trauma patients knew what operation they had received (p = 0.06). Overall recall of complications was poor, but was significantly lower in trauma patients compared with elective patients (62% vs 22%, p<0.001). 30% of trauma patients desired more information about their operation compared to 12% of elective patients (p = 0.049), although only 35% of trauma patients wanted written as well as verbal explanations, compared to 85% of elective patients p<0.001). Overall 100% of elective and 90% of trauma patients were happy with the consent process (p = 0.06). Subset analysis of neck of femur compared to other trauma patients showed that the above factors were not significantly different between the two groups. Conclusions: Recall of complications in the trauma patients is significantly lower than in elective patients, although both groups scored poorly overall. Repeated verbal explanations should be reinforced with the option of additional information leaflets for trauma operations. Further research into the usefulness of DVDs for commonly performed operations is warranted, although official internet resources may be more cost-effective. (shrink)

Background:Surveillance technology such as tag and tracking systems and video surveillance could increase the freedom of movement and consequently autonomy of clients in long-term residential care settings, but is also perceived as an intrusion on autonomy including privacy.Objective:To explore how clients in residential care experience surveillance technology in order to assess how surveillance technology might influence autonomy.Setting:Two long-term residential care facilities: a nursing home for people with dementia and a care facility for people with intellectual disabilities.Methods:Ethnographic field study.Ethical considerations:The boards (...) representing clients and relatives/proxies of the clients were informed of the study and gave their written consent. The clients’ assent was sought through a special information leaflet. At any time clients and/or proxy were given the option to withdraw from the study. The research protocol was also reviewed by a medical ethics committee.Findings:Our findings show a pattern of two themes: (1) coping with new spaces which entailed clients: wandering around, getting lost, being triggered, and retreating to new spaces and (2) resisting the surveillance technology measure because clients feel stigmatized, missed the company, and do not like being “watched.”Conclusion:Client experiences of surveillance technology appear to entail a certain ambivalence. This is in part due to the variety in surveillance technology devices, with each device bringing its own connotations and experiences. But it also lies in the devices’ presupposition of an ideal user, which is at odds with the actual user who is inherently vulnerable. Surveillance technology can contribute to the autonomy of clients in long-term care, but only if it is set in a truly person-centered approach. (shrink)

In all domains of life, transmembrane proteins from the ATP‐binding cassette (ABC) transporter family drive the translocation of diverse substances across lipid bilayers. In pathogenic fungi, the ABC transporters of the pleiotropic drug resistance (PDR) subfamily confer antibiotic resistance and so are of interest as therapeutic targets. They also drive the quest for understanding how ABC transporters can generally accommodate such a wide range of substrates. The Pdr5 transporter from baker's yeast is representative of the PDR group and, ever since (...) its discovery more than 30 years ago, has been the subject of extensive functional analyses. A new perspective of these studies has been recently provided in the framework of the first electron cryo‐microscopy structures of Pdr5, as well as emergent applications of machine learning in the field. Taken together, the old and the new developments have been used to propose a mechanism for the transport process in PDR proteins. This mechanism involves a “flippase” step that moves the substrates from one leaflet of the bilayer to the other, as a central element of cellular efflux. (shrink)

The UK Medical Research Council, in order to further its mission of maintaining and improving human health, supports a substantial number of clinical trials on a wide variety of medical questions; some of these trials involve the use of placebos as controls or to maintain blinding. Before providing support, proposed trials are carefully reviewed to assess scientific quality, and to determine whether a placebo is required and is ethical — in addition to ethics review by independent Research Ethics Committees. Some (...) questions such as the choice of placebos in trials in developing countries, in surgical trials and those involving alternative medicine require consideration of additional, specific issues. Involvement of consumers in MRC work has been increasing and includes the establishment of a Consumer Liaison Group; members of this group comment on patient information leaflets for clinical trials, helping to improve patient understanding of trials and ensuring topics like placebo use are explained clearly. Views differ on the value of placebos in clinical care and on their mechanism of action; continuing research is helping to clarify the issues. (shrink)

