Pathways to Parenthood: Regulating Assisted Reproductive Technologies in the United States

According to the Centers for Disease Control, approximately 10.8 percent of women and 7.5 percent of men in the United States have sought infertility treatment. With advances in medical technology, treatment options range from drug therapy, to in vitro fertilization, to surrogate parenthood. These new technologies - often referred to as assisted reproductive technologies (ART) - have provided infertile couples with new options for becoming parents. They have also opened the door for non-traditional families to be formed, allowing single women and same-sex couples the opportunities to enter parenthood. While ART appears to present a solution to the heartache of infertility, it also evokes debates about women's rights, gay parenting, and eugenics. Thus, debate over the use of assisted reproductive technologies places itself at the intersection of our greatest hopes and biggest fears. More than half of the states have some form of regulation of ART, and these policies vary in scope and influence. This dissertation amasses a comprehensive set of data on state regulation of reproductive technologies and addresses three objectives. The first objective is to understand the ways in which states have attempted to regulate the use of ART. These forms of regulation include banning or restricting contracts with surrogate mothers, limiting who can become a surrogate, determining the legal parentage of children conceived using these technologies, regulating the disposition of excess embryos, and preventing single women from using ART. The second objective is to understand why states are passing such legislation and why there is such variation in state regulation. The final objective is to assess the impact of these regulations on access to fertility treatments in a state. The findings in this analysis show that states have approached the regulation of ART in a variety of ways. Some states have created permissive ART environments with their various legislative and judicial outputs, and some have created restrictive environments. The results suggest that most state regulation does not have a significant impact on the availability of ART options within a state. The results do show, however, that states' efforts to increase access through insurance mandates have increased fertility treatment options

Giving Girls a Shot: An Examination of State Policies Addressing the HPV Vaccination

On June 8, 2006, the FDA approved the vaccine Gardisil, which protects women from the Human Papilloma Virus (HPV) that is linked to 99 percent of all cervical cancers. Immediately, forty-one state legislatures began entertaining initiatives that would make the vaccine mandatory for all fifth and sixth grade girls in public schools. HPV suddenly went from a non-issue to one that catapulted itself onto the public and political agenda. The vaccine's producer, Merck & Co., encouraged this flurry of activity through its marketing and lobbying efforts. This project seeks to understand the agenda setting and policy adoption processes associated with the HPV vaccine. The results indicate that despite the millions of dollars spent promoting its vaccine, Merck's attempts to influence policy actually decreased the likelihood of policy adoption

Reducing epilepsy diagnostic and treatment gaps:Standardized paediatric epilepsy training courses for health care professionals

Aim: To evaluate improvement in knowledge and clinical behaviour among healthcare professionals after attendance at paediatric epilepsy training (PET) courses.Method: Since 2005, 1-day PET courses have taught evidence-based paediatric epilepsy management to doctors and nurses in low-, middle-, and high-income countries. A cohort study was performed of 7528 participants attending 252 1-day PET courses between 2005 and 2020 in 17 low-, middle-, and high-income countries, and which gathered data from participants immediately after the course and then 6 months later. Training outcomes were measured prospectively in three domains (reaction, learning, and behaviour) using a mixed-methods approach involving a feedback questionnaire, a knowledge quiz before and after the course, and a 6-month survey.Results: Ninety-eight per cent (7217 of 7395) of participants rated the course as excellent or good. Participants demonstrated knowledge gain, answering a significantly higher proportion of questions correctly after the course compared to before the course (88% [47 883 of 54 196], correct answers/all quiz answers, vs 75% [40 424 of 54 196]; p &lt; 0.001). Most survey responders reported that the course had improved their epilepsy diagnosis and management (73% [311 of 425]), clinical service (68% [290 of 427]), and local epilepsy training (68% [290 of 427]).Interpretation: This was the largest evaluation of a global epilepsy training course. Participants reported high course satisfaction, showed knowledge gain, and described improvements in clinical behaviour 6 months later. PET supports the global reduction in the epilepsy 'treatment gap' as promoted by the World Health Organization.</p

MENOS4 trial: a multicentre randomised controlled trial (RCT) of a breast care nurse delivered cognitive behavioural therapy (CBT) intervention to reduce the impact of hot flushes in women with breast cancer: Study Protocol

BACKGROUND: Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer.METHODS: This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed.DISCUSSION: There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively help women with hot flushes and whether and how it can be translated into routine clinical practice.TRIAL REGISTRATION: ISRCTN 12824632 . Registered 25-01-2017.</p

