Ethical obligation and legal requirements: On informed consent practices in Bangladesh

Informed consent to medical intervention is fundamental in both ethics and law. But in practice it is often not taken seriously in developing countries. This paper provides an appraisal of informed consent practices in Bangladesh. Following a review of the ethical and legal principles of informed consent, it assesses the degree to which doctors adhere to it in Bangladesh. Based on findings of non-compliance, it then investigates the reasons for such non-compliance through an appraisal of informed consent practices in Bangladesh and provides recommendations aimed at improving such practices. The significance of this paper lies in unveiling the interdependence between the ethical and legal traits of informed consent and their ramifications on strengthening the patient-oriented approach of duty to care.     

Dietary exposure and risk assessment to trace elements and iodine in seaweeds

IntroductionSeaweeds are a rich source of elements such as iodine, and are also able to accumulate contaminants such as trace elements.MethodsThe aim of this study was to assess the dietary exposure as well as the risk from iodine and trace elements in edible seaweeds for the French population using current consumption data. The contribution of seaweeds to overall dietary exposure to trace elements and iodine was evaluated, and for those substances with minimal contribution to overall dietary exposure, simulations were performed to propose increased maximal limits in seaweeds.ResultsCadmium, inorganic arsenic and mercury in seaweeds were very low contributors to total dietary exposure to these contaminants (0.7 % 1.1 % and 0.1 % on average, respectively). Dietary exposure to lead via seaweed may contribute up to 3.1 % of total dietary exposure. Dietary consumption of iodine via seaweed may contribute up to 33 % of total exposure to iodine, which makes seaweeds the strongest contributor to iodine in diet.DiscussionNew maximal values in seaweeds are proposed for the very low contributors to total dietary exposure: 1 mg/kg dw for cadmium, 10 mg/kg dw for inorganic arsenic and 0.3 mg/kg dw for mercury.     

Developing new hospital-at-home models based on Comprehensive Geriatric Assessment: Implementation recommendations by the Working Group on Hospital-at-Home and Community Geriatrics of the Catalan Society of Geriatrics and Gerontology

Last decade, the Government of Catalonia have urged an integrated care strategy for planning the care model to older populations living with frailty, multimorbidity and advanced illnesses. Based on international evidence that was reviewed by a group of experts from the Catalan Society of Gerontology and Geriatrics, we summarised some recommendation to adapt hospital-at-home care to older populations in our system. We defined Comprehensive Geriatric Assessment (CGA) hospital-at-home (HaH) as a specialised home hospitalisation service formed by interdisciplinary teams, characterised by using the clinical methodology of CGA, and by adapting geriatric units’ protocols for the provision of person-centred care at home. Main benefits of CGA-HaH in these populations are: response to heath crises according to individualised care plans based on the situational diagnosis carried out by Primary Care teams; provision of a comprehensive health and social approach tailored to the complexity of cases and situations; and adaptation of multipurpose hospitalisation, by working on different person-centred care, aspects, such as caregivers support on care provision, focusing on function or home adaptation.     

The application of reproductive technology to endangered species breeding programmes

Captive breeding plays an increasingly important role in species conservation, but special problems are encountered in achieving the ideal of a demographically stable but genetically diverse population. Breeding programmes involving co-operation among a number of centres are now being developed which will overcome some of these difficulties by identifying individual animals, genetic lineages or age cohorts from which to breed. Application of techniques such as artificial insemination, embryo transfer and semen collection and storage, as well as the monitoring of reproductive status will contribute to the success of such programmes. The usefulness of these procedures for various population problems is discussed and criteria for their appropriate implementation within breeding programmes is outlined.     

Non‐target habitat exploitation by Trichogramma brassicae (Hym. Trichogrammatidae): what are the risks for endemic butterflies?

Abstract 1 Trichogramma brassicae Bezdenko is inundatively released against the European corn borer in Switzerland. Because parasitoids dispersing from the release fields might pose a threat to native butterflies, the searching efficiency of T. brassicae was investigated in nontarget habitats. 2 In field studies, T. brassicae was released at rates of 120 000 females/ha. Parasitism of sentinel Ephestia kuehniella egg clusters was 1.6–3.6% in meadows and 2.0–4.0% in flower strips. The respective figures were 57.6–66.7% and 19.2–46.9% in maize, significantly higher than the parasitism rates in the nontarget habitats. Experiments carried out in small field cages confirmed these results: Again, significantly higher parasitism rates were found in maize compared to meadows and flower strips, and also compared to hedgerows (in sleeve cages). 3 To elucidate potential factors underlying the low searching efficiency in nontarget habitats, the behaviour of individual T. brassicae females was investigated on four meadow plants comparatively to maize and a filter paper control. Mean (±SE) walking speed on maize was 2.2 ± 0.2 mm/s, similar to three of the plants tested and filter paper but significantly higher than on Trifolium pratense (0.85 mm/s). A higher turning rate was found on T. pratense, Viola wittrockiana and Plantago lanceolata, in contrast to the longer leaved maize and Alopecurus pratensis. The number of wasps leaving the plant within the observation period differed significantly between plant species, and was twice as high for T. pratense (and the filter paper control) compared to the other plant species. 4 In a choice experiment carried out in a climate cabinet with all five host plant species in cages, we obtained the highest parasitism rates on maize and the lowest parasitism on T. pratense, thus confirming the behavioural observations. 5 In conclusion, there is evidence for a decreased searching efficiency on plants in nontarget habitats compared to maize. However, the data explain only part of the differences found between parasitism in maize compared to nontarget habitats. Other factors, such as the structural complexity of a habitat, may also play a role. We conclude that the risk for butterfly populations in the tested nontarget habitat due to mass released T. brassicae is low.     