Cette étude critique deux notions très répandues: 1° que les genes chromosomes forment les unités fondamentales du mécanisme biologique: 2° que les organismes sont des conséquences d'ensembles de genes ‘libres’.Il est suggéré que 3° l'information codée dans les chromosomes est plutôt comparable aux indications données par un livret d'instructions et que 4° des actions fondamentales des cellules ont pu précéder les instructions qui les concernent de même façon que les techniques humaines ont précédé des textes qui les analysent.Cette analogie est (...) élaborée en certains détails et quelquesunes de ses limitations sont demonstrées.In this paper two widely held ideas are criticized: that chromosomal genes are the fundamental units of biological machinery and that organisms have arisen from assemblies of “free” genes.Instead it is suggested that the information encoded in the chromosomes may better be compared with the instructions contained in a textbook or leaflet, an that basic cell activities may have preceded the instructions dealing with them in the same way in which human skills have preceded any texts dealing with them.This analogy is elaborated in certain details and some of its limitations are shown.Die Arbeit ist eine Kritik zweier weitverbreiteter Ideen, nämlich dass die Gene in den Chromosomen die fundamentalen Bestandteile der biologischen Maschinerie sind und dass die Organismen von Aggregaten „freier“ Gene abstammen.Statt dessen wird vorgeschlagen, dass die in den Chromosomen kodifizierte Information eher mit den Instruktionen eines Lehrbuchs oder einer Gebrauchsanweisung vergleichbar ist und dass die grundlegenden Zellaktivitäten früheren Ursprungs sein dürften, als die Instruktionen zu ihrer Ausführung, etwa in der Weise in der menschliche Fertigkeiten gedruckten Anweisungen zu ihrer Ausführung vorausgegangen sind.Verschiedene Einzelheiten dieser Analogie werden verfolgt und einige ihrer Grenzen aufgezeigt. (shrink)

Radio Free Europe used balloons to drop leaflets in an attempt to supplement radio with printed words in the 1950s—a historical moment when closing borders, censoring the press, jamming foreign radios, tapping telephone lines, and tracking letters from abroad created an almost hermetically sealed space without many means for exchanging information across the Iron Curtain. This article traces how distorted and limited information shaped Cold War propaganda and practices of information-gathering. The article further examines unpredictable environmental factors that were (...) transformed into persuasive political rhetoric. A comparative analysis of communist media shows similarities of imagination in a visual propaganda campaign across five communist countries. Fantasies evolved into an object of public interest when propaganda strategies embraced a language of facts. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Objectives To develop and test two educational programmes (interactive and passive) aimed at improving family doctors' (FD) prescribing practices and patient's knowledge and use of non-opioid analgesics (NOA).Methods The educational programmes were conducted in two family medicine clinics by using a three-stage approach: baseline evaluation, design, and implementation of educational activities, and post-programme evaluation. An interactive educational programme (IEP) was compared with a passive educational programme (PEP); both were participated by FDs and patients. The IEP for FDs comprised of workshops, (...) discussion groups, in-service training and guidelines, while for patients the IEP consisted of an interactive session with a video, leaflets and a discussion. The PEP consisted in delivering the guidelines to the FDs and the leaflets to patients. The effect of the programmes on the FDs was measured through the appropriateness of prescriptions and analysed using the differences-in-differences estimator (D-in-D), and on patients through changes in self-medication and in their knowledge about the proper use and adverse events by analysing the inter- and intra-group differences before and after the programmes.Results The IEP obtained better results to improve appropriate FDs prescription of NOA than PEP (D-in-D = 15%). Regarding the patients, the PEP group reached higher reduction of self-medication than the IEP group (13.4% vs. 9.1%); the knowledge of proper NOA use increased by 8.5% in both groups, whereas knowledge of NOA-related adverse events was better in the IEP (39.6%) than in the PEP group (9.2%).Conclusions The IEP was better to improve the doctors' abilities to prescribe NOAs, and both programmes improved patients' knowledge. (shrink)

