Day: June 21, 2022

Categories : Ethics and Law Obstetrics & GynaecologyTags :

High Court Wrong about Law on Foetuses under 26 Weeks, Concourt Rules

On By ModernMedia
Gavel
Photo by Bill Oxford on Unsplash

The Constitutional Court has declined to confirm the constitutional invalidity of sections of the Births and Deaths Registration Act. This comes after the Pretoria High Court found that the Act denied parents the right to bury the remains of a foetus less than 26-weeks.

The application was brought by The Voice of the Unborn Baby NPC and the Catholic Archdiocese of Durban against the ministers of Home Affairs and Health.

The applicants argued that the Act was “insensitive, hurtful and disrespectful” as it only allows for a death certificate to be issued in “stillborn” cases when the foetus is more than 26-weeks.

High Court Judge Nomonde Mngqibisa-Thusi agreed and ruled that sections of the Act are unconstitutional on the basis it “deemed a foetus less than 26-weeks to be medical waste that must be incinerated”.

However, the Constitutional Court, in a unanimous judgment, said the judge was wrong. Acting Judge Pula Tlaletsi said the applicants had submitted that the provisions of the Act had the effect that no burial order could be issued for foetuses lost through miscarriage before the 26-week mark, and that the regulations only made provision for the burial of corpses and human remains, but not foetal remains.

“While it may be true, as the applicants argued, that throughout the years the practice has been to deny parents this right in the apparent belief that this is what the law provides, matters not. The Act contains no such prohibition,” Judge Tlaletsi said.

“The relevant sections cannot be declared inconsistent with the Constitution because of such omission … the Act does not stand in the way of that burial,” he said, noting that the Act only regulated the burial of “dead human bodies or still-born children”.

The Judge said that the court was not in a position to grant the relief.

Read the judgment here

The question as to what medical staff at public hospitals must do if parents expressed the wish to bury or cremate pre-viable foetal remains was not clear, he said.

“Such a burial or cremation would no doubt require the cooperation of healthcare professionals and public hospitals would be expected to allocate the necessary resources.

“Because of the way the case was pleaded, we do not have the necessary evidence to evaluate considerations relating to how hospitals would manage this … There may be other restrictions, for example, limitations imposed by municipal regulations (regarding cemeteries and crematoriums).”

The Catholic Church, arguing that its members held “sincere religious beliefs” that they become parents from the moment of conception, said the burial right should also extend to lost pregnancies “due to human intervention”, including termination of pregnancies.

But two amici in the case — the Women’s Legal Centre Trust and the Sexual and Reproductive Justice Coalition — said this would have a profound impact on the termination of pregnancy services offered to women, and the attached confidentiality.

This burden, they said, would lead to a decrease in facilities offering termination and a diminution of sexual and reproductive rights.

However, the apex court did not comment on this.

By Tania Broughton

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Healthcare Politics and RegulationsTags : 1 Comment

Will NHI Mean the End of Medical Aid in South Africa?

On By ModernMedia

Once again, concerns are being raised over the implementation of the proposed National Health Insurance (NHI) scheme. This time, it is over the future of private healthcare and medical aid under the contentious Section 33 of the Bill.

Many previous discussions have focused on the NHI’s affordability, accountability, the potential mass flight of healthcare professionals from the country, and even whether NHI is even possible to achieve given South Africa’s challenges.

In a new healthcare stakeholder opinion report [PDF] published by Section 27 and the Concentric Alliance on Monday, 20 June, it is noted that private healthcare is a major contributor to the economy. May public and private sector respondents believe it could play a significant role in achieving health reform thanks to its resources and capacity.

However, Section 33 of the NHI Bill states that medical schemes may only provide “cover that constitutes complementary or top-up cover and that does not overlap with the personal health care service benefits purchased by the National Health Insurance Fund on behalf of users”.

This basically means medical schemes which are not gap cover will no longer operate – something which does not sit well with the private sector respondents in the report, who argue that even in countries with the best developed public health systems, private healthcare funders still exist.

