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A comprehensive, accessible approach to the everyday ethical challenges faced in obstetric and gynecological practice. Offering practical guidance for practitioners at all levels, the text also provides a sustained exploration of professional ethics in the intersection of obstetrics and gynecology with psychiatry. Drawing on their award-winning teaching, the authors start each chapter with goals, objectives, topics, and a list of key concepts, which are defined in a separate section. Chapters cover a multitude of topics, from pregnancy and the quest for the 'perfect' baby to end-of-life care - all underpinned by the need for professionally responsible research, advocacy, and health policy. Professional Ethics in Obstetrics and Gynecology is an indispensable resource for both trainee and practicing obstetricians and gynecologists. A chapter devoted solely to pedagogy in professional ethics in obstetrics and gynecology supports the readers' learning and those with or without formal training in ethics to teach students, residents, and colleagues.
Mary has new kinds of experiences when she leaves the black and white room. The change is akin to the difference between seeing black and white films and seeing films in colour. That much is common ground in the debate over the knowledge argument. This suggests that an ultimately satisfying reply to the argument on behalf of physicalism should base itself on a plausible view about the nature of the experiences she has for the first time on leaving the black and white room. It is, after all, the nature of these experiences that lies at the heart of the argument’s intuitive appeal. In this chapter, I offer an account of colour experiences and explain how it tells us physicalists what is wrong with the knowledge argument.
In the ambitious strategy of Greenland to attract foreign companies to engage in extractive industries as a means to create increased national independence the question of minerals emerges as pivotal. The article investigates how two prominent Greenlandic premiers (2009–2014) translated hard rock into soft human welfare in a complex post-colonial context. The article develops the concept of “brokers of hope” which points the analytical attention to the entrepreneurial activities of future- and people-makers in a dense field of indigenous politics. By linking this concept to the idea of “resource materialities” it becomes possible to see resources as relational assemblages that are in a constant state of becoming and also to examine how different engagements with substances can make certain political struggles and political systems legitimate. Furthermore, the article investigates how these “brokers of hope” use the Chinese interests, and ideas of new cooperation with Chinese partners to underpin the intrinsic motivation to create new beginnings and thus to transform existing asymmetrical relations between Denmark and Greenland. This process is conceptualised as “double orientalism”. The article points out how hope and promise in two quite different ways are creatively used to make the future work in the present and how people and nations are made up in that process.
This concluding chapter reflects on the contributions in this volume in light of Dan S. Lev’s work on legal evolution and political change. Munger highlights Lev’s admirable lifetime of academic-activism on Indonesian law. It is this mix of academic scholarship and practical advocacy that informs the chapters in this volume and orients the chapters towards Lev’s work as an example of scholarship infused with activism.
The German Twin Family Panel (TwinLife) is a German longitudinal study of monozygotic and dizygotic same-sex twin pairs and their families that was designed to investigate the development of social inequalities over the life course. The study covers an observation period from approximately 2014 to 2023. The target population of the sample are reared-together twins of four different age cohorts that were born in 2009/2010 (cohort 1), in 2003/2004 (cohort 2), in 1997/1998 (cohort 3) and between 1990 and 1993 (cohort 4). In the first wave, the study included data on 4097 twin families. Families were recruited in all parts of Germany so that the sample comprises the whole range of the educational, occupational and income structure. As of 2019, two face-to-face, at-home interviews and two telephone interviews have been conducted. Data from the first home and telephone interviews are already available free of charge as a scientific use-file from the GESIS data archive. This report aims to provide an overview of the study sample and design as well as constructs that are unique in TwinLife in comparison with previous twin studies — such as an assessment of cognitive abilities or information based on the children’s medical records and report cards. In addition, major findings based on the data already released are displayed, and future directions of the study are presented and discussed.
Childhood disruptive behaviors are highly prevalent and associated with adverse long-term social and economic outcomes. Trajectories of welfare receipt in early adulthood and the association of childhood behaviors with high welfare receipt trajectories have not been examined.
