Genetics and patients' rights: where are the limits?
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BACKGROUND: No two countries have adopted identical regulatory measures on cloning. Understanding the complexity of these regulatory variations is essential. It highlights the challenges associated with the regulation of a controversial and rapidly evolving area of science and sheds light on a regulatory framework that can accommodate this reality. METHODS: Using the most reliable information available, we have performed a survey of the regulatory position of thirty countries around the world regarding the creation and use of cloned embryos (see Table 1). We have relied on original and translated legislation, as well as published sources and personal communications. We have examined the regulation of both reproductive cloning (RC) and non-reproductive cloning (NRC). RESULTS: While most of the countries studied have enacted national legislation, the absence of legislation in seven of these countries should not be equated with the absence of regulation. Senator Morin was not correct in stating that the majority of recent legislation bans both RC and NRC. Recent regulatory moves are united only with regard to the banning of RC. While NRC is not permitted in seventeen of the countries examined, it could be permitted in up to thirteen countries. CONCLUSIONS: There is little consensus on the various approaches to cloning laws and policies, and the regulatory position in many countries remains uncertain.
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The dynamics of formation, reproduction, and recognition of trace conditioned reflexes to positive and differentiation stimuli was studied on subjects of 15-17 years old. Formation and reproduction of such reflexes was found to occur under a close interaction of both levels of the higher nervous activity--recognized and unrecognized levels. Recognized reactions prevailed on unrecognized ones in cases of involvement of active attention. On the basis of this fact, the formation and reproduction of trace conditioned reflexes to positive stimuli has been supposed to occur with an active participation of the left hemisphere. The right hemisphere apparently plays a leading role in formation and reproduction of trace conditioned reflexes to differention stimuli to which the attention of the subjects was not fixed.
The Ponzo figure was used to test predictions based upon Pressey's 1971 concept of attentive fields. Subjects made judgements using either the method of successive reproduction (n = 18) or the method of reproduction (n = 17). Size of the acute angle between the oblique and test lines (30 degrees, 45 degrees, and 60 degrees) and orientation of test figures (apex pointed up, left, right, and down) were varied. It was predicted with the method of successive reproduction that illusions of shrinkage would occur and that the variable of orientation would not affect size of illusion. With the method of reproduction the prediction was made that illusions of expansion would occur when the apex pointed up and that illusions of shrinkage would occur when the apex pointed down. Analysis showed that with the method of successive reproduction illusions of shrinkage occurred when the apex was pointed either up or down. When the apex pointed either to the right or left nonsignificant illusions were found. With the method of reproduction the classical illusion of expansion occurred when the apex pointed up but changed to one of shrinkage when the apex pointed down. Size of expansion illusion diminished as the acute angle formed between the oblique and standard lines decreased. In general, some of the results were consistent with Pressey's concept of attentive fields.
The effect of asymmetrical tonic reflexes on the upper limb in man was studied by analyzing errors in reproducing a targeted movement in right elbow extension following head rotation and vibration of the neck muscles. Overshoot of reproduction was observed only when the head was rotated to the left in contrast to no rotation or with rotation to the right. However, there was no influence on errors of reproduction after vibration of the neck muscles. These observations suggest that the proprioception in the rotated head controls the kinesthetic input by peripheral sensory receptors, namely, vestibular input plays a greater role in the accurate positioning of the upper limb, especially in inhibiting sensory input from the opposite side of the rotated head.
This experiment examined the participation of the auditory cortex of the temporal lobe in the perception and retention of rhythmic patterns. Four patient groups were tested on a paradigm contrasting reproduction of auditory and visual rhythms: those with right or left anterior temporal lobe removals which included Heschl's gyrus (HG), the region of primary auditory cortex (RT-A and LT-A); and patients with right or left anterior temporal lobe removals which did not include HG (RT-a and LT-a). Estimation of lesion extent in HG using an MRI-based probabilistic map indicated that, in the majority of subjects, the lesion was confined to the anterior secondary auditory cortex located on the anterior-lateral extent of HG. On the rhythm reproduction task, RT-A patients were impaired in retention of auditory but not visual rhythms, particularly when accurate reproduction of stimulus durations was required. In contrast, LT-A patients as well as both RT-a and LT-a patients were relatively unimpaired on this task. None of the patient groups was impaired in the ability to make an adequate motor response. Further, they were unimpaired when using a dichotomous response mode, indicating that they were able to adequately differentiate the stimulus durations and, when given an alternative method of encoding, to retain them. Taken together, these results point to a specific role for the right anterior secondary auditory cortex in the retention of a precise analogue representation of auditory tonal patterns.
Only few studies have addressed temporal processing for durations longer than 1 s, and even fewer studies have investigated cortical involvement in time perception, in particular temporal production and reproduction. The present study investigated temporal reproduction in healthy control subjects and patients with anterior or posterior cortical lesions in the left or right hemisphere, or with subcortical left-hemispheric lesions. The paradigm involved presentation of either auditory or visual stimuli of 10 different standard intervals ranging from 1 to 5.5 seconds duration. Participants were required to reproduce the duration of a stimulus. Our results show that: (1) temporal reproduction across this temporal range can be better described with two separate linear regressions (bilinear approach) than with one single linear regression, thus contrasting the scalar timing concept; (2) that patients can, regardless of the hemisphere lesioned, perform reproductions of durations smaller than 2-3 s with reasonable accuracy; and (3) that patients with right-hemispheric lesions appear to be impaired in reproductions of stimuli longer than 2-3 s. Since attention appeared not to be impaired in the patients tested, the findings suggest that the integrity of the right hemisphere seems to be critical for temporal reproduction of intervals longer than 2-3 s.
