Anti-abortion strategizing and the afterlife of the Geneva Consensus Declaration.

The Geneva Consensus Declaration, introduced by the Trump-Pence administration in 2020 and signed by thirty-two countries, claims that there is no international right to abortion. Although the Declaration was subsequently repudiated by the Biden administration, it did not die. This paper traces the afterlife of the Geneva Consensus Declaration as part of an ongoing antiabortion strategy to form a global coalition. Its supporters hope to mobilize signing nations to remove sexual and reproductive rights from the agendas of multilateral agencies including the United Nations and Organization of American States. The Geneva Consensus Declaration puts antiabortion politics above all other considerations, creating common cause among governments that oppose reproductive and sexual rights by undermining multilateral governance.

Claiming Rosa Parks: conservative Catholic bids for 'rights' in contemporary Latin America.

When the Rosa Parks Prize was awarded to a conservative Argentine senator in 2009 for her outspoken opposition to contraception, sterilisation and abortion, it was clear that something odd was happening. This paper documents the appropriation of 'human rights' discourses by conservative Catholics in Latin America, where the recent success of reproductive and sexual rights social movements has generated a significant backlash. It specifically traces an effort by Catholic legal scholars to justify what they term 'a distinctively Latin American approach to human rights' while ignoring decades of human rights activism by others. Opponents of reproductive and sexual rights are deploying rights-talk selectively and strategically, it is argued, using this as secular cover to advance pro-life and pro-family policies.

The value of library and information services in patient care: results of a multisite study.

OBJECTIVE: The research conducted a large-scale, multisite study on the value and impact of library and information services on patient care. METHODS: THE STUDY USED: (1) 2 initial focus groups of librarians; (2) a web-based survey of physicians, residents, and nurses at 56 library sites serving 118 hospitals; and (3) 24 follow-up telephone interviews. Survey respondents were asked to base their responses on a recent incident in which they had sought information for patient care. RESULTS: Of the 16,122 survey respondents, 3/4 said that they had definitely or probably handled aspects of the patient care situation differently as a result of the information. Among the reported changes were advice given to the patient (48%), diagnosis (25%), and choice of drugs (33%), other treatment (31%), and tests (23%). Almost all of the respondents (95%) said the information resulted in a better informed clinical decision. Respondents reported that the information allowed them to avoid the following adverse events: patient misunderstanding of the disease (23%), additional tests (19%), misdiagnosis (13%), adverse drug reactions (13%), medication errors (12%), and patient mortality (6%). CONCLUSIONS: Library and information resources were perceived as valuable, and the information obtained was seen as having an impact on patient care.

Association of factor H autoantibodies with deletions of CFHR1, CFHR3, CFHR4, and with mutations in CFH, CFI, CD46, and C3 in patients with atypical hemolytic uremic syndrome.

Factor H autoantibodies have been reported in approximately 10% of patients with atypical hemolytic uremic syndrome (aHUS) and are associated with deficiency of factor H-related proteins 1 and 3. In this study we examined the prevalence of factor H autoantibodies in the Newcastle cohort of aHUS patients, determined whether the presence of such autoantibodies is always associated with deficiency of factor H-related proteins 1 and 3, and examined whether such patients have additional susceptibility factors and/or mutations in the genes encoding complement regulator/activators. We screened 142 patients with aHUS and found factor H autoantibodies in 13 individuals (age 1-11 years). The presence of the autoantibodies was confirmed by Western blotting. By using multiplex ligation-dependent probe amplification we measured complement factor H-related (CFHR)1 and CFHR3 copy number. In 10 of the 13 patients there were 0 copies of CFHR1, and in 3 patients there were 2. In 3 of the patients with 0 copies of CFHR1 there was 1 copy of CFHR3, and these individuals exhibited a novel deletion incorporating CFHR1 and CFHR4. In 5 patients mutations were identified: 1 in CFH, 1 in CFI, 1 in CD46, and 2 in C3. The latter observation emphasizes that multiple concurrent factors may be necessary in individual patients for disease manifestation.

Reproductive governance in Latin America.

