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PubMed1997

Promoting the well-being of children: the need to broaden our vision--the 1996 Martha May Eliot Award Lecture.

As those in the field of maternal and child health attempt to redefine their role to meet the challenges of the 1990s and beyond, they should review the history of their field. They should examine the legacy of the Children's Bureau which investigated and reported upon all matters pertaining to the welfare of children. They should note the medicalization of MCH and the drift away from broader child welfare issues. In Dr. Eliot's words, they should remember "the inseparability of the health and social aspects of the growth and development of a child." MCHers can advance the well-being of children by defining child health broadly and by promoting it in many ways.

Adult↗
PubMed1997

Children's health and the environment--the first Herbert L. Needleman Award Lecture.

Children today are exposed extensively to toxins in the environment. Prominent among these are exposures to over 70,000 synthetic chemicals, all newly developed in the past 50 years and largely untested for their hazards to children's health. Children are uniquely vulnerable to toxins, and with increasing incidence they are developing chronic, disabling, life-threatening diseases known or suspected to be of environmental origin-asthma, endocrine disruption, cancer, and the diseases caused by tobacco. Pediatricians need to consider toxic etiologies in the differential diagnosis of childhood illness.

Asthma↗
PubMed2004

Culture and pathology: flathead loneliness revisited. The 2001 Roger Allan Moore lecture.

My earlier considerations of Flathead loneliness and depressive disorder yielded an interpretation that emphasized the lack of necessary pathology in the Flathead experience of loneliness. In this paper I detail a shift in my thinking about the pathological character of loneliness, a shift traceable to a set of interactions that have led me away from illness experience and diagnosis to questions of treatment, intervention, and healing. I explore how this new set of questions refocused my attention-away from an exclusive preoccupation with the lonesome individual. I conclude with a reimagination of the pathological dimensions of Flathead loneliness as aspects of both group and individual health.

Colonialism↗
PubMed2004

Human cloning and embryo research: the 2003 John J. Conley Lecture on medical ethics.

The author, a member of the U.S. President's Council on Bioethics, discusses ethical issues raised by human cloning, whether for purposes of bringing babies to birth or for research purposes. He first argues that every cloned human embryo is a new, distinct, and enduring organism, belonging to the species Homo sapiens, and directing its own development toward maturity. He then distinguishes between two types of capacities belonging to individual organisms belonging to this species, an immediately exerciseable capacity and a basic natural capacity that develops over time. He argues that it is the second type of capacity that is the ground for full moral respect, and that this capacity (and its concomitant degree of respect) belongs to cloned human embryos no less than to adult human beings. He then considers and rejects counter-arguments to his position, including the suggestion that the capacity of embryos is equivalent to the capacity of somatic cells, that full human rights are afforded only to human organisms with functioning brains, that the possibility of twinning diminishes the moral status of embryos, that the fact that people do not typically mourn the loss of early embryos implies that they have a diminished moral status, that the fact that early spontaneous abortions occur frequently diminishes the moral status of embryos, and that his arguments depend upon a concept of ensoulment. He concludes that if the moral status of cloned human embryos is equivalent to that of adults, then public policy should be based upon this assumption.

Cloning, Organism↗
PubMed2000

Epidemiological research in mental disorders: lessons for the next decade of research--the NAPE Lecture 1999. Nordic Association for Psychiatric Epidemiology.

OBJECTIVE: To provide an overview of the progress in the field of epidemiology of mental disorders during the last decade, and to discuss challenges for the future. METHOD: Following a review of the achievements of psychiatric epidemiology, current shortcomings in the research and publications in the field are discussed. Suggestions for changes in research and solutions to current deficits are proposed. RESULTS: Future research needs to cover a broader spectrum of psychopathology, including inquiries into sub-threshold characterizations; explore etiopathogenic processes and pathways including genetic, neuroscientific and psychological factors for the onset and persistence of psychopathology; and provide a better assessment of help-seeking behaviors and service utilization. CONCLUSION: Future epidemiological research should strengthen the emerging collaborative links with the neurosciences, clinical research and public health by acknowledging the full range of available epidemiological designs and methods, beyond the current emphasis on large-scale, cross-sectional general population studies.