Incorporação de resíduos cerâmicos vidrados em argamassas bastardas: estudo de propriedades físicas e mecânicas

Dissertação de Natureza Científica para obtenção do grau de Mestre em Engenharia Civil Perfil de EdificaçõesA conservação do património edificado constitui no presente, a memória de uma civilização. O conhecimento da composição e comportamento dos revestimentos antigos é importante para garantir a conservação do património edificado através das intervenções de conservação e reabilitação. A presente dissertação tem como objetivo o estudo do desempenho de argamassas bastardas de cal aérea e cimento com substituição de cal aérea por resíduo cerâmico vidrado. As argamassas formuladas foram sujeitas a cura laboratorial. Realizou-se a caracterização física, e mecânica de modo a avaliar o seu desempenho ao longo do tempo. O sector da construção pauta a sua atividade por elevados impactos ambientais ao nível da extração de elevadas quantidades de matérias-primas não renováveis, de elevados consumos energéticos e das consequentes e elevadas emissões de gases responsáveis por efeito de estufa. Além dos enormes excedentes que provem da indústria que normalmente seguem para aterro. De forma a aproveitar esses excedentes de algumas indústrias, nomeadamente da cerâmica procedeu-se à transformação de produtos excedentes em resíduo, de forma a ser possível a sua incorporação argamassas, uma vez que na antiguidade, no império romano já se efetuava esta incorporação. A produção de cimento tem elevados impactos ambientais, deste modo a redução da sua utilização através da incorporação de outros ligantes de natureza natural (cal aérea) e a possível substituição desses recursos naturais por excedentes irá aumentar a sustentabilidade do sector.In the present, the conservation of the built heritage constitutes the memory of a civilization. The knowledge of composition and performance of the old coverings is crucial to ensure the preservation of the built heritage through intervention of conservation and rehabilitation. This thesis aims to study the performance of aerial lime based mortars and cement with replacement of the aerial lime with glazed ceramic waste. The bastard mortars have characteristics well-suited for these functions, once incorporates the best features of air lime and cement. The construction sector bases its activity by high environmental impacts, because of the extraction of non-renewable raw material, high energy consumption and high emission of gases responsible for the greenhouse effect. In addition to huge surpluses that comes from the industry and that usually goes to landfill. In order to take advantage of the surpluses in some industries, including ceramics, it was proceeded the transformation of surpluses in residue. In this way was possible to incorporate the residues in mortars, as the Roman Empire in ancient time proceeded. The production of cement has high environmental impacts, thereby reducing their use by incorporating other ligands with natural source (air lime) and the possible replacement of these natural resources by surpluses will increase the sustainability of the sector. The incorporation of residues leads to the study of new mortars formulations. The formulated mortars were subject to a process of laboratory cure. It was reported over time, the performance, the physical and mechanical characterization of the mortars. In the properties studied was recorded a good performance of the mortars, due to the placement of the ceramic powder

Think Outside the Color Box: Probabilistic Target Selection and the SDSS-XDQSO Quasar Targeting Catalog

We present the SDSS-XDQSO quasar targeting catalog for efficient flux-based quasar target selection down to the faint limit of the Sloan Digital Sky Survey (SDSS) catalog, even at medium redshifts (2.5 <~ z <~ 3) where the stellar contamination is significant. We build models of the distributions of stars and quasars in flux space down to the flux limit by applying the extreme-deconvolution method to estimate the underlying density. We convolve this density with the flux uncertainties when evaluating the probability that an object is a quasar. This approach results in a targeting algorithm that is more principled, more efficient, and faster than other similar methods. We apply the algorithm to derive low-redshift (z < 2.2), medium-redshift (2.2 <= z 3.5) quasar probabilities for all 160,904,060 point sources with dereddened i-band magnitude between 17.75 and 22.45 mag in the 14,555 deg^2 of imaging from SDSS Data Release 8. The catalog can be used to define a uniformly selected and efficient low- or medium-redshift quasar survey, such as that needed for the SDSS-III's Baryon Oscillation Spectroscopic Survey project. We show that the XDQSO technique performs as well as the current best photometric quasar-selection technique at low redshift, and outperforms all other flux-based methods for selecting the medium-redshift quasars of our primary interest. We make code to reproduce the XDQSO quasar target selection publicly available

Preparation, structural characterisation and antibacterial properties of Ga-doped sol-gel phosphate-based glass

