Amidst the misinformation climate about trans people and their health care that dominates policy and social discourse, autonomy‐based rationales for gender‐affirming care for trans and nonbinary youth are being called into question. In this commentary, which responds to “What Is the Aim of Pediatric ‘Gender‐Affirming’ Care?,” by Moti Gorin, we contextualize the virulent ideas circulating in misinformation campaigns that have become weaponized for unprecedented legal interference into standard health care. We conclude that the current legal justifications for upending gender‐affirming care (...) gloss over how this health care field meets conventional evidentiary standards and aligns protocols with most other fields of medicine. Refusal to offer gender‐affirming care is more harmful than centralizing trans and nonbinary people's health autonomy. (shrink)

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

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

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

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

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

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

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

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

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

We present a general framework for analyzing the contribution to reproductive success of a behavioural action. An action may make a direct contribution to reproductive success, but even in the absence of a direct contribution it may make an indirect contribution by changing the animal's state. We consider actions over a period of time, and define a reward function that characterizes the relationship between the animal's state at the end of the period and its future reproductive success. Working back from (...) the end of the period using dynamic programming, the optimal action as a function of state and time can be found. The procedure also yields a measure of the cost, in terms of future reproductive success, of a suboptimal action. These costs provide us with a common currency for comparing activities such as eating and drinking, or eating and hiding from predators. The costs also give an indication of the robustness of the conclusions that can be drawn from a model. We review how our framework can be used to analyze optimal foraging decisions in a stochastic environment. We also discuss the modelling of optimal daily routines and provide an illustration based on singing to attract a mate. We use the model to investigate the features that can produce a dawn song burst in birds. State is defined very broadly so that it includes the information an animal has about its environment. Thus, exploration and learning can be included within the framework. (shrink)

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

A general framework for analysing the effects of variability and the effects of interruptions on foraging is presented. The animal is characterised by its level of energetic reserves, x. We consider behaviour over a period of time [0,T]. A terminal reward function R(x) determines the expected future reproductive success of an animal with reserves x at time T. For any state x at a time in the period, we give the animal a choice between various options and then constrain it (...) to follow a background strategy. The best option is the one that maximizes expected future reproductive success. Using this framework, we show that sensitivity to variability in amount of energy gained is logically distinct from sensitivity to variability in the time at which food is obtained. We also show that incorporating interruptions results in both a preference for variability in time and a preference for a reward followed by a delay as opposed to the same delay before the reward. (shrink)

Judges face difficult choices when the birth and genetic mothers of a child are separate people who dispute maternal access; the views of the general population may help them. Fifty women were asked whether, if they were infertile and could have only one child, they would prefer to be birth mothers (to carry a baby which was not genetically theirs) or genetic mothers (to have another woman carry their genetic baby). Similarly, fifty men were asked about their preference for a (...) partner's child. In both groups the strength of preferences was measured using a lottery technique. The direction and strength of preferences was similar between men and women, and approximately equally divided between birth and genetic motherhood. These attitudes should be taken into account by those adjudicating custody disputes between such mothers. (shrink)

It is shown that in a range of models, the probability that a forager dies from starvation is, to a good approximation, an exponential function of energy reserves. Using a time and energy budget for a 19g passerine, we explore the consequences, in terms of starvation and predation, of various levels of energy reserves. It is shown that there exists an optimal level L of reserves at which total mortality (starvation plus predation) is minimized. L increases when the environment deteriorates (...) as a result of a decrease in either temperature or mean gross gain or an increase in the mean search time. The effect of combined deteriorations is greater than the sum of their individual effects. At L, the probability of predation is much higher than the probability of starvation. A simple analytic model suggests that this result will be fairly general, but also indicates conditions under which the result might not hold. (shrink)

Rolls discusses various adaptive explanations of physiological processes and the emotions. We give a critical analysis of some of these from the perspective of behavioural ecology. While agreeing with the approach adopted by Rolls, we identify topics that could have been better presented by making use of the existing literature.