bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographic and behavioral determinants of self-reported history of sexually-transmitted diseases (STDs) among young migrant men who have sex with men (MSM) in Beijing, China
Authors: Song Yan , Li Xiaoming , Zhang Liying , Liu Yingjie , Jiang Shulin , Stanton Bonita 
Published: October 2011

Background: Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The current study intends to examine the association between demographic and behavioral factors and STD infection. Methods: Data were collected from a sample of 307 migrant MSM aged 18–29 years in Beijing in 2009. Multivariate logistic regression analysis was employed to examine the factors associated with a history of STDs. Results: Results showed that about 13% of MSM reported a history of STDs. The average number of lifetime sexual partners was 15.0. About 56.7% of MSM did not use a condom at the first sexual encounter. The percentage of MSM who used a condom consistently was 47.4%. Multivariate logistic regression results showed that STD history was positively associated with education, income, the number of lifetime male sexual partners, and negatively associated with the frequency of properly using a condom. Conclusion: STD history was associated with socioeconomic status and sexual risk behaviors. The results suggested that HIV prevention intervention programs need to educate MSM to reduce the number of sexual partners and to use a condom properly. Furthermore, HIV prevention intervention programs among MSM need to be tailored to meet the needs of different socioeconomic groups of MSM.
Effects of comprehensive geriatric assessment and targeted intervention on mobility in persons aged 75 years and over: a randomized controlled trial
Authors: Lihavainen Katri , Sipilä Sarianna , Rantanen Taina , Kauppinen Markku , Sulkava Raimo , Hartikainen Sirpa 
Published: October 2011

Objective: To assess the effect of a comprehensive geriatric assessment and individually tailored intervention on mobility in older people. In addition, the effectiveness of the geriatric intervention was evaluated among a subgroup of persons with musculoskeletal pain. Design: Three-year geriatric development project with randomized assignment to intervention and control group. Setting: Research centre, community and assisted living facilities. Participants: Seven hundred and eighty-one Finnish persons aged 75–98 years were assigned to an intervention ( n = 404) or control ( n = 377) group. Intervention: A comprehensive geriatric assessment with a multifactorial intervention lasting two years. The intervention included individualized referrals, recommendations, physical activity counselling and supervised resistance training. Measurements: Perceived limitation in walking 400m was gathered annually during the intervention and at the one-year post-intervention follow-up. Results: The proportion of persons with mobility limitation at the beginning, at the two-year intervention and at the one-year post-intervention follow-up was 16%, 15%, 12% and 14%, respectively, in the intervention group. In the control group, the corresponding proportions were 19%, 18%, 23% and 26%. The treatment effect was significant at the end of the two-year intervention (odds ratio 0.82, 95% confidence interval 0.70–0.96, P = 0.013), and at the one-year post-intervention follow-up (0.84, 0.75–0.94, P = 0.002). The parallel positive effect of the intervention on mobility was even greater among persons with musculoskeletal pain. Conclusion: The comprehensive geriatric assessment and individually tailored multifactorial intervention had a positive effect on mobility, underlining their importance in health promotion and disability prevention in older people.
What is the role of specialist palliative care in an acute hospital setting? A qualitative study exploring views of patients and carers
Authors: Yang Grace M , Ewing Gail , Booth Sara 
Published: October 2011

Background: Since the medical specialty of palliative medicine was recognized in 1988, the role of hospital specialist palliative care services has been developing, extending to patients who have a life-limiting illness but are not in the terminal phase. Aim: This qualitative study aims to explore patient and carer perspectives of the role of palliative care in the acute hospital setting, with patients not imminently dying. Design: Semi-structured interviews with 12 patients and 10 carers. Data were analysed using framework analysis. Setting/participants: Patients recruited were adults who had palliative care input for symptom control or psychological support and were discharged either to general ward care or to home. The family member/friend designated as their carer was also approached to take part. Results: All patients in this study were treated in an acute hospital, described as a bewildering and pressured environment of care. Initial perceptions of palliative care were varied, some interpreting referral as an indication that they were approaching the end of life. However, after palliative care input, patients and carers developed an understanding of their role which they saw as three-fold: physical symptom control, psychological support and a reliable liaison. The theme of cross-cutting interviews was that the palliative care team made time for patients, giving them a sense of value and worth. Feeling their care was a priority and being listened to made palliative care input effective. Conclusions: These findings will aid continuing development and evaluation of palliative care teams, in the domains of effectiveness as well as patient experience.
Vitamin D receptor gene BsmI polymorphism B allele, but not BB genotype, is associated with systemic lupus erythematosus in a Han Chinese population
Authors: Luo X-Y , Yang M-H , Wu F-X , Wu L-J , Chen L , Tang Z , Liu N-T , Zeng X-F , Guan J-L , Yuan G-H 
Published: October 2011