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Laws that allow competent persons to make free and informed decisions for sterilization serve their entitlements to reproductive choice. Laws that allow others to consent to sterilization of disadvantaged persons who cannot freely consent risk oppression and denial of human rights. Laws that prohibit competent persons' choices for their own sterilization are comparably oppressive and violative of human rights to decide whether and how often to have children. Whether laws approach sterilization as a procedure done for patients, or to patients, is often ambivalent. Details of laws may indicate their liberating and oppressive potential. Programs offering inducements to persons to be sterilized may assist those who are disadvantaged to achieve their goals, but may appear to coerce those who, through poverty or dependency, cannot resist the inducement.
OBJECTIVE: The aim of this study is to determine the knowledge, attitude, behaviour and practices regarding HIV/AIDS among the fishermen community in the coastal areas of Balochistan. DESIGN: A cross-sectional survey. PLACE AND DURATION OF STUDY: This study was conducted between September-October 2000 at Gidani, a coastal area of Balochistan. PATIENTS AND METHODS: About 1000 fishermen were interviewed to assess the knowledge, attitude, behaviour and practices regarding HIV/AIDS. It was a community based survey involving the key informants, interviews and focused group discussions. RESULTS: There was little awareness regarding causes and prevention of HIV/AIDS in the community. While healthcare providers believe that the prevalence of HIV/AIDS is high, the community did not consider themselves at risk. Adolescents with any sexual health problems visit hakims and quacks. The community was aware of the etiology and some of the risk factors associated with AIDS, most probably due to the recent public health campaigns against the disease. CONCLUSION: Considering the suspected high prevalence of HIV/AIDS and the relative lack of knowledge, it is imperative that a public health intervention program be initiated in these areas. This must include educating not only the community but also the health workers. The Government's initiative to train community workers in reproductive health is a step in the right direction.
Building on the broad agenda set forth at the 1994 International Conference on Population and Development, this article articulates similarly broad expectations for informed choice in family planning service delivery. A framework developed by a Global Working Group in 1998 sets forth various issues into a single analysis of informed choice. In an effort to bring international perspectives to bear on the articulation of new objectives for the home front, the article applies this framework to the US research literature in family planning. Review of the literature indicates a heartening degree of attention to issues of access and choice, but it also uncovers challenges faced by clients and providers and gaps in what is known. Few studies look beyond access to how providers actually do or could better facilitate informed decision making within the family planning setting. Such studies could help improve innovative and ambitious service delivery approaches that go beyond meeting the reproductive health needs of clients to ensure rights, improve choice, and empower individuals.
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OBJECTIVE: To determine knowledge, attitude and practices regarding sexually transmitted infections in district Khairpur, Sindh, Pakistan. DESIGN AND METHODOLOGY: A needs assessment study employing a community based survey, key informant interviews and focus group discussions was conducted in all seven sub-districts of the district. This paper is based on the results of the key informant interviews and the focus group discussions. Thirty interviews and six group discussions were held with members of the community and with the health care providers. RESULTS: There was little awareness regarding causes and prevention of sexually transmitted infections in the community. The situation was slightly better among health care providers. While health care providers believed that the prevalence of sexually transmitted infections is high, the community did not consider themselves at risk. The community believed that these diseases are a problem among a sub-population of male adolescents, especially those who have homosexual relations. However, due to social norms, they rarely discussed such health problems with other family members or elders. Adolescents with any sexual health problems visit hakims and quacks. The community was aware about aetiology and some of the risk factors associated with AIDS and hepatitis, most probably due to the recent public health campaigns against both diseases. CONCLUSION: Considering the suspected high prevalence of sexually transmitted infections and the relative lack of knowledge, it is imperative that a public health intervention be initiated. This must include educating not only the community but also the health workers. The governments' initiative to train community workers in reproductive health is a step in the right direction.
The distribution of oviductal lymphatic vessels in the bovine mesosalpinx and bursa ovarica, and their communications with other lymphatics in the uterine broad ligament were examined after exposition of all lymphatic pathways with varicoloured microfil and/or ink-gelatin mixture. However, filling of the lumen of the oviductal infundibulum lymphatics was difficult or impossible because of its slender walls. Lymphatics of the isthmus and ampulla with short precollectors formed branches 1.5-2.0 cm long on both sides: dorsal and ventral of the uterine broad ligament. Collectors with slender and long lymphangions, visible after filling their lumen, encircled the alymphatic area in the parainfundibullar mesosalpinx. The greatest number of lymphatic branches, which originated from the paraisthmal part of the oviductal ampulla were observed in the subovarian area. The characteristic feature was their immediate proximity with uterine and oviductal arterial vessels. Subsequent studies have provided convincing evidence that there are direct connections of lymphatics leaving the oviduct and ovarian sac with lymphatics emerging from the uterus and ovary (after bilateral filling of lymphatics pathways in the whole broad liagment of the uterus). The performed investigations showed particularly characteristic feature in the cow--mixing lymph leaving various reproductive organs in the area of the right and left ligament--before two long collector branches reach the nearest lymphatic node/-s.