Background: Black, Asian and minority ethnic groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks. Objective: To identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent. Methods: Three-phase programme comprising community-based research (...) involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; hospital-based research examining staff practices and influences on family consent through ethics discussion groups with staff, a study on intensive care units and interviews with bereaved ethnic minority families; and development and evaluation of a training package to enhance cultural competence among ICU staff. Setting: Community focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts. Participants: Community studies: 228 focus group participants; hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and evaluation: 66 health professionals. Data sources: Focus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation. Review methods: Systematic review and narrative synthesis. Results: Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. Evaluation: professional development package – a digital versatile disk-based training package was developed to promote confidence and skills in cross-cultural communication. Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation. Limitations: Participants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families. Conclusions: The research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS. Future work: Greater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families. Funding: The National Institute for Health Research Programme Grants for Applied Research programme. (shrink)

Although social scientists have identified diverse behavioral patterns among children from dissimilarly structured families, marketing scholars have progressed little in relating family structure to consumption-related decisions. In particular, the roles played by members of single-mother families—which may include live-in grandparents, mother’s unmarried partner, and step-father with or without step-sibling(s)—may affect children’s influence on consumption-related decisions. For example, to offset a parental authority dynamic introduced by a new stepfather, the work-related constraints imposed on a breadwinning mother, or the imposition of adult-level (...) household responsibilities on children, single-mother families may attend more to their children’s product preferences. -/- Without a profile that includes socio-economic, behavioral, and psychological aspects, efficient and socially responsible marketing to single-mother households is compromised. Relative to dual-parent families, single-mother families tend to have fewer resources and less buying power, children who consume more materialistic and compulsively, and children who more strongly influence decision making for both own-use and family-use products. Timely research would ensure that these and other tendencies now differentiate single-mother from dual-parent families in ways that marketers should address. Hence, our threefold goal is (1) to consolidate and highlight gaps in existing theory applied to studying children’s influence on consumption-related decision making in single-mother families, and (2) to propose a hybrid framework that merges two theories conducive to such research, and (3) to identify promising research propositions for future research. (shrink)

Any author should be happy when commentators on a long book discuss it thoroughly, raise important issues, and show their sensitivity to its main themes. So I want to begin with thanks to Isaac Levi, Peter Machamer, Richard Miller and Dudley Shapere. This is not, of course, to register agreement with all their criticisms. Indeed, that would be impossible, for their perspectives are so varied as to resist integration into a consistent synthesis. Nevertheless, each of them poses problems that my (...) approach to the growth of scientific knowledge must address, and I believe that the combination of their essays greatly advances the discussion. (shrink)

Study of Tārkikarakṣā of Varadarāja Miśra, 11th cent., work on Nyaya and Vaiśeṣika philosophy.

The article attempts to define a worldview paradigm in the philosophy of H. Skovoroda. In historical and philosophical studies, there is a certain difference of opinion regarding the evaluation of the main provisions of the Ukrainian’s enlightener philosophy. Scientists emphasize the manifestations of pantheism, dualism, pluralism and mysticism in the work of H. Skovoroda. This is a palette of mutually exclusive definitions of the main philosophies of the thinker.The conducted critical analysis of the Skovoroda’s philosophical heritage allows us to reveal (...) the deistic direction of his worldview positions. However, compared to the conceptual presentation of deism by the founder of the French Enlightenment of the 18th century, F. Walter, the philosophical deistic positions of H. Skovoroda have their own characteristics. The deistic tendencies of Walter’s worldview are based on the principles of rationalism. They permeate the foundations of his theoretical and practical philosophy. The Ukrainian enlightener’s principle of deism is based on manifestations of the highest divine wisdom. They include rational forms of existence and knowledge, spiritual and practical, moral foundations of human existence. (shrink)

The merit of Plato’s Laws remains largely untapped by those seeking genuinely collaborative models of the doctor–patient tie as alternatives to paternalism and autonomy. A persistent difficulty confronting proposed alternatives has been surpassing the notion of pronounced intellectual and values asymmetry favoring the doctor. Having discussed two prominent proposals, both of which evince marked paternalism, I argue that reflection on Plato yields four criteria that a genuinely collaborative model must meet and suggest how the Laws addresses them. In the process, (...) the Laws’ doctor–patient tie is shown to be far more nuanced than interpreters have previously observed. Although Plato’s account will not solve our own quandaries, it illustrates how one might retain asymmetry of a kind without capitulating to familiar oppositional modalities. Through this account, I hope to show that the Laws merits fuller inclusion in contemporary discussions than it has heretofore received. (shrink)

Volume 8 of this landmark edition follows Peirce from May 1890 through July 1892—a period of turmoil as his career unraveled at the U.S. Coast and Geodetic Survey. The loss of his principal source of income meant the beginning of permanent penury and a lifelong struggle to find gainful employment. His key achievement during these years is his celebrated Monist metaphysical project, which consists of five classic articles on evolutionary cosmology. Also included are reviews and essays from The Nation in (...) which Peirce critiques Paul Carus, William James, Auguste Comte, Cesare Lombroso, and Karl Pearson, and takes part in a famous dispute between Francis E. Abbot and Josiah Royce. Peirce's short philosophical essays, studies in non-Euclidean geometry and number theory, and his only known experiment in prose fiction complete his production during these years. Peirce's 1883-1909 contributions to the Century Dictionary form the content of volume 7 which is forthcoming. (shrink)

In contrast to The Methods of Ethics, Sidgwick’s Practical Ethics counsels not trying to “get to the bottom of things” in our efforts to reach “some results of value for practical guidance and life.” For Sidgwick, both practical and theoretical ethics should start from the Morality of Common Sense. Although he retained his utilitarian outlook in Practical Ethics, this paper suggests that the Morality of Common Sense has the resources to hold its own against utilitarian revision.

On religious and spiritual life as depicted in Bhāgavatapurāṇa, Hindu mythological text.

В монографии рассмотрены философские аспекты научно-инновационной деятельности: общие закономерности ее развития, структура научно-инновационной деятельности, ее категориальная основа, методы и условия эффективности. Для магистров, аспирантов.

The Buddha’s final illness, brought on by his last meal prior to his death, was traditionally seen as one of a set of ailments suffered by him at various points during his lifetime. This paper looks at different Buddhist explications of the causes of these ailments and applies them to the episode of the Buddha’s final illness. In both instances, three explanatory strategies are detected: the first stresses the causative importance of the Buddha’s own negative karmic deeds in past lives; (...) the second looks to the negative deeds and karma of others than the Buddha; the third offers non-karmic explanations. The first two engendered two rather different kinds of j?taka stories; the last did not involve any j?takas but highlighted various kinds of ‘natural’ explanations. (shrink)

Moral theories may differ not only in the substantive moral principles they assert, but also in their concept of a person or moral agent. Thus, for example, Utilitarianism stresses the ability of a human being to calculate rationally the profit and loss which attend particular actions; and Aristotle bases his Nichomachean Ethics on a moral psychology tied to the notion of harmonious self-development.

I. Pryor on McKinsey: " A. Pryor’s Version of McKinsey-style Reasoning 1. Given authoritative self-knowledge, I can usually tell the contents of my own thoughts just by introspection. So I can know the following claim on the basis of reflection alone: " McK-1: I am thinking a thought with the content _water puts out fires_.