Aims: To assess patient receipt of written information. To ensure patients understand the written information about a resuscitation policy and to determine whether they disapproved of or had concerns about the policy. Methods: All admissions to four wards of the hospital were approached for an interview. A set questionnaire was asked by one of 2 interviewers. Results: 72% of 572 admissions were interviewed. Refusal accounted for only 2 of the people not interviewed. 11% were unable to advocate for themselves by (...) reason of mental incompetence, inability to communicate or impairment secondary to their illness. Of the 401 interviewed only 49% recalled receiving the patient information booklet. Few patients (17%) recalled reading the information in the patient information booklet. They were all then given the paragraph about the hospital’s resuscitation policy. 352 were asked their understanding and only 61% demonstrated that they understood the paragraph. 91% of all 401 patients approved of the hospital having the option of DNR orders. 31% of people however had concerns related to DNR orders. These are discussed. Conclusions: Many acutely unwell patients are unable to advocate for themselves. Written information is a poor method of communicating with patients. There was limited receipt of the information and many misunderstood the paragraph about the hospitals resuscitation policy. There was a wide range of patient thoughts and concerns expressed. (shrink)

Transgender inclusion within policy is critical yet often missing. We propose a policy tool to assesses human rights, access to resources and opportunities, language, and implications for transgender and nonbinary individuals. Acknowledging trans communities as standard policy practice can serve as an essential practice to shift dialogue and norms.

Attentional control has grown in importance within theoretical and predictive models of psychopathology over past decades. The Attentional Style Questionnaire is a novel measure of internal a...

The title of Hopkins’ book is apt in at least two ways. First, it is a "companion"—a book which is best read in conjunction with a serious reading of Anselm’s works. Hopkins states that his book is "envisioned primarily as a handbook for students", but that is true in the sense that Taylor’s book on Plato or Gilson’s books on Augustine, Bonaventure, and Aquinas could be said to be intended for students. Secondly, it is a study of practically all (...) of Anselm’s philosophical and theological contributions. The only significant work that is not treated in some detail is De Grammatico, a lacuna which is understandable in light of the complex and recondite nature of that dialogue: one either says nothing or very much about it. There are chapters on the unity and chronology of and the historical influences on Anselm’s works; the role of faith and reason in Anselm; the Ontological Argument; Anselm’s writings on the nature of the Trinity and the relations between the three persons; Anselm on human nature, truth, freedom of choice, and evil; and Anselm on the necessity of the Incarnation, Christology, and original sin. There are two appendices: one consisting of a translation of Ein neues unvollendetes Werk..., and the other on "Anselm’s Methods of Arguing." There is also a very helpful sixteen-page bibliography. One of the valuable side features of the book is the wealth of references to the works of Augustine. Southern’s Saint Anselm and His Biographer, Henry’s The Logic of Saint Anselm, and Hopkins’ Companion all approach Anselm from different perspectives, and lay emphasis on different issues, but they are the three most important books on the historical, philosophical, and theological Anselm in English.-W.E.M. (shrink)