The vitamin D receptor (VDR) gene is a candidate gene for susceptibility to autoimmune disorders. Association studies of VDR polymorphisms and risk of systemic lupus erythematosus (SLE) have often produced conflicting results in different ethnic backgrounds. The aim of this study is to test the association between VDR gene BsmI polymorphism and the genetic susceptibility to SLE in a Han Chinese population. Three hundred and thirty-seven patients with SLE and 239 healthy controls were genotyped for the VDR gene BsmI polymorphism (rs1544410) by polymerase chain reaction and restriction fragment length polymorphism analysis in this study, after which the relationship between BsmI polymorphisms and the mRNA expression of VDR, as well as clinical manifestations in patients with SLE, was evaluated. It was found that the frequency of B allele was significantly increased in SLE relative to the control group (χ2 = 4.681, p = 0.031), although the distribution of VDR BsmI polymorphism genotype frequencies did not differ significantly between patients and controls (χ2 = 4.098, p = 0.129). Moreover, VDR B allele was found to be associated with lupus nephritis ( p = 0.027) and also with production of anti-nucleosome antibodies ( p = 0.037). The mRNA of VDR was markedly down-regulated in patients with VDR B allele compared with that in patients without B allele ( p = 0.016). Our results indicate a possible role of genetic factors (the VDR B allele) in influencing disease susceptibility in Han Chinese patients. Also, VDR B allele is associated with the development of nephritis and the down-regulation of VDR mRNA expression in SLE.
Pre-Implantation Genetic Diagnosis, Tissue Typing and Beyond: The Legal Implications of the Hashmi Case
Authors: Mulvenna Beverley 
Published: October 2011

The legality of pre-implantation genetic diagnosis (PGD) has recently been confirmed by the Court of Appeal in the Hashmi case, based on a purposive construction of the statute. The court went on to declare tissue typing lawful and strained the wording of the statute in order to do so. The Hashmi case confirms that it would be lawful for the HFEA to license tissue typing in the absence of PGD. However, the HFEA only licenses tissue typing where PGD is also indicated, on the basis of a blanket application of the welfare of the child test set out in S 13 (5). This policy can be criticised. Firstly, a blanket approach to S 13 (5) is not appropriate. Secondly, the HFEA is applying the test too strictly when compared to the ‘best interests’ test which would govern the situation were an existing child to be a potential donor. Thirdly, by licensing tissue typing in the Hashmi case, where it was the primary reason for testing, the HFEA has undermined the argument that it can be justified only in cases where it is ancillary to PGD. These arguments, coupled with human rights arguments, based on Art 8 and Art 12, could be used to challenge the legitimacy of the HFEA's policy. The restriction on tissue typing to cases where PGD is also indicated is not ethically justified. It offers the same direct benefit to the embryo as PGD, namely selection for implantation. PGD does not cure the relevant condition so offers no additional benefit in a causative sense. Moreover, the Kantian injunction against treating people solely as means is not breached where the child will be wanted for its own sake, as well as for its potential as a cord blood donor.
Excessive Risk Disclosure: The Effects of the Law on Medical Practice
Authors: Heywood Rob 
Published: October 2011

This article examines the debate surrounding the challenging concept of informed consent. It argues whilst the English courts have effectively excluded the use of the tort of battery as an appropriate mechanism for protecting a patient's right to self-determination, they have left the law in a state of flux due to the uncertainties associated with categorising similar claims within negligence where the onus is on risk disclosure. This confusion may stem firstly from the fact that medical practitioners are unsure exactly which risks to disclose, and secondly, from the way in which both doctors and patients perceive the consent process. The paper suggests this disorder may be having a detrimental effect on medical practice as medical practitioners are taking it upon themselves to disclose excessive information, which patient's may not want or need. A suggestion is also made that in these situations, in order that the law truly respects self-determination, consideration must be given to the patient's desire to waive their right to informed consent. ‘while all are agreed that “doctor knows best” is no longer acceptable, for some “doctor knows better” is just as outdated and paternalistic. The assumption that the doctor's knowledge is deployed to ends that are of benefit to patients is treated with suspicion.’ 1
Harmonizing the International Regulation of Embryonic Stem Cell Research: Possibilities, Promises and Potential Pitfalls
Authors: Campbell Angela , Nycum Gillian 
Published: October 2011

