After Novelty: The Mundane Practices of Ensuring a Safe and Stable Supply of Bone

New medical technologies to a great extent use material from human bodies as therapeutic tools. Social science studies of such ‘tools’ have tended to focus on technologies associated with novelty and drama. This paper, in contrast, concerns an old, well-entrenched and ostensibly undramatic technology, bone transfers, that has only recently gained public attention. The history of bone transplants is intertwined with a desire for a safe and stable supply of bone. This desire has a number of rarely debated social implications of relevance to transplant medicine in general: the gradual industrialization of procurement; the institutional production of the view of the body as a dividable resource; the emergence of a notion of scarcity; of body parts as waste; of death as a productive moment in which body parts acquire potential exchange value; and of tensions between an ethics of respect for donors and an ethics of efficient procurement. Historical analysis combined with a contemporary phenomenological approach suggests that the ‘newness’ typically associated with usage of human biological material is not related to transplant technologies as a medical discipline as such, but rather to changes in its social organization and features of the everyday experience of living with the transplant technologies.     

Living liver donation: Attitudes of the general public and general practitioners in Scotland

In April 2006, the Scottish Liver Transplant Unit in Edinburgh became the first NHS transplant unit in the UK to offer adult-to-adult living donor liver transplantation (LDLT). This procedure allows a healthy individual to donate part of their liver to someone with end-stage liver disease. With donations from the deceased in short supply, this procedure has the capacity to save lives. The aim of this study was to explore the attitudes of the general public and general practitioners (GPs) towards LDLT, before its implementation. A total of 1041 members of the Scottish general public and 155 GPs working in Scotland completed a short questionnaire devised for this study. The majority of participants supported the option of LDLT, but frequency counts showed that only 34% of the general public wish to donate their organs following death compared to 85% of GPs. With regards to an acceptable risk of death before volunteering to donate, 25% of GPs would accept a 1 in 20 risk of death, whereas 50% of the general public either could not make a decision or selected ‘No risk’. The question of how well people understand the concept of risk was again highlighted in this study.     

血清Cys C的检测对肾移植术后患者肾功能评价的临床意义

探讨分析血清胱抑素C（Cys C）水平在肾移植术后患者肾功能监测中的应用价值.对25例肾移植成功患者在术前、术后第1、3、5、7、10天的血清Cys C、Scr、β2-MG、BUN水平进行动态监测,同时随机抽取健康体检者中的20例作为对照组.发现移植组的Cys C、Scr、β2-MG、BUN水平在术前均明显高于健康对照组（P＜0.01）.这四项指标在手术后第一天都有所下降,且术后第1、3、5、7、10天的水平都比术前低（P＜0.01）.四项指标与GFR的关系均为显著性负相关（P＜0.01）,其中血清Cys C与GFR的相关性最好.Cys C、Scr、β2-MG、BUN检测后的ROC曲线下面积分别是：0.937、0.838、0.798、0.772,其差异都具有统计学意义（P＜0.05）.血清Cys C优于Scr、β2-MG、BUN,在肾移植患者术后的动态监测中具有重要的临床应用价值.     

Escape as reinforcement and escape extinction in the treatment of feeding problems

Given the effectiveness of putative escape extinction as treatment for feeding problems, it is surprising that little is known about the effects of escape as reinforcement for appropriate eating during treatment. In the current investigation, we examined the effectiveness of escape as reinforcement for mouth clean (a product measure of swallowing), escape as reinforcement for mouth clean plus escape extinction (EE), and EE alone as treatment for the food refusal of 5 children. Results were similar to those of previous studies, in that reinforcement alone did not result in increases in mouth clean or decreases in inappropriate behavior (e.g., Piazza, Patel, Gulotta, Sevin, & Layer, 2003). Increases in mouth clean and decreases in inappropriate behavior occurred when the therapist implemented EE independent of the presence or absence of reinforcement. Results are discussed in terms of the role of negative reinforcement in the etiology and treatment of feeding problems.