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Background: Predicting disease progression in patients with the first clinical episode suggestive of multiple sclerosis (MS) is crucial for personalized therapeutic approaches. This study aimed to develop the EUMUS score for accurately estimating the risk of early evidence of disease activity and progression (EDA). Methods: Retrospective analysis was conducted on data from 221 patients with a first clinical MS episode collected from four Italian MS centers. Various variables including socio-demographics, clinical features, cerebrospinal fluid analysis, evoked potentials, and brain MRI were considered. A prognostic multivariate regression model was identified to develop the EUMUS score. The optimal cutoff for predicting the transition from no evidence of disease activity (NEDA3) to EDA was determined. The accuracy of the prognostic model and score were tested in a separate UK MS cohort. Results: After 12 months, 61.54% of patients experienced relapses and/or new MRI lesions. Younger age (OR 0.96, CI 0.93–0.99; p = 0.005), MRI infratentorial lesion(s) at baseline (OR 2.21, CI 1.27–3.87; p = 0.005), positive oligoclonal bands (OR 2.89, CI 1.47–5.69; p = 0.002), and abnormal lower limb somatosensory-evoked potentials (OR 2.77, CI 1.41–5.42; p = 0.003) were significantly associated with increased risk of EDA. The EUMUS score demonstrated good specificity (72%) and correctly classified 80% of patients with EDA in the independent UK cohort. Conclusions: The EUMUS score is a simple and useful tool for predicting MS evolution within 12 months of the first clinical episode. It has the potential to guide personalized therapeutic approaches and aid in clinical decision-making. [ABSTRACT FROM AUTHOR]

In recent decades, the issue of violence against women has increasingly drawn the attention of international and national legislators and policymakers. The term "femicide" became widespread in the early 2000s and was incorporated into the criminal codes of several countries. The onset of the COVID-19 pandemic and the subsequent social distancing measures raised significant concerns about their impact on women's safety. This study examines the effect of COVID-19 confinement measures on femicide trends in Italy, a country which adopted stringent COVID-19 confinement measures and, since 2019, implemented new legislation to counteract violence against women. Using two data sets—one from the Italian Ministry of Interior containing 1,382 cases of female homicides (2013–2022) and another from Italian NGOs detailing 1,253 femicides according to media coverage (2012–2022)—the study employs autoregressive integrated moving average (ARIMA) analysis to assess monthly trends alongside the stringency index for COVID-19 containment efforts. The findings reveal that, although overall femicide rates remained stable during lockdowns, there was a significant shift in victim–perpetrator relationships. Specifically, from March to May 2020, there was a decline in femicides by former partners, offset by an increase in those by cohabiting partners. These results underscore the complexity of femicide and the need for further research on various facets of violence against women. This includes the potential escalation of physical and psychological violence during lockdowns, influenced by forced proximity and substance abuse in domestic environments. [ABSTRACT FROM AUTHOR]

Ethnic media are playing an increasingly important role in the exercise of full citizenship. But globalisation and new technologies affect citizenship in many ways. In this context, the migrants, thanks to their media especially, actively contribute to the reinterpretation of the notion and practices of citizenship. This paper is based on two comparative research studies on the Turkish-language media and the Muslim media in Britain and France. It tries to show how the ethnic media have brought new opportunities of citizenry to minority groups. [ABSTRACT FROM AUTHOR]

We explored the relationship between board characteristics and sustainability of higher education institutions in the United Kingdom (UK). We analysed 153 UK universities using data for the year 2019. Our analysis revealed that board size, the number of students on the board, and the number of academic members on the board were found to have significant and positive relationships with sustainability. Also, the composition of the sustainability committee was shown to have a significant and positive impact on sustainability score. However, the relationships between board gender diversity, the number of external members on the board, and the number of board meetings held during the year with sustainability score were not significant. The results provide guidance to universities for developing their sustainability practices. [ABSTRACT FROM AUTHOR]

