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PubMed1997

The use of figural reproduction tests as measures of nonverbal memory in epilepsy surgery candidates.

The construct of nonverbal memory, as assessed by figural reproduction tests, has recently been questioned by a number of investigators. The purpose of this study was to reexamine this construct and its relationship to right temporal lobe dysfunction. Figural reproduction test scores were examined in 757 epilepsy surgery candidates obtained from 8 epilepsy centers participating in the Bozeman Epilepsy Consortium. All participants exhibited unequivocal evidence of left (LTL) or right (RTL) temporal lobe epilepsy observed in ictal and interictal EEG recordings. All subjects also had IQ scores exceeding 70, right-hand preference, and left hemisphere language dominance confirmed by intracarotid sodium amytal testing. Comparisons of LTL and RTL groups showed no significant differences in scores on the Visual Reproduction subtests from the Wechsler Memory Scale (WMS) or Wechsler Memory Scale-Revised (WMS-R) or on the copy and delayed recall conditions of the Rey-Osterrieth Complex Figure Test (ROCFT). Significant differences were observed among centers on WMS and ROCFT scores, which are likely to be a result of variations in administration and/or scoring procedures. The lack of significant differences between LTL and RTL groups in this large sample raise questions about the nature of nonverbal memory and its relationship to right temporal lobe dysfunction.

Adult↗
PubMed1991

Contraceptive prevalence, reproductive health and our common future.

The 1980s will go into history as a decade of lost opportunities to increase contraceptive prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached only in 2065 (high projection), the global population in 2100 will consist of more than 14 billion people, with major consequences on every walk of life. To restrict the final population to 10 billion, contraceptive prevalence must increase from 51% to 58% of married women of reproductive age before the year 2000 and to 71% by 2020, implying an increase from the present 350 million users to 500 and 800 million, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Contraception↗
PubMed1994

Minnesota court overturns ban on Medicaid coverage for abortion.

Hennipin County District Court Judge William Posten issued a decision on June 16 striking down Minnesota's near ban on abortion coverage for low-income women. Ruling in Women of the State of Minnesota vs. Haas-Steffen, Judge Posten found that the state Constitution's rights of privacy and equality are more protective of women's reproductive choices than the corresponding federal rights. Holding that "the state's selective funding of childbirth over abortion impinges on an indigent woman's fundamental right to decide for herself whether to continue or terminate her pregnancy," the state district court permanently enjoined enforcement of the measure. Minnesota must now cover all medically necessary abortions for women receiving Medicaid. For more than 15 years, the statutes and regulations invalidated by Judge Posten have limited abortion coverage to cases of life endangerment or reported rape or incest. State officials have indicated that they will seek a stay and expedited review of Judge Posten's decision from the Minnesota Supreme Court. Filed on March 8, 1993, the Minnesota case is one of 5 such lawsuits brought by CRLP. Last December, in a similar case, the West Virginia Supreme Court struck down that state's ban on Medicaid coverage for abortions. Similar CRLP cases are still pending in Florida, Texas, and Montana. Plaintiffs--a class of Minnesota Medicaid-eligible women seeking abortions, Dr. Jane Hodgson, Pro-Choice Resources, Women's Health Center, Midwest Health Center for Women, and Meadowbrook Women's Clinic, on behalf of themselves and the women they serve--are represented by CRLP's Simon Heller, Janet Benshoof, and Lenora Lapidus, along with Minnesota attorney Linda Ojala.

Abortion, Induced↗
PubMed2005

Interactions of law and ethics affecting reproductive choice.

