Physician-facilitated designation of proxy decision maker.

With vast improvements in healthcare in recent decades, people are living longer but often with higher rates of morbidity and chronic illnesses. This has resulted in a higher proportion of the population who may benefit from early end-of-life 'conversation and planning', but also gives healthcare professionals more time during which these discussions are relevant, as people live longer with their chronic diseases. A survey conducted by Lifshitz et al (Isr J Health Policy Res 5:6, 2016) sought to assess physician awareness and willingness to discuss designating a proxy decision-maker with patients, in order to aid end-of-life care in the event that the patient is rendered unable to make or communicate these decisions later in life. Their article suggests that proxy decision-maker designation is only one aspect of end-of-life care; a challenging area littered with ethical and moral dilemmas. Without early, open and frank discussions with patients regarding their wishes at the end of life, proxy decision-makers may be in no better position than physicians or a court appointed proxy to make decisions in the patients' best interests/benefits. This commentary also touches upon the use of health and care passports being developed or in early phases in the United Kingdom, and whether these may be utilised in the field of palliative care in Israel

Religion and the Pathologization of Fandom: Religion, Reason, and Controversy in My Little Pony Fandom

Popular media and academic studies have often compared media fandom to a form of secularized religion, suggesting excessive and irrational involvement. Fans respond to this charge by emphasizing rational elements of their fandom and the imagined worlds they explore. This article examines fan response when the rationality of this imagined world is undermined through the fan object itself, focusing on Brony (adult My Little Pony) fandom: a fandom often perceived by fans as pathologized in the media. Fans have highlighted their role as cultural gate-keepers, protecting children from irrationality and recasting the text into an attack on poor scientific method, or have used fandom as a forum to discuss religion. This article argues that the “fandom as religion” metaphor pathologizes both religion and fandom and ignores the diversity of fan responses to religion

Implicit religion in popular culture: The case of doctor who

© Equinox Publishing Ltd. 2015. Science fiction has often been presented as an ideal lens through which to examine the presence of implicit religion in contemporary society. This article provides an overview of the way in which both implicit and explicit religion has been read through the British science fiction show Doctor Who (1963-present). Commentators have argued for Buddhist, Christian or Humanist themes as predominant within the diegesis, although such claims are shown to be problematic. Instead, Doctor Who presents a variety of religious positions which can be used in a polysemic manner to discuss religion by both religious and non-religious viewers. The show has been recognised by some fans and commentators as fulfilling an implicitly religious function in and of itself, and the diegetic setting, producers, and fans are all shown to have expressed interest in exploring the concept of implicit religion. In spite of this, the article concludes with a note of caution over the dangers of over-reading implicit religiosity into contemporary cultural forms such as fandom

Politics and eschatology: Reassessing the appeal of the “jewish Indian” theory in England and new England in the 1650s

© 2015 Religious History Association. This article examines the “Jewish Indian” theory — which claimed that American Indians were the ten lost tribes of Israel — in 1650s England and New England. The theory found support in England while failing in New England. This difference in reception can be explained by considering its ecclesiological, political, and eschatological implications. Biblical commentators in both England and New England held to a form of “Judeo-Centric” eschatology, which looked for a sudden, miraculous conversion of the Jews and their eventual superiority to Gentile believers. Such beliefs undermined crucial elements of New England ecclesiology when applied to Native Americans. Conversely, the New England Company used the theory in its publications as a fund-raising tool in England. These publications impacted upon debates on Jewish readmission to England in the mid-1650s, with New England missionary models suggested as a way of evangelising Jews. This article therefore argues for the importance of understanding eschatological beliefs in local contexts, while demonstrating the way in which such beliefs can be maintained and reoriented in the face of apparent disconfirmation

The 1753 'Jew Bill' Controversy: Jewish Restoration to Palestine, Biblical Prophecy, and English National Identity

Examinations of the controversy surrounding the Jewish Naturalization Act (or ‘Jew Bill’) of 1753 have tended to concentrate on the role of either systematic anti-Semitism or political expediency in attempting to explain the sudden, violent uproar that the Act occasioned. While both of these approaches shed light on the controversy, they ignore the central role of prophecy in debates surrounding the Act, both for its proponents and opponents. Both groups drew upon a reservoir of Restorationist images of the Jews, built on the biblical prophecies of a Jewish return to Palestine. For opponents, the ‘Jew Bill’ represented an attempt to discredit prophecies of Jewish separation and denigrate scripture. Restorationist concepts were used to portray the Jews as violent and disloyal, and to suggest that if naturalised they would use England as a staging ground for their conquest of Palestine. For supporters of the Act, naturalisation offered England a unique opportunity to fulfil prophecy. They saw the Act as allowing the nation to take the first steps in fulfilling the apocalyptic role God had prepared for it as the nation that would ‘bless’ the Jews. Both sides of the debate therefore used Restorationism to negotiate concepts of Englishness and alterity. This paper constructs its argument by examining a range of material surrounding the controversy including parliamentary debates, sermons, pamphlets and newspaper reports. It argues for the importance of a nuanced understanding of the role of religion in eighteenth-century political debates