The relationship between board characteristics and micro-level organizational factors is an area that has been significantly under-researched, and there is a lack of understanding of how these two elements interact with each other. Hence, we aim to explore how board characteristics could potentially have an impact on individual-level job satisfaction. The dataset used for this study encompasses a total of 4020 observations gathered from 804 companies listed in the FTSE 350 and S&P 500 indices, and it covers the period spanning from 2016 to 2021. The results of the adopted multiple regression analysis showed significant positive relationships between board gender diversity, diversity of specific skills, board independence, board meeting attendance, board size, and average board tenure and employees' job satisfaction of the companies under analysis. However, cultural diversity was not found to have a significant impact on employees' satisfaction. We draw out the theoretical implications of these findings and provide practical recommendations regarding companies' boards composition and structure that help them to enhance the level of their employees' job satisfaction. [ABSTRACT FROM AUTHOR]

Responding to the calls in both earnings management and sustainability literature to examine corporate governance patterns, this study fills the sustainability literature gap by shedding light on the moderating role of corporate governance on earnings management and environmental, social and governance performance. Using a sample of UK firms listed on the London Stock Exchange for the period 2016–2020, we find considerable evidence that earnings management reduces environmental, social and governance performance. Importantly, we find that board gender diversity among other corporate governance mechanisms is stronger and more effective in attenuating the negative effects of earnings management on environmental, social and governance performance significantly. We find support for the agency theory that corporate governance mechanisms reduce the managerial exploitation of resources required for sustainable investments and sustainability performance. [ABSTRACT FROM AUTHOR]

Background and aims: Opioids are now the most cited class in fatal overdoses. However, the antidote for opioid overdose—naloxone—is not always readily available. Our aim was to evaluate the feasibility of naloxone transit via drone to provide rapid access at the point of care. Methods and findings: Real‐world data pertaining to opioid overdoses, which occurred in the Teesside area of the UK 2015–2019, were extracted from the National Programme on Substance Abuse Deaths (NPSAD). The original locations of these opioid overdoses were used to compare the projected response times of ambulances with that of drones when considering the impacts of actual traffic and weather conditions, respectively; 58 cases were identified where a bystander—who could have called for and administered emergency naloxone—was likely present. Results: In 78% of cases (n = 45/58) a class C1 commercial‐off‐the‐shelf drone carrying naloxone could have reached the overdose location in 7 min—the benchmark time for the arrival of emergency services for Category 1 calls in England. With the implementation of recent advances in drone engineering, such as increased speeds and temperature‐controlled cargo cradles, it is estimated that 98% of overdoses could have been reached in this timeframe (n = 57/58). Ambulances were able to reach a significantly lower number of cases in 7 min, even when considering best‐case scenario traffic conditions (14%, n = 8/58, χ2P < 0.001). Conclusions: This study provides proof‐of‐concept that, in the Teesside area of the UK, drones are more likely than ambulance to get naloxone to the site of an opioid overdose in 7 min. [ABSTRACT FROM AUTHOR]

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The United Nations' Sustainable Development Goals persuade governments and businesses to fight modern slavery as part of the 2030 Agenda for Sustainable Development. The UK government took the initiative by introducing the Modern Slavery Act in 2015. Despite this, little is known about how companies disclose information about their efforts to tackle modern slavery as required by the Act and the role of corporate governance as a determinant of modern slavery disclosure (MSD) levels. This study, therefore, investigates the extent to which companies engage in MSD and empirically examines the impact of board gender diversity (BGD) on MSD. Based on a content analysis of FTSE 100 companies' modern slavery statements during the 2016–2020 period, we find that MSD improved over time but is still relatively low. Our results show that companies pay less attention to the core practices of modern slavery, such as key performance indicators (KPIs), due diligence procedures, risk assessment and management, and training. This evidence suggests that companies tend to comply with the Act by focusing largely on symbolic structures rather than providing a comprehensive disclosure of their impacts on modern slavery practices to minimise regulatory risks and manage stakeholders' perceptions. We also find that boards with greater female representation have a positive and significant association with MSD. This finding is consistent with the gender socialisation theory in that women are more sensitive to communal values and ethics. Consequently, companies with a greater proportion of female directors are more transparent about their strategies and actions related to fighting modern slavery. Furthermore, a critical mass of at least four female directors is necessary before any positive impact on MSD can be observed. Our findings shed new light on this under‐researched area and the role of female directors in addressing modern slavery risk and can be of interest to companies, policymakers, and other stakeholders. [ABSTRACT FROM AUTHOR]

