Why are some South African children with Down syndrom not being offered cardiac surgery?

About 1 in 1 000 children has Down syndrome. Extra chromosomal material results in a myriad of potential problems for the affected individual. About 40% of Down syndrome children will have cardiac abnormalities, ranging from the simple arterial duct to the complex atrioventricular septal defect. Virtually all these defects are amenable to surgical correction and extended survival is possible. In South Africa many of these children do not undergo cardiac surgery

Is Neolithic land use correlated with demography? An evaluation of pollen-derived land cover and radiocarbon-inferred demographic change from Central Europe

The transformation of natural landscapes in Middle Europe began in the Neolithic as a result of the introduction of food-producing economies. This paper examines the relation between land-cover and demographic change in a regionally restricted case study. The study area is the Western Lake Constance area which has very detailed palynological as well as archaeological records. We compare land-cover change derived from nine pollen records using a pseudo-biomisation approach with 14C date probability density functions from archaeological sites which serve as a demographic proxy. We chose the Lake Constance area as a regional example where the pollen signal integrates a larger spatial pattern. The land-cover reconstructions for this region show first notable impacts at the Middle to Young Neolithic transition. The beginning of the Bronze Age is characterised by increases of arable land and pasture/meadow, whereas the deciduous woodland decreases dramatically. Changes in the land-cover classes show a correlation with the 14C density curve: the correlation is best with secondary woodland in the Young Neolithic which reflects the lake shore settlement dynamics. In the Early Bronze Age, the radiocarbon density correlates with open land-cover classes, such as pasture, meadow and arable land, reflecting a change in the land-use strategy. The close overall correspondence between the two archives implies that population dynamics and land-cover change were intrinsically linked. We therefore see human impact as a key driver for vegetation change in the Neolithic. Climate might have an influence on vegetation development, but the changes caused by human land use are clearly detectable from Neolithic times, at least in these densely settled, mid-altitude landscapes

Designing a Good Life: A Matrix for the Technological Mediation of Morality

Technologies fulfill a social role in the sense that they influence the moral actions of people, often in unintended and unforeseen ways. Scientists and engineers are already accepting much responsibility for the technological, economical and environmental aspects of their work. This article asks them to take an extra step, and now also consider the social role of their products. The aim is to enable engineers to take a prospective responsibility for the future social roles of their technologies by providing them with a matrix that helps to explore in advance how emerging technologies might plausibly affect the reasons behind people’s (moral) actions. On the horizontal axis of the matrix, we distinguished the three basic types of reasons that play a role in practical judgment: what is the case, what can be done and what should be done. On the vertical axis we distinguished the morally relevant classes of issues: stakeholders, consequences and the good life. To illustrate how this matrix may work in practice, the final section applies the matrix to the case of the Google PowerMeter

Bioavailability in soils

The consumption of locally-produced vegetables by humans may be an important exposure pathway for soil contaminants in many urban settings and for agricultural land use. Hence, prediction of metal and metalloid uptake by vegetables from contaminated soils is an important part of the Human Health Risk Assessment procedure. The behaviour of metals (cadmium, chromium, cobalt, copper, mercury, molybdenum, nickel, lead and zinc) and metalloids (arsenic, boron and selenium) in contaminated soils depends to a large extent on the intrinsic charge, valence and speciation of the contaminant ion, and soil properties such as pH, redox status and contents of clay and/or organic matter. However, chemistry and behaviour of the contaminant in soil alone cannot predict soil-to-plant transfer. Root uptake, root selectivity, ion interactions, rhizosphere processes, leaf uptake from the atmosphere, and plant partitioning are important processes that ultimately govern the accumulation ofmetals and metalloids in edible vegetable tissues. Mechanistic models to accurately describe all these processes have not yet been developed, let alone validated under field conditions. Hence, to estimate risks by vegetable consumption, empirical models have been used to correlate concentrations of metals and metalloids in contaminated soils, soil physico-chemical characteristics, and concentrations of elements in vegetable tissues. These models should only be used within the bounds of their calibration, and often need to be re-calibrated or validated using local soil and environmental conditions on a regional or site-specific basis.Mike J. McLaughlin, Erik Smolders, Fien Degryse, and Rene Rietr

PREDICTORS OF HYPERTENSION

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74570/1/j.1749-6632.1978.tb25565.x.pd

Free will and mental disorder: Exploring the relationship

A link between mental disorder and freedom is clearly present in the introduction of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It mentions “an important loss of freedom” as one of the possible defining features of mental disorder. Meanwhile, it remains unclear how “an important loss of freedom” should be understood. In order to get a clearer view on the relationship between mental disorder and (a loss of) freedom, in this article, I will explore the link between mental disorder and free will. I examine two domains in which a connection between mental disorder and free will is present: the philosophy of free will and forensic psychiatry. As it turns out, philosophers of free will frequently refer to mental disorders as conditions that compromise free will and reduce moral responsibility. In addition, in forensic psychiatry, the rationale for the assessment of criminal responsibility is often explained by referring to the fact that mental disorders can compromise free will. Yet, in both domains, it remains unclear in what way free will is compromised by mental disorders. Based on the philosophical debate, I discuss three senses of free will and explore their relevance to mental disorders. I conclude that in order to further clarify the relationship between free will and mental disorder, the accounts of people who have actually experienced the impact of a mental disorder should be included in future research

Variants in the FFAR1 Gene Are Associated with Beta Cell Function

The FFAR1 receptor is expressed mainly in pancreatic beta cells and is activated by medium to long chain free fatty acids (FFAs), as well as by thiazolidinediones, resulting in elevated Ca(2+) concentrations and promotion of insulin secretion. These properties suggest that FFAR1 could be a mediator of lipotoxicity and a potential candidate gene for Type 2 diabetes (T2D). We therefore investigated whether variations at the FFAR1 locus are associated with T2D and beta cell function.We re-sequenced the FFAR1 region in 96 subjects (48 healthy and 48 T2D individuals) and found 13 single nucleotide polymorphisms (SNPs) 8 of which were not previously described. Two SNPs located in the upstream region of the FFAR1 gene (rs1978013 and rs1978014) were chosen and genotyped in 1929 patients with T2D and 1405 healthy control subjects. We observed an association of rs1978013 and rs1978014 with insulinogenic index in males (p = 0.024) and females (p = 0.032), respectively. After Bonferroni corrections, no association with T2D was found in the case-control material, however a haplotype consisting of the T-G alleles conferred protection against T2D (p = 0.0010).Variation in the FFAR1 gene may contribute to impaired beta cell function in T2D

A case for increased private sector involvement in Ireland's national animal health services

Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands)