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

Medida de la humedad en el hormigón

Not availablePara medir el contenido de humedad del hormigón se conocen varios métodos, además del procedimiento gravimétrico, los cuales difieren unos de otros tanto en lo que se refiere a su exactitud como a su viabilidad. Dentro de un programa de investigaciones, los autores han tenido que resolver el problema de la realización de medidas de larga duración en elementos de hormigón de grandes dimensiones. Con el fin de obtener una visión de conjuntó sobre las experiencias adquiridas por la aplicación de los diferentes métodos, se ha remitido un cuestionario a un cierto número de institutos y con el aval del RILEM. En el presente trabajo se hace un análisis de las contestaciones recibidas. Del estudio de estas respuestas y teniendo en cuenta la literatura sobre el tema, de la cual se da aquí una amplia referencia, se llega a la conclusión de que todavía no se dispone de un método universal para la medida del contenido de humedad

Medidas de porosidad en mortero de cemento y en hormigón

Not availableLa porosidad del hormigón, en la que, por una parte influye, el valor agua/cemento (valor a/c) dado previamente, y por otra, está sometida a variaciones según crece la edad del hormigón (1), es de importancia decisiva para el desarrollo de sus propiedades tecnológicas. Las modificaciones de la estructura de los poros pueden intervenir para definir el progreso de la madurez, que se caracteriza por la hidrólisis, hidratación y disposición. Objeto de los análisis efectuados en el Instituto del Vidrio, Cerámica y Aglomerantes de la Universidad Técnica de Berlín y del Centro Federal para Comprobación de Materiales (BAM) de Berlín, fueron las mediciones de porosidad en el mortero de cemento y hormigón en función del valor a/c y la edad

Intrinsic Photoconductivity of Ultracold Fermions in Optical Lattices

We report on the experimental observation of an analog to a persistent alternating photocurrent in an ultracold gas of fermionic atoms in an optical lattice. The dynamics is induced and sustained by an external harmonic confinement. While particles in the excited band exhibit long-lived oscillations with a momentum dependent frequency a strikingly different behavior is observed for holes in the lowest band. An initial fast collapse is followed by subsequent periodic revivals. Both observations are fully explained by mapping the system onto a nonlinear pendulum.Comment: 5+7 pages, 4+4 figure

Macroergonomic factors in the patient work system: examining the context of patients with chronic illness

Human factors/ergonomics recognises work as embedded in and shaped by levels of social, physical and organisational context. This study investigates the contextual or macroergonomic factors present in the health-related work performed by patients. We performed a secondary content analysis of findings from three studies of the work of chronically ill patients and their informal caregivers. Our resulting consolidated macroergonomic patient work system model identified 17 factors across physical, social and organisational domains and household and community levels. These factors are illustrated with examples from the three studies and discussed as having positive, negative or varying effects on health and health behaviour. We present three brief case studies to illustrate how macroergonomic factors combine across domains and levels to shape performance in expected and unexpected ways. Findings demonstrate not only the importance of context for patients\u27 health-related activities but also specific factors to consider in future research, design and policy efforts. Practitioner Summary: Health-related activities of patients are embedded in and shaped by levels of social, physical and organisational context. This paper combined findings from three studies to specify 17 contextual or macroergonomic factors in home-and community-based work systems of chronically ill patients. These factors have research, design and policy implications

Data collection challenges in community settings: Insights from two field studies of patients with chronic disease

Purpose Collecting information about health and disease directly from patients can be fruitfully accomplished using contextual approaches, ones that combine more and less structured methods in home and community settings. This paper's purpose is to describe and illustrate a framework of the challenges of contextual data collection. Methods A framework is presented based on prior work in community-based participatory research and organizational science, comprised of ten types of challenges across four broader categories. Illustrations of challenges and suggestions for addressing them are drawn from two mixed-method, contextual studies of patients with chronic disease in two regions of the US. Results The first major category of challenges was concerned with the researcher-participant partnership, for example, the initial lack of mutual trust and understanding between researchers, patients, and family members. The second category concerned patient characteristics such as cognitive limitations and a busy personal schedule that created barriers to successful data collection. The third concerned research logistics and procedures such as recruitment, travel distances, and compensation. The fourth concerned scientific quality and interpretation, including issues of validity, reliability, and combining data from multiple sources. The two illustrative studies faced both common and diverse research challenges and used many different strategies to address them. Conclusion Collecting less structured data from patients and others in the community is potentially very productive but requires the anticipation, avoidance, or negotiation of various challenges. Future work is necessary to better understand these challenges across different methods and settings, as well as to test and identify strategies to address them

Multi-Locus Phylogenetic Analyses of the Almadablennius Clade Reveals Inconsistencies with the Present Taxonomy of Blenniid Fishes

We used a multi-locus phylogenetic approach (i.e., combining both mitochondrial and nuclear DNA fragments) to address some long-standing taxonomic inconsistencies within the diverse fish clade of Combtooth Blennies (Blenniidae—unranked clade Almadablennius). The obtained phylogenetic trees revealed some major inconsistencies in the current taxonomy of Parablennini, such as the paraphyletic status of the Salaria and Parablennius genera, casting some doubt regarding their actual phylogenetic relationship. Furthermore, a scarce-to-absent genetic differentiation was observed among the three species belonging to the genus Chasmodes. This study provides an updated taxonomy and phylogeny of the former genus Salaria, ascribing some species to the new genus Salariopsis gen. nov., and emphasizes the need for a revision of the genus Parablennius

Blocking soluble Fas Ligand ameliorates pemphigus: PC111 efficacy in ex-vivo human pemphigus models

: Pemphigus is a life-threatening, chronic, autoimmune bullous disease affecting both the skin and the mucous membranes. Based on the mainstream concept that blister formation occurs upon binding of autoantibodies to their antigen proteins (desmoglein1, DSG1 and desmoglein3, DSG3), current therapies mostly aim to suppress the immune system. To avoid the severe side effects associated with the chronic use of immunosuppressive treatments, we have developed PC111, a fully human monoclonal antibody targeting human Fas ligand (FasL). We have provided a number of in vitro and in vivo evidences showing that soluble FasL induces keratinocyte apoptosis followed by acantholysis. An anti-murine FasL prevents blister formation in the pemphigus neonatal mouse model. To confirm the mechanism of action (MoA) and the efficacy of PC111 in a human pemphigus context, we used the keratinocyte dissociation assay and two independent Human Skin Organ Cultures (HSOC) pemphigus models. PC111 reduced acantholysis in vitro, as shown by the dose-dependent reduction of fragments in the monolayer cultures. In the first HSOC model, normal human skin was subcutaneously injected with a scFv antibody fragment directed against DSG1 and DSG3, resulting in a severe acantholysis (70-100%) after 24 hours. PC111 inhibited blister formation to around 50% of control. In the second model, normal human skin was injected with a mixture of pemphigus patients' autoantibodies resulting in a less severe acantholysis (20-30%). PC111 significantly suppressed blister formation to more than 75% up to 72 hours. These results confirm PC111 MoA and demonstrates the efficacy of the anti-FasL antibody also in a pemphigus setting

Alignment dependent chemisorption of vibrationally excited CH4(ν3) on Ni(100), Ni(110), and Ni(111)

International audienceWe present a stereodynamics study of the dissociative chemisorption of vibrationally excited methane on the (100), (110), and (111) planes of a nickel single crystal surface. Using linearly polarized infrared excitation of the antisymmetric C-H stretch normal mode vibration (ν3), we aligned the angular momentum and C-H stretch amplitude of CH4(ν3) in the laboratory frame and measured the alignment dependence of state-resolved reactivity of CH4 for the ν3 = 1, J = 0-3 quantum states over a range of incident translational energies. For all three surfaces studied, in-plane alignment of the C-H stretch results in the highest dissociation probability and alignment along the surface normal in the lowest reactivity. The largest alignment contrast between the maximum and minimum reactivity is observed for Ni(110), which has its surface atoms arranged in close-packed rows separated by one layer deep troughs. For Ni(110), we also probed for alignment effects relative to the direction of the Ni rows. In-plane C-H stretch alignment perpendicular to the surface rows results in higher reactivity than parallel to the surface rows. The alignment effects on Ni(110) and Ni(100) are independent of incident translational energy between 10 and 50 kJ/mol. Quantum state-resolved reaction probabilities are reported for CH4(ν3) on Ni(110) for translational energies between 10 and 50 kJ/mol