The rationale behind reshoring activities remains unclear. Multinationals reshore their subsidiaries when regulations in the host country become too costly or difficult to manage. However, it is unclear whether the positive association between the propensity for reshoring subsidiaries and the host country's regulations applies to all types of subsidiaries (i.e. majority or minority owned) and whether it is moderated by other factors. We suggest that external stakeholders play a crucial role in strengthening the relationship between the decision to reshore and the host country's regulations. Within the context of international business, we examine the reshoring decision of a panel of subsidiaries controlled by UK multinationals located in 39 countries and focus on a specific set of environmental and corporate governance regulations. Our findings suggest that reshoring amongst minority‐owned subsidiaries is more likely to happen in countries with weak protection of shareholders and mandatory environmental disclosure. Such a relationship is also strengthened by the presence of external stakeholders, namely, foreign directors sitting on subsidiaries' boards. We contribute to the reshoring literature by showing the role of external stakeholders and the impact of institutions and regulatory requirements on reshoring decisions. [ABSTRACT FROM AUTHOR]

Beliefs about free will and determinism have been shown to associate with and influence behavior. The present study examined the relationship between these beliefs, key social cognitive constructs, and gambling behavior. A cross-sectional design was used with assessments taken of participants' (N = 316) past gambling behavior; beliefs in free will and determinism; and attitude, perceived behavioral control, and intention toward gambling. Four weeks after survey completion, participants (N = 218) reported their gambling behavior. A MANOVA examined differences between gambling frequency and constructs. Bivariate correlations and regressions were undertaken to understand the relationships between constructs and gambling behavior. Results showed frequent gamblers had significantly greater positive attitudes and intentions toward gambling compared to infrequent gamblers. Infrequent gamblers also had significantly stronger perceived behavioral control and beliefs in free will than frequent gamblers. Free will significantly predicted attitude and perceived behavioral control, and explained additional variance in intention above attitude and perceived behavioral control. There was no effect for determinism. Finally, gambling behavior was explained by intention and perceived behavioral control, but not beliefs in free will and determinism. The study provides evidence for the association between free will beliefs, key social cognitive constructs, and gambling behavior. Future research should confirm the causal role of these relations. [ABSTRACT FROM AUTHOR]

Background: In Iran, the emergency departments (EDs) have largely adopted the emergency severity index (ESI) to prioritize the emergency patients, however emergency medical services (EMS) mainly triage the patients based on the paramedics' gestalt. The National Early Warning Score (NEWS) is a recommended prehospital triage in the UK. We aimed to compare prehospital NEWS and ED ESI for predicting severe outcomes in emergency patients.Methods: An observational study was conducted in a university-affiliated ED between January and April 2021. Adult patients who arrived in the ED by EMS were included. EMS providers calculated the patients' NEWS upon arriving on the scene using an Android NEWS application. In the ED, triage nurses utilized the ESI algorithm to prioritize patients with higher clinical risk. Then, Research nurses recorded patients' 30-day severe outcomes (death or ICU admission). Finally, The prognostic properties of ESI and NEWS were evaluated.Results: One thousand forty-eight cases were included in the final analysis, of which 29 (2.7%) patients experienced severe outcomes. The difference between the prehospital NEWS and ED ESI in predicting severe outcomes was not statistically significant (AUC = 0.825, 95% CI: 0.74-0.91 and 0.897, 95% CI, 0.83-0.95, for prehospital NEWS and ESI, respectively).Conclusion: Our findings indicated that prehospital NEWS compares favorably with ED ESI in predicting 30-day severe outcomes in emergency patients. [ABSTRACT FROM AUTHOR]