This paper develops the concept of reproductive governance as an analytic tool for tracing the shifting political rationalities of population and reproduction. As advanced here, the concept of reproductive governance refers to the mechanisms through which different historical configurations of actors - such as state, religious, and international financial institutions, NGOs, and social movements - use legislative controls, economic inducements, moral injunctions, direct coercion, and ethical incitements to produce, monitor, and control reproductive behaviours and population practices. Examples are drawn from Latin America, where reproductive governance is undergoing a dramatic transformation as public policy conversations are coalescing around new moral regimes and rights-based actors through debates about abortion, emergency contraception, sterilisation, migration, and assisted reproductive technologies. Reproductive discourses are increasingly framed through morality and contestations over 'rights', where rights-bearing citizens are pitted against each other in claiming reproductive, sexual, indigenous, and natural rights, as well as the 'right to life' of the unborn. The concept of reproductive governance can be applied to other settings in order to understand shifting political rationalities within the domain of reproduction.

Pneumococcal antibody levels after pneumovax in patients with rheumatoid arthritis on methotrexate.

INTRODUCTION: Immunisation against pneumococcus has been shown to reduce pneumonia in rheumatoid arthritis (RA). There is concern that methotrexate may reduce its efficacy. There are very few objective data on the effect of methotrexate on the efficacy of pneumococcal vaccination with pneumovax, and no objective evidence on whether revaccination is necessary in RA patients on methotrexate. METHODS: The authors collected information from 180 RA patients on methotrexate relating to their vaccination status and assayed their pneumococcal antibody levels. Data on pulmonary infection were retrieved in the same patients over the preceding decade. RESULTS: Full data were available for 152 patients, of whom 28 had never been vaccinated against pneumococcus. Median levels were significantly higher in those who had been vaccinated. Unvaccinated patients and those taking oral prednisone were more likely to have had pneumonia in the previous 10 years. The RR for developing pneumonia among non-vaccinated patients was 9.7 (p=0.005) and among steroid-treated patients was 6.5 (p=0.001), after adjusting for age, gender, disease duration and comorbidity. No significant correlation was found between pneumococcal antibody levels and time since vaccination. CONCLUSIONS: This study suggests that a single administration of pneumovax early in RA offers up to 10 years protection against the development of pneumococcal pneumonia in RA patients on methotrexate.

MCMV Centrifugal Enhancement: A New Spin on an Old Topic.

Human cytomegalovirus (HCMV) is a ubiquitous pathogen infecting a majority of people worldwide, with diseases ranging from mild to life-threatening. Its clinical relevance in immunocompromised people and congenital infections have made treatment and vaccine development a top priority. Because of cytomegaloviruses' species specificity, murine cytomegalovirus (MCMV) models have historically informed and advanced translational CMV therapies. Using the phenomenon of centrifugal enhancement, we explored differences between MCMVs derived in vitro and in vivo. We found centrifugal enhancement on tissue culture-derived virus (TCV) was ~3× greater compared with salivary gland derived virus (SGV). Using novel "flow virometry", we found that TCV contained a distinct submicron particle composition compared to SGV. Using an inhibitor of exosome production, we show these submicron particles are not extracellular vesicles that contribute to centrifugal enhancement. We examined how these differences in submicron particles potentially contribute to differing centrifugal enhancement phenotypes, as well as broader in vivo vs. in vitro MCMV differences.

Persistent inequalities in Hospice at Home provision.

OBJECTIVE: To describe the nature and scope of a new Hospice at Home (H@H) service and to identify its equality of provision. METHODS: Case note review of patients supported by a H@H service for 1 year from September 2012 to August 2013 (n=321). Descriptive analysis to report frequencies and proportions of quantitative data extracted from service logs, referral forms and care records; thematic analysis of qualitative data from care record free text. RESULTS: Demand outstripped supply. Twice as many night care episodes were requested (n=1237) as were provided (n=613). Inequalities in access to the service related to underlying diagnosis and socioeconomic status. 75% of patients using the service had cancer (221/293 with documented diagnosis). Of those who died at home in the areas surrounding the hospice, 53% (163/311) of people with cancer and 11% (49/431) of those without cancer received H@H support. People who received H@H care were often more affluent than the population average for the area within which they lived. Roles of the service identified included: care planning/implementation, specialist end-of-life care assessment and advice, 'holding' complex patients until hospice beds become available and clinical nursing care. CONCLUSION: There is significant unmet need and potentially large latent demand for the H@H service. People without cancer or of lower socioeconomic status are less likely to access the service. Action is needed to ensure greater and more equitable service provision in this and similar services nationally and internationally.

"Human Life is Inviolable": Costa Rica's Human Rights Crucible.

