Death and the artificial placenta.

Artificial Amnion and Placenta Technology (AAPT)-sometimes referred to as 'Artificial Womb Technology'-could provide an extracorporeal alternative to bodily gestations, allowing a fetus delivered prematurely from the human uterus to continue development while maintaining fetal physiology. As AAPT moves nearer to being used in humans, important ethical and legal questions remain unanswered. In this paper, we explore how the death of the entity sustained by AAPT would be characterized in law. This question matters, as legal ambiguity in this area has the potential to compound uncertainty and the suffering of newly bereaved parent(s). We first identify the existing criteria used to delineate the legal characterization of death, which occurs before birth or during the immediate neonatal period in England and Wales. We then demonstrate that attempting to apply these in the context of AAPT gives rise to a number of challenges, which make it impossible to reach a definitive conclusion as to the nature of death in AAPT using the current legal framework. In doing so, we demonstrate that the current legal framework in England and Wales may be unable to adequately capture the situation of an entity being sustained by AAPT.

Artificial placentas, pregnancy loss and loss-sensitive care.

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process-and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used.

The Warnock report and partial ectogestation: retracing the past to step into the future.

Partial ectogestation continues to move towards human clinical trials. This article draws upon the Report of the Committee of Inquiry into Human Fertilisation and Embryology (Warnock Report) to provide guidance as to what may need to be considered for the future regulation of this technology. While the Warnock Report dates back to 1984, its significance and legacy continue to influence the current regulation of reproductive practices in the UK. By drawing upon specific elements within the report, many of the decisions and recommendations within it could provide direction for the future regulation of partial ectogestation. The role of the public, the social and political context at the time of the Warnock report, the determination of the status of the embryo, and arguments pitted against in vitro fertilisation (IVF) at the time, are all examined. As a result, this article suggests that the inclusion of the general public in the development and implementation of partial ectogestation prior to another Warnock-style inquiry will increase the success of long-standing regulatory and legislative provisions.

Youth Perspectives on the Recommended Age of Mobile Phone Adoption: Survey Study.

BACKGROUND: Despite increasing prevalence of phone ownership in early adolescence, there is a deficit of evidence-based guidance on the appropriate time to provide youth their first phone. OBJECTIVE: This survey study explored age recommendations for phone ownership among a diverse panel of youths, as their experiences are an important contribution to the development of ownership guidelines. METHODS: Participants were recruited from MyVoice, a national panel of over 765 youth (14 to 24 years old) who respond to weekly SMS text message-based surveys. Questions were distributed between January 24 2018, and March 20, 2018. Inductive qualitative analysis was used to identify major themes among youths' open-ended responses. RESULTS: In all, 469 youth (mean age 18.8 years; female: 299/469, 63.8%; White race: 332/468, 70.8%) responded. On average, respondents obtained their first phone at 12.2 years of age. Most participants (325/459, 71.1%) stated they received their first phone out of necessity rather than for entertainment or social reasons. Youth recommended that early adolescents receive their first phone between 12 and 13 years of age primarily for reasons of necessity (146/448, 32.6%). CONCLUSIONS: According to the participants, phones supported safety and independence by allowing communication with parents and participation in activities. Youth-serving professionals and parents can incorporate these youth perspectives into shared decision-making about phone ownership among families. This can include discussions about essential features, safety, or phone use, as well as maturity and responsibility milestones, which were all key considerations reported by participants in the survey.

Impact of ectogenesis on the medicalisation of pregnancy and childbirth.

The medicalisation of pregnancy and childbirth has been encouraged by the continuing growth of technology that can be applied to the reproductive journey. Technology now has the potential to fully separate reproduction from the human body with the prospect of ectogenesis-the gestation of a fetus outside of the human body. This paper considers the issues that have been caused by the general medicalisation of pregnancy and childbirth and the impact that ectogenesis may have on these existing issues. The medicalisation of pregnancy and childbirth is criticised for its impact on the relationship between doctors and pregnant women and the way in which doctors treat fetuses. It is argued that ectogenesis may cause more imbalance in the doctor and intended parent relationship and may result in an increased lack of clarity regarding a doctor's duty to the fetus. This paper finds that extensive guidance and revised legislation will be necessary to minimise the impact of ectogenesis on the existing issues caused by the medicalisation of reproduction.

Transgender Adolescents' Uses of Social Media for Social Support.

PURPOSE: Transgender adolescents are at higher risk for negative mental health outcomes, such as depression, anxiety, and suicidality, compared with cisgender adolescents. Social media may be an effective venue for addressing these health disparities because most adolescents have access to online information and socialization. This study used qualitative inquiry to explore transgender adolescents' uses of social media for social support. METHODS: Transgender adolescents between the ages of 15 and 18 years with a social media profile were recruited from a pediatric gender clinic in the Midwestern U.S. A 30- to 60-minute semistructured interview assessed ways participants used social media to access transgender-related support. Thematic analysis was used to develop categories and code the transcripts. Coding discrepancies were resolved by two researchers following initial coding. RESULTS: Results represent data from 25 interviews comprising 13 transmasculine, 11 transfeminine, and one nonbinary participant(s), with 68% of the sample identifying as white, non-Hispanic. Categories emerged regarding forms of support participants received from transgender-related online communities including emotional support through peers and role models, appraisal support for validating their experiences, and informational support for navigating health decisions and educating family and friends. Participants also referenced negative experiences, including harassment and exclusionary behavior online. CONCLUSIONS: Social media platforms represent hubs of community for transgender adolescents. These communities provide emotional, appraisal, and informational support that transgender youth may not otherwise be able to access. Future research should use the affordances of social media to identify approaches to addressing health disparities and improving the well-being of transgender adolescents.

Advertising in Young Children's Apps: A Content Analysis.

OBJECTIVE: Young children use mobile devices on average 1 hour/day, but no studies have examined the prevalence of advertising in children's apps. The objective of this study was to describe the advertising content of popular children's apps. METHODS: To create a coding scheme, we downloaded and played 39 apps played by children aged 12 months to 5 years in a pilot study of a mobile sensing app; 2 researchers played each app, took detailed notes on the design of advertisements, and iteratively refined the codebook (interrater reliability 0.96). Codes were then applied to the 96 most downloaded free and paid apps in the 5 And Under category on the Google Play app store. RESULTS: Of the 135 apps reviewed, 129 (95%) contained at least 1 type of advertising. These included use of commercial characters (42%); full-app teasers (46%); advertising videos interrupting play (e.g., pop-ups [35%] or to unlock play items [16%]); in-app purchases (30%); prompts to rate the app (28%) or share on social media (14%); distracting ads such as banners across the screen (17%) or hidden ads with misleading symbols such as "$" or camouflaged as gameplay items (7%). Advertising was significantly more prevalent in free apps (100% vs 88% of paid apps), but occurred at similar rates in apps labeled as "educational" versus other categories. CONCLUSION: In this exploratory study, we found high rates of mobile advertising through manipulative and disruptive methods. These results have implications for advertising regulation, parent media choices, and apps' educational value.