Our research explored the social representations of the 'vegetative state' across different cultural (India, Italy, and the UK) and social milieus (left‐leaning, right‐leaning, and religious/tabloid newspapers). The aim was to discover how public discourse engages liminality between life and death. Qualitative and quantitative text analyses were conducted on news headlines and full‐texts from British (n = 300), Indian (n = 300), and Italian (n = 300) newspapers published between January 1990 and June 2019. Our study shows three results: (a) the vegetative state is a potentially global issue that remains discussed with local timing and characteristics; (b) it is commonly represented in eight frames of different resonance across cultural milieus; (c) the news flows are organised on different dimensions (quality, political, and ideological). Results shed light on how liminality is discursively managed by the interplay of cultural resources and social positionings. In particular, this suggests a hitherto unrecognised function of the objectification process: personification as position‐taking. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the set of corporate social responsibility (CSR) committee attributes that may enhance CSR performance and CSR strategy formation and reduce CSR controversies.[AQ1] Towards this end, the study also explores the differences between companies with and without CSR committees in terms of these three CSR performance facets. Design/methodology/approach: The study uses a sample of financial times stock exchange (FTSE) 100 non-financial companies in 2015–2017. Kruskal-Wallis test is conducted to test the differences in CSR performance in firms with CSR board-level committee, CSR management committee and no committees. Additionally, a regression model is used to explore the attributes of CSR committees that lead to better/less CSR performance and CSR strategy/CSR controversies. A two-stage least squares regression model was used as a robustness check. Findings: Firms with board CSR committee have better CSR performance and CSR strategy and lower CSR controversies than both firms with no CSR committees and firms with a CSR management committee. Regression results show that CSR committees that are predominantly consisting of independent board members, chaired by a female director and setting more meetings have better CSR performance. Additionally, CSR committees were found to have lower CSR controversies when having more independent directors and a chair with CSR expertise. CSR strategy was better with the CSR committee represented by a larger group of members. Originality/value: This study makes several contributions to the sustainability governance literature and regulatory/guidance interfaces. There is extant literature examining audit committee attributes and their effects on various firm outcomes. The same can be said on the regulations of the audit committee. CSR committees' composition and benefits are, by far, less regulated and largely under-researched. Hence, this paper is considered an early attempt to explore the CSR performance improvements a CSR committee may bring and the composition that would bring better CSR performance. [ABSTRACT FROM AUTHOR]

This study investigates whether corporate governance (CG) leads to improved corporate social responsibility (CSR) in relation to carbon performance. We draw on multiple theoretical lenses for CSR and use a sample of the top 350 listed UK companies. Our results show that overall CG quality has a discernible influence on carbon performance, based on outcome‐based carbon emissions. Our empirical findings and inferences still hold with an action‐based performance measure as well. In addition, we find that the relationship between CG and carbon performance is significantly moderated by carbon strategy and managerial awareness of carbon risk. Our evidence supports the claim that reforms of CG in the UK have promoted CSR behaviour in carbon performance, and this insight is not documented elsewhere. [ABSTRACT FROM AUTHOR]

The article examines three Romanian diasporic publications in the UK, aiming to identify the formation of a diasporic counterpublic in opposition to mainstream anti-EU immigration stances, during and after the 2016 referendum. Drawing upon (critical) discourse analysis, argumentation theory and rhetoric, it proposes a discursive operationalisation of the concept of counterpublic, employed to analyse the articulation of exclusion and the expression of opposition in diasporic media. The diasporic contributions undermine the nativist logic of particular mainstream stances by exposing discrimination and injustice against EU immigrants as unacceptable for a democratic society, and by openly rejecting the identity-based hierarchies that uphold this logic. Such positions co-exist with the partial reproduction of symbolic boundaries, in a style that is similarly mixed (deliberation, irony, personal narratives, classic reporting and blog style). Despite these contradictory tendencies, critical awareness is raised through (self-)reflexivity and resistance, and claims grounded in EU citizenship rights are made. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the impact of board sustainability committees on environmental and social performance and to examine the mediating effect of corporate social responsibility (CSR) strategy on the relationship between the presence of board sustainability committees and corporate sustainability performance. Using data of U.K. listed firms for the period of 2009–2016, the study employs panel regression analysis and bootstrapping techniques to test study hypotheses. The results suggest that the presence of a sustainability committee improves the effectiveness of CSR strategies. The results also indicate that firms with effective CSR strategies exhibit better environmental and social performance. Further, the empirical results show that the effectiveness of CSR strategy explains the positive relationship between board sustainability committees and corporate environmental and social performance, thus supporting the theoretical framework of the study. The findings of the study shed new light on this research direction and could be of interest to board members, managers, practitioners, investors, policy makers, and regulators that plan to promote sustainability practices and strategies needed for sustainable development. [ABSTRACT FROM AUTHOR]

