PRESIDENTIAL ADDRESS: THE ETHICS OF RECOGNITION, RESPONSIBILITY, AND RESPECT

Ethics can be understood as a code of behaviour or as the study of codes of behaviour. While the mission of the International Association of Bioethics is a scholarly examination of moral issues in health care and the biological sciences, many people in the field believe that it is also their task to create new and better codes of practice. Both ways of doing bioethics are sound, but it is important to be aware of the distinction. In this paper, I will study the sources and aims of ethics and suggest a code of conduct for bioethicists based on recognition, responsibility, and respect.     

CONSTRUCTION AND PRACTICE OF MEDICAL RESPONSIBILITY: DILEMMAS AND NARRATIVES FROM GERIATRICS

A narrative approach is employed in this article about dilemmasand physician reasoning in geriatric medicine in order toexplore the moral-medical worlds of urban American physicians.Reconstructed dilemmas, in the form of stories told by 51doctors, are analyzed as cultural documents of both clinical-moralknowledge and practice and the physician as moral actor. Discussionfocuses on ways in which responsibility is constituted and enactedthrough a particular language of clinical action. This analysisopens the subject of bioethics to a range of infrequently discussedissues that physicians cite as deeply troubling and contributesto a broadening of anthropological approaches useful in the studyof bioethics.     

THE ‘WARRIOR GENE’ AND THE MÃORI PEOPLE: THE RESPONSIBILITY OF THE GENETICISTS

The ‘gene of’ is a teleosemantic expression that conveys a simplistic and linear relationship between a gene and a phenotype. Throughout the 20th century, geneticists studied these genes of traits. The studies were often polemical when they concerned human traits: the ‘crime gene’, ‘poverty gene’, ‘IQ gene’, ‘gay gene’ or ‘gene of alcoholism’. Quite recently, a controversy occurred in 2006 in New Zealand that started with the claim that a ‘warrior gene’ exists in the Mãori community. This claim came from a geneticist working on the MAOA gene. This article is interested in the responsibility of that researcher regarding the origin of the controversy. Several errors were made: overestimation of results, abusive use of the ‘gene of’ kind of expression, poor communication with the media and a lack of scientific culture. The issues of the debate were not taken into account sufficiently, either from the political, social, ethical or even the genetic points of view. After more than 100 years of debates around ‘genes of’ all kinds (here, the ‘warrior gene’), geneticists may not hide themselves behind the media when a controversy occurs. Responsibilities have to be assumed.     

THE EVOLUTION OF THRESHOLD TRAITS: A QUANTITATIVE GENETIC ANALYSIS OF THE PHYSIOLOGICAL AND LIFE-HISTORY CORRELATES OF WING DIMORPHISM IN THE SAND CRICKET

Many traits are phenotypically discrete but polygenically determined. Such traits can be understood using the threshold model of quantitative genetics that posits a continuously distributed underlying trait, called the liability, and a threshold of response, individuals above the threshold displaying one morph and individuals below the threshold displaying the alternate morph. For many threshold traits the liability probably consists of a hormone or a suite of hormones. Previous experiments have implicated juvenile hormone esterase (JHE), a degratory enzyme of juvenile hormone, as a physiological determinant of wing dimorphism in the crickets Gryllus rubens and G. firmus. The present study uses a half-sib experiment to measure the heritability of JHE in the last nymphal stadium of G. firmus and its genetic correlation with fecundity, a trait that is itself genetically correlated with wing morph. The phenotypic and genetic parameters are consistent with the hypothesis that JHE is a significant component of the liability. Comparison of sire and dam estimates suggest that nonadditive effects may be important. Two models have been proposed to account for the fitness differences between morphs: the dichotomy model, which assumes that each morph can be characterized by a particular suite of traits, and the continuous model, which assumes that the associated fitness traits are correlated with the liability rather than the morphs themselves. The latter model predicts that the fitness differences will not be constant but change with the morph frequencies. Variation in fecundity and flight muscle histolysis are shown to be more consistent with the continuous model. Data from the present experiment on JHE are inconclusive, but results from a previous selection experiment also suggest that variation in JHE is consistent only with the continuous model.     

