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The climate change issue has attracted the attention of civil society organisations in the European Union but standard theories of groups as interest aggregators fail to offer a convincing explanation of their characteristics and contribution. However as the concept of representation has been transformed – from a static view pertaining mostly to legislatures, to a dynamic view of a creative act involving all political actors – it has opened up the possibility of a new explanatory framework for understanding how groups make environmental issues present. This is in direct contrast to the idea of representation and the role of groups outlined in the Lisbon Treaty. [ABSTRACT FROM PUBLISHER]

the European Citizens’ Initiative (ECI) is the latest in a line of institutional innovations that have sought to enhance the participatory nature of EU politics. The extent to which this results in a more democratic EU, however, is questionable because simply having opportunities for participation does not equate to participatory democracy. Participation in the EU has tended to favour the involvement of various ‘civil society’ organisations rather than individual citizens. Moreover it has been justified largely on the grounds that it results in more democratic and efficient institutions and decision-making processes. The notion of participation and its relationship with democracy found in the writings of theorists of participatory democracy is somewhat more radical. Not only does it address individuals in favouring measures that make democracy count in people's everyday lives, it also views participation as leading to human development by enhancing feelings of efficacy, reducing a sense of distance from political authority, stimulating concern for collective problems and solutions, and encouraging citizens to be active and knowledgeable about politics. This paper argues that the ECI sees the EU move a little closer to a more radical view. It finds evidence of this in an acknowledgement that the ECI is to be valued partly because of the ways in which it can benefit individual citizens (as opposed to the EU's decision-making structures) in the arguments for a ‘citizen-friendly’ and usable instrument. [ABSTRACT FROM PUBLISHER]

In this article we analyse the phenomenon of public debate on the future of Europe which has been become a preferred tool of EU policymakers over the last decade. We assess the potential legitimacy benefits of such a public debate process and examine in detail two case studies: the Convention on the Future of Europe and the Debate Europe website. We compare these two public debates with regard to their composition, objectives and working procedures. Our findings show that public debate is no panacea for the EU's ongoing legitimacy-related problems and they also point to general challenges for citizens' involvement in the ongoing European integration process. [ABSTRACT FROM AUTHOR]

Describes the role of the receptor for urokinase-type plasminogen activator in regulating fibronectin matrix assembly in human skin fibroblasts. Integrins; Extracellular matrix; Monoclonal antibodies.

Background: Advance care planning (ACP) is the process supporting individuals with life-limiting illness to make informed decisions about their future healthcare. Ethnic disparities in ACP have been widely highlighted, but interpretation is challenging due to methodological heterogeneity. This review aims to examine differences in the presence of documented ACP in individuals' care records for people with advanced disease by ethnic group, and identify patient and clinician related factors contributing to this. Methods: Mixed-methods systematic review. Keyword searches on six electronic databases were conducted (01/2000–04/2022). The primary outcome measure was statistically significant differences in the presence of ACP in patients' care records by ethnicity: quantitative data was summarised and tabulated. The secondary outcome measures were patient and clinician-based factors affecting ACP. Data was analysed qualitatively through thematic analysis; themes were developed and presented in a narrative synthesis. Feedback on themes was gained from Patient and Public Involvement (PPI) representatives. Study quality was assessed through Joanna Briggs Institute Critical Appraisal tools and Gough's Weight of Evidence. Results: N=35 papers were included in total; all had Medium/High Weight of Evidence. Fifteen papers (comparing two or more ethnic groups) addressed the primary outcome measure. Twelve of the fifteen papers reported White patients had statistically higher rates of formally documented ACP in their care records than patients from other ethnic groups. There were no significant differences in the presence of informal ACP between ethnic groups. Nineteen papers addressed the secondary outcome measure; thirteen discussed patient-based factors impacting ACP presence with four key themes: poor awareness and understanding of ACP; financial constraints; faith and religion; and family involvement. Eight papers discussed clinician-based factors with three key themes: poor clinician confidence around cultural values and ideals; exacerbation of institutional constraints; and pre-conceived ideas of patients' wishes. Conclusions: This review found differences in the presence of legal ACP across ethnic groups despite similar presence of informal end of life conversations. Factors including low clinician confidence to deliver culturally sensitive, individualised conversations around ACP, and patients reasons for not wishing to engage in ACP (including, faith, religion or family preferences) may begin to explain some documented differences. Trial registration: PROSPERO-CRD42022315252. [ABSTRACT FROM AUTHOR]

Objective: Psychosocial assessment following self-harm presentations to hospital is an important aspect of care. However, many people attending hospital following self-harm do not receive an assessment. We sought to explore reasons why some patients do not receive a psychosocial assessment following self-harm from the perspective of patients and carers. Methods: Between March and November 2019, we recruited 88 patients and 14 carers aged ⩾18 years from 16 mental health trusts and community organisations in the United Kingdom, via social media, to a co-designed qualitative survey. Thematic analyses were used to interpret the data. Results: Patients' reasons for refusing an assessment included long waiting times, previous problematic interactions with staff and feeling unsafe when in the emergency department. Two people refused an assessment because they wanted to harm themselves again. Participants reported organisational reasons for non-assessment, including clinicians not offering assessments and exclusion due to alcohol intoxication. Other patients felt they did not reach clinically determined thresholds because of misconceptions over perceived heightened fatality risk with certain self-harm methods (e.g. self-poisoning vs self-cutting). Conclusion: Our results provide important insights into some of the reasons why some people may not receive a psychosocial assessment following self-harm. Parallel assessments, compassionate care and specialist alcohol services in acute hospitals may help reduce the number of people who leave before an assessment. Education may help address erroneous beliefs that self-injury and self-harm repetition are not associated with greatly raised suicide risk. [ABSTRACT FROM AUTHOR]