In plant morphology, most structures of vascular plants can easily be assigned to pre-established organ categories. However, there are also intermediate structures that do not fit those categories associated with a classical approach to morphology. To integrate the diversity of forms in the same general framework, we constructed a theoretical morphospace based on a variety of modalities where it is possible to calculate the morphological distance between plant organs. This paper gives emphasis on shoot, leaf, leaflet and trichomes while ignoring (...) the root. This will allow us to test the hypothesis that classical morphology (typology) and dynamic morphology occupy the same theoretical morphospace and the relationship between the two approaches remains a question of weighting of criteria. Our approach considers the shoot (i.e. leafy stem) as the basic morphological structural unit. A theoretical data table consisting of as many lines as there are possible combinations between different modalities of characters of a typical shoot was generated. By applying a principal components analysis (PCA) to these data it is possible to define a theoretical morphospace of shoots. Typical morphological elements (shoots, leaves, trichomes) and atypical structures (phylloclades, cladodes) including particular cases representing ‘exotic’ structures such as the epiphyllous appendages of Begonia and ‘water shoot’ and ‘leaf’ of aquatic Utricularia were placed in the morphospace. The more an organ differs from a typical shoot, the further away it will be from the barycentre of shoots. By giving a higher weight to variables used in classical typology, the different organ categories appear to be separate, as expected. If we do not make any particular arbitrary choice in terms of character weighting, as it is the case in the context of dynamic morphology, the clear separation between organs is replaced by a continuum. Contrary to typical structures, “intermediate” structures are only compatible with a dynamic morphology approach whether they are placed in the morphospace based on a ponderation compatible with typology or dynamic morphology. The difference in points of view between typology and continuum leads to a particular mode of weighting. By using an equal weighting of characters, contradictions due to the ponderation of characters are avoided, and the morphological concepts of continuum’ and ‘typology’ appear as sub-classes of ‘process’ or ‘dynamic morphology’. (shrink)

The author traces some forms of underground anti-Soviet activities of students of the Lviv Polytechnic Institute, currently the National University 'Lviv Politekhnika'. The rest of Lviv higher education establishments were also engaged in such activities. The research is based on scientific studies, recollections, archive materials and records of the Ukrainian Rebel Army, which cover the period of 1944-1953. The paper is timed to the bicentenary of the Lviv Politekhnika foundation and aims to demonstrate fortitude of Ukrainian spirit of young people (...) who sought after their independent Ukrainian state. A list of Politekhnika students is given, who displayed their bravery in individual anti-Soviet actions, as well as some underground independent student organizations and representatives of the national underground which considered youth development its priority since 1948 are indicated. Anti-Soviet activities of the student milieu included the making of politically focused leaflets and their distribution among city-folk and at higher education establishments. Despite a small time of underground activities because of frequent arrests, Lviv students continued their work up to 1953. All detected members of clandestine organizations were sentenced by the Military Tribunal of the Ministry for State Security to the terms of 10 - 25 years in correctional labor camps of the GULAG. Some of the released returned to their native land and managed to get across their viewpoint and motivation of their actions over the above period to new generations. (shrink)

Context: Despite much research on informed choice and the individuals’ autonomy in organised medical screening, little is known about the individuals’ decision-making process as expressed in their own words.Objectives: To explore the decision-making process among women invited to a mammography screening programme.Setting: Women living in the counties of Sør- and Nord-Trøndelag, Norway, invited to the first round of the Norwegian Breast Cancer Screening Program in 2003.Methods: Qualitative methods based on eight semistructured focus-group interviews with a total of 69 women aged (...) 50–69 years.Results: The decision to attend mammography screening was not based on the information in the invitation letter and leaflet provided by the NBCSP. They perceived the invitation letter with a prescheduled appointment as if a decision for mammography had already been made. This was experienced as an aid in overcoming the postponements that easily occur in daily lives. The invitation to mammography screening was embraced as an indication of a responsible welfare state, “like a mother taking care.”Conclusion: In a welfare state where governmental institutions are trusted, mass screening for disease is acknowledged by screening participants as a valued expression of paternalism. Trust, gratitude, and convenience were more important factors than information about benefits, harms, and risks when the women made their decisions to attend screening. These elements should be included in the ethical debates on informed choice in preventive medicine. (shrink)

One persistent puzzle in the life sciences is the asymmetric lipid composition of the cellular plasma membrane: while the exoplasmic leaflet is enriched in lipids carrying predominantly saturated fatty acids, the cytoplasmic leaflet hosts preferentially lipids with (poly‐)unsaturated fatty acids. Given the high energy requirements necessary for cells to maintain this asymmetry, the question naturally arises regarding its inherent benefits. In this paper, we propose asymmetry to represent a potential solution for harmonizing two conflicting requirements for the plasma membrane: first, (...) the need to build a barrier for the uncontrolled influx or efflux of substances; and second, the need to form a fluid and dynamic two‐dimensional substrate for signaling processes. We hence view here the plasma membrane as a composite material, where the exoplasmic leaflet is mainly responsible for the functional integrity of the barrier and the cytoplasmic leaflet for fluidity. We reinforce the validity of the proposed mechanism by presenting quantitative data from the literature, along with multiple examples that bolster our model. (shrink)

