Endovascular arterial intervention: expression of concern.
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A number of concerns have been publicly expressed concerning children conceived by in vitro fertilization (IVF). For this reason the first 52 infants in the Monash University IVF Programme were seen for paediatric follow-up. Forty-nine children completed the Programme with one child dying at 4 months and one set of twins being withdrawn from the study. Assessment was by general paediatric interview and examination. A sub-group comprising 33 of the children and their parents received psychosocial assessment including developmental assessment. Results revealed no particular areas of concern related to the IVF conception itself. Problems found appeared to be related to the high incidence of preterm delivery (21%), twinning (21%), and Caesarean delivery (37%). The limitations of this preliminary study are noted and a longer term controlled study is planned.
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The UKCC has received well over a thousand responses to their proposals for community education and practice (CEP). Here we reproduce an extract from the response of the United Kingdom Standing Conference on health visitor education (UKSC) by Frances Appleby and Joy Merrell, UKSC chair and honorary treasurer respectively.
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In order to assess the acceptability of voluntary population screening for antibodies against human immunodeficiency virus (HIV), a random sample of 300 Danish men, aged 20-49 years, were sent a self-administered questionnaire. Among nonrespondents, recruitment attempts were repeated three times with intervals of 8-10 days. In total, 76.7% responded. Two hundred men (87.0% of the respondents) would accept an offer to be tested in an anti-HIV screening programme. Among respondents, 72.9% agreed to identify themselves to the researchers, 22.1% preferred to be tested under a code number known only by the participant himself, and 5% wanted the test information to be completely anonymous. Among the 30 men refusing HIV testing, 40% reported they were not concerned about AIDS, 16.7% expressed concern with confidentiality problems, and another 16.7% had been tested already and for this reason declined to participate. Previous reports have indicated high seroprevalences among nonrespondents and raised prevalences of behavior at high risk for HIV infection among persons who do themselves take the initiative to be tested or who decline to be tested because they worry about confidentiality. Low respondency and the associated disproportional loss of subjects at high risk of HIV infection may bias HIV seroprevalence estimates based on population probability sampling, especially in areas with low HIV infection prevalence. Because of these biases, voluntary population screening is likely to give only lower bound estimates of HIV seroprevalence. So, this technique should only be used in combination with other surveillance approaches.
There was a lack of consensus among DATTA panelists about the safety and, especially, the effectiveness of radial keratotomy. For patients with a preoperative refractive error greater than -6.00 D, DATTA panelists believed that radial keratotomy has not been established as safe or effective. Concerns about effectiveness focused on the lack of predictability of the results and the continuing change in the refractive error following surgery. Daily fluctuations in visual acuity and the occurrence of anisometropia were other reported adverse events that contributed to the concern expressed by DATTA panelists. Concern over the safety and effectiveness of the procedure became greater as the magnitude of the preoperative refractive error increased. Nevertheless, there is a subpopulation of myopic patients who regard their myopia as a sufficiently severe handicap for them to undergo radial keratotomy. Such carefully chosen patients who have the procedure performed may achieve emmetropia and be free of corrective lenses.
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