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    ABSTRACT: The vegan project is defined as the project that strives for radical legal reform to pass laws that would reserve the consumption of animal products to a very narrow range of situations, resulting in vegan diets being the default diets for the majority of human beings. Two objections that have been raised against such a project are described. The first is that such a project would jeopardise the nutritional adequacy of human diets. The second is that it would alienate human beings from nature. It is argued that neither undermines the vegan project.
    Journal of Bioethical Inquiry 03/2013;
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    ABSTRACT: Partly in response to rising rates of obesity, many governments have published healthy eating advice. Focusing on health advice related to the consumption of animal products (APs), I argue that the individualistic paradigm that prevails must be replaced by a radically new approach that emphasizes the duty of all human beings to restrict their negative “Global Health Impacts” (GHIs). If they take human rights seriously, many governments from nations with relatively large negative GHIs—including the Australian example provided here—must develop strategies to reduce their citizens’ negative GHIs. As the negative GHIs associated with the consumption of many APs are excessive, it is my view that many governments ought to adopt a qualified ban on the consumption of APs.
    Journal of Bioethical Inquiry 01/2013; 10(1).
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    Journal of Bioethical Inquiry 12/2012; 9(4):377-9.
  • Medical Teacher 04/2012; 34(5):349-50.
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    ABSTRACT: Hyponatraemia is present in 15-20% of non-selected emergency admissions to hospitals in the UK. It is associated with increased mortality and morbidity as well as increased duration of stay, independent of the cause for admission. Hyponatraemia is therefore common and important, driving the need for a rational but practical management strategy. This must encompass a stratified approach based on clinical presentation, balancing diagnostic uncertainty and the relative merits of different interventions to achieve the best outcome.
    The journal of the Royal College of Physicians of Edinburgh 09/2010; 40(3):240-5.
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    ABSTRACT: This study investigated the formal and informal ways pre-registration students from medicine, nursing, physiotherapy and pharmacy learn about keeping patients safe. This paper gives an overview of the study and explores findings in relation to organizational context and culture. The study employed a phased design using multiple qualitative methods. The overall approach drew on 'illuminative evaluation'. Ethical approval was obtained. Phase 1 employed a convenience sample of 13 pre-registration courses across the UK. Curriculum documents were gathered, and course directors interviewed. Phase 2 used eight case studies, two for each professional group, to develop an in-depth investigation of learning across university and practice by students and newly-qualified practitioners in relation to patient safety, and to examine the organizational culture that students and newly-qualified staff are exposed to. Analysis was iterative and ongoing throughout the study, using frameworks agreed by all researchers. Patient safety was felt to have become a higher priority for the health care system in recent years. Incident reporting was a key feature of the patient safety agenda within the organizations examined. Staff were often unclear or too busy to report. On the whole, students were not engaged and may not be aware of incident reporting schemes. They may not have access to existing systems in their organization. Most did not access employers' induction programmes. Some training sessions occasionally included students but this did not appear to be routine. Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety.
    Journal of Health Services Research & Policy 01/2010; 15 Suppl 1:4-10.
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    Medical Education 11/2009; 43(11):1109-10.
  • British Journal of Oral and Maxillofacial Surgery 06/2009; 47(6):494-5; author reply 495-6.
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    ABSTRACT: The importance of supervision is increasingly recognized, yet it remains little understood, impairing research and practice. Specifically, the CBT supervision model provides a relatively "heartless" account of professional development, which may undermine its effectiveness. A theoretical review of emotions in supervision and learning is provided, to summarize relevant theoretical and empirical literature. The objectives are to clarify the role of emotions in CBT supervision, and to use this understanding to outline an emotionally-attuned model, illustrating its application to two critical aspects of CBT supervision (the development of a learning alliance and enhancing professional competence). The reviewed literature (theory and research evidence) supports the explicit and systematic incorporation of emotions into CBT supervision. Conceptually, this can be achieved by integrating Lazarus's (1991) general theory of emotion with the CBT model. The illustrations of this augmented model indicate its value in understanding and managing both the "rupture-repair" cycle that can affect the supervisory alliance, and the "deskilling-development" pattern that appears to be necessary for the acquisition of competence. We propose that CBT supervision might usefully be guided by our expanded model, as this affords greater internal consistency and may be more effective educationally.
    Behavioural and Cognitive Psychotherapy 04/2009; 37(2):207-19.
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    ABSTRACT: To investigate NHS doctors' perceived benefits of being involved in mentoring schemes and to explore the overlaps and relationships between areas of benefit. Extended qualitative analysis of a multi-site interview study following an interpretivist approach. Six NHS mentoring schemes across England. Perceived benefits. While primary analysis resulted in lists of perceived benefits, the extended analysis revealed three overarching areas: professional practice, personal well-being and development. Benefits appear to go beyond a doctor's professional role to cross the personal-professional interface. Problem solving and change management seem to be key processes underpinning the raft of personal and professional benefits reported. A conceptual map was developed to depict these areas and relationships. In addition secondary analysis suggests that in benefitting one area mentoring may lead to consequential benefits in others. Prior research into mentoring has mainly taken place in a single health care sector. This multi-site study suggests that the perceived benefits of involvement in mentoring may cross the personal/professional interface and may override organizational differences. Furthermore the map developed highlights the complex relationships which exist between the three areas of professional practice, personal wellbeing and personal and professional development. Given the consistency of findings across several studies it seems probable that organizations would be strengthened by doctors who feel more satisfied and confident in their professional roles as a result of participation in mentoring. Mentoring may have the potential to take us beyond individual limits to greater benefits and the conceptual map may offer a starting point for the development of outcome criteria and evaluation tools for mentoring schemes.
    Journal of the Royal Society of Medicine 12/2008; 101(11):552-7.
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