Women as moral pioneers? Experiences of first trimester antenatal screening

Copyright @ 2005 Elsevier Ltd.The implementation of innovative medical technologies can raise unprecedented ethical, legal and social dilemmas. This is particularly so in the area of antenatal screening, which is dominated by the language of risk and probabilities. Second trimester serum screening for Down's syndrome and neural tube defects has a well-established place in antenatal care. Increasingly, first trimester screening with biochemical and ultrasound markers is being proposed as advance on this, yielding higher detection rates of Down's syndrome at an earlier gestational age. This article explores the experiences of 14 women offered innovative first trimester screening, which takes place within the context of a detailed ultrasound scan. The study is set within the UK, where recent policy changes mean that the offer of screening for fetal anomalies, particularly Down's syndrome, will become a routine part of antenatal care and offered to all pregnant women. This paper focuses on the significance of the scan in first trimester screening, and some of the potential dilemmas for women that can result from this. It then discusses the ways in which women made their decisions about screening, in particular, their work as ‘moral pioneers’. We found that the part played by the ultrasound scan in first trimester screening, particularly in relation to the higher-quality images now being obtained, has the potential to introduce new and novel ethical dilemmas for pregnant women. Although concerns have been raised about pregnant women viewing ultrasound scans as benign, many of the women reported having thought carefully through their own moral beliefs and values prior to screening. It seems that whatever other implications they may have, first trimester screening technologies will continue the tradition of pregnant women acting as ‘moral pioneers’ in increasingly complex settings.ESRC/MRC Innovative Health Technologies Programme for funding the project (grant no: L218252042). CW acknowledges the support of The Wellcome Trust Biomedical Ethics Programme in funding her postdoctoral fellowship, which enabled her to work on this project

Modeling the effect of variation in sagittal curvature on the force required to produce a follower load in the lumbar spine

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How far from here is home : space and silence in creative practice

University of Technology, Sydney. Faculty of Humanities and Social Sciences.“Captain Starlight’s Apprentice” is a novel about home, displacement and longing. Beginning as a novel about a woman bushranger, Jessie Hickman, the novel is historical in setting without being categorisable as an historical novel. At the centre of the novel is a connection between two characters across time. Part Two of this thesis, “How Far From Here is Home”, is a series of journalistic pieces using a mix of memoir, op-ed and reportage, which as a whole form a study of the processes of writing fiction. In particular, these essays consider the necessity for silence and solitude in the making of an emotionally authentic creative work. As the title suggests, “How Far From Here is Home”, is concerned with the importance of home, and displacement, in literature, and in particular in “Captain Starlight’s Apprentice”

Center of mass and relative motion in time dependent density functional theory

It is shown that the exchange-correlation part of the action functional $A_{xc}[\rho (\vec r,t)]$ in time-dependent density functional theory , where $\rho (\vec r,t)$ is the time-dependent density, is invariant under the transformation to an accelerated frame of reference $\rho (\vec r,t) \to \rho ' (\vec r,t) = \rho (\vec r + \vec x (t),t)$, where $\vec x (t)$ is an arbitrary function of time. This invariance implies that the exchange-correlation potential in the Kohn-Sham equation transforms in the following manner: $V_{xc}[\rho '; \vec r, t] = V_{xc}[\rho; \vec r + \vec x (t),t]$. Some of the approximate formulas that have been proposed for $V_{xc}$ satisfy this exact transformation property, others do not. Those which transform in the correct manner automatically satisfy the ``harmonic potential theorem", i.e. the separation of the center of mass motion for a system of interacting particles in the presence of a harmonic external potential. A general method to generate functionals which possess the correct symmetry is proposed

Method and apparatus for thermographically and quantitatively analyzing a structure for disbonds and/or inclusions

A heat source such as a magnetic induction/eddy current generator remotely heats a region of a surface of a test structure to a desired depth. For example, the frequency of the heating source can be varied to heat to the desired depth. A thermal sensor senses temperature changes in the heated region as a function of time. A computer compares these sensed temperature changes with calibration standards of a similar sample having known disbond and/or inclusion geography(ies) to analyze the test structure. A plurality of sensors can be arranged linearly to sense vector heat flow

