Global Kidney Exchange: Analysis and Background Papers from the Perspective of the Right to Health

Global Kidney Exchange (GKE) is a program aimed at facilitating trans-national kidney donation. Although its proponents aim at reducing the unmet demand of kidneys in the United States through the trans-nationalization of kidney exchange programs, the World Health Organization (WHO) and The Transplantation Society (TTS) have expressed concerns about its potential effect on black markets of organs and transnational organ trafficking, as well as on low- or middle-income countries health systems. For GKE to be implemented, it would need to be permitted to operate in at least some low- or middle-income countries. What are the right to health implications of GKE’s implementation? With the aim of answering this question, the eighteen University of Denver students in the First Year Seminar course I taught in autumn 2017 with the title “The Right to Health in Theory and Practice”, identified and researched the different aspects that would affect this issue, and produced the analysis we present in this report. Based on our analysis, the potential right to health implications of GKE are: First, the program may improve timely access to organ donation primarily to patients with health insurance in the United States. Second, a large-scale implementation of the program may have a positive impact on health costs savings, which potentially could benefit the United States health system. Third, on a global health level, the program relies on existing health inequalities among countries in terms of funding, human resources, and health system strengthening, and it is likely to exacerbate those inequalities. Fourth, the program has the potential of negatively affecting the efforts that low- and middle-income countries are already doing to address end-stage renal failure, including the improvement of their own organ donation systems. Finally, given what we have learned about the current situation of organ trafficking, it is easy to think that GKE would unintentionally end up being linked to chains of organ trade. The only way how a program like GKE could have a positive impact from a right to health perspective is if it establishes local partnerships that have the effect of decreasing health inequalities. Additionally, we identified some issues of concern that are beyond the level of influence of local authorities: the unmet demand of kidneys in high-income countries is a reality that incentivizes organ trade and transplant tourism, and this is a problem in need of solutions; transnational organ trafficking as well as human trafficking with the purpose of organ donation are problems that need more visibility; for a global exchange of organs to be implemented, it would need to rely on supranational or transnational regulation and oversight; and the global epidemic of chronic kidney disease needs to be addressed through a public health perspective that emphasizes prevention

Generation Times in Wild Chimpanzees and Gorillas Suggest Earlier Divergence Times in Great Ape and Human Evolution

Fossils and molecular data are two independent sources of information that should in principle provide consistent inferences of when evolutionary lineages diverged. Here we use an alternative approach to genetic inference of species split times in recent human and ape evolution that is independent of the fossil record. We first use genetic parentage information on a large number of wild chimpanzees and mountain gorillas to directly infer their average generation times. We then compare these generation time estimates with those of humans and apply recent estimates of the human mutation rate per generation to derive estimates of split times of great apes and humans that are independent of fossil calibration. We date the human–chimpanzee split to at least 7–8 million years and the population split between Neanderthals and modern humans to 400,000–800,000 y ago. This suggests that molecular divergence dates may not be in conflict with the attribution of 6- to 7-million-y-old fossils to the human lineage and 400,000-y-old fossils to the Neanderthal lineage.Human Evolutionary Biolog

Measuring reliable change in cognition using the Edinburgh Cognitive and Behavioural ALS Screen (ECAS)

doi:https://doi.org/10.1080/21678421.2017.1407794Background: Cognitive impairment affects approximately 50% of people with amyotrophic lateral sclerosis (ALS). Research has indicated that impairment may worsen with disease progression. The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was designed to measure neuropsychological functioning in ALS, with its alternate forms (ECAS-A, B, and C) allowing for serial assessment over time. Objective: The aim of the present study was to establish reliable change scores for the alternate forms of the ECAS, and to explore practice effects and test-retest reliability of the ECAS?s alternate forms. Method: Eighty healthy participants were recruited, with 57 completing two and 51 completing three assessments. Participants were administered alternate versions of the ECAS serially (A-B-C) at four-month intervals. Intra-class correlation analysis was employed to explore test-retest reliability, while analysis of variance was used to examine the presence of practice effects. Reliable change indices (RCI) and regression-based methods were utilized to establish change scores for the ECAS alternate forms. Results: Test-retest reliability was excellent for ALS Specific, ALS Non-Specific, and ECAS Total scores of the combined ECAS A, B, and C (all?>?.90). No significant practice effects were observed over the three testing sessions. RCI and regression-based methods produced similar change scores. Conclusion: The alternate forms of the ECAS possess excellent test-retest reliability in a healthy control sample, with no significant practice effects. The use of conservative RCI scores is recommended. Therefore, a change of ?8, ?4, and ?9 for ALS Specific, ALS Non-Specific, and ECAS Total score is required for reliable chang