Michigan is a critical agricultural state, and small family farms are a crucial component of the state’s food sector. This paper examines how the race/ethnicity of the family farm owners/operators is related to farm characteristics, financing, and impacts of the pandemic. It compares 75 farms owned/operated solely by Whites and 15 with People of Color owners/operators. The essay examines how farmers finance their farm operations and the challenges they face doing so. The article also explores how the Coronavirus-19 pandemic affected (...) farming operations, the financial viability of farms, and how farmers responded to the challenges posed by the pandemic. The study found that People of Color farm owners/operators were younger than White farm owners/operators. The People of Color farm owners/operators tended to manage smaller farms for shorter periods than White farm owners/operators. Though two-thirds of the Farmers of Color owned their farms, they were more financially vulnerable than White farm owners/operators. The farmers studied had difficulty obtaining loans to finance their farms. Farmers reported increasing requests from people for food assistance during the pandemic. Farmers responded to the pandemic by participating in government programs such as the Farm to Families Food Box Program that purchased their produce. It allowed farmers to supply emergency food assistance programs with products from their farms. The products went to families receiving food assistance from soup kitchens, food banks, and other community-based nonprofits. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 62.3 (2001) 505-522 [Access article in PDF] Mary Astell's Ironic Assault on John Locke's Theory of Thinking Matter E. Derek Taylor Mary Astell (1666-1731), most famous today for her call for the establishment of Protestant nunneries in Serious Proposal to the Ladies, Part I (1694) and for her acute Reflections Upon Marriage (1700), has lurked for years at the edges of that (...) infinitely contentious category "feminism," but she is only now beginning to receive her rightful inheritance as a theological and philosophical thinker, probably the title she would most have preferred. 1 This is not to say that Astell's Christian-Platonism has been ignored. In her 1986 biography Ruth Perry gave cogent expression to the centrality of Astell's idealist Christianity to all aspects of her thought 2 and in the same year, Bridget Hill thoughtfully warned her readers against attempting to force Astell, a religious conservative, "into some preconceived idea of what late seventeenth and early eighteenth century feminism ought to have been." 3 More recently, Patricia Springborg has written two significant essays that rely in part on Astell's more neglected theological-philosophical works, Letters concerning the Love of God (1695), a collection of Astell's correspondence with John Norris of Bemerton (1657-1711), and The Christian Religion, As Professed by a Daughter of the Church of England (1705; 3d edition 1730), far and away her most developed theological-philosophical [End Page 505] statement. 4 Despite these important forays, however, both Letters and Christian Religion continue to be largely ignored, as is suggested by the relative dearth of scholarly work on either text and the short shrift each receives in anthologies of Astell's works. 5 Despite the great popularity of Letters throughout the eighteenth century and despite the fact that, as Springborg points out, Astell considered Christian Religion "her magnum opus," neither text has found new life in a modern edition. 6This omission creates a rather vexing problem for would-be scholars of Astell's philosophical and theological ideas. The major primary texts themselves not being available, we have little choice but to rely on the limited accounts of other scholars for our information. Over a decade ago, for instance, The Journal of the History of Philosophy published a long note by Kathleen M. Squadrito on "Mary Astell's Critique of John Locke's View of Thinking Matter," and hers has since been the standard (if not quite only) account of this historically fascinating and important philosophical comment in Christian Religion.7 Squadrito wants, she writes, to "present a short account of [Astell's] work and her criticism of Locke's view of thinking matter." 8 Unfortunately, Squadrito's account of Astell's "work" is significantly flawed, which leads her to serious mischaracterizations of Astell's "criticism" of Locke's hypothesis. Briefly put, Astell's "own philosophy" in Christian Religion does not, as Squadrito claims, emerge "as an attempted reconciliation of the views of Norris and Locke" 9 ; because she supposes it does, however, Squadrito is able to present Astell's critique of Locke's theory [End Page 506] of thinking matter as a respectful, even-handed philosophical analysis, a theoretical bridge, as it were, between the Platonism of Norris and the Empiricism of Locke. As we shall see, Astell's critique of Locke's hypothesis actually amounts to a bitterly ironic assault, wherein Astell does not so much build bridges as burn them. Just why Astell in Christian Religion decided not to strike a middling position between Locke and Norris, and how this decision invigorated her attack on Locke's materialist hypothesis, are the primary questions this essay seeks to answer. In order to arrive at such answers, however, it is necessary first to examine the text in which Astell does attempt to carve out a position between Locke and Norris, namely Astell and Norris's Letters.The basic history of Letters is well enough understood. Mary Astell, a well-read young woman of significant perspicacity, first wrote in... (shrink)

Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

In lieu of an abstract, here is a brief excerpt of the content:Parenting Adults with ASD: Lessons for Researchers and CliniciansCassandra R. Newsom, Amy S. Weitlauf, Cora M. Taylor, and Zachary E. WarrenRecent reviews of treatments for individuals with autism spectrum disorders (ASD) reveal how little we still know about how to help adolescents with ASD and their families successfully transition into adulthood (Shattuck et al., 2012b; Taylor et al., 2012a). Shattuck and colleagues found that services in the (...) United States for adults with ASD were marked by high unemployment rates, a reliance on families to provide care across the lifespan, high turnover rates in front-line service providers, insufficient transition planning for high school students, and generally insufficient services to meet current needs. In a recent Agency for Healthcare Research and Quality (AHRQ) Comparative Effectiveness Review, the authors similarly found that there is very little evidence available to pinpoint specific intervention approaches for adolescents and young adults with ASD due to a lack of good quality studies. This was especially true for evidence-based approaches to support the transition of youth with ASD to adulthood (Taylor et al., 2012a).For the last decade, with dramatic increases in both ASD awareness and estimates of ASD prevalence, our field has understandably focused intensely on improving early detection and treatment of ASD. Our diagnostic tools and understanding of ASD presentation in very young children has improved tremendously. Different from many of the young adults in these stories, who were often diagnosed in their early teens, we now aim to identify children well before their third birthdays. Research has consistently shown that early and intense ASD-specific intervention can dramatically enhance outcomes for children with ASD. As such, there has been heavy investment in attempting to take full advantage of this early window of neuro-plasticity. However, as these stories illustrate, these children grow up. Their needs change, and our systems are often poorly equipped to help them live fulfilling lives, capitalize on their talents, and obtain independence and equal access, while still providing a safe, supportive environment. Without readily accessible and understandable coordinated systems of care, parents are forced to adopt the multiple roles of case manager, teacher, therapist, community educator, advocate, job coach, housing specialist, financial planner, and often, lifelong caregiver. These stories eloquently illustrate those struggles and successes.Grief and Joy: Opposite Sides of the Same Parenting CoinThe idea of grieving a diagnosis is controversial. Many of the writers seemed to feel conflicted about their grief responses and the validity of their feelings. Research shows that many families view the diagnostic process as extremely stressful (Siklos & [End Page 199] Kerns, 2005; Heiman, 2002). Feelings of sadness, anxiety, and depression are common at the point of diagnosis and may reemerge as milestones pass unmet. Families must modify the futures they imagined for their children and begin to envision new goals and dreams. Anonymous Three described this process when she wrote:Most children grow up, go to school, get jobs, move out of their parents’ home, etc. My husband and I have had to seriously consider how much of these are even possible for a young man with autism, even one who has a good number of functional life skills.Tasks of adolescence and adulthood such as starting high school, driving a car, and moving out of the house may be delayed and hard won if met. Raising a child with ASD appears to have particular challenges. Throughout this process, families begin to redefine what “success” means. Rather than ascribing to societal standards, they find joy in personal milestones. McDonald described the triumph of teaching his nephew to shake women’s hands instead of touching their hair, an important safety goal that took three months to accomplish. Each family thereby creates its own path.People outside of the family often do not understand the complicated interplay of love and obligation as well as the frustration and fulfillment that families experience. Just like any family, the parents of children with ASD describe many joys in addition to their struggles. They see their children’s strengths in a world that too often focuses on their weaknesses. Gifted with the everyday experience of their child’s development, they see past the necessity of a... (shrink)