Objective: To examine lay persons’ ability to identify methods of random allocation and their acceptability of using methods of random allocation in a clinical trial context.Design: Leaflets containing hypothetical medical, non-medical, and clinical trial scenarios involving random allocation, using material from guidelines for trial information leaflets.Setting and participants: Adults attending further education colleges , covering a wide range of ages, occupations, and levels of education.Main measures: Judgements of whether each of five methods of allocation to two groups was (...) random in a medical or non-medical scenario. Judgements of whether these allocation methods were acceptable in a randomised clinical trial scenario, with or without a scientific justification for randomisation.Results: The majority of our group of participants judged correctly that allowing people their preference was not random, and that the following were random: using a computer with no information about the individual , tossing a coin, drawing a name out of a hat. Judgements were split over allocating people in turn . Judgements were no different in medical and non-medical scenarios. Few of the correctly identified random methods were judged to be acceptable in a clinical trial scenario. Inclusion of a scientific justification for randomising significantly increased the acceptability of only one random method: allocation by computer.Conclusions: Current UK guidelines’ recommended description of random allocation by computer seems warranted. However, while potential trial participants may understand what random allocation means, they may find it unacceptable unless offered an acceptable justification for its use. (shrink)

BackgroundApproval of the research proposal by an ethical review committee from both sponsoring and host countries is a generally agreed requirement in externally sponsored research.However, capacity for ethics review is not universal. Aim of this study was to identify opinions and views of the members serving in ethical review and ethics committees in Sri Lanka on informed consent, essential components in the information leaflet and the consent form.MethodsWe obtained ethical approval from UK and Sri Lanka. A series of consensus generation (...) meetings on the protocol were conducted. A task oriented interview guide was developed. The interview was based on open-ended questionnaire. Then the participants were given a WHO checklist on informed consent and requested to rate the items on a three point scale ranging from extremely important to not important.ResultsTwenty-nine members from ethics committees participated. Majority of participants (23), believed a copy of the information leaflet and consent form, should accompany research proposal. Opinions about the items that should be included in the information leaflets varied. Participants identified 18 criteria as requirements in the information leaflet and 19 for the consent form.The majority, 20 (69%), believed that all research need ethical approval but identified limited human resource, time and inadequate capacity as constraints. Fifteen (52%) believed that written consent is not required for all research. Verbal consent emerged as an alternative to written consent. The majority of participants rated all components of the WHO checklist as important.ConclusionThe number of themes generated for the consent form (N = 18) is as many as for the information leaflet (N = 19) and had several overlaps. This suggests that the consent form should be itemized to reflect the contents covered in the information leaflet. The participants' opinion on components of the information leaflets and consent forms proved to be similar with WHO checklist on informed consent. (shrink)

Phosphatidylinositol 3‐phosphate (PtdIns3P) is generated on the cytosolic leaflet of cellular membranes, primarily by phosphorylation of phosphatidylinositol by class II and class III phosphatidylinositol 3‐kinases. The bulk of this lipid is found on the limiting and intraluminal membranes of endosomes, but it can also be detected in domains of phagosomes, autophagosome precursors, cytokinetic bridges, the plasma membrane and the nucleus. PtdIns3P controls cellular functions through recruitment of specific protein effectors, many of which contain FYVE or PX domains. Cellular processes known (...) to be controlled by PtdIns3P and its effectors include endosomal fusion, sorting and motility, autophagy, cytokinesis, regulated exocytosis and signal transduction. Here we discuss how Ptdins3P is generated on specific cellular membranes, how its localizations and functions can be studied, and how its effectors serve to control cellular functions.Editor's suggested further reading in BioEssays:Phosphatidylinositol 4,5‐bisphosphate: Targeted production and signalingAbstractHow does SHIP1/2 balance PtdIns(3,4)P2 and does it signal independently of its phosphatase activity?AbstractPhosphatidylinositol‐3,4,5‐trisphosphate: Tool of choice for class I PI 3‐kinasesAbstractPhosphatidylinositol‐4‐phosphate: The Golgi and beyondAbstract. (shrink)