This paper examines how religious news organizations in the UK covered the Syrian refugee crisis in Europe. Using narrative framing theory, this paper examines all coverage from 2015 and 2016 published in BBC Religion (a part of BBC News), The Muslim News , and Christian Today to examine shared and disparate narratives regarding Syrian refugees migrating to the UK. Four major frames emerged from our analysis of the media coverage in religious and mainstream publications: a humanizing frame, saviour frame, dehumanizing frame, and, redemption frame. The publications differed in their use of these frames as well as the use of sources, news values, and tone of coverage. We discuss each of these frames as well as the implications of the differing coverage. [ABSTRACT FROM AUTHOR]

This article, focusing on journalists working for Turkish-language newspapers in the United Kingdom, examines the way that journalists working in ethnic media perceive their professional roles and performance. Ethnic media have different forms and functions to mainstream media and present different challenges and pressures for journalists, reflecting their communities’ consumption habits and social, economic and political circumstances. This study, based on interviews conducted with journalists and editors working for Turkish-language newspapers, suggests three conceptual dimensions that can be operationalized as a model to help understand ethnic media journalists’ professional roles and performance: perception of audience, relation to power and professional ideals. These dimensions, which may overlap in practice, aim to provide the basis for studying ideas and attitudes towards journalism and the context of production within ethnic media. [ABSTRACT FROM AUTHOR]

Purpose: To fashion an analytic view of representations of Muslim women in British Muslim magazines. Design/methodology/approach: Drawing on theories from within the history of Islamic art and data from the current population of Muslims in the United Kingdom, this paper examines the representation of Muslim women. Four images were selected from recent media products and discussed to expose how the magazines have employed their cultural identity to represent Muslim women. Findings: The paper explores the representation of Muslim women within Muslim media in the UK. It explores the extent to which the history of Islamic art has relevance for making sense of recent media representations and outputs. Research limitations/implications: Future research into Muslim images may improve the way Muslims are visually represented in the mass media and help position them as 'us' and 'insider' rather than 'them' and 'alien' in a context of multiculturalism. Originality/value: The paper contributes to scholarship by improving understanding of the visual representations of Islam and Muslims in the media. [ABSTRACT FROM AUTHOR]

Through a critical review of recent literature and policy concepts, this article puts together history and analysis to consider the relationship between race and UK public service broadcasting. Building on earlier work that recognizes a paradigmatic shift from multiculturalism to cultural diversity, this article identifies a third phase, “creative diversity.” Creative diversity provides a further incremental depoliticization of race in public service broadcasting contexts. Here, ideas of quality and creativity are foregrounded over (structural) questions of (in)equality or the positive recognition of social and cultural difference. The article situates the rise of creative diversity alongside parallel developments in the “crisis of multiculturalism,” UK equality legislative frameworks, and creative industries policy. It is argued that creative diversity shifts the paradigm of the multicultural problem (in public service broadcasting), enables the “marketization” of television and multiculture, and ultimately continues to safeguard the interests of public service broadcasting. [ABSTRACT FROM AUTHOR]

Crime suspects in the USA are typically questioned in a two-step process aimed, first, at behavioural lie detection during a pre-interrogation interview, followed by the elicitation of a confession during the interrogation itself (in Great Britain, the practice of investigative interviewing does not make this sharp distinction). Research conducted on the first step shows that police investigators often target innocent people for interrogation because of erroneous but confident judgments of deception. Research on the second step shows that innocent people are sometimes induced to confess to crimes they did not commit as a function of certain dispositional vulnerabilities or the use of overly persuasive interrogation tactics. Citing recent studies, this paper proposes that laboratory paradigms be used to help build more diagnostic models of interrogation. Substantively, we suggest that the British PEACE approach to investigative interviewing may provide a potentially effective alternative to the classic American interrogation. As a matter of policy, we suggest that the videotaping of entire interrogations from a balanced camera perspective is necessary to improve the fact finding accuracy of judges and juries who must evaluate confession evidence in court. [ABSTRACT FROM AUTHOR]