Controversies affecting reproductive choice can often be resolved within interactions of legal and ethical decision-making. This paper addresses three topics, following the methodology presented in Reproductive Health and Human Rights: Integrating Medicine, Ethics, and Law, by R.J. Cook, B.M. Dickens and M.F. Fathalla (Oxford University Press, 2003). The book's 15 case studies each addresses medical, ethical, legal and human rights aspects, and structural approaches at clinical, healthcare system and societal levels. STERILIZATION: Individual self-determination supports legal and ethical rights of intellectually competent persons to sterilization. Sterilization of intellectually compromised persons was historically abused, causing reactions of excessively protective prohibition. ABORTION: Most developed countries have liberalized abortion legislation, thereby reducing abortion-related mortality and morbidity, but many developing countries retain repressive colonial laws. Over 95% of the estimated 20 million unsafe abortions annually occur in developing countries. COURT-ORDERED CAESAREAN DELIVERIES: A concern in developed countries is the willingness of some courts to order Caesarean procedures over competent women's objections.

Adolescent↗
PubMed2003

Individual good and common good: a communitarian approach to bioethics.

The field of bioethics emerged in the late 1960s and early 1970s. Among its early issues were the protection of human research subjects, the rights of patients, abortion, and reproductive issues. Partly as a reflection of the times, and of those issues, the field became focused on autonomy and individual rights, and liberal individualism came to be the dominant ideology in the 1980s and 1990s. Communitarianism, as an alternative ideology focused more on the common good and the public interest than on autonomy, was a neglected approach. But many bioethical issues can not reasonably be reduced to questions of individualism and choice only. Issues of genetics and reproduction will of necessity touch on the society as a whole, its values, and its social institutions. Serious ethical analysis must take the social implications seriously and not simply assume that they should be left to autonomous choices of individuals. Human beings are social animals and our nature is distorted if we think of ourselves only as co-existing social atoms. Various approaches to communitarianism are outlined, and the question of the relationship between individual good and common good is confronted.

Bioethical Issues↗
PubMed2002

Reproductive tourism as moral pluralism in motion.

Reproductive tourism is the travelling by candidate service recipients from one institution, jurisdiction, or country where treatment is not available to another institution, jurisdiction, or country where they can obtain the kind of medically assisted reproduction they desire. The more widespread this phenomenon, the louder the call for international measures to stop these movements. Three possible solutions are discussed: internal moral pluralism, coerced conformity, and international harmonisation. The position is defended that allowing reproductive tourism is a form of tolerance that prevents the frontal clash between the majority who imposes its view and the minority who claim to have a moral right to some medical service. Reproductive tourism is moral pluralism realised by moving across legal borders. As such, this pragmatic solution presupposes legal diversity.

Abortion, Illegal↗
PubMed2000

Postponing sexual intercourse among urban junior high school students-a randomized controlled evaluation.

PURPOSE: To describe a randomized, controlled evaluation of a school-based intervention to delay sexual intercourse among urban junior high school students. METHODS: Six Washington, D.C., junior high schools were randomly assigned to the intervention or nonintervention control condition for an educational program. During the first school year, seventh graders (n = 582) from the six schools obtained written parental consent to participate. Three health professionals (one per intervention school) implemented the program, which consisted of reproductive health classes, the Postponing Sexual Involvement Curriculum, health risk screening, and "booster" educational activities during the following (eighth grade) school year. Cross-sectional surveys were administered at baseline, the end of the seventh grade, and the beginning and end of the eighth grade. Intervention and control group differences in virginity, attitudes toward delayed sex and childbearing, and sexual knowledge and behavior were assessed at all four time points. RESULTS: At baseline, 44% of the seventh grade males and 81% of the seventh grade females reported being virgins. At the end of the seventh grade (first follow-up), after controlling for baseline study group differences, intervention-group females were more likely to report virginity, self-efficacy to refuse sex with a boyfriend, and the intention to avoid sexual involvement during the following 6 months. At the end of the eighth grade, significantly more intervention- than control-group females reported virginity, birth control use at last intercourse (for nonvirgins), and knowledge of adolescent reproductive health and confidentiality rights. No changes in virginity, self-efficacy to refuse sex, or sexual intent for the next 6 months were observed among male participants at any time during the study. However, on all three follow-up surveys, intervention-group males scored significantly higher than their control-group counterparts in knowledge of birth control method efficacy. No change in attitudes toward abstinence was observed for either gender at any follow-up point. CONCLUSIONS: Gender differences in baseline sexual activity rates and in various study outcomes suggest a possible need for separate, gender-specific intervention activities that can adequately address the social and cognitive needs of both sexes.