This article explores the history of British Mensa to examine the contested status of high intelligence in Great Britain between the late 1940s and the late 1980s. Based on journals and leaflets from the association and newspaper articles about it, the article shows how protagonists from the high IQ society campaigned for intelligence and its testing among the British public. Yet scathing reactions to the group in newspapers suggest that journalists considered it socially provocative to stress one’s own brainpower (...) as extraordinarily high. To better understand such disagreements, the article analyses communicative patterns that were used to make judgements about intelligence. This case study sheds light on how aspects of difference and the ascription of social positions are negotiated in public understandings of intelligence. (shrink)

Introduction: The decision of “do not attempt resuscitation” in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients’ own views regarding DNAR discussion.Aim: The aim of this study was to determine patients’ attitudes regarding discussing DNAR before they are critically ill.Methods: A prospective study was performed in a general out patients department. A questionnaire was distributed to (...) consecutive outpatients along with an explanatory leaflet in the adult outpatient clinic.Results: 364 patients completed the questionnaire . 90% of respondents wanted all patients to be asked regarding DNAR decision at some point during a hospital admission. The majority would not find a DNAR discussion distressing. Only 10% would find it upsetting, however, 48% of these still wanted a discussion. 37% of respondents wanted to discuss DNAR decisions on admission; 32% in outpatients; 17% at consent for surgery, 14% when they are critically ill. 87% of respondents would not object to their relatives being involved in making decisions about their resuscitation status. However, only 12% of the subjects in the study had been involved in discussing the resuscitation status of a relative and 21% would not be comfortable to discuss a relative’s resuscitation status. Although 33% of patients preferred their resuscitation status to simply be documented within their clinical notes, 77% wanted it to be more easily accessible.Conclusions: This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows. (shrink)

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, (...) how decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

In this article I argue that contemporary counterinsurgency functions as a type of violent environmentality that aims to pre-empt or prevent the formation of insurgencies. Counterinsurgency becomes anticipatory as the ‘War on Terror’ morphs into a global counterinsurgency campaign oriented to the threat of insurgency and insurgents. The insurgent is faced as a spectral network that appears and disappears as distinctions between states of war and peace collapse and war is fought ‘amongst the people’. In this context, the population is (...) targeted as an unstable collective of future friends and future enemies that contains an ever present potential to become (counter)insurgent. Through examples of PSYOPS and the dropping of leaflets from above, I describe how preventing or pre-empting the formation of insurgents becomes a question of controlling the environment through the creation of biopolitical ‘effects’. (shrink)

The aim of this article is to investigate the concept of minority up to the temporary stabilization of its meaning in Polish concluded in the adoption of the March constitution of 1921. The history of the concept of national minority bore an imprint on the accommodation to the new political, territorial, and discursive circumstances after transition from empire to nation-state. The idea itself was well anchored in the liberal tradition, but the nationalist right also took it on board to protect (...) the cultural hegemony of the Poles in the areas where they were a minority. Tackling the nexus of the emerging nation-state and the ensuing logic of minoritization sheds light on tiered visions of citizenship essential for understanding the 1921 debate. For this purpose, I use various available sub-corpora of texts—political leaflets, press, and parliamentary debates from the period 1788–1922. (shrink)

The principle of informed consent is now well established within the National Health Service (NHS) in relation to any type of medical treatment. However, this ethical principle appears to be far less well established in relation to medical screening programmes such as Britain's national cervical screening programme. This article will critically examine the case for health care providers vigorously pursuing women to accept an invitation to be screened. It will discuss the type of information which women would need in order (...) to make an informed decision about whether or not to be screened. The lack of such information in current patient leaflets on the "smear test" will then be documented. Finally, the article will explore possible ways of maximising women's autonomy in relation to the cervical screening programme without sacrificing any of its main benefits. (shrink)

Professor Duncan Vere lays before us the idealised guidelines used for recruiting volunteers on which to try and test new medicines. He points out that if these were followed rigidly, few, if any volunteers would be found for this vital work. Inducements are used, but the size of these determines whether society deems it right or wrong. However, the aim is to help and advise volunteers of the need for such tests and the risks involved and therefore the information leaflet (...) reprinted as part of the article indicates how the drug testers are attempting to encourage volunteers in as ethical a way as possible. To abandon human tests with new drugs may be unethical. A balance is sought. (shrink)