EFFECT OF TOURISM ON THE DISTRIBUTION OF LARVAL BLACKFLIES (DIPTERA: SIMULIUM) IN PALNI HILLS OF SOUTH INDIA

The effect of tourism on the distribution of larval blackflies during three different seasons of Palni hills was investigated.Six streams were selected(Kumbakkarai,Moolayar,Kurusedi,Silver cascade Pampar and Guntar) for this study,of which,three streams(Silver cascade Pampar and Guntar) were in peak of Palni hills(Kodaikanal town areas) and easy access to the tourists.The remaining three streams(Kumbakkarai,Moolayar and Kurusedi) were in downhill areas.The physico-chemical and stream parameters analyses indicated that the most tourist accessible site of Silver cas-cade stream had poor water quality and the predominant of larval blackfly population when compared to other sampling streams.The highest population of larval blackflies was observed during winter followed by summer and northeast monsoon.Since the effect of tourism causes pollution to streams,which in turn to promote the population of blackfly larvae and affect the other insect community in streams.       

A UNIFIED MODEL FOR THE COEVOLUTION OF RESISTANCE,TOLERANCE, AND VIRULENCE

We present a general host–parasite model that unifies previous theory by investigating the coevolution of virulence, resistance, and tolerance, with respect to multiple physiological, epidemiological, and environmental parameters. Four sets of new predictions emerge. First, compared to virulence coevolving with resistance or tolerance, three‐trait coevolution promotes more virulence and less tolerance, and broadens conditions under which pure defenses evolve. Second, the cost and efficiency of virulence and the epidemiological rates are the key factors of virulence coevolving with resistance and tolerance. Maximum virulence evolves for intermediate infection rate, at which coevolved levels of resistance and tolerance are both high. The influence of host and parasite background mortalities is strong on the evolution of defenses and weak on the coevolution of virulence. Third, evolutionary correlations between defenses can switch sign along single‐parameter gradients. The evolutionary trade‐off between resistance and tolerance may coevolve with virulence that either increases or decreases monotonically, depending on the underlying parameter gradient. Fourth, despite global attractiveness and stability of coevolutionary equilibria, not‐so‐rare and not‐so‐small mutations can beget large variation in virulence and defenses around equilibrium, in the form of transient “evolutionary spikes.” Implications for evolutionary management of infections are discussed and directions for future research are outlined.     

承德市避暑山庄植被生态规划有关问题的探讨

本文首先对避暑山庄现状植被及存在的问题进行研究,绘制了现状植被图;然后分析了旅游及城市化对避暑山庄土壤及植物的影响程度以及不同生境土壤中N,P、K、有机质、水分含量及pH大小,针对避暑山庄不同游览区存在的植物配置不协调、生境不适、环境污染等问题,从植被生态角度出发对避暑山庄进行了规划和设计,最后完成了1:10000规划植被图。     

PROFITS AND PLAGIARISM: THE CASE OF MEDICAL GHOSTWRITING

This paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti‐ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations.     

THE VALIDITY OF THE FATIGUE AND RISK INDEX FOR PREDICTING IMPAIRMENTS OF HEALTH AND SAFETY UNDER DIFFERENT SHIFT SCHEDULES IN THE CONTEXT OF RISK ASSESSMENTS

In Germany, risk assessment of the working time arrangement is legally required, and within this context the authors assessed the usefulness of the fatigue and risk index (FRI) to predict any detrimental effects to health and safety. This assessment was made using data from two different surveys. Each contained records of working hours over a 4-wk period plus information on occupational accidents and health complaints. The independent variables drawn from the FRI parameters included the maxima, means, variances, and index factor scores. Phi-correlations between the FRI (dichotomized to the index of the reference system) and the incidence of an occupational accident were rather moderate, with a maximum correlation of .22 using the mean fatigue index (FI). Correlations between the two index factor scores and health complaints (sleep problems, stomach pain, eructation/heartburn) revealed the FI component, but not the risk index (RI) component, was related to those health complaints. Forward stepwise logistic regression analysis indicated the FI (but not the RI) predicted occupational accidents (FI_factor odds ratio [OR]?=?1.90, confidence interval [CI] 1.23–2.93). When using multiple regression analyses, the FI was able to predict sleep problems and other circadian related-problems, but the regression coefficients were moderate. In general, the results were not considered sufficient to justify a mandatory use of the FRI. (Author correspondence: jana.greubel@gawo-ev.de)     

PHYLOGEOGRAPHY OF THE SPOTTED SAND BASS, PARALABRAX MACULATOFASCIATUS: DIVERGENCE OF GULF OF CALIFORNIA AND PACIFIC COAST POPULATIONS

