Redefining procreation: facing the issues

It is now possible for a child to have up to 5 individuals claiming to be parents: a sperm donor, an egg or ovum donor, the woman providing a womb for gestation, and the couple raising the child. Technology has provided 3 techniques of conception: artificial insemination, in vitro fertilization and embryo transfer, and surrogate motherhood. There is increased concern with infertility in the US and decreased availability of children for adoption. New reproductive technologies share, with the recent profound changes in the American family and more relaxed attitudes towards sexuality, a common potential to alter family structure and family dynamics. Certain issues are germane to all birth technologies such as whether such technologies should exist at all, whether there is a right to procreate, what criteria should govern access to these technologies, and how they should be regulated. Complex ethical, legal, social and moral questions are involved. Advances in reproductive technologies have created a gap between science and public policy. The articulation of guiding principles is essential to narrow that gap.     

The etiology of low back pain in military helicopter aviators: prevention and treatment

Low back pain (LPB) is a major health problem among military rotary-wing aircrews worldwide. In order to define the etiology and propose remedies to LBP in helicopter aviators a review and critique of the literature was conducted. In-flight sitting posture and vibration generated by the aircraft were identified as high risk factors for LBP. Consequently, researchers recommended ergonomic modifications to the crew stations. The efficacy of these technical interventions has not been proven. As well, these design changes are not financially practical. Following an in depth kinesiological analysis of the physical demands of this type of flying, and preliminary experimentation, an alternative aeromedical approach focusing on the aircrew rather than the craft is presented. The authors propose a set of flight-specific exercises that might effectively deal with this problem. A thorough testing of this approach is envisioned.     

Health care futures, Part 1. The emergence of the new health care consumer. Panel discussion

In Part 1 of this second annual panel discussion, six experts examine the new health care consumer. The whole concept of the patient as consumer still makes people uneasy when it's applied to health care. Whether you prefer consumer, customer, purchaser, end-user, ultimate buyer, or beneficiary, one thing's for sure: Many of us are as different from the bygone patient as an HMO is from the general practitioner who made house calls. One of the reasons for many Americans' new interest, knowledge, attitudes, and expectations about health and health care is the Internet, the second topic in this discussion. In Part 2, physician executives from the three leading physician practice management companies (PPMCs) join Jeff Goldsmith, Barbara LeTourneau, and Uwe Reinhardt for a spirited exchange about this burgeoning new industry in the American health care sector. They will tackle questions such as: Are PPMCs delivering what they promise? What will separate successful PPMCs from the rest? Can PPMCs meet Wall Street's earnings expectations and also help physicians deliver better care? When PPMCs win, who loses? And, what roles will physician executives play in PPMCs?     

A hut on Holy Island: reframing northern landscape

This essay explores the evolution and significance of a shelter constructed in 2002 by the artist Sally Madge on a remote beach on Holy Island, off the north-east coast of Northumberland. In the context of a legacy of cultural interactions with and representations of this island – a popular tourist destination – the concern is with how the simple structure might be understood in terms of a potential refiguring of a heavily prefigured location, enabling an alternative, even transgressive notion of place, disturbing preconceived boundaries between artists, community, insiders and outsiders and so engendering a new way of thinking about northern peripheries. In the process the essay considers recent examples of public art; from the increasingly design-practice led, spectacular structures at Kielder Reservoir Sculpture Trail, to Charles Jencks’ monumental earth sculpture, Northumberlandia constructed out of the top-soil excavated from an open-cast coal mine at Shotton. By contrast, the specific character of the Holy Island shelter and the nature of the practices associated with it unsettle some of our assumptions about place and the rhetoric underpinning art and creativity.     

THREAT AND PUNISHMENT IN PUBLIC GOOD EXPERIMENTS

Experimental studies of social dilemmas have shown that while the existence of a sanctioning institution improves cooperation within groups, it also has a detrimental impact on group earnings in the short run. Could the introduction of pre‐play threats to punish have enough of a beneficial impact on cooperation, while not incurring the cost associated with actual punishment, so that they increase overall welfare? We report an experiment in which players can issue non‐binding threats to punish others based on their contribution levels to a public good. After observing others' actual contributions, they choose their actual punishment level. We find that threats increase the level of contributions significantly. Efficiency is improved, but only in the latter periods. However, the possibility of sanctioning differences between threatened and actual punishment leads to lower threats, cooperation, and welfare, restoring them to levels equal to or below the levels attained in the absence of threats. (JEL C92, H41, D63)     

The Effect of Work Experience on the Self-Concept and Anxiety Level of the Social Work Graduate Student

Summary It has been assumed by some leading social work educators thatstudents in professional training display unproductive or evencounter-productive anxiety in field-learning situations. Ithas been further suggested that this excess anxiety has ledto a certain amount of threat to the ego which could resultin problems in work performance. This paper tells of an investigationinto the impact of previous work experience on the manifestanxiety level and self-concept of a set of graduate social workstudents in a mid-western university in the United States. Datawere gathered using widely used tests, the Taylor Manifest AnxietyScale and the Tennessee Self Concept Scale. Contrary to thehypothesis, prior work experience did not act as an inhibitorof anxiety nor as a support to self-concept. No significantdifference on test scores was found between those students withwork experience and those with no work experience. The writeris unable to satisfyingly account for the lack of significancein these findings. An unexpected by-product of this researchwas the finding that manifest anxiety levels and self-conceptscores of social work graduate students in either category werenot different from those found in other occupational populations.This suggests, tentatively of course, that social work studentsmay not have higher anxiety levels as some of the literaturehas led us to expect. It may be the anxiety that social workeducators see in students in the field is quite within normallimits, that it does not threaten students' self-concepts, andthat it does not inhibit learning