The Costa Rican Constitutional Court banned in vitro fertilization in 2000, citing the inviolability of life. Conservatives hoped the ban would initiate a hemispheric movement to protect the unborn. But in 2012 the Inter-American Court of Human Rights ruled that reproductive rights are human rights and that women's rights take precedence over embryo rights. The episode precipitated a national identity crisis: how could a country that supports universal health care be labeled a human rights violator as a result of its efforts to protect nascent human life? Expanding the health and human rights framework helps us appreciate how IVF became Costa Rica's human rights crucible.

The Dublin Declaration on Maternal Health Care and Anti-Abortion Activism: Examples from Latin America.

The Dublin Declaration on Maternal Healthcare-issued by self-declared pro-life activists in Ireland in 2012-states unequivocally that abortion is never medically necessary, even to save the life of a pregnant woman. This article examines the influence of the Dublin Declaration on abortion politics in Latin America, especially El Salvador and Chile, where it has recently been used in pro-life organizing to cast doubt on the notion that legalizing abortion will reduce maternal mortality. Its framers argue that legalizing abortion will not improve maternal mortality rates, but reproductive rights advocates respond that the Dublin Declaration is junk science designed to preserve the world's most restrictive abortion laws. Analyzing the strategy and impact of the Dublin Declaration brings to light one of the tactics used in anti-abortion organizing.

The changing library: what clinicians need to know.

Over the last two decades, changes in technology have allowed academic medical center libraries to bring the world of biomedical information to the physician's computer desktop. Because digital libraries have grown so rapidly and in so many ways, some clinicians may be uncertain about the services and resources that are available to them. This article explains how clinical faculty can best utilize their library to support their research and patient care. It addresses some of the most common myths about the "new" medical library, and it highlights innovations in library resources and services that can help physicians to better access, use and manage medical information.

Culture, Health, and Science: A Multidisciplinary Liberal Arts Alternative to the Public Health Major.

Since the 2003 call by the Institute of Medicine to educate undergraduates in public health, various models have emerged for incorporating public health into the liberal arts and sciences. One model is a professionalized public health major that uses core public health competencies to prepare a workforce of health professionals. A second model offers a broad-based public health major rooted in liberal arts principles, resisting the utilitarian trend toward human capital formation. A third model resists even the label of "public health," preferring instead to introduce undergraduates to many ways of analyzing human health and healing. The multidisciplinary Culture, Health, and Science Program, based on six key commitments for preparing liberal arts students to analyze health and respond to global health challenges, is offered as an alternative to the public health major.

Reproductive Rights or Reproductive Justice? Lessons from Argentina.

Argentine sexual and reproductive rights activists insist on using the language and framework of "human rights," even when many reproductive rights activists in the US and elsewhere now prefer the framework of "reproductive justice." Reflecting on conversations with Argentine feminist anthropologists, social scientists, and reproductive rights activists, this paper analyzes why the Argentine movement to legalize abortion relies on the contested concept of human rights. Its conclusion that "women's rights are human rights" is a powerful claim in post-dictatorship politics where abortion is not yet legal and the full scope of women's rights has yet to be included in the government's human rights agenda. Argentine feminist human rights activists have long been attentive to the ways that social class, gender, migration, and racism intersect with reproduction. Because their government respects and responds to a human rights framework, however, they have not felt it necessary--as U.S. feminists have--to invent a new notion of reproductive justice in order to be heard. Given the increasing popularity of reproductive justice in health and human rights, the Argentine case shows that rights-based claims can still be politically useful when a State values the concept of human rights.

A social biography of Carnegie embryo no. 836.

A tiny, sectioned embryo specimen known as Carnegie no. 836 has served as the prototype for Stage 13 (28-32 days) since the 1910s. Recently digitalized and reanimated for the 21st century, this singular specimen is now being used to develop 3D and 4D visualizations. Yet the social origins of the specimen have been largely forgotten. This essay traces the biography of 836 from its origins in a young woman's life, through sectioning and transformation into a scientific specimen, to its contemporary manifestations as a symbol of life. By reuniting the specimen with its story, we can appreciate how cultural attitudes toward embryo specimens have changed over the past century.

"Properly disposed of": a history of embryo disposal and the changing claims on fetal remains.