Experimental philosophy leading to a small scale digital data base of the conterminous United States for designing experiments with remotely sensed data

Research using satellite remotely sensed data, even within any single scientific discipline, often lacked a unifying principle or strategy with which to plan or integrate studies conducted over an area so large that exhaustive examination is infeasible, e.g., the U.S.A. However, such a series of studies would seem to be at the heart of what makes satellite remote sensing unique, that is the ability to select for study from among remotely sensed data sets distributed widely over the U.S., over time, where the resources do not exist to examine all of them. Using this philosophical underpinning and the concept of a unifying principle, an operational procedure for developing a sampling strategy and formal testable hypotheses was constructed. The procedure is applicable across disciplines, when the investigator restates the research question in symbolic form, i.e., quantifies it. The procedure is set within the statistical framework of general linear models. The dependent variable is any arbitrary function of remotely sensed data and the independent variables are values or levels of factors which represent regional climatic conditions and/or properties of the Earth's surface. These factors are operationally defined as maps from the U.S. National Atlas (U.S.G.S., 1970). Eighty-five maps from the National Atlas, representing climatic and surface attributes, were automated by point counting at an effective resolution of one observation every 17.6 km (11 miles) yielding 22,505 observations per map. The maps were registered to one another in a two step procedure producing a coarse, then fine scale registration. After registration, the maps were iteratively checked for errors using manual and automated procedures. The error free maps were annotated with identification and legend information and then stored as card images, one map to a file. A sampling design will be accomplished through a regionalization analysis of the National Atlas data base (presently being conducted). From this analysis a map of homogeneous regions of the U.S.A. will be created and samples (LANDSAT scenes) assigned by region

Long-term results of NOPHO ALL-92 and ALL-2000 studies of childhood acute lymphoblastic leukemia

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldAnalysis of 2668 children with acute lymphoblastic leukemia (ALL) treated in two successive Nordic clinical trials (Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000) showed that 75% of all patients are cured by first-line therapy, and 83% are long-term survivors. Improvements in systemic and intrathecal chemotherapy have reduced the use of central nervous system (CNS) irradiation to <10% of the patients and provided a 5-year risk of isolated CNS relapse of 2.6%. Improved risk stratification and chemotherapy have eliminated the previous independent prognostic significance of gender, CNS leukemia and translocation t(1;19)(q23;p13), whereas the post-induction level of minimal residual disease (MRD) has emerged as a new risk grouping feature. Infant leukemia, high leukocyte count, T-lineage immunophenotype, translocation t(4;11)(q21;q23) and hypodiploidy persist to be associated with lower cure rates. To reduce the overall toxicity of the treatment, including the risk of therapy-related second malignant neoplasms, the current NOPHO ALL-2008 protocol does not include CNS irradiation in first remission, the dose of 6-mercaptopurine is reduced for patients with low thiopurine methyltransferase activity, and the protocol restricts the use of hematopoietic stem cell transplantation in first remission to patients without morphological remission after induction therapy or with high levels of MRD after 3 months of therapy

Schoolchildren’s transitive reasoning with the spatial relation ‘is left/right of’

We examine schoolchildren’s reasoning with spatial relations, such as ‘is to the left of’. Our aims are to obtain a more precise account of the effect of working memory on reasoning, a more detailed understanding of the internal representation of mental models and a developmental perspective. We discuss two experiments in which 348 children, between eight and twelve years old, needed to verify conclusions for 24 reasoning problems describing the spatial relations between pieces of clothing. In both experiments, children in the experimental condition were allowed to take notes by means of paper and pencil. We find that the participants spontaneously draw iconic representations of the items’ spatial ordering, have a strong preference for only considering one possible state of affairs even when more are relevant, and that an explanation in terms of working memory capacity alone cannot fully explain the data.Multivariate analysis of psychological dat