A sol-gel preparation of Ga-doped phosphate-based glass with potential application in antimicrobial devices has been developed. Samples of composition (CaO)(0.30)(Na2O)(0.20-x) (Ga2O3) (x) (P2O5)(0.50) where x = 0 and 0.03 were prepared, and the structure and properties of the gallium-doped sample compared with those of the sample containing no gallium. Analysis of the P-31 MAS NMR data demonstrated that addition of gallium to the sol-gel reaction increases the connectivity of the phosphate network at the expense of hydroxyl groups. This premise is supported by the results of the elemental analysis, which showed that the gallium-free sample contains significantly more hydrogen and by FTIR spectroscopy, which revealed a higher concentration of -OH groups in that sample. Ga K-edge extended X-ray absorption fine structure and X-ray absorption near-edge structure data revealed that the gallium ions are coordinated by six oxygen atoms. In agreement with the X-ray absorption data, the high-energy XRD results also suggest that the Ga3+ ions are octahedrally coordinated with respect to oxygen. Antimicrobial studies demonstrated that the sample containing Ga3+ ions had significant activity against Staphylococcus aureus compared to the control

The SDSS-III Baryon Oscillation Spectroscopic Survey: Quasar Target Selection for Data Release Nine

The SDSS-III Baryon Oscillation Spectroscopic Survey (BOSS), a five-year spectroscopic survey of 10,000 deg^2, achieved first light in late 2009. One of the key goals of BOSS is to measure the signature of baryon acoustic oscillations in the distribution of Ly-alpha absorption from the spectra of a sample of ~150,000 z>2.2 quasars. Along with measuring the angular diameter distance at z\approx2.5, BOSS will provide the first direct measurement of the expansion rate of the Universe at z > 2. One of the biggest challenges in achieving this goal is an efficient target selection algorithm for quasars over 2.2 < z < 3.5, where their colors overlap those of stars. During the first year of the BOSS survey, quasar target selection methods were developed and tested to meet the requirement of delivering at least 15 quasars deg^-2 in this redshift range, out of 40 targets deg^-2. To achieve these surface densities, the magnitude limit of the quasar targets was set at g <= 22.0 or r<=21.85. While detection of the BAO signature in the Ly-alpha absorption in quasar spectra does not require a uniform target selection, many other astrophysical studies do. We therefore defined a uniformly-selected subsample of 20 targets deg^-2, for which the selection efficiency is just over 50%. This "CORE" subsample will be fixed for Years Two through Five of the survey. In this paper we describe the evolution and implementation of the BOSS quasar target selection algorithms during the first two years of BOSS operations. We analyze the spectra obtained during the first year. 11,263 new z>2.2 quasars were spectroscopically confirmed by BOSS. Our current algorithms select an average of 15 z > 2.2 quasars deg^-2 from 40 targets deg^-2 using single-epoch SDSS imaging. Multi-epoch optical data and data at other wavelengths can further improve the efficiency and completeness of BOSS quasar target selection. [Abridged]Comment: 33 pages, 26 figures, 12 tables and a whole bunch of quasars. Submitted to Ap

Beyond Gross-Pitaevskii Mean Field Theory

A large number of effects related to the phenomenon of Bose-Einstein Condensation (BEC) can be understood in terms of lowest order mean field theory, whereby the entire system is assumed to be condensed, with thermal and quantum fluctuations completely ignored. Such a treatment leads to the Gross-Pitaevskii Equation (GPE) used extensively throughout this book. Although this theory works remarkably well for a broad range of experimental parameters, a more complete treatment is required for understanding various experiments, including experiments with solitons and vortices. Such treatments should include the dynamical coupling of the condensate to the thermal cloud, the effect of dimensionality, the role of quantum fluctuations, and should also describe the critical regime, including the process of condensate formation. The aim of this Chapter is to give a brief but insightful overview of various recent theories, which extend beyond the GPE. To keep the discussion brief, only the main notions and conclusions will be presented. This Chapter generalizes the presentation of Chapter 1, by explicitly maintaining fluctuations around the condensate order parameter. While the theoretical arguments outlined here are generic, the emphasis is on approaches suitable for describing single weakly-interacting atomic Bose gases in harmonic traps. Interesting effects arising when condensates are trapped in double-well potentials and optical lattices, as well as the cases of spinor condensates, and atomic-molecular coupling, along with the modified or alternative theories needed to describe them, will not be covered here.Comment: Review Article (19 Pages) - To appear in 'Emergent Nonlinear Phenomena in Bose-Einstein Condensates: Theory and Experiment', Edited by P.G. Kevrekidis, D.J. Frantzeskakis and R. Carretero-Gonzalez (Springer Verlag