Umbilical cord blood banking: beyond the public-private divide

Umbilical cord blood is a source of haematopoietic progenitor cells, which are used to treat a range of malignant, genetic, metabolic and immune disorders. Until recently, cord blood was either collected through donations to publicly funded cord blood banks for use in allogeneic transplantation, or stored in commercial cord blood banks for use in autologous transplantation. The line between public and private cord blood banking is being blurred by the emergence of "hybrid" models that combine aspects of both the public and private systems. The authors describe these hybrid models and argue that their emergence is explained by both market forces and public sector policy They propose that the future of the sector will depend heavily on several key developments that will differentially affect public, private and hybrid banking models.     

Racially conditional donation: the example of umbilical cord blood

While direction of donated tissue to family members has long been accepted, direction to members of specific racial groups has been opposed, on the basis that it is discriminatory and contrary to the ethos the institution of organ donation seeks to promote. It has, however, recently been proposed that racially conditional donation may provide a useful--and ethically acceptable--way to address the social inequalities and injustices experienced by certain cultural groups. This article examines the ethical, legal and cultural arguments for and against racially conditional donation, concluding that the practice is more likely to undermine the values of equity and justice than to promote them and that it may also lead to other unfavourable personal and social outcomes.     

Child and adolescent suicide deaths in New Mexico, 1990-1994

The suicide death rate in New Mexico is consistently higher than the national rate. Among adolescents, suicide is the third leading cause of death nationally, but in New Mexico it is the second leading cause of death. This study describes the pattern of adolescent suicide deaths in New Mexico. We conducted a retrospective review of all medical examiner autopsies for adolescent suicides (ages 20 years and younger) in New Mexico from 1990-1994. Records were reviewed for demographics and possible contributing factors such as depression, previous attempts, and alcohol and drug use. We identified 184 suicide deaths among children and adolescents ages 9-20 years for an overall rate of 12.9 per 100,000. Our rates for ages 5-9 years (0.2), 10-14 years (3.8), and 15-19 years (22.3) are over twice the U. S. rates. Suicide deaths resulted primarily from firearms (67%), hanging (16%), poisoning (6%), inhalation (4%), and other methods (7%). Method varied by ethnicity (p = .01) and gender (p = .03); males and non-Hispanic Whites were overrepresented among firearm deaths. Firearm ownership was known in 60 (48%) of the firearm deaths. Of these, 53% of the firearms belonged to a family member, 25% to the decedent, and 22% to a friend. Over one-third of decedents (41%) experienced mental disorders, primarily depressed mood and clinical depression. Previous suicide attempts were noted for 15% of the decedents. Some 50% of the decedents had alcohol or drugs present at the time of death; among American Indians/Alaska Natives, 74% had drugs or alcohol present (p = .003). Targeted interventions are needed to reduce adolescent suicide in New Mexico. We suggest raising awareness about acute and chronic contributing factors to suicide; training physicians to look for behavioral manifestations of depression; and involving physicians, teachers, and youth activity leaders in efforts to limit firearm accessibility, such as advising parents to remove firearms from their households.     

Forensic aspects of ocular injury

A case of homicidal stabbing resulting in bilateral penetrating ocular injuries is described. The case is noteworthy in that it highlights an unusual mechanism of death in homicidal stabbing. Disturbances in heart rhythm including asystole can be ascribed to the so-called oculocardiac or trigeminocardiac reflex. Although this phenomenon is well known to ophthalmologists, neurosurgeons, and anesthetists, it is much less familiar to forensic pathologists. This is a potential mechanism of death worthy of consideration in cases of sudden unexpected death occurring in the context of facial injury.     

New Citizens and Old Politics in Peru

The article presents an analysis of the disjunction between civil and political society in Perú and its consequences in the collapse of the political parties and the rise of an authoritarian regime. It explains how citizenship developed as social rights in the realm of Peruvian civil society before the population gained access to full civil and political rights. This situation diminished the capacity of Peruvian citizens to have their own political representation and created a distance between Peru's civil and political societies, making it difficult for the population to hold politicians accountable for their actions in government and the opposition. This situation proved particularly serious when the country went through a period of deep economic crisis and extended political violence during the 1980s. The breach between civil and political society destroyed the prestige of politicians and democracy, paving the way for an authoritarian cuadillo who dismissed representation with promises of "direct communication with the people" and harsh solutions to the problems of economic crisis and political violence.     

Protecting Individual Rights Through a Federal System: James Buchanan's View of Federalism

James Buchanan is a Nobel Prize winning economist and the founderof the public choice movement in economics. Public Choice playeda critical role in underpinning conservative attacks on thewelfare state in the 1980s and 1990s in the United States. Asa committed supporter of free markets and strong skeptic oflarge governments, Buchanan has long supported the use of federalismto protect individual liberty, promote democratic efficiency,and help foster community values. This article reviews Buchanan'sresearch on the advantages of a federal system.     

President Donald Trump: A Case Study of Spectacular Power

Donald Trump's election as president certainly startled many, though not all political observers. In this article, I offer my own observation that Mr Trump's election represents a developmental progression of America's electoral system from a political process to an entertainment process. The effect of the office of the president now is to distract and entertain. I will aim to convince readers that his election as America's president is not an anomaly, but rather represents how the politics of image and representation now work as an everyday event and should be treated as part of a reality that we should now take for granted.