Boys (n = 1000) from low socioeconomic backgrounds were assessed by kindergarten teachers for inattention, hyperactivity, aggression, opposition, and prosociality, and prospectively followed up for 30 years. We used group-base trajectory modeling to estimate trajectories of welfare receipt from age 19–36 years using government tax return records, then examined the association between teacher-rated behaviors and trajectory group membership using mixed effects multinomial regression models.
Three trajectories of welfare receipt were identified: low (70.8%), declining (19.9%), and chronic (9.3%). The mean annual personal employment earnings (US$) for the three groups at age 35/36 years was $36 500 (s.d. = $24 000), $15 600 (s.d. = $16 275), and $1700 (s.d. = $4800), respectively. Relative to the low welfare receipt group, a unit increase in inattention (mean = 2.64; s.d. = 2.32, range = 0–8) at age 6 was associated with an increased risk of being in the chronic group (relative risk ratio; RRR = 1.16, 95% CI 1.03–1.31) and in the declining group (RRR = 1.13, 95% CI 1.03–1.23), after adjustment for child IQ and family adversity, and independent of other behaviors. Family adversity was more strongly associated with trajectories of welfare receipt than any behavior.
Boys from disadvantaged backgrounds exhibiting high inattention in kindergarten are at elevated risk of chronic welfare receipt during adulthood. Screening and support for inattentive behaviors beginning in kindergarten could have long-term social and economic benefits for individuals and society.
The Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill, originally introduced by Tim Loughton MP as a private Member's bill in the Commons, received Royal Assent on 26 March and came into force two months after it was passed. Section 1 empowers the Secretary of State to amend by regulations the Marriage Act 1949 to provide for a central register of marriages in England and Wales ‘which is accessible in electronic form’. Section 2 requires the Secretary of State to amend the Civil Partnership Act 2004 so that opposite-sex couples become eligible to form a civil partnership in England and Wales – and the amending regulations must be in force no later than 31 December 2019. Section 3 requires the Secretary of State to report on whether the law should be changed to allow the registration of pregnancy losses which cannot be registered as stillbirths under the Births and Deaths Registration Act 1953 and section 4 requires the Secretary of State to make arrangements for the preparation of a report on whether, and if so how, the law should be changed to enable or require coroners to investigate stillbirths.
For over a decade a transdiagnostic clinical staging framework for youth with anxiety, mood and psychotic disorders (linked with measurement of multidimensional outcomes), has been utilised in over 8,000 young people presenting to the enhanced primary (headspace) and secondary care clinics of the Brain and Mind Centre of the University of Sydney. This framework has been evaluated alongside a broad range of other clinical, neurobiological, neuropsychological, brain imaging, circadian, metabolic, longitudinal cohort and controlled intervention studies. This has led to specific tests of its concurrent, discriminant and predictive validity. These extensive data provide strong preliminary evidence that: i) varying stages of illness are associated with predicted differences in a range of independent and objectively measured neuropsychological and other biomarkers (both cross-sectionally and longitudinally); and, ii) that earlier stages of illness progress at variable rates to later and more severe or persistent disorders. Importantly, approximately 15-20% of those young people classed as stage 1b or ‘attenuated’ syndromes at presentation progress to more severe or persistent disorders. Consequently, this cohort should be the focus of active secondary prevention trials. In clinical practice, we are moving to combine the staging framework with likely pathophysiological paths (e.g. neurodevelopmental-psychotic, anxiety-depression, circadian-bipolar) to underpin enhanced treatment selection.