In her 2006 book The Jumbled Jigsaw, Donna Williams, an autistic author and poet, presents an example of a list of traits associated with autism—one of many such lists commonly found in text books, academic publications, and information leaflets. Her list includes the following: a tendency to stick to well-tried routines and avoid change, a tendency to have a narrow range of interests, a tendency to develop irrational fears and anxieties, a tendency not to develop a sense of danger, (...) a tendency to demonstrate bizarre behaviors and mannerisms, a tendency to copy speech parrot fashion, and isolated areas of ability. "The problem with such a list," Williams explains, "is that the features of each of these areas can be... (shrink)

Judith Clark looks at fashion exhibition-making alongside Aby Warburg’s Mnemosyne Atlas for her 2011 gallery exhibition entitled The Judgement of Paris. By looking at the three goddesses’ attributes, the reproduced exhibition leaflet wonders about the styling of mannequins and props that are intrinsic to exhibition-making but extrinsic to the exhibited object, which is omitted from the exhibition entirely. The visual essay links Aby Warburg to Anna Piaggi’s monthly collages for Vogue Italia and their idiosyncratic act of recovery.

Many controversial issues have come under discussion regarding the recent war in Iraq. The justifications given for the war itself, the way the war was prosecuted, and the handling of the post-war situation have all been hotly contested matters. This paper focuses on an aspect of the war that has not drawn much attention—the decisions made by members of the Iraqi military to either fight or not to fight. From the very beginning of hostilities the United States made concerted efforts, (...) through such methods as e-mails and leaflets dropped from aircraft, to encourage the desertion of Iraqi military personnel. Many Iraqi soldiers followed this advice and surrendered to U.S. forces at the first opportunity; others continue to fight to this day. Were the soldiers that deserted the military or surrendered without a fight morally justified in doing so? This article attempts to answer that question through an examination of such related issues as patriotism, political and moral duties, obligations arising from oaths and promises, and political legitimacy. Though this analysis does not lead to the development of iron-clad rules that definitively resolve the moral issues underlying military desertion, it can help us to get a clearer understanding of these issues and to develop guidelines by which to judge the morality of specific instances of desertion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Diacritics 32.2 (2002) 3-19 [Access article in PDF] (Queer) Theory and the Universal Alternative James Penney Judith Butler. Antigone's Claim: Kinship Between Life and Death. New York: Columbia UP, 2000. Judith Butler, Ernesto Laclau, and Slavoj Žižek. Contingency, Hegemony, Universality: Contemporary Dialogues on the Left. London: Verso, 2000. In October 2000, just a few weeks before the US presidential election, a young, fashionable, handsome man handed me a political (...) leaflet while I crossed Christopher Street in Greenwich Village. I didn't give it much thought at the time (apart from noticing that the boy was kind of cute): I was in transit toward the 4th Street subway station and the Port Authority where I would catch the bus back to Cornell. When I decided to write a review essay on the current state of poststructuralism, Marxism, and queer theory through the lens of the two books listed above, I discovered I had lost the pamphlet, certain that my hostile reaction to what I considered its fundamental conservatism and trendy political correctness had unconsciously caused its mysterious disappearance.When I rediscovered the leaflet in the chaos of my move away from Ithaca, I realized that my relation to it had been hysterical: I was reluctant to address its traumatic content, unwilling to excavate my multiple frustrations at the apparent impossibility of being a homosexual and a socialist in America. And yet I couldn't really forget about it either: though not an American citizen and therefore unable to vote, I found myself equally unable simply to dismiss the leaflet as a mere inconsequential symptom of the pseudo-democracy that America has always been, or unequivocally to endorse the snooty CBC/Queen Street condescension of my fellow Canadian Lefties toward the primitive, superficial, liberal (in the worst psychologistic sense), irremediably ideological, and thoroughly depressing state of American political discourse. "Those poor Americans," the far-from-irrelevant logic goes. "They either unquestioningly submit to the individualistic fantasy of the American Dream in order to participate in the 'political process,' or they become hermetically imprisoned in their pseudo-political anti-statist minoritarianism, too cool and too radical to condescend to the public sphere." After six years in the United States, I've now become aware that my inability to swallow much of contemporary queer theory—authored overwhelmingly by young, elite-educated Americans with relatively narrow political horizons—is mostly due to the manner in which it articulates numerous political assumptions fundamentally alien to my own socialization in a country whose political differences from the US are insufficiently appreciated in that nation, and in which extremes of climate and geography have engendered a collectivist ethos in many ways fundamentally hostile to the American-style extreme individualism with which I had lived for so many years.But the interest of this sort of political autobiography is in this context undoubtedly limited. What—you might now find yourself impatiently wondering if you don't already [End Page 3] know—were the contents of this famous pamphlet? And what exactly was my problem with it? Published by a coalition of queer voters in New York called the Empire State Pride Agenda, the pamphlet presented extremely selective profiles of the main candidates, both Democrat and Republican, running for the offices of President, US Senator, State Senator, and Member of the State Assembly. Each profile summarized the history of a candidate's positions with respect to rights issues of concern to gay, lesbian, bisexual, and transgendered persons. The profiles made no concerted effort to represent the candidates' perspectives on any other issue: gun control, education, foreign policy, the death penalty, taxation, health care (generally speaking, that is to say above and beyond the issues related to AIDS-related illness and reproductive rights); only policies directly concerning civil rights for nonheterosexual citizens were thoroughly broached.I should confess that once I got the general idea I threw the pamphlet away in disgust: "Am I supposed to feel interpellated," I asked myself in full hysterical Althusserian mode, "by this utterly pseudo-political claptrap?" Is this what it means to be gay and political in America... (shrink)