Epidemiologic Factors↗
PubMed2003

Methodological pitfalls in early detection studies - the NAPE Lecture 2002. Nordic Association for Psychiatric Epidemiology.

OBJECTIVE: To identify and discuss methodological pitfalls that may help explain why many questions around early detection (ED) and duration of untreated psychosis (DUP) are still unsolved. METHOD: This paper concentrates on pitfalls in the following areas: sampling, measurement and data analyses. RESULTS: The main problems seem to be: SAMPLING: Referral bias, exclusion of patients, patient refusal, and patients lost to follow-up. MEASUREMENT: Reliability, which is particularly cogent for multisite investigations, and validity, which includes: Start of illness, start of psychosis, diagnoses, start of treatment, the relationship between ED and DUP and choice of outcome measures. Data Analyses: Overlooking threshold effects of DUP, improper control for baseline scores, and lack of control for confounders. CONCLUSION: Methodological pitfalls may bias ED studies. Several pitfalls are unavoidable, but proper design and quality assurance can reduce their impact. Researchers ought to identify the pitfalls, and to estimate and discuss their influence.

Humans↗
PubMed2003

The Seiji memorial lecture: the melanosome: an ideal model to study cellular differentiation.

Melanosomes provide an intriguing model for study at many levels. In part this is due to their unique structure and function, but also in part to their involvement in pigmentary diseases and as a model to study basic cellular mechanisms of organelle biogenesis. Recent studies have elucidated the full proteome of the melanosome and the metabolic and molecular lesions involved in a number of pigmentary diseases have been resolved. This paper summarizes recent advances in the field in these areas.

Animals↗
PubMed2003

The IFPCS presidential lecture: a chemist's view of melanogenesis.

The significance of our understanding of the chemistry of melanin and melanogenesis is reviewed. Melanogenesis begins with the production of dopaquinone, a highly reactive o-quinone. Pulse radiolysis is a powerful tool to study the fates of such highly reactive melanin precursors. Based on pulse radiolysis data reported by Land et al. (J Photochem Photobiol B: Biol 2001;64:123) and our biochemical studies, a pathway for mixed melanogenesis is proposed. Melanogenesis proceeds in three distinctive steps. The initial step is the production of cysteinyldopas by the rapid addition of cysteine to dopaquinone, which continues as long as cysteine is present (1 microM). The second step is the oxidation of cysteinyldopas to give pheomelanin, which continues as long as cysteinyldopas are present (10 microM). The last step is the production of eumelanin, which begins only after most cysteinyldopas are depleted. It thus appears that eumelanin is deposited on the preformed pheomelanin and that the ratio of eu- to pheomelanin is determined by the tyrosinase activity and cysteine concentration. In eumelanogenesis, dopachrome is a rather stable molecule and spontaneously decomposes to give mostly 5,6-dihydroxyindole. Dopachrome tautomerase (Dct) catalyses the tautomerization of dopachrome to give mostly 5,6-dihydroxyindole-2-carboxylic acid (DHICA). Our study confirmed that the role of Dct is to increase the ratio of DHICA in eumelanin and to increase the production of eumelanin. In addition, the cytotoxicity of o-quinone melanin precursors was found to correlate with binding to proteins through the cysteine residues. Finally, it is still unknown how the availability of cysteine is controlled within the melanosome.

Animals↗
PubMed2004

Society for Reproductive Biology Founders' Lecture 2003. The making of an embryo: short-term goals and long-term implications.

During early development, the eutherian mammalian embryo forms a blastocyst comprising an outer trophectoderm epithelium and enclosed inner cell mass (ICM). The short-term goal of blastocyst morphogenesis, including epithelial differentiation and segregation of the ICM, is mainly regulated autonomously and comprises a combination of temporally controlled gene expression, cell polarisation, differentiative cell divisions and cell-cell interactions. This aspect of blastocyst biogenesis is reviewed, focusing, in particular, on the maturation and role of cell adhesion systems. Early embryos are also sensitive to their environment, which can affect their developmental potential in diverse ways and may lead to long-term consequences relating to fetal or postnatal growth and physiology. Some current concepts of embryo-environment interactions, which may impact on future health, are also reviewed.

Animals↗