Chimpanzees communicate to two different audiences during aggressive interactions

Conflict and aggressive interactions are common phenomena in group-living animals and vocal behaviour often plays an important role in determining their outcomes. In some species, vocal signals seem to provide bystanders with information about the nature of an ongoing aggressive interaction, which can be beneficial for the victims. For example, in chimpanzees and some other primates, victims adjust their screams depending on the composition of the by-standing audience, probably to solicit their support. Considerably less is known, however, about the role of other call types produced by victims of aggression. In this study, we focused on the fact that, immediately after screams, chimpanzee, Pan troglodytes schweinfurthii, victims often produce 'waa' barks, but little is known about their function. Our results showed that for screams, but not 'waa' barks, production was dependent on the audience composition with victims being more likely to scream when adult or late-adolescent males were in close proximity. We also found that after 'waa' barking, but not screaming, victims were more likely to retaliate against and less likely to reconcile with their aggressors, and that 'waa' barking was more common after victims had received support from other party members. These results suggest that, in chimpanzees, victims of aggression vocalize with a dual social strategy of attempting to recruit support from bystanders and to repel their attackers by signalling readiness to retaliate. We conclude that victim scream and 'waa' bark calls, although often produced during the same agonistic event, are directed at different audiences and fulfil different social functions, and that these calls can mediate both aggressive interactions and aggressor-victim relationships following aggression

St. John’s United Methodist Church

SC, Rock Hil

FOCUS on Corrymeela: Reflections on Northern Ireland

A panel presentation and discussion featuring 12 sophomores who participated in the spring break 2019 program in Ballycastle, Northern Ireland which was sponsored by the Cothran Center

Chimpanzee alarm call production meets key criteria for intentionality

BBSRC-funded, but difficult to identify the specific grant.Determining the intentionality of primate communication is critical to understanding the evolution of human language. Although intentional signalling has been claimed for some great ape gestural signals, comparable evidence is currently lacking for their vocal signals. We presented wild chimpanzees with a python model and found that two of three alarm call types exhibited characteristics previously used to argue for intentionality in gestural communication. These alarm calls were: (i) socially directed and given to the arrival of friends, (ii) associated with visual monitoring of the audience and gaze alternations, and (iii) goal directed, as calling only stopped when recipients were safe from the predator. Our results demonstrate that certain vocalisations of our closest living relatives qualify as intentional signals, in a directly comparable way to many great ape gestures. We conclude that our results undermine a central argument of gestural theories of language evolution and instead support a multimodal origin of human language.Publisher PDFPeer reviewe

Generation times in wild chimpanzees and gorillas suggest earlier divergence times in great ape and human evolution

Fossils and molecular data are two independent sources of information that should in principle provide consistent inferences of when evolutionary lineages diverged. Here we use an alternative approach to genetic inference of species split times in recent human and ape evolution that is independent of the fossil record. We first use genetic parentage information on a large number of wild chimpanzees and mountain gorillas to directly infer their average generation times. We then compare these generation time estimates with those of humans and apply recent estimates of the human mutation rate per generation to derive estimates of split times of great apes and humans that are independent of fossil calibration. We date the human–chimpanzee split to at least 7–8 million years and the population split between Neanderthals and modern humans to 400,000–800,000 y ago. This suggests that molecular divergence dates may not be in conflict with the attribution of 6- to 7-million-y-old fossils to the human lineage and 400,000-y-old fossils to the Neanderthal lineage