Cloning for therapeutic purposes: ethical and policy considerations.

This essay reviews how cloning techniques may be used for therapeutic purposes, analyzes ethical implications, and makes recommendations for public policy discourse. Although cloning may bring many potential benefits, they remain uncertain. Furthermore, human embryo research is morally problematic. Therefore, alternatives to human cloning for therapeutic aims should be sought at present. In addition to central ethical issues, public discourse should maintain an emphasis on the value of the human embryo over scientific expediency, the relativity of health, and the principle of justice. Society should support the laudable mission of medical research, while also attending to the moral concerns often threatened by the promises of scientific progress.

Biotechnology and commodification within health care.

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes.

Cross-cultural study of beliefs about smoking among teenaged females.

This study was designed to identify beliefs associated with smoking behavior in three different ethnic groups of teenaged females. The Neuman Systems Model provided the conceptual framework, and the Theory of Planned Behavior provided the basis for the development of the research instrument. Participants included 141 African American, 146 Puerto Rican, and 143 non-Hispanic White females, ages 13 to 19. Logistic regression analyses identified beliefs that were significantly related to smoking behavior in each ethnic group. Beliefs related to attitudes about smoking and perceived social pressure regarding smoking differed among the three ethnic groups. The findings suggest that specific beliefs distinguish between smokers and nonsmokers and that some beliefs differ by ethnicity.

Religious voices in biotechnology: the case of gene patenting.

On 18 May 1995, nearly 200 religious leaders joined with leading biotechnology critic Jeremy Rifkin in a press conference named the "Joint Appeal against Human and Animal Patenting," a move that many within the biotechnology industry could only interpret as seeking to inhibit biotechnological advance. What moral and religious concerns motivated this challenge to patenting? How could the biotechnology industry understand and respectfully attend to these concerns? What values were at play in the debates that followed the joint appeal? What lessons for future dialogue can be learned from attempts at conversation between the opposing positions? This essay is a report from a Hastings Center research project that accepted the task of addressing these questions. Specifically, the project focused on the patenting of human genetic material, a subset of the issues raised by the joint appeal.

Otitis media with effusion.

Otitis media with effusion is common in young children and varies widely in duration and severity. Defined as fluid in the middle ear without signs or symptoms of infection, it is generally asymptomatic. However, it has the potential to adversely affect hearing, speech development, and language acquisition.

The theory of planned behavior applied to cigarette smoking in African-American, Puerto Rican, and non-Hispanic white teenage females.

The purpose of the study was to evaluate the adequacy of Ajzen's Theory of Planned Behavior to predict cigarette-smoking intention in three groups of teenage females. Participants were 141 African-Americans, 146 Puerto Ricans, and 143 non-Hispanic whites, 13 to 19 years of age. Consistent with the Theory of Planned Behavior, path analysis revealed direct relationships among attitude, subjective norm, perceived behavioral control, and smoking intention for African-Americans. For Puerto Ricans and non-Hispanic whites, only the relationships among attitude, perceived behavioral control, and smoking intention were supported. Subjective norm was not found to be a significant predictor of smoking intention for these two groups. The results suggest that the Theory of Planned Behavior provides an empirically adequate explanation of cigarette smoking among female African-American teenage women.

An exploratory study of the relationship between alternative therapies, functional status, and symptom severity among people with multiple sclerosis.

Roy's Adaptation Model guided an exploratory study of the association of alternative therapies with functional status and symptoms in people with multiple sclerosis (MS). Data were collected from 16 volunteers by a telephone-administered interview schedule and a mailed questionnaire. All 16 respondents reported seeking traditional medical treatment and at least 1 alternative therapy (mode = 3, range = 1-9). The correlation between the number of alternative therapies and functional status was -.42; the greater the number of therapies used by the respondents, the lower their functional status. Qualitative data analysis revealed that functional status was enhanced by beneficial effects of specific alternative therapies, pacing oneself, changing the perception of self, and focusing on spiritual aspects of self. Self-reported MS symptoms were less severe following use of alternative therapies (p < .0005). Study of the differential effects of single and combined alternative therapies on functional status and symptom severity for large samples of people with MS is recommended.

Acute otitis media in children.

Acute otitis media, a common childhood disorder, is an inflammation of the middle ear. It is the most frequent diagnosis made in primary care settings for children under 15 years of age. Almost all children are afflicted with at least one episode of otitis media before age 6. Diagnosis can often be challenging, especially in infants and toddlers. Moreover, management controversies exist. This article addresses the epidemiology, clinical presentation, and diagnosis of acute otitis media and presents treatment options based on results of recent research. When a child is diagnosed with acute otitis media, it behooves the clinician to use sound research-based clinical judgment in prescribing treatment.

The critical care nurse practitioner: an advanced practice role for the critical care nurse.

Research provides compelling evidence that supports the current and future utilization of critical care nurse practitioners (CCNPs) in pivotal roles as providers of cost-effective, quality patient-centered care for critically ill and technology-dependent adults. This paper gives a historical perspective and describes the current national need for CCNPs to practice in expanded roles both within and outside the boundaries of intensive care. An existing CCNP program is described. In addition, guidelines for CCNP program development and role implementation are discussed.

Sociocultural and physiological correlates of cigarette smoking in women.

Cigarette smoking is a major modifiable risk factor for cancer and coronary heart disease and the chief avoidable cause of death in the United States. Over the past few decades, the prevalence of cigarette smoking among males has significantly decreased. However, the same significant decrease has not been seen among women. Researchers have identified sociocultural factors and physiological correlates associated with women's cigarette smoking. It is essential that health care professionals understand the findings of research on women's smoking if they wish to identify and counsel women at risk and to define directions for future research.