Submitochondrial particles asin vitro biosensors of heavy metal toxicity

The effects on mitochondrial respiratory parameters of heavy metals, such as Cu, Ni, Pb, Cd, Zn, Ag, Hg, were recorded by using thein vitro response of submitochondrial particles (SMP) from beef heart mitochondria.The toxicity of these elements was estimated by determining their effects on the energy-coupled reverse electron transfer (RET), which is induced by ATP and succinate at first site level of the respiratory chain in SMP.The RET rate was easily monitored by recording spectrophotometrically at 340 nm the production of NADH, arising from the reduction of exogenous NAD⁺ by RET.The toxicity values were expressed as the toxicant molar concentration which decreases the rate of reduction of NAD⁺ to an extent of 50 percent (EC50). The toxicity increased in the following order: Ni²⁺2+2+< Cd²⁺2+2++.The SMP data were compared with the toxicity values obtained from a variety of biological systems currently used for toxicity testing. The results obtained demonstrate that the SMP test generally provides a good estimate of metal toxicity for several fish and invertebrate species. This is demonstrated by the statistical parameters obtained in the regression analysis. The broadened 95% confidence intervals and, in particular, the poor correlations obtained for some aquatic organisms can be ascribed to the more complex metabolic interactions and competing toxic pathways in aquatic organisms, when compared to SMP.     

The ecosystem approach to environmental assessment: moving from theory to practice

The ecosystem approach to environmental management is viewed by many as being fundamental to the development of appropriate management strategies. While this approach represents a major advance in the way researchers view environmental assessment, the approach in itself does not provide practical information as to what questions to ask and what tools to use in assessing and managing ecosystems. Similarly, the concept of ecosystem health, as it is usually defined, has little practical value for ecosystem managers. We suggest the next stage in environmental assessment will be the development of specific frameworks designed to assess individual ecosystems. Of primary importance is the need to consider the basic structure and function of the ecosystem itself. Such consideration, together with explicit identification of anthropogenic stresses particular to the system, serves to identify those components most at risk and those issues most deserving of attention. Researchers should explore critical linkages between environmental stressors and their observable, measurable and predictable effects on ecological parameters and use this understanding to develop a management strategy that incorporates appropriate ecological indicators. The importance of these considerations will be illustrated using examples from the Northern River Basins Study.     

Utility of field-based artificial streams for assessing effluent effects on riverine ecosystems

Experimentation using field-based artificial streams provides a promising, complimentary approach to biomonitoring assessments because artificial streams provide control over relevant environmental variables and true replication of treatments. We have used large and small artificial stream systems, based in the field, to examine the effect of treated bleached kraft pulp mill effluent (BKME) on the benthos of three large rivers in western Canada. Under natural regimes of temperature, water chemistry, and insolation, these artificial streams provide current velocities and substrata to food chains or food webs that are representative of those in the study river. With these tools we have shown that BKME stimulated mayfly growth in the Thompson River above that which could be accounted for by fertilization of their algal food supply. In contrast, moulting frequency was inhibited at high BKME concentrations. Results from artificial streams also indicate that increased algal biomass and abundances of benthic communities downstream of BKME outfalls were induced by nutrient enrichment from the effluent. BKME treatments did not change diatom species richness in the Fraser River, or diatom species diversity in either the Athabasca or Fraser Rivers. Artificial streams provide a means of understanding the mechanisms of stressor effects over a continuum ranging from single stressor effects on specific taxa to the effects of multiple stressors on communities and ecosystems. Because riverside deployment provides environmental realism within a replicated experimental design, this approach can (i) address questions that cannot be examined using laboratory tests or field observations, (ii) improve our mechanistic understanding of stressor effects on riverine ecosystems, and (iii) can contribute directly to the development, parameterization, and testing of models for predicting ecosystem-level responses.     

Environmental biotechnology in India: prospects and case studies

The emergence and acceptance of the concept of sustainable development warrants that the scope of environmental biotechnology be enlarged to address issues like environmental monitoring, restoration of environmental quality, resource/residue/waste-recovery/utilization/treatment, and substitution of the non-renewable resource base with renewable resources. This paper delineates the current and prospective applications in these sub-areas of environmental biotechnology, and documents case studies on environmental monitoring (enteric viruses), restoration of environmental quality (oil spill remediation), resource recovery (hydrocarbon recovery from oily sludges, biosurfactants from distillery spentwash, desulphurization of coal & sour gases), and substitution of non-renewable resources with renewables (conversion of lignocellulisics into value added chemicals).The author is with the National Environmental Engineering Research Institute, Nagpur: 440 020, India     

Environmental risk assessment of releases of transgenic plants containing virus-derived inserts

Sequences derived from the genomes of plant viruses are being used to provide virus resistance in transgenic crop plants. Although the environmental hazards associated with the release of such plants have been discussed widely, it has not been possible to reach generally acceptable conclusions about their safety. A case-by-case approach to the risk assessment of real examples is recommended as a means of building up confidence and of indicating areas of uncertainty. A logical framework for risk assessment is suggested, a key feature of which is identification of the viruses in the release environment that may infect the transgenic plants. Each of these is considered in relation to each of the three main classes of hazard (transcapsidation, recombination and synergism), and the risk associated with each event is analysed.