Aim: The primary aim of the study was to evaluate two different methods of communicating information on cardiopulmonary resuscitation to patients admitted to general medical and elderly care wards. The information was either in the form of a detailed information leaflet or a summary document . The study examined the willingness of patients in seeking detailed information on cardiopulmonary issues.Setting: The study was conducted over three months on a general medical ward and an acute elderly care ward in two district (...) general hospitals.Methods: A detailed information leaflet on CPR was provided to the nursing staff on the wards. An A4 summary document summarising the CPR decision making process and basic information on cardiopulmonary issues was placed in a folder at the foot of each bed on the elderly care ward. On the general medical ward it was displayed prominently over the head of all beds.Results: Out of the 274 patients admitted to the general medical ward only two requests were received for the detailed information leaflet. On the elderly care ward there were 182 admissions but no patients or their relatives requested the leaflet.Conclusions: Availability of basic information on cardiopulmonary resuscitation to all patients is practical and does not lead to unnecessary distress or offence to patients or their carers. It makes the decision making process more transparent. Detailed information leaflets are of value for a minority of hospitalised patients. (shrink)

This article is concerned with the reasons why sometimes good arguments in health communication leaflets fail to convince the targeted audience. As an illustrative example it uses the age-dependent eligibility of women in the Netherlands to receive routine breast cancer screening examinations: according to Dutch regulations women under 50 are ineligible for them. The present qualitative study rests on and complements three experimental studies on the persuasiveness of mammography information leaflets; it uses interviews to elucidate reasons why the (...) arguments in the health communication leaflets for the exclusion of women under 50 from routine mammographic screenings do not work. (shrink)

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key features of (...) what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information. (shrink)

Eric G. Forbes, Lesley Murdin and Francis Willmoth , The Correspondence of John Flamsteed, First Astronomer Royal. Volume 1: 1666–1682. Bristol and Philadelphia: Institute of Physics Publishing, 1995. Pp. xlix+955. ISBN 0-7503-0147-3. £140.00, $280.00.Heinz-Jurgen Hess, James G. O'Hara and Herbert Breger , Gottfried Wilhelm Leibniz: Sämtliche Schriften und Briefe. Dritte Reihe, Mathematischer, naturwissenschaftlicher und technischer Briefwechsel: Volume 3, 1680–1683; Volume 4, 1683–1690. Berlin: Akademie Verlag, 1991, 1995. Pp. lxx+895; lxvi+747. ISBN 3-05-000766-4, DM 490.00 ; 3-05-002602-2, DM 490.00 .Wilhelm Schmidt-Biggemann , (...) Samuel Pufendorf. Gesammelte Werke, Band 1: Briefwechsel . Berlin: Akademie Verlag, 1996. Pp. xxix+453. ISBN 3-05-001920-4. DM 298.00.The editing of the correspondence of major figures in intellectual history is an essential scholarly activity. Yet in this country in recent years it has neither been the priority it should be, nor has it received the support that it deserves. Of course there have been exceptions to this, perhaps notably – for the early modern period – the epic one-man effort of Esmond de Beer in his later years in producing The Correspondence of John Locke . A further exception, the edition of The Correspondence of Henry Oldenburg by A. R. and M. B. Hall, was unfortunately flawed by the need to change publishers midway in the series, which has led to a marked disparity in the availability of the latter part of the set compared with its early volumes. In any case, like the Locke edition, this was conceived in the heady days of the 1960s and early 1970s, and few have ventured such enterprises since. Virtually the only exception is Noel Malcolm's edition of the manageable-sized Correspondence of Thomas Hobbes . Moreover, it is revealing of the acute need to justify the publication of such material felt by editors and publishers alike that the promotional leaflet for this edition went so far as to claim that it was ‘one of the most important scholarly publications of the twentieth century’ – a claim that is the more ironic in view of the quite significant shortcomings in its method of presenting the material that it contains. (shrink)

