Abstract
The UK Department of Health's consultation on the future of the Human Fertilisation and Embryology Authority (HFEA) presented an opportunity to review current practice in relation to donor ...conception (DC) and make recommendations for improving services to those seeking fertility treatment, to families with donor conceived children and those of donors, and to those seeking later information. The year 2023 marks the start of post-2005 donor conceived adults having statutory access to identifying information about their donor(s); some adults with pre-2005 donors will have access sooner if the donor(s) re-registers as 'willing to be identified'. This paper examines current practice in UK licensed treatment centres in collecting and disseminating donor information and in supporting donors and prospective parents. Further, it considers current HFEA functions concerning DC including its responsibilities for the Register of Information and Donor Sibling Link and its approach to policy making, regulation and the release of information from these Registers to applicants. Proposals for how these functions could be carried out in the future are set out together with recommendations for national support and intermediary services. The key evidence available to support these recommendations is outlined.
Recent data suggest substantial variations in the treatment of acute myocardial infarction based on age, race, gender and socioeconomic status. We evaluated the use of primary angioplasty (PA) in ...acute myocardial infarction (AMI) in elderly and minority patients treated at an urban, teaching hospital.
We reviewed the records of 322 patients with AMI admitted to an urban, teaching hospital from 1997-2000. Our main outcome was PA in AMI. Secondary outcomes included use of post-infarction therapies. Univariate analysis was performed on the variables of interest, age and race, as well as all candidate variables.
Unadjusted analysis revealed that elderly and African-American patients were significantly less likely to receive PA for AMI, and post-infarction beta-blockers, (all p <.05). Other factors that had a significant negative impact on use of PA included do-not-resuscitate status, increasing acuity of presenting signs and symptoms, severity of illness, dementia and subendocardial infarcts (all p <.05). After adjustment for these potential confounders, increasing age remained inversely associated with both PA (p <.001), and use of standard post-myocardial infarction beta-blockers, (p <.05). Additionally, African-American patients in our study were less likely to undergo PA as initial AMI (p <.01).
Our results indicate differences in the use of PA in the elderly and African-Americans. These differences are not explained by severity of illness and suggest that interventions and standard therapies may be withheld from those who may benefit most.
The Evidence Based Midwifery Network (EBMN) held its third conference in Leicester on 25 March 2006. Attended by approximately 70 midwives from posts in clinical practice, midwifery education and ...research, delegates travelled from the UK, Sweden, Holland, Denmark and Ireland for this event. The conference theme Celebrating Change: Evidence led innovations in midwifery practice was pursued in two plenary sessions complemented by a programme of concurrent sessions.
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