Among children exposed to elevated maternal depression symptoms (MDS), recent studies have demonstrated reduced internalizing and externalizing problems for those who have attended formal childcare (i.e., center-based, family-based childcare). However, these studies did not consider whether childcare attendance is associated with benefits for the child only or also with reduced MDS. Using a four-wave longitudinal cross-lagged model, we evaluated whether formal childcare attendance was associated with MDS or child behavior problems and whether it moderated longitudinal associations between MDS and child behavior problems and between child behavior problems and MDS. The sample was drawn from a population-based cohort study and consisted of 908 biologically related mother–child dyads, followed from 5 months to 5 years. Attending formal childcare was not associated with MDS or child behavior problems but moderated the association between MDS at 3.5 years and child internalizing and externalizing problems at 5 years as well as between girls’ externalizing problems at 3.5 years and MDS at 5 years. No other moderation of formal childcare was found. Findings suggest that attending formal childcare reduces the risks of behavior problems in the context of MDS but also the risk of MDS in the context of girls’ externalizing problems.
Ancient Egypt and the Egyptians have been renowned for their culture and literacy since classical antiquity. The storerooms of knowledge and literature were the libraries of the temples from the third millennium BC down to the fourth century AD. We distinguish three periods of ancient Egyptian history in the third and second millennia BC: the Old Kingdom (c. 2657–2120), the Middle Kingdom (c. 2119–1794), and the New Kingdom (c. 1550–1069). A period of foreign rule followed, and the pharaonic culture and religion were gradually Hellenized under the rule of Alexander and (after 332 BC) his successors, the Ptolemaic dynasty, and in the Roman empire, and finally replaced by Christendom. We can easily speak of 4,000 years of written culture in the Nile Valley if we include the Christian or Coptic period, which ended when the Ancient Egyptian language, of which Coptic is the latest offspring, disappeared and was finally replaced by Arabic in the fourteenth century AD. This immense time period is the frame or scope of this chapter.
This study reviews patient encounters at a Boston-area community hospital Psychiatric Emergency Services (PES) following the Boston Marathon bombings, with the goal of describing the impact of terrorist attacks on PES encounters.
All PES encounters for 2 months preceding and 2 months following the bombing were identified in the electronic medical record. Demographics, current and past psychiatric problems, and trauma history were assessed for all records. Encounters seen post-bombing were compared with those before the bombing.
Demographics, current and past psychiatric problems, and trauma history were not significantly different before versus after the bombing; 36 of 440 (8.2%) post-bombing encounters directly mentioned the bombings. New-onset posttraumatic stress disorder (PTSD) symptoms caused by the bombing occurred in only 4 encounters (0.9%).
PES encounters after a terrorist event are likely to mirror those seen before a terrorist event, with only a minority of encounters presenting for new PTSD or acute stress disorder.
Apolipoprotein E (APOE) E4 is the main genetic risk factor for Alzheimer’s disease (AD). Due to the consistent association, there is interest as to whether E4 influences the risk of other neurodegenerative diseases. Further, there is a constant search for other genetic biomarkers contributing to these phenotypes, such as microtubule-associated protein tau (MAPT) haplotypes. Here, participants from the Ontario Neurodegenerative Disease Research Initiative were genotyped to investigate whether the APOE E4 allele or MAPT H1 haplotype are associated with five neurodegenerative diseases: (1) AD and mild cognitive impairment (MCI), (2) amyotrophic lateral sclerosis, (3) frontotemporal dementia (FTD), (4) Parkinson’s disease, and (5) vascular cognitive impairment.
Genotypes were defined for their respective APOE allele and MAPT haplotype calls for each participant, and logistic regression analyses were performed to identify the associations with the presentations of neurodegenerative diseases.
Our work confirmed the association of the E4 allele with a dose-dependent increased presentation of AD, and an association between the E4 allele alone and MCI; however, the other four diseases were not associated with E4. Further, the APOE E2 allele was associated with decreased presentation of both AD and MCI. No associations were identified between MAPT haplotype and the neurodegenerative disease cohorts; but following subtyping of the FTD cohort, the H1 haplotype was significantly associated with progressive supranuclear palsy.
This is the first study to concurrently analyze the association of APOE isoforms and MAPT haplotypes with five neurodegenerative diseases using consistent enrollment criteria and broad phenotypic analysis.