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S J Genuis

Publications and source records attributed to S J Genuis.

8 recordsLinked to original sources

Time for an oil check: the role of essential omega-3 fatty acids in maternal and pediatric health.

Deficiency of omega-3 fatty acids (omega3FAs) is an often unrecognized determinant of clinical disease; the adequate availability of these essential nutrients may prevent affliction or facilitate health restoration in some pregnant women and developing offspring. The human organism requires specific nutrients in order to carry out the molecular processes within cells and tissues and it is well established that omega3FAs are essential lipids necessary for various physiological functions. Accordingly, to achieve optimal health for patients, care givers should be familiar with clinical aspects of nutritional science, including the assessment of nutritional status and judicious use of nutrient supplementation. In view of the mounting evidence implicating omega3FA deficiency as a determinant of various maternal and pediatric afflictions, physicians should consider recommending purified fish oil supplementation during pregnancy and lactation. Furthermore, omega3FA supplementation may be indicated in selected pediatric situations to promote optimal health among children.

Child↗

Dismembering the ethical physician.

Physicians may experience ethical distress when they are caught in difficult clinical situations that demand ethical decision making, particularly when their preferred action may contravene the expectations of patients and established authorities. When principled and competent doctors succumb to patient wishes or establishment guidelines and participate in actions they perceive to be ethically inappropriate, or agree to refrain from interventions they believe to be in the best interests of patients, individual professional integrity may be diminished, and ethical reliability is potentially compromised. In a climate of ever-proliferating ethical quandaries, it is essential for the medical community, health institutions, and governing bodies to pursue a judicious tension between the indispensable regulation of physicians necessary to maintain professional standards and preserve public safety, and the support for "freedom of conscience" that principled physicians require to practise medicine in keeping with their personal ethical orientation.

Attitude of Health Personnel↗

Primary prevention of sexually transmitted disease: applying the ABC strategy.

Escalating rates of sexually transmitted disease (STD) in many areas of the world necessitate a re-evaluation of current public health STD preventive programmes. Pervasive long term sequelae for many STD afflicted people and the emerging threat, caused by the HIV/AIDS pandemic, to some national infrastructures, suggests that ongoing initiatives focusing primarily on risk reduction through barrier protection have not met their desired objective. Recent strategies to promote non-coital sexual involvement as a means of achieving STD reduction fail to address the transmission of infection that may occur through alternative non-intercourse sexual activities. The demonstrated success of the innovative, comprehensive ABC strategy shows that while risk reduction and treatment of existing infection remain important, the promotion of optimal health may be achieved more effectively through broad based comprehensive and adaptable programmes that include an emphasis on risk avoidance through delayed sexual debut and partner reduction.

Condoms↗

Orgasm without organisms: science or propaganda?

The worldwide epidemic of sexually transmitted diseases (STDs) presents a major public health challenge to medical practitioners and educators as they seek to implement preventive educational strategies in the adolescent population. The serious consequences of many STDs and the insufficient impact of condom promotion in this high-risk group have led to increasing recognition that sexual intercourse is medically unwise for young adolescents. As a result of this recognition, some educators have proposed that adolescent sexuality education focus on the explicit teaching of noncoital sexual activities, sometimes called outercourse. This paper explores the emergence of this educational strategy, the assertion that noncoital sexual activities will positively impact the rising incidence of STDs and unplanned pregnancy in teenagers, and the hypothetical benefits of adolescent noncoital sex.

Adolescent↗

Public attitudes toward the right to die.

OBJECTIVE: To determine public attitudes toward the right to die, euthanasia and related end-of-life decisions. DESIGN: Mail survey based on telephone numbers randomly selected by computer. SETTING: Edmonton. PARTICIPANTS: Of 1347 computer-generated, randomly selected telephone numbers called between February and June 1992, 902 individuals were reached, and 500 eligible contacts (55%) agreed to fill out the mailed questionnaire based on 12 vignettes involving end-of-life decisions. A total of 356 usable questionnaires (71%) were subsequently returned. MAIN OUTCOME MEASURES: Attitudes toward end-of-life decisions including withdrawal of life support, euthanasia, chronic suffering and the right to die, living wills and family involvement in decision making for incompetent individuals. Comments and demographic data were also solicited. RESULTS: Of the respondents 84% supported a family's right to withdraw life support from a patient in a persistent coma, and 90% supported a mentally competent patient's right to request that life support be withdrawn. Active euthanasia was supported by 65% for only patients experiencing severe pain and terminal illness. There was marked opposition to euthanasia for patients in other circumstances, such as an elderly disabled person who feels he or she is a burden on relatives (opposed by 65%), a patient with chronic depression resistant to treatment (by 75%) or an elderly person no longer satisfied with life and who has various minor physical ailments (by 83%). In all, 63% of the respondents felt that legalization of euthanasia for terminal illnesses would lead to euthanasia for many other, unsupported reasons, and 34% supported legislation to prohibit euthanasia in all situations. CONCLUSIONS: Public support for the right to die varies depending on the circumstances of the patient. The single most significant factor determining attitudes was the level of religious activity. The family's wishes were an important factor in end-of-life decisions for patients unable to communicate their desires. Both the general public and physicians should be primary participants in determining legislation regarding the right to die.

Adolescent↗

Public attitudes in Edmonton toward assisted reproductive technology.

OBJECTIVE: To determine public attitudes toward the use and possible limitations of assisted reproductive technology (ART). DESIGN: Mail survey based on telephone numbers selected at random by computer. SETTING: Edmonton. PARTICIPANTS: A total of 602 Edmonton residents aged 16 years or more (57% of eligible subjects) reached by telephone agreed to participate. Completed questionnaires were received from 455 subjects (76%). MAIN OUTCOME MEASURES: Attitudes toward egg donation, sperm donation, selective fetal reduction, embryo freezing and experimentation, and surrogacy, as determined through responses to five cases. Comments and demographic data were also solicited. MAIN RESULTS: Overall, 66% and 63% respectively of the respondents would donate an egg or sperm to a sibling; the corresponding rates for donation to a stranger were 41% and 44%. Selective fetal reduction was supported by 47% of the respondents, although only 24% would support fetal reduction to eliminate fetuses of an undesired sex. Most (64%) thought that live embryo freezing should be permitted by law. A total of 74% agreed with surrogacy if done for medical reasons, but 85% opposed its use for reasons of convenience. Overall, 72% of the respondents thought that ART should be regulated. A total of 58% felt that physicians should be primarily responsible for determining the allowable limits of this technology, and 38% felt that the public should be primarily responsible. Only 21% agreed with public funding of ART. Religious affiliation strongly influenced attitudes toward ART. CONCLUSIONS: Public support for ART varies depending on the circumstances of its use. Education is needed to make the general community aware of the various aspects of ART. The results of this survey should help physicians and governing bodies make informed decisions about the future directions of ART in Canada.

Adolescent↗