This paper explores recent controversies concerning the disposal of embryonic and fetal remains in order to ask how such remains came to be classified as "medical waste." Based on archival research into the social history of human embryo collecting in Baltimore, Maryland, in the early 20th century, I argue that the classification of embryos and fetal remains as medical waste can be traced to a pragmatic alliance between embryologists and state functionaries. Embryologists relied on the state to assist them in acquiring thousands of human embryo remains for scientific study, while state authorities relied on embryologists to provide authoritative knowledge that could be used to facilitate state control over nascent citizens. This alliance contributed to the development of an "embryological worldview," in which human embryos were cast as objective biological "specimens" of use only to embryologists. This exclusive view of the social value of embryos and fetal tissue is now being challenged as other constituencies claim jurisdiction over the remains in order to advance diverse social agendas.

Honrar a Rosa Parks? Intentos de los sectores católicos conservadores a favor de los derechos en la América Latina contemporánea / Claiming Rosa Parks: conservative catholic bids for rights in contemporary Latin America / Honrar Rosa Parks? Tentativas dos setores católicos conservadores a favor dos direitos na América Latina contemporânea

Cuando en el año 2009 se otorgó en Argentina el Premio Rosa Parks a una senadora conservadora por su oposición abierta al uso de anticonceptivos, a la esterilización y al aborto, era evidente que algo extraño ocurría. En este artículo se documenta la apropiación de los discursos de "derechos humanos" por parte de los sectores católicos conservadores en América Latina, donde el éxito reciente de los movimientos sociales a favor de los derechos sexuales y reproductivos ha generado una reacción significativa. En particular, se indagan los esfuerzos por parte de académicos católicos especialistas en leyes para justificar lo que denominan "un enfoque distintivamente latinoamericano hacia los derechos humanos", dejando de lado décadas de activismo por los derechos humanos emprendido por otros sectores. Quienes se oponen a los derechos reproductivos y sexuales despliegan un discurso de derechos de forma selectiva y estratégica, utilizándolo como una cubierta secular para promover políticas pro-vida y pro-familia.

When the Rosa Parks Prize was awarded to a conservative Argentine senator in 2009 for her outspoken opposition to contraception, sterilisation, and abortion, it was clear that something odd was happening. This paper documents the appropriation of "human rights" discourses by conservative Catholics in Latin America, where the recent success of reproductive and sexual rights social movements has generated a significant backlash. It specifically traces an effort by Catholic legal scholars to justify what they term "a distinctively Latin American approach to human rights" while ignoring decades of human rights activism by others. Opponents of reproductive and sexual rights are deploying rights-talk selectively and strategically, I argue, using it as secular cover to advance pro-life and pro-family policies.

Quando se outorgou o Prêmio Rosa Parks na Argentina a uma senadora conservadora, no ano de 2009, por sua oposição aberta ao uso de anticoncepcionais, à esterilização e ao aborto, era evidente que algo estranho acontecia. Nesta exposição documenta-se a apropriação dos discursos de "direitos humanos" por parte dos setores católicos conservadores na América Latina, onde o êxito recente dos movimentos sociais a favor dos direitos sexuais e reprodutivos gerou uma reação significativa. Em particular, indaga-se sobre os esforços por parte de acadêmicos católicos especialistas em leis para justificar o que denominam de "um enfoque distintivamente latino-americano para os direitos humanos", deixando de lado décadas de ativismo pelos direitos humanos empreendido por outros setores. Quem se opõe aos direitos reprodutivos e sexuais desdobra ou faz um desdobramento de um discurso de direitos de forma seletiva e estratégica, em minha opinião, utilizando-o como uma coberta/divisória secular para promover as políticas pró-vida pró-família.

The rise and demise of a collection of human fetuses at Mount Holyoke College.

When I found myself at the center of a controversy over the disposition of an old collection of human fetal specimens at Mount Holyoke College, I was motivated to explore the historical transformation that turned embryo collecting for research and pedagogical purposes from a noble to a disparaged practice, and dead fetuses from prized anatomical specimens to ugly, anomalous entities. Using Linda Layne's analysis of the literal and symbolic erasure of dead fetuses from American cultural discourse, this article examines the shifting circumstances that once encouraged the collection of fetal specimens but that now mandate their disappearance. Using Mount Holyoke as a case study, it describes the scientific logic and specific social exchange networks that led to the acquisition of hundreds of fetal specimens in the first half of the 20th century. It also examines the factors--including changes in biology education, concerns about handling hazardous fixatives, and especially the prominence of beautified and lifelike fetal images consistent with the so-called "culture of life"--that prompt the dissolution and demise of human embryo and fetal collections.