A carrot vs stick approach

An academic respondent suggested incentivising people into switching to a public healthcare funder, rather than removing private healthcare funding. A private sector respondent also suggested the idea of competition with private funders as a means to improve the NHI’s efficiency. Indeed, it may even be necessary the NHI to function well.

The report makes note of Section 33 of the NHI Bill becoming “something of a hill to die on”. The report says that “During the six-a-side engagements between Business Unity and the National Department of Health, urgent discussions on NHI were nearly derailed by demands that Section 33 be re-opened for discussion and one respondent in the NDOH stating that the Bill was now before parliament. This respondent stated that they would rather see this point litigated, than back down. The current approach to this draft provision has the potential to undermine the implementation of the NHI and delay urgent reform to the health system.”

Categories : Lab Tests and Imaging NeurologyTags :

Retinal Scans May be Able to Detect ASD and ADHD

On By ModernMedia
Eye
Source: Daniil Kuzelev on Unsplash

By measuring the electrical activity of the retina in responses to a light stimulus, researchers found that they may be able to neurodevelopmental disorders such as ASD and ADHD, as reported in new research published in Frontiers in Neuroscience.

In this groundbreaking study, researchers found that recordings from the retina could identify distinct signals for both Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) providing a potential biomarker for each condition.

Using the ‘electroretinogram’ (ERG) – a diagnostic test that measures the electrical activity of the retina in response to a light stimulus – researchers found that children with ADHD showed higher overall ERG energy, whereas children with ASD showed less ERG energy.

Research optometrist at Flinders University, Dr Paul Constable, said the preliminary findings indicate promising results for improved diagnoses and treatments in the future.

“ASD and ADHD are the most common neurodevelopmental disorders diagnosed in childhood. But as they often share similar traits, making diagnoses for both conditions can be lengthy and complicated,” Dr Constable says.

“Our research aims to improve this. By exploring how signals in the retina react to light stimuli, we hope to develop more accurate and earlier diagnoses for different neurodevelopmental conditions.

“Retinal signals have specific nerves that generate them, so if we can identify these differences and localise them to specific pathways that use different chemical signals that are also used in the brain, then we can show distinct differences for children with ADHD and ASD and potentially other neurodevelopmental conditions.”

“This study delivers preliminary evidence for neurophysiological changes that not only differentiate both ADHD and ASD from typically developing children, but also evidence that they can be distinguished from each other based on ERG characteristics.”

According to the World Health Organization, one in 100 children has ASD, with 5–8% of children diagnosed with ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterised by being overly active, struggling to pay attention, and difficulty controlling impulsive behaviours. Autism spectrum disorder (ASD) is also a neurodevelopmental condition where children behave, communicate, interact, and learn in ways that are different from most other people.

Co-researcher and expert in human and artificial cognition at the University of South Australia, Dr Fernando Marmolejo-Ramos, says the research has potential to extend across other neurological conditions.

“Ultimately, we’re looking at how the eyes can help us understand the brain,” Dr Marmolejo-Ramos says.

“While further research is needed to establish abnormalities in retinal signals that are specific to these and other neurodevelopmental disorders, what we’ve observed so far shows that we are on the precipice of something amazing.

“It is truly a case of watching this space; as it happens, the eyes could reveal all.”

Source: Flinders University

Categories : Diseases, Syndromes and Conditions General InterestTags :

Ancient Y. Pestis DNA Suggests Earlier Start to Black Death

On By ModernMedia
Plague doctor costume
Photo by Peter Kvetny on Unsplash

The origin of the mediaeval Black Death pandemic (AD 1346–1353) has long been studied because of its massive impact on population and society. However, most studies have focused on surviving European records, but they provide little insight into the actual origin of this world-changing pandemic. A new study published in Nature reconstructs the DNA of Yersinia pestis from ancient burial sites, suggesting that 1338 was the date of the first outbreak which would later go on to ravage Eurasia.

