Stem Cell Research and Same Sex Reproduction

Recent advances in stem cell research suggest that in the future it may be possible to create eggs and sperm from human stem cells through a process that we term in vitro gametogenesis (IVG). IVG would allow treatment of some currently untreatable forms of infertility. It may also allow same-sex couples to have genetically-related children. For example, cells taken from one man could potentially be used to create an egg, which could then be fertilised using naturally produced sperm from another man to create a genetically-related child with half of its DNA from each of the men. In this chapter, we consider whether this technology could justifiably be denied to same-sex couples if it were made available as a fertility treatment to different-sex couples. We argue that it could not

Oneota Lithic Economy and Tool Function at the Schmeling Site (47JE833) in Southeastern Wisconsin

The perceived homogeneity of Oneota lithic assemblages has often provided a challenge for archaeologists to extrapolate broader conclusions about Oneota tool economies beyond their preference for speed and efficiency. Using standardized methods, lithic materials recovered from the 2006 and 2008 excavations at the Schmeling site (47JE833) are examined to determine if the lithic economy is indicative of day-to-day activity or reflects a particular cultural function like that of a mortuary precinct. The results of this analysis are then contrasted against the Crescent Bay Hunt Club site (47JE0904), Koshkonong Creek Village site (47JE0379), and the Carcajou Point site (47JE0002) to examine procurement, manufacturing strategies, and assemblage diversity across Oneota sites in southcentral Wisconsin

Accuracy of multiparametric magnetic resonance imaging to detect significant prostate cancer and index lesion location

Background: Multiparametric magnetic resonance imaging (mpMRI) of the prostate appears to improve prostate cancer detection, but studies comparing mpMRI to histopathology at the time of radical prostatectomy (RP) are lacking. This retrospective study determined the accuracy of mpMRI predicting Gleason score and index lesion location at the time of RP, the current gold standard for diagnosis. Methods: Between April 2013 and April 2016, a database of all men aged more than 40 years who underwent RP after positive transrectal ultrasound biopsy by an experienced urological surgeon was collated at a single regional centre. This was cross‐referenced with a database of all men who had mpMRIs performed at a single centre and reported according to Prostate Imaging Reporting and Data System (PI‐RADS version 1) during this period to generate a sample size of 64 men. A Spearman\u27s rho test was utilized to calculate correlation. Results: Median age of patients was 64 years, the median prostate‐specific antigen at RP was 6.22 ng/mL. mpMRI was positive (≥PI‐RADS 3) in 85.9% of patients who underwent RP. More than 92% of participants had Gleason ≥7 disease. A positive relationship between mpMRI prostate PI‐RADS score and RP cancer volume was demonstrated. An anatomical location correlation calculated in octants was found to be 89.1% accurate. Conclusion: mpMRI accurately detects prostate cancer location and severity when compared with gold standard histopathology at the time of RP. It thus has an important role in planning for future prostate biopsy and cancer treatment

A preliminary report on the awareness and knowledge of seafood-borne parasitic diseases among medical doctors in Australia

Despite the increasing popularity of seafood in Australia and various reports of infection with transmissible parasites in Australian edible aquatic animals such as fish, the number of reported cases of human infections in the country is low. This raised the question that Australian medical doctors may not be fully aware of the presence of these parasites in Australia, which in turn can lead to misdiagnosis of infections. This also may lead to an underestimation of the risk seafood-borne parasites may pose to public health. This preliminary study was conducted to determine the awareness and level of knowledge among Australian medical practitioners in New South Wales, the most populated and multicultural state in Australia, about seafood-borne parasitic diseases. Medical doctors, both general practitioners and gastroenterologists, were surveyed through an anonymous questionnaire (n = 376). Although the response rate was low at 11%, participants represented a diverse group in terms of gender, age, nationality and expertise. Despite several publications on occurrence of zoonotic parasites in Australian fish and other edible aquatic animals, and also in humans in the country, all respondents said no seafood-borne parasite had been reported as being seen within Australian or overseas practice. Although, due to low response rate, we are unable to confidently comment on the level of awareness, the findings of this study clearly suggest that further research is needed to investigate the extent of unawareness among Australian medical doctors about these highly important parasites and understanding the underlying issues in medical education that lead to the unawareness

What influences trainee decisions to practise in rural and regional Australia?