Reconsidering religion and fandom: Christian fan works in My Little Pony fandom

© 2014 Taylor & Francis. Studies of religion and fandom have tended to explore the extent to which fan cultures might be seen as forms of surrogate religion. This article suggests that a more detailed examination of the way in which believers use their faith within their individual fandoms would offer more interesting insights into both contemporary religious practice and fandom. Conducting a case study of Brony fandom (adult fandom of cartoon My Little Pony: Friendship is Magic), this article explores the ways in which Christian fans use fan fiction and art to promote religious literacy, explore theological issues and engage in evangelism and exegesis. Fan knowledge is used as a way to quickly impart and explore complex religious concepts in a manner which utilises the shared culture of fandom. This should not be seen as a symptom of mediatisation but as part of a complex synthesis of faith and popular culture

Management of chylous ascites following hand assisted laparoscopic donor nephrectomy: Case report

We report a case of chylous ascites following a hand assisted laparoscopic donor nephrectomy (HALDN). In this case a 70-year-old male was re-admitted three weeks after undergoing a left HALDN with anorexia and abdominal distension. Abdominal CT confirmed ascites. Paracentesis yielded five litres of chylous fluid. He was treated conservatively with a high protein, low fat diet and made a full recovery. The management of this complication remains controversial with some advocating early surgical intervention and others preferring conservative management techniques. Consideration must be given to early surgical intervention in cases not responding immediately to conservative measures

Substance Misuse Education for Physicians: Why Older People are Important.

This perspective article focuses on the need for training and education for undergraduate medical students on substance-related disorders, and describes initiatives undertaken in the United Kingdom (UK), Netherlands, United States (US), and Norway to develop the skills, knowledge, and attitudes needed by future doctors to treat patients adequately. In addition, we stress that in postgraduate training, further steps should be taken to develop Addiction Medicine as a specialized and transverse medical domain. Alcohol use disorder is a growing public health problem in the geriatric population, and one that is likely to continue to increase as the baby boomer generation ages. Prescription drug misuse is a major concern, and nicotine misuse remains problematic in a substantial minority. Thus, Addiction Medicine training should address the problems for this specific population. In recent years, several countries have started an Addiction Medicine specialty. Although addiction psychiatry has been a subspecialty in the UK and US for more than 20 years, in most countries it has been a more recent development. Additional courses on addiction should be integrated into the curriculum at both undergraduate and postgraduate levels, as well as form part of the continuous training of other medical specialists. It is recommended that further research and mapping of what is currently taught in medical programs be undertaken, so as to enhance medical education in addiction and improve treatment services

Efficient and stable CRISPR/Cas9-mediated genome-editing of human type 2 innate lymphoid cells

Innate lymphoid cells (ILCs) are a family of innate lymphocytes with important roles in immune response coordination and maintenance of tissue homeostasis. The ILC family includes group 1 (ILC1s), group 2 (ILC2s) and group 3 (ILC3s) ‘helper’ ILCs, as well as cytotoxic Natural Killer (NK) cells. Study of helper ILCs in humans presents several challenges, including their low proportions in peripheral blood or needing access to rare samples to study tissue resident ILC populations. In addition, the lack of established protocols harnessing genetic manipulation platforms has limited the ability to explore molecular mechanism regulating human helper ILC biology. CRISPR/Cas9 is an efficient genome editing tool that enables the knockout of genes of interest, and is commonly used to study molecular regulation of many immune cell types. Here, we developed methods to efficiently knockout genes of interest in human ILC2s. We discuss challenges and lessons learned from our CRISPR/Cas9 gene editing optimizations using a nucleofection transfection approach and test a range of conditions and nucleofection settings to obtain a protocol that achieves effective and stable gene knockout while maintaining optimal cell viability. Using IL-4 as a representative target, we compare different ribonucleoprotein configurations, as well as assess effects of length of time in culture and other parameters that impact CRISPR/Cas9 transfection efficiency. Collectively, we detail a CRISPR/Cas9 protocol for efficient genetic knockout to aid in studying molecular mechanism regulating human ILC2s

Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence

It is thought that between a third and a half of all medicines1 There are many causes of non-adherence but they fall into two overlapping categories: intentional and unintentional. Unintentional non-adherence occurs when the patient wants to follow the agreed treatment but is prevented from doing so by barriers that are beyond their control. Examples include poor recall or difficulties in understanding the instructions, problems with using the treatment, inability to pay for the treatment, or simply forgetting to take it. prescribed for long-term conditions are not taken as recommended. If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. Adherence presumes an agreement between prescriber and patient about the prescriber’s recommendations. Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock-on costs arising from increased demands for healthcare if health deteriorates. Non-adherence should not be seen as the patient’s problem. It represents a fundamental limitation in the delivery of healthcare, often because of a failure to fully agree the prescription in the first place or to identify and provide the support that patients need later on. Addressing non-adherence is not about getting patients to take more medicines per se. Rather, it starts with an exploration of patients’ perspectives of medicines and the reasons why they may not want or are unable to use them. Healthcare professionals have a duty to help patients make informed decisions about treatment and use appropriately prescribed medicines to best effec