Conventional thinking puts the onset of the Black Death at 1346 in the Black Sea region. Recent analysis of historical, genetic and ecological data led to the suggestion that the emergence of Y. pestis branches occurred more than a century before the beginning of the Black Death. According to the proposed model, this initial diversification was linked with territorial expansions of the Mongol Empire across Eurasia during the early thirteenth century. But in this study, the researched present ancient Y. pestis data from central Eurasia supporting a fourteenth-century emergence – putting the emergence a full century later, closer to the conventionally accepted 1346 date.

Until now, the most debated archaeological evidence on the pandemic’s initiation came from cemeteries located near Lake Issyk-Kul in modern-day Kyrgyzstan.

These sites are thought to have housed victims of a fourteenth-century epidemic as tombstone inscriptions directly dated to 1338–1339 state ‘pestilence’ as the cause of death for the buried individuals.

Researchers analysed ancient DNA data from seven individuals exhumed from two of these cemeteries, Kara-Djigach and Burana. The combination of archaeological, historical and ancient genomic data implicates Y. pestis in this epidemic event.

Two reconstructed ancient Y. pestis genomes represent a single strain and are identified as the most recent common ancestor of a major diversification commonly associated with the pandemic’s emergence, here dated to the first half of the fourteenth century. Comparing these ancient genomes present-day diversity from Y. pestis reservoirs in the Tian Shan area where China, Kazakhstan and Kyrgyzstan meet supports a local emergence of the recovered ancient strain.

Exactly how Y. pestis made it to western Eurasia is unknown, but previous research suggested that both warfare and/or trade networks were some of the main contributors in the spread of Y. pestis. However, the lack of any military campaigns in this period and the proximity of trans-Asian networks plus trade items at the site suggest trade playing a role in Y. pestis dissemination.

The authors conclude that “Although the ancient Y. pestis genomes reported in this Article offer biological evidence to settle an old debate, it is the unique historical and archaeological contexts that define our study’s scope and importance. As such, we envision that future synergies will continue to reveal important insights for a detailed reconstruction of the processes that triggered the second plague pandemic.”

Categories : UncategorizedTags :

Moderate Beer Consumption May Improve Gut Health

On By ModernMedia
Photo by Pavel Danilyuk on Pexels

The negative effects of beer on health have long been studied, but a new research suggests that beer – both alcoholic and nonalcoholic – has a positive impact on gut health. A lucky group of adult male volunteers drank moderate amounts of beer daily for a month, and the findings on their gut health biomarkers were published in the Journal of Agricultural and Food Chemistry.

Gut microbiota modulation might constitute a mechanism mediating the effects of beer on health. However, intestinal microorganisms can use compounds present in beer. Previous work has found beneficial effects on intestinal from moderate beer drinking, mostly from butyric acid and gut bacteria changes.

In this randomised, double-blinded, two-arm parallel trial, 22 healthy men were recruited to drink 330 mL of nonalcoholic beer (0.0% v/v) or alcoholic beer (5.2% v/v) daily during a 4-week follow-up period. Blood and faecal samples were collected before and after the intervention period. To measure diversity, gut microbiota were gene sequenced to identify strains.

Drinking nonalcoholic or alcoholic beer daily for 4 weeks did not increase body weight and body fat mass, an encouraging sign. The nonalcoholic beer had 26kcal of energy and 5.9g of carbohydrates per 100mL, but the alcoholic beer had more energy (38.5kcal/100mL) despite having fewer carbohydrates (2.8g/100mL). The researchers also found no significant effect on serum cardiometabolic biomarkers.

Both types of beer increased gut microbiota diversity, something which has been associated with positive health outcomes and tended to increase faecal alkaline phosphatase (ALP) activity, a marker of intestinal barrier function.

The increase in gut microbiota may be down to phenolic compounds in the beer, chiefly from the yeast, and other types of beer besides the Lager used may have higher levels of these beneficial compounds. This benefit appears to outperform the negative effect alcohol

These results suggest the effects of beer on gut microbiota modulation are independent of alcohol and may be mediated by beer polyphenols.