Despite near unanimous global opposition to human reproductive cloning, the United Nations has been unable to reach a consensus as to how cloning practices should be regulated at the international level. As a result, the U.N. objective of establishing binding international regulations governing cloning and stem cell research has yet to be achieved. Given the lack of consensus that exists within the global community on this topic, it seems that any attempt to harmonize the international regulation of cloning and stem cell science will face important obstacles. This paper seeks to illuminate the particular challenges to harmonizing international laws and policies related to stem cell research and human cloning, and to investigate potential methods for overcoming these challenges. By drawing on two other areas in which regulatory harmonization has been attempted, namely: environmental and human safety aspects of international trade, and pharmaceutical research and development, we study approaches to global regulatory harmonization. We conclude that while the challenges to harmonization are diverse and important, so too are the benefits of establishing uniformity in approaches to stem cell research worldwide. This paper proposes a model for harmonizing the regulation of stem cell research that focuses on broader norms and principles rather than specific rules. It further recommends that such harmonization should occur through a process initiated and developed by an independent international agency marked by diversity, both in terms of the cultural identities and perspectives represented, and the interdisciplinary expertise of its members.
Sex Selection under International Human Rights Law
Authors: Toebes Brigit 
Published: October 2011

Sex selection embraces attempts to choose or influence the sex of a child before pregnancy, during pregnancy, and after birth (infanticide). This paper examines these issues from an international human rights perspective and considers whether human rights laws are permissive or prohibitive with regard to sex selection. It discusses some of the ethical views on the matter. India and the UK are used as case studies. In both countries sex selection is—roughly speaking—prohibited, but the difference is that, while in India there is widespread practice of ‘son preference’, in the UK reasons for choosing to sex select are mostly because of ‘family balancing’. The key question is whether choosing the sex of one's child is inherent in the right of reproductive choice, which is an important principle under international human rights law. It will be concluded that international human rights law does not recognise a right to ‘sex selection’. Rather, international human rights law is generally geared towards prohibiting sex selection based on the assumption that it enhances discrimination of women. On this basis it is argued that a right to choose the sex of one's child is not an element of women's ‘right of reproductive choice’, which stipulates a right to choose the number and spacing of one's children, not the sex. Based on these findings this article argues that international human rights law provides strong legal and moral grounds for prohibiting sex selection, in particular in countries like India where there is extensive practice of sex selection. In countries like the UK, where the current main reason to sex select is for ‘family balancing’, the basis for prohibition under international human rights law is not as strong, yet several reasons can be put forward to nonetheless prohibit the practice.
Consent, Autonomy and the Infantilised Patient
Authors: Robertshaw Paul , Thacker Rajeev 
Published: October 2011

In this article we examine a particular aspect of the doctor-patient relationship — that of consent to treatment procedures — from three perspectives: ethics, sociology of medicine, and the Common Law. The legal deliberation and judgments are considered within the first two perspectives. Ethics provide us with ideal standards such as personal autonomy or the sanctity of life, whereas the sociological perspective focuses on the actuality of the doctor-patient relationship in terms of knowledge and mystification or power and dependence. In our analysis of the cases, including a spate of recent decisions, we note how the rhetoric of patient autonomy in the leading House of Lords cases has not followed through into the later crisis-handling judgments. We argue that the practical model for these decisions is not the rhetoric of autonomy but the prerogative jurisdiction of wardship: the infantilised patient. We argue that there is an aspect of professional collusion here between lawyers and doctors, which exemplifies much of the sociological literature as well as the individual constituted as subject, rather than citizen, in English jurisprudence. We suggest a number of reforms for the situation we have criticised.
Assisted Suicide for People with Depression: An Advocate's Perspective
Authors: Biggs Hazel , Diesfeld Kate 
Published: October 2011

Assisted suicide is a topical issue which has been brought to public attention recently through international cases and legislation. In particular, a recent case in the Netherlands concerning the assisted suicide of a depressed patient, and the pro assisted suicide legislation in Oregon, raise disturbing issues especially for advocates representing people with mental or terminal illness. The justifications for assisted suicide for both groups appear similar since both are vulnerable. Their vulnerability stems either from physical and emotional exhaustion caused by disease or mental distress and depression (J. Griffiths, 1994), which is often concomitant with physical disease (J. Billings, S. Block, 1994). Therefore, it is valuable to analyse the issues raised by assisted suicide for people with depression in either group. The arguments for assisted suicide are manifold, but the way in which society responds highlights inherent assumptions regarding the quality of life of people with depression. The limited rights and protections for people with mental disabilities in Britain emphasise the necessity for ethical inquiry and advocacy on behalf of these individuals. However, a conflict may arise for the advocate who opposes the ultimate outcome, death, yet values legal representation of the stated desires of the client.
Generic Consistency in the Reproductive Enterprise: Ethical and Legal Implications for Exclusion Testing for Huntington's Disease
Authors: Beyleveld Deryck , Quarrell Oliver , Toddington Stuart 
Published: October 2011

