Where Have All the Midwives Gone?

In past centuries, only women attended women in childbirth. Birthing women were in control, choosing who should attend them and where and how to give birth. Men were usually excluded unless they were needed for their strength and their tools if labor was obstructed. Eventually, with the medicalization of childbirth, male physicians became involved, introducing new techniques that interfered with the normal birth process and competed with midwives. By the 19th century, midwives struggled to hold onto their profession and advance through education. Midwives survived in Europe, but in America, they were eventually usurped in the early 20th century when birth began taking place in hospitals and as medical science and technology advanced. Midwives eventually rose again as educated nurse-midwives. Technology and obstetric interventions in normal childbirth continue, in spite of lack of evidence of their efficacy. Midwives are again in jeopardy because of rising malpractice insurance costs, women's trust in technology, and, most recently, renewed efforts by physicians to once again prevent midwives from practicing autonomously and outside the hospital environment in the United States

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field