Although international medical graduates (IMGs) make up a substantial part of the Australian rural general practice workforce, most research on factors associated with rural practice has focused on Australian medical graduates (AMGs). This study aimed to determine whether there were differences between IMGs and AMGs in terms of these factors. Registrars in training and recent fellows (Fellowship of the Royal Australian College of General Practitioners/ Fellowship of the Australian College of Rural and Remote Medicine) who participated in training in rural and regional Australia were surveyed about practice models and rural practice. Almost two-thirds of participants were practicing or intending to practice in rural areas, with no difference between AMGs and IMGs. None of the variables associated with rural practice for AMGs was found to be associated with rural practice in IMGs in univariate binary regression analysis. Two key variables that are strongly associated with rural medical practice in the current literature, namely rural background and rural exposure, were not significant predictors of rural practice among IMGs. Due to the significant number of IMGs in regional training programs, any future incentives designed to improve rural recruitment and retention need to address factors relevant to IMGs

Improving the management and care of refugees in Australian hospitals: A descriptive study

Objectives: The aim of the study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals’ views regarding improvements that could be made in this area were also sought. Methods: Two page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site. Results: Response rates were 50% and 49% at the rural and urban sites respectively. Refugees were seen at least monthly by 40% of the respondents. Additional support was requested by 70% of respondents. Confidence was associated with being born overseas (p=0.029) and increased time working with refugees (rs=0.418, p\u3c0.001). Only 47% of respondents felt confident managing social and psychological needs of refugees. Midwives saw refugees more than nursing and allied healthcare staff combined and this was significant at the rural hospital (p\u3c0.001). Rural respondents reported that working with refugees enhanced their practice (p=0.025), although felt significantly less confident (p\u3c0.001) than urban respondents. Themes that arose regarding barriers to care included: language and cultural barriers, paucity of knowledge and issues accessing available services including appropriate interpreters, Medicare eligibility and patient factors including lack of patient trust in government systems. Desire for support was more pronounced in the rural setting (p=0.001). Conclusions: Refugees were seen frequently in both settings and most respondents requested additional support highlighting that caring for refugees in Australian hospitals is a significant challenge. Additional support and education should be targeted to those helping refugees most frequently, particularly midwifery services, to reduce barriers to care

The Effects Of Female Size On Fecundity In A Large Marine Gastropod Rapana Venosa (Muricidae)

The life history strategy of the veined rapa whelk Rapana venosa, a temperate marine gastropod, includes generation times of 1 y, individual longevity of \u3e 10 y, annual production of egg cases, and an adult size range of 40 to \u3e 160 mm shell length (SL). This life history combined with the animal\u27s generalist ecological preferences and broad physiological tolerances makes rapa whelks well suited for ecological success along a gradient of habitat and community types. Ballast water transport of veliger larvae across traditional zoogeographic boundaries has resulted in the establishment of invasive rapa whelk populations in Chesapeake Bay, USA, as well as European habitats. Although the need for a quantitative understanding of rapa whelk reproductive biology in terms of annual embryo production or fecundity is acknowledged as a necessary step in assessing the biological and ecological consequences of such an invasion, rapa whelk fecundity in relation to size for the entire adult size range (40-\u3e 160 mm SL) has not previously been quantified. The relationships between rapa whelk female size and egg case height, number of embryos egg case(-1), number of egg cases produced female whelk(-1) yr(-1) and fecundity, and the number of embryos female-(1) yr(-1), are described for a size range of individuals from Chesapeake Bay. In 2001 and 2003, egg laying began in mid to late May at water temperatures of approximately 18 degrees C and salinities 14-20 ppt and continued for 11-12 wk. The smallest rapa whelk observed (45 mm SL, 5.8 g wet tissue weight) laid egg cases with heights of approximately 7 mm. The largest whelk (163 mm SL, 220 g) laid egg cases with heights 30-33 mm. The number of embryos observed in egg cases produced by Chesapeake Bay rapa whelks ranged from 123 embryos in a 7.4 mm high egg case to 3,673 embryos in a 33.5 mm high egg case. Rapa whelk fecundity (number of embryos female(-1)yr(-1)) increased with female size. Egg case production was observed in rapa whelks that had hatched from egg cases and recruited within the previous year (\u3c 1 y old). Small (\u3c 80 mm SL, \u3c 28 g wet tissue weight) rapa whelks have relatively lower annual fecundities (1 x 10(5) embryos fernale(-1) yr(-1)) than large (\u3e 80 mm SL, \u3e 28 g wet tissue weight) rapa whelks that may produce between 1 x 10(6) and 4 x 10(6) embryos female(-1) yr(-1). Estimates of rapa whelk fecundity, even for small rapa whelks, are at least an order of magnitude greater than similar estimates for native United States Atlantic coast gastropods