Abstract Have the warm tropical waters and currents of the southern Gulf of California, Mexico (also known as the Sea of Cortez), formed a barrier to gene flow, resulting in disjunct populations in the upper gulf that are isolated from the outer Pacific Coast? Phylogeographic and genetic divergences of the spotted sand bass, Paralabrax maculatofasciatus, from three Gulf of California and two outer Pacific coastal locations were tested using mitochondrial DNA (mtDNA) control region sequences. Sequence data from two congeners that are sympatrically distributed along the outer Pacific Coast, the barred sand bass, P. nebulifer, and the kelp bass, P. clathratus, were used to gauge the levels of genetic divergences. Differences among the three species and between the northern gulf and outer Pacific coastal populations of P. maculatofasciatus also were analyzed using 40 allozymic presumptive gene loci. Allozyme and mtDNA analyses each revealed many fixed differences among the species. Three significant allozymic frequency differences and two fixed mtDNA substitutions differentiated the gulf and outer Pacific coastal populations of P. maculatofasciatus. Three unique mtDNA haplotypes and three unique allozyme alleles were identified from the outer Pacific coastal population. The gulf sites contained four unique mtDNA haplotypes and six unique allozyme alleles. Partitioning of the mtDNA variation revealed that 72% of the variance occurred between the gulf and outer Pacific Coast, 20% between sampling sites in the two regions, and 8% within the sites. There appears to be little gene flow across the waters of the southern Baja Penninsula, producing divergence estimated as 120,000 to 600,000 years between the outer Pacific coastal and the Gulf of California populations. This separation level may date to a hypothesized seaway closure near La Paz, Mexico, during the mid‐Pleistocene, and characterizes other fish populations. A second pattern of deeper allopatric species‐level divergences in some other fishes may date to a Pliocene closure of a mid‐Baja Penninsular seaway. Significant differences also were discerned in P. maculatofasciatus between the San Diego and central Baja California coastal sites and between the upper/central and the lower gulf locations. Variation between locations in the two regions may be indicative of larval retention and low adult migration, which needs to be tested further.     

BEYOND REINFORCEMENT: THE EVOLUTION OF PREMATING ISOLATION BY DIRECT SELECTION ON PREFERENCES AND POSTMATING, PREZYGOTIC INCOMPATIBILITIES

Abstract The evolution of premating isolation after secondary contact is primarily considered in the guise of reinforcement, which relies on low hybrid fitness as the driving force for mating preference divergence. Here I consider two additional forces that may play a substantial role in the adaptive evolution of premating isolation, direct selection on preferences and indirect selection against postmating, prezygotic incompatibilities. First, I argue that a combination of ecological character displacement and sensory bias can cause direct selection on preferences that results in the pattern of reproductive character displacement. Both analytical and numerical methods are then used to demonstrate that, as expected from work in single populations, such direct selection will easily overwhelm indirect selection due to low hybrid fitness as the primary determinant of preference evolution. Second, postmating, prezygotic incompatibilities are presented as a driving force in the evolution of premating isolation. Two classes of these mechanisms, those increasing female mortality after mating but before producing offspring and those reducing female fertility, are shown to be identical in their effects on preference divergence. Analytical and numerical techniques are then used to demonstrate that postmating, prezygotic factors may place strong selection on preference divergence. These selective forces are shown to be comparable if not greater than those produced by the low fitness of hybrids.     

IMPACT OF NIGHT-FLOAT ROTATION ON SLEEP,MOOD, AND ALERTNESS: THE RESIDENT'S PERCEPTION

Night-float rotations were designed to alleviate the workload of residents on night call and thereby improve patient safety. However, the impact of the night float on residents is yet to be surveyed. We assessed the impact of the night-float rotation on pediatric residents using an anonymous questionnaire that covered topics, based on recall, about sleep, mood, alertness, adjustment, and others. The study was conducted in a major tertiary pediatric teaching hospital in the United States. Participants were pediatric residents who had completed one or two night-float rotations and were in active training at our teaching hospital at the time of the study. Fifty-two of 60 eligible residents (87%) responded. Sleep duration during the night-float rotation was shorter than during day-shift work in 24 residents (46%), longer in 20 (38%), and unchanged in eight (15%). A higher proportion of residents took longer to fall asleep, had more difficulty falling asleep, had more sleep interruptions, and felt less rested upon awakening. Twenty-four residents (46%) felt that their bodies never adjusted to the night shift. Also, 22 residents (43%) felt moody or depressed in contrast to seven (14%) who felt depressed during the daytime rotation (p=0.0001). Twenty-one residents (41%) felt they were slower in their thinking during the night float than daytime rotations. The results suggest that disturbances of sleep and mood and decreased alertness, typical of night shift, are present in the night-float rotation. Residency programs should monitor closely the impact of the night-float rotation on resident well being and patient safety. The impact of night-shift work should be considered in the design of night-float schedules, and teaching should be provided for residents to learn coping strategies for night-shift work.     