Women are consistently reported to have a greater prevalence of depressive disorders than men. The reason for this is unclear, and is as likely to be social as biological. There is some evidence that the excess of depression is greater during women's reproductive lives. Data from the National Survey of Psychiatric Morbidity were used to test the hypothesis that the excess disappeared in the post-menopausal years and that obvious social explanations for this were inadequate. Subjects (n = 9792) from a random sample of the British population provided data for the analysis. Lay interviewers using the CIS-R carried out psychiatric assessment. Subjects with ICD-10 depressive episode or mixed anxiety/depression were compared with the remainder. Social variables that were likely to contribute to a postmenopausal decline in depressive disorders were controlled in logistic regression analyses. There was a clear reversal of the sex difference in prevalence of depression in those over age 55. This could not be explained in terms of differential effects of marital status, childcare, or employment status. This large and representative survey adds considerably to the increasingly held view that the sex difference in prevalence of depression is less apparent in later middle age. This may be linked to the menopause, and our attempts to explain it in terms of obvious conditions among social variables were not successful. More specific studies are required to clarify the finding. [ABSTRACT FROM AUTHOR]

This paper describes the Household Survey from the National Survey of Psychiatric Morbidity. This covered a sample drawn at random from the population of Britain, with the exception of the Highlands and Islands of Scotland. The Postcode Address File was used as the sampling frame. Nearly 13,000 adults aged 16-65 were selected for interview, of which 10,108 (79.4%) were successfully interviewed. Eight percent could not be contacted and 13% refused interview. Psychiatric assessment was carried out by lay interviewers using the CIS-R. Subjects were also screened for psychosis, and screen-positive individuals were examined by psychiatrists using SCAN. Sixteen per cent of subjects scored above the standard cut-off of 12 on the CIS-R. The overall one-week prevalence of neurotic disorder was 12.3% in males and 19.5% in females. Unmarried and post-marital groups had high rates of disorder, as did single parents and people living on their own. Respondents in Social Class I had notably lower rates of neurotic disorder than the remainder of the sample. Unemployment was strongly associated with disorder. Subjects living in urban areas had a higher overall prevalence, but there was no significant variation by region. Black respondents had higher rates of disorders that were entirely explained by their age, family type, and social class. Individual neurotic disorders were all significantly commoner in women, with the exception of panic disorder. The one-year prevalence of functional psychoses was four per 1000, with no sex difference. Alcohol and drug dependence was considerably more prevalent in men. For the first time, the survey provides data on the prevalence and correlates of psychiatric disorder on a nationwide sample that can be used to inform equitable and effective national psychiatric services. [ABSTRACT FROM AUTHOR]

Examines the occurrence of pityriasis lichenoides (PL) in a pediatric patient with the granulomatous form of common variable immunodeficiency (CVID) in Great Britain. Efficiency of prednisone for treatment of splenomegaly and autoimmune cytopenias; Contribution of a defect in T-cell function on the development of PL; Features of CVID.

1. Two experiments were performed to evaluate the effect of dietary fat on performance and fat and protein accretion in broiler chickens according to the degree of saturation. 2. The first experiment was designed to test 2 sources of dietary fat and 3 levels of dietary energy using a factorial (2×3) experimental design. The foods were formulated to maintain a constant ratio of energy to protein (and other nutrients). There were no significant differences in weight gain, intake, final body weight or food to gain ratio between broilers fed on diets differing solely in the degree of fat saturation. Broilers fed on diets containing animal fat showed higher whole-body fat retention (P = 0·02) and lower protein accretion (P = 0·03) than those fed on diets containing vegetable oils. 3. In the second experiment, only 1 concentration of fat (tallow, lard or sunflower oil) was incorporated into the experimental diets, providing different energy to protein ratios. The carcase protein content was not affected by dietary fat source, while total fat accretion (P = 0·01) and energy retention (P = 0·14) were highest in broilers fed on a diet containing tallow. 4. The findings suggest that the degree of saturation of dietary fats affects their metabolic use and fat accumulation in broiler chickens. [ABSTRACT FROM AUTHOR]

In the 2011 landmark case of W v M, the English Court of Protection ruled that it was unlawful to withdraw artificial nutrition and hydration from a woman who had been in a minimally conscious state for 8 years. From the perspective of the court, the absence of a written advance directive negated the woman's previous, autonomous interests and, consequently, emphasis was given to her current welfare and well-being. While life itself is a moral good, prolonging life for a person in regular pain with no hope of recovering to a more complete state of awareness simply because that person only verbalized her wishes about her treatment decisions seems to drastically undervalue the principle of autonomy. We refute the notion that it is the role of the court to prolong life insofar as it can and argue that withholding and withdrawing life sustaining technologies from patients in a minimally conscious state can be ethically justified. [ABSTRACT FROM AUTHOR]