Adolescent↗
PubMed2005

Eugenics: some lessons from the past.

Eugenics was first debated by the ancient Greeks, particularly Plato and Aristotle, developed in the nineteenth century by Francis Galton and Charles Darwin, and then abused in the twentieth century by right-wing politicians. With the new methods of assisted conception combined with the use of genetic markers, all the old problems of eugenics have resurfaced. Gender selection, embryo selection, preimplantation genetic diagnosis of common disease, and gene replacement techniques (somatic cells) have added greatly to the power of the modern eugenicist. How are these procedures to be monitored and regulated? What is the role of the State compared with individual families for the implementation of the new methodologies? Some of these issues will be discussed.

Bioethical Issues↗
PubMed2001

Legal issues in fertility treatment.

This article examines the law relating to the provision of fertility treatment in an international context. It is argued that the legal framework that was developed from the findings of the Warnock Report faces increasing challenges, not just from technological advances, but from major shifts in the legal landscape. In particular, this article examines the likely impact of the patriation of the European Convention of Human Rights into United Kingdom law after the enactment of the Human Rights Act 1998.

Embryo, Mammalian↗
PubMed2004

Law & bioethics: from values to violence.

The relationship of law of bioethics always complex, has shifted post 9/11. Instead of looking to law as protector of rights and liberties, the new bioethics approach, exemplified by the President's Council on Bioethics, deploys law as aggressor. Thus we see a call to get tough, to prohibit a range of biomedical practices, with the prospect of not only civil but criminal enforcement. Bioethicists face a grave choice, whether to embrace the use of state force to resolve bioethics debates.

Bioethical Issues↗
PubMed1985

Bilateral distribution of implantation sites in small mammals of 22 North American species.

The distribution of activity between the left and right sides of the reproductive tract, as measured by numbers of CL, embryos and placental scars, was studied in small mammals of 22 species. Shrews ovulate from the two ovaries in a distribution that does not differ from the binomial. Implantation of blastocysts in the two uterine horns is more nearly even ('balanced') than would be predicted from the binomial distribution. Balance in this group apparently is achieved by transuterine migration of blastocysts, perhaps in conjunction with some spacing mechanism within the uterus. Some cricetid rodents show little or no balance, but in others the distribution of activity sites (embryos, CL and placental scars) departs significantly from the binomial distribution. Reproductive activity sites of heteromyid and geomyid rodents (Geomyoidea) are highly balanced; uterine balance apparently is achieved by means of ovarian rather than uterine control. We know of no previous reports of ovarian balance and suggest that physiological mechanisms controlling numbers of ovulations in the species exhibiting this characteristic may differ from those in species exhibiting a random distribution of ovulation sites. Hypotheses regarding evolutionary aspects of balance are considered in phylogenetic and ecological terms, generating several testable research questions for physiologists, anatomists, and evolutionary ecologists.

Animals↗
PubMed2003

Ethical and legal issues and the "new genetics".

Although uniquely personal, the information from gene analyses impacts on parents, siblings, children and even entire ethnic groups. Doctors need to carefully balance the right of a patient to privacy against the wider family and society interests, consistent with ethical standards and their legal obligations. Doctors also need to be in a position to advise their patients of potential risks that may result from obtaining predictive genetic information, such as discrimination by third parties. While these issues are not new, they occur with new sharpness in the "new genetics", where clinicians have to be familiar not only with clinical significance, but also the ethical and legal implications of genetic analyses and information.

Australia↗