THE EVOLUTION OF ALTERNATE MORPHOLOGIES: FITNESS AND WING MORPHOLOGY IN MALE SAND CRICKETS

Many organisms show distinct morphological types. We argue that the evolution of these alternate morphologies depends upon both fitness differences between morphs within each sex and the genetic correlation between sexes. In this paper, we examine the evolution of alternate morphologies using wing dimorphism in insects as a model system. Many insect species are wing dimorphic, one morph having wings and being capable of flight, the other lacking functional wings. While there is a well established trade-off in females between macroptery and reproduction, there are few data on the possible costs in males. We examine trade-offs between macroptery and life-history traits in male sand crickets, Gryllus firmus, and estimate the genetic correlation of wing dimorphism between the sexes. Macropterous males develop faster than micropterous males and are either larger or the same size depending upon rearing conditions. There is no difference in absolute or relative testis size at eclosion or 7 d thereafter. Finally, there is no difference between macropterous and micropterous males in relative success at siring offspring. Thus, with respect to the above traits, there are no costs associated with being winged in male G. firmus. It is possible that there may be a trade-off between calling rate and macroptery. A comparison of the relative frequency of macroptery between males and female across different orders of insects supports this hypothesis. The genetic correlation of wing dimorphism between the sexes is high (r₈ = 0.86), and hence the frequency of macroptery in males may be strongly influenced by selection acting on females.     

FROM MEDICAL RATIONING TO RATIONALIZING THE USE OF HUMAN RESOURCES FOR AIDS CARE AND TREATMENT IN AFRICA: A CASE FOR TASK SHIFTING

With a global commitment to scaling up AIDS care and treatment in resource‐poor settings for some of the most HIV‐affected countries in Africa, availability of antiretroviral treatment is no longer the principal obstacle to expanding access to treatment. A shortage of trained healthcare personnel to initiate treatment and manage patients represents a more challenging barrier to offering life‐saving treatment to all patients in need. Physician‐centered treatment policies accentuate this challenge. Despite evidence that task shifting for nurse‐centered AIDS patient care is effective and can alleviate severe physician shortages that currently obstruct treatment scale‐up, political commitment and policy action to support task shifting models of care has been slow to absent. In this paper we review the evidence in support of task shifting for AIDS treatment in Africa and argue that continued policy inaction amounts to unwarranted healthcare rationing and as such is ethically untenable.     

THE NEW MILITARY MEDICAL ETHICS: LEGACIES OF THE GULF WARS AND THE WAR ON TERROR

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990–1991) and the War on Terror (2001–). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non‐therapeutic bioactive agents to soldiers were set aside because of the sense of being in a ‘new kind of war’. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military‐civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency.     

DETAINED AND DRUGGED: A BRIEF OVERVIEW OF THE USE OF PHARMACEUTICALS FOR THE INTERROGATION OF SUSPECTS, PRISONERS, PATIENTS, AND POWS IN THE US

Using medical literature citations, Congressional hearings, and declassified documents this paper examines the uses of pharmaceuticals in the interrogation of vulnerable populations. From the use of IV relaxants on criminal suspects during the 1920s to the Global War on Terror, the nexus of drugs, testing, and interrogations will be explored in both the domestic and international contexts.     

ADEQUATE TRUST AVAILS,MISTAKEN TRUST MATTERS: ON THE MORAL RESPONSIBILITY OF DOCTORS AS PROXIES FOR PATIENTS' TRUST IN BIOBANK RESEARCH

In Sweden, most patients are recruited into biobank research by non‐researcher doctors. Patients' trust in doctors may therefore be important to their willingness to participate. We suggest a model of trust that makes sense of such transitions of trust between domains and distinguishes adequate trust from mistaken trust. The unique position of doctors implies, we argue, a Kantian imperfect duty to compensate for patients' mistaken trust. There are at least three kinds of mistaken trust, each of which requires a different set of countermeasures. First, trust is mistaken when necessary competence is lacking; the competence must be developed or the illusion dispelled. Second, trust is irrational whenever the patient is mistaken about his actual reasons for trusting. Care must therefore be taken to support the patient's reasoning and moral agency. Third, some patients inappropriately trust doctors to recommend only research that will benefit them directly. Such trust should be counteracted by nurturing a culture where patients expect to be asked occasionally to contribute to the common good.