The aim of this study was to ascertain nurses' and doctors' perspectives on the practice of slow codes, which are cardiopulmonary resuscitative efforts that are intentionally performed too slowly for resuscitation to occur. A Heideggerian phenomenological study was conducted in 2005, during which data were gathered in the Republic of Ireland from three nurses and two doctors (via unstructured interviews) and analysed using Colaizzi's reductive procedure. Slow codes do occur in Ireland and are intended as beneficent acts. However, slow codes (...) were identified as pointless and undignified when intrusive measures were employed. There is a need for discussion on the topic of slow codes in Ireland, and for aids to cardiopulmonary resuscitation decision making to be developed, such as advance directives, communication training, clinical guidelines and an explanatory leaflet for patients and families. (shrink)

Apoptosis is a physiological mechanism for the removal of unwanted or damaged cells. Apoptotic cells are rarely seen in living tissues, however, because of their rapid and efficient removal by phagocytosis. Phagocytotic cells such as macrophages or dendritic cells recognize apoptotic cells by specific changes of cell surface markers, which usually are not present on normal cells. One such event is the exposure of phosphatidylserine, which moves from the plasma membrane inner leaflet to the outer leaflet in preapoptotic cells. An (...) unresolved problem, however, was the nature of the phosphatidylserine receptor on the phagocytotic cells. In a recent issue of Nature, Fadok et al.(1) have reported the cloning of a phosphatidylserine receptor using an antibody raised against activated macrophages. Antibody treatment of these macrophages blocks this capacity to engulf. BioEssays 22:878–881, 2000. © 2000 John Wiley & Sons, Inc. (shrink)

Richard Ryder created the term speciesism in early 1970 and shared the idea with Peter Singer, who popularised it in his classic work _Animal Liberation_. A key figure in the modern animal rights revival Ryder appeared on the first-ever televised discussion of animal rights in December 1970. He further promoted the ideas around speciesism in recorded discussions with Bridget Brophy, for the Open University, and in his contribution to the seminal philosophical work _Animals Men and Morals_ edited by the Oxford (...) philosophers Stanley and Roslind Godlovitch and John Harris in 1971. From 1969 Ryder organised protests against animal experiments and bloodsports. He continued to promote his ideas about speciesism in leaflets and broadcasts, culminating in the publication of his _Victims of Science_ in 1975 - a book that provoked debates in Parliament and on television and was described by _The Spectator_ at the time as "a morally and historically important book". Dr Ryder was elected to the RSPCA Council in 1971, first becoming Chairman in 1977. In 1980 he was founding Chairman of the Liberal Democrat Animal Protection Group, and later ran for Parliament, was Director of the Political Animal Lobby and then Mellon Professor in the Department of Philosophy at Tulane University. Ryder coined the term painism to describe his wider moral theory in 1990. He has several times broadcast on the BBC's Moral Maze. (shrink)

This Savonarola of our century can fill a hall at the drop of a leaflet. But where the inflammatory friar of Florence was silenced by hanging and roasting at the stake, Chomsky's punishment is to be consigned to media oblivion in his own land.

The asymmetric distribution of lipids, maintained by flippases/floppases and scramblases, plays a pivotal role in various physiologic processes. Scramblases are proteins that move phospholipids between the leaflets of the lipid bilayer of the cellular membrane in an energy‐independent manner. Recent studies have indicated that viral infection is closely related to cellular lipid distribution. The level and distribution of phosphatidylserine (PtdSer) in cells have been demonstrated to be critical regulators of viral infections. Previous studies have supported that the infection of (...) human immunodeficiency virus (HIV), Zika virus, Ebola virus (EBOV), influenza virus, and dengue fever virus require the externalization of phospholipids mediated by scramblases, which are also involved in the pathogenicity of the pandemic severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). In this review, we review the relationship of scramblases with viruses and the potential viral effector proteins that might utilize host scramblases. (shrink)