ABSTRACT With few exceptions, the effectiveness of continuing education mandates has been measured by self-report assessments of the professional psychologists who fulfill them. The present investigation provided a longitudinal look at the number of approved CE providers and the incidence of licensing board complaints across a succession of two-year cycles prior to, and following, the 2012 implementation of CE mandates in the State of Illinois. Findings showed a substantial increase in the number of CE providers across that time, though no (...) significant change in the incidence of licensing board complaints, suggesting that the increased availability of CE did not translate into lower complaint rates. Possible reasons for these findings are noted, and recommendations for future work are detailed in support of an evidence-based approach to CE that better articulates and aligns its objectives with its outcomes in an era of renewed accountability in the health professions. (shrink)

A major challenge in neuroscience is to understand what happens to a brain as it ages. Such insights could make it possible to distinguish between individuals who will undergo typical aging and those at risk for neurodegenerative disease. Over the last quarter century, thousands of human brain imaging studies have probed the neural basis of age-related cognitive decline. “Aging” studies generally enroll adults over the age of 65, a historical precedent rooted in the average retirement age of U.S. wage-earners. A (...) consequence of this research tradition is that it overlooks one of the most significant neuroendocrine changes in a woman’s life: the transition to menopause. The menopausal transition is marked by an overall decline in ovarian sex steroid production – up to 90% in the case of estradiol – a dramatic endocrine change that impacts multiple biological systems, including the brain. Despite sex differences in the risk for dementia, the influence that biological sex and sex hormones have on the aging brain is historically understudied, leaving a critical gap in our understanding of the aging process. In this Perspective, we highlight the influence that endocrine factors have on the aging brain. We devote particular attention to the neural and cognitive changes that unfold in the middle decade of life, as a function of reproductive aging. Next, we consider emerging evidence from animal and human studies that other endocrine factors occurring earlier in life (e.g. pregnancy, hormonal birth control use) also shape the aging process. Applying a women’s health lens to. (shrink)

In the present article, we review the theory and research on religious deconversion with a focus on adolescence and young adulthood. First, we present the relevant terminology (e.g. religious deconversion, religious disaffiliation, and religious deidentification) and statistical trends (e.g. the prevalence of religious Nones and Dones). We define religious deconversion as any movement away from religion. Religiosity decreases across adolescence and into young adulthood, and these developmental periods also have heightened rates of religious deidentification, at least in many Western cultures. (...) Second, we review the theory and research on processes, predictors, and outcomes of religious deconversion. Deconversion is discussed both in terms of individuals becoming less religious and possibly deidentifying from religion. In terms of processes of deconversion, we discuss various theoretical models and self-expressed reasons for deconversion. Religious deconversion tends to progress in phases, often initiated by religious and spiritual struggles. In terms of predictors, we identify predictors at the level of the individual (e.g. demographics, personality, norm-violating behavior, and dimensions of religiosity), family (e.g. parent and family religiosity, family dynamics such as parenting styles, and religious socialization), peers (e.g. peer religiosity and religious conversations with peers), religious communities (e.g. supportiveness, engagement, and dialogue), formal education, and social media. In line with developmental systems perspectives, religious deconversion is a complex and dynamic process involving numerous individual and contextual factors. In terms of outcomes of deconversion, we identify potential individual and relational outcomes that are considered both negative and positive. Finally, we outlined 10 promising future directions for research on religious deconversion. (shrink)