This paper applies Alan Gewirth's Principle of Generic Consistency (PGC) to assess the morality of exclusion testing for Huntington's Disease (HD). Part 1 presents the PGC and outlines ways in which its use may be justified. Part 2 considers how the PGC might grant protection to potential agents as such (the moral status of which is problematic under the PGC). Part 3 contends that the morality of exclusion testing rests not only on its implications for the fetus (at most a potential agent), but also on the intended relations between the possibly affected parent and the future “child-when-agent” (CA) (born after a negative test) that are intrinsic consequences of the central motivation for exclusion testing. Part 4 argues that the PGC renders it immoral, all things being equal, to permit exclusion tests on the fetus unless CA is granted (under specified circumstances) a right to find out whether the at risk parent is carrying the mutation for HD, with the implication that it is morally wrong for the at risk parent to be provided with the results of an exclusion test unless a legally binding duty is imposed on him or her to undergo a mutation test at CA's request. This right and its correlative duty might, however, be overridden by conflicting rights-considerations. The complexities of such an assessment are indicated.
Equality and Non-Discrimination in the South African Constitution
Authors: Small Joan , Grant Evadne 
Published: October 2011

Equality occupies the first place in most written constitutions, but in South Africa, its importance is magnified both in terms of the text of the Constitution and in terms of the context in which that Constitution operates. The Bill of Rights is expected, in South Africa, to help bring about the transformation of the society. These expectations of transformation through the operation of the Bill of Rights are informing the development of the law in relation to equality and non-discrimination by the Constitutional Court. The concept of discrimination is uniquely defined in the South African Bill of Rights. The Courts are struggling to give legal effect to the terminology. The test developed by the Court to interpret the equality clause, it is submitted, is comprehensive and informed. But the application of the test is sometimes problematic. This paper addresses the evolving concepts of equality and discrimination in South Africa and discusses some of the difficulties with certain aspects of the test for discrimination, including the concepts of unfairness and human dignity, which have caused division among the judiciary.
Gender Equality, Constitutional Values and Religious Family Laws in South Africa
Authors: Rautenbach Christa 
Published: October 2011

South Africa has a pluralistic society in which various religious and cultural groups, such as Muslims and Hindus, live according to their own customs and usages. At present the law of South Africa generally does not recognise the validity of some of these customs and usages, for example marriages concluded in terms of Islamic law or Hindu law are not recognised as valid marriages. The consequences of non-recognition have been particularly unfair to women. There have been calls for the recognition of other family law systems and, in particular, for the recognition of Islamic family law. The Constitution of the Republic of South Africa, 1996 recognises the cultural diversity of South Africa and provides for the enactment of legislation recognising other systems of law based on religion or culture. However, such legislative recognition must be consistent with the Bill of Rights and other provisions of the 1996 Constitution. All inequalities between men and women should therefore be dealt with before legislative recognition is given to family law systems that discriminate against women. In this paper the obvious tension between gender-equality and freedom of religion within the new constitutional dispensation is discussed. In doing so, the focus will be on Islamic law and the position of Muslim women with respect to inheritance laws.
A New Framework for Tackling Institutional Racism in Scottish Housing Rights
Authors: Macewen Martin 
Published: October 2011

This paper outlines the new framework emerging under a devolved Scottish Parliament to monitor and review the provision of housing with particular reference to racial discrimination and disadvantage. The broader context of housing rights reflected in international and regional obligations is described as well as the influence of the Council of Europe and the European Union. The housing circumstances of ethnic minority communities is established and the actual and potential roles of three key agencies explored, the Scottish Executive, the Commission for Racial Equality and Scottish Homes. The paper concludes by suggesting that the parallel concerns of social inclusion, human rights and racial equality would benefit from a more coherent bridging mechanism than now apparent with a Scottish Human Rights Commission being a possible solution.
The Role of the Psychological Parent in the Dissolution of the Homosexual Relationship
Authors: Kinsey Caroline L. 
Published: October 2011

This note analyzes the definition of the “psychological parent” in its application to the dissolved homosexual relationship. In urging state courts to render custodial decisions not solely on the basis of the parent's biological ties to the child, but also on the presence of a psychological relationship between the non-biological parent and the child in question, this note reviews conflicting state court decisions that discussed the doctrine of the “psychological parent” and determined whether a non-biological parent was fit to receive custody of his or her child once dissolution of the couple's relationship had occurred. United States state courts frequently rely upon the “best interests of the childl” standard when making custodial decisions. It is this author's position that the application of the “psychological parent” doctrine is what is in the “best interest of the child” when awarding custody to non-legal parents, and as such should be at the forefront of state court decisions before a determination of child custody is made.