May / June, 2017 Volume 9 | Number 3 Ofpjournal.Com

Total Page:16

File Type:pdf, Size:1020Kb

May / June, 2017 Volume 9 | Number 3 Ofpjournal.Com THE OFFICIAL PEER-REVIEWED PUBLICATION OF THE AMERICAN COLLEGE OF OSTEOPATHIC FAMILY PHYSICIANS May / June, 2017 Volume 9 | Number 3 ofpjournal.com EDITOR’S MESSAGE Yes, Healthcare is Complicated RESEARCH ARTICLE Effectiveness of a Clinically Oriented Motivational Interviewing Training Program REVIEW ARTICLES To Circumcise or Not to Circumcise Ethical Considerations in Prescribing Opioids or Not Sleep Disorders & Treatment CLINICAL IMAGES Keeping Slipped Capital Femoral Epiphysis in Mind PATIENT EDUCATION HANDOUT Circumcision www.acofp.org 2018 CALL FOR PAPERS Osteopathic Family Physician Osteopathic Family Physician is the ACOFP’s official peer-reviewed journal The bi-monthly publication features original research, clinical images and articles about preventive medicine, managed care, osteopathic principles and practices, pain management, public health, medical education and practice management. RESERVE A TOPIC Reserve a review article topic today by emailing ACOFP Managing Editor, Belinda Bombei at [email protected]. Please provide your name and the review title you would like to reserve. Once you reserve a review article topic, you will receive an email confirmation from ACOFP. This will initiate a three-month deadline for submission. If the paper is not received within three months, the system will release the review article topic for other authors to reserve. Articles submitted for publication must be original in nature and may not be published in any other periodical. Materials for publication should be of clinical or didactic interest to osteopathic family physicians. Any reference to statistics and/or studies must be footnoted. Material by another author must be in quotations and receive appropriate attribution. ACOFP reserves the right to edit all submissions. Visit ofpjournal.com to view author guidelines, policies, and manuscript checklist. CLINICAL IMAGES We are seeking clinical images from the wards that covers essential concepts or subject matter to the primary care physician. Please provide a brief synopsis of how the case presented along with 1-4 questions and approximately 1 page of education with reference to the image and questions. REVIEW ARTICLE TOPICS: RESEARCH TOPICS • Approach to the Patient with a Tremor We are seeking original clinical or applied research papers. Original contributions include controlled • Approach to Polyarthritis for the Primary Care Physician trials, observational studies, diagnostic test studies, cost-effectiveness studies, and survey-based • Chronic Abdominal Pain: Tips for the Primary Care Provider studies. The OFP will accept basic scientific research • Combating the Opioid Prescription Epidemic: only if the work has clear clinical applications. For randomized controlled trials, study flow diagrams Appropriate vs. Inappropriate Prescribing must be submitted. For all other types of original • CPPD: Common and Under Recognized contributions, flow diagrams are encouraged. Original contributions should be 3000 words with • Direct Primary Care: Emerging Practice Alternative no more than 50 references and 5 tables or figures. OFP requires you to submit a 250-word abstract, • The Food Allergy Revolution along with four to six keywords. • Gas, Bloating and Belching: Tips for the Primary Care Physician The content should include the following: • Irregular Menstrual and Postmenopausal Bleeding: Now What? Abstract Discussion • Newborn Disorders & Nutritional Guidance Introduction Conclusions Methods Acknowledgments • Patient Engagement Results (Help define the science of engaged research, provide tangible examples of the impact of engaged research, or answer a question or controversy related to patient engagement.) • Vaccinations: Past the Misinformation & Reaching Patients • Working Effectively with Patients with Borderline personality Amy Keenum, DO, PharmD Ronald Januchowski, DO, FACOFP Editor-in-Chief Associate Editor AOBFP EST. EXAM SCHEDULE 1972 2018 CALL FOR PAPERS CERTIFICATION & OCC (RECERTIFICATION) Osteopathic Family Physician Osteopathic Family Physician is the ACOFP’s official peer-reviewed journal The bi-monthly publication features original research, clinical images and articles about preventive medicine, managed care, osteopathic principles and practices, pain management, public health, medical education and practice management. EXAMS LOCATIONS POSTMARK DATE AOA OMED Conference RESERVE A TOPIC Family Medicine / OMT Philadelphia, PA April 1, 2017 Reserve a review article topic today by emailing ACOFP Managing Editor, Belinda Bombei at [email protected]. Please provide your Certification / OCC October 7 - 11, 2017 Late fee through June 1 name and the review title you would like to reserve. Once you reserve a review article topic, you will receive an email confirmation from ACOFP. This will initiate a three-month deadline for submission. If the paper is not received within three months, the system will release Performance Evaluation Only October 6 - 8, 2017 the review article topic for other authors to reserve. Articles submitted for publication must be original in nature and may not be published in any other periodical. Materials for publication should be of clinical or didactic interest to osteopathic family physicians. Any reference to statistics and/or studies must be footnoted. Material by another author must be in quotations and receive appropriate attribution. Family Medicine / OMT Electronic Testing April 1, 2017 ACOFP reserves the right to edit all submissions. Visit ofpjournal.com to view author guidelines, policies, and manuscript checklist. Certification / OCC Regional Sites Late fee through June 1 Cognitive Exam October 21, 2017 CLINICAL IMAGES We are seeking clinical images from the wards that covers essential concepts or subject matter to the primary care physician. Please provide a brief synopsis of how the case presented along with 1-4 questions and approximately 1 page of education with reference ACOFP Conference to the image and questions. Family Medicine / OMT Austin, TX November 1, 2017 Certification / OCC March 22 - 25 , 2018 Late fee through December 1 Performance Evaluation Only REVIEW ARTICLE TOPICS: RESEARCH TOPICS March 20 - 23, 2018 • Approach to the Patient with a Tremor We are seeking original clinical or applied research papers. Original contributions include controlled Family Medicine / OMT Electronic Testing October 1, 2017 • Approach to Polyarthritis for the Primary Care Physician trials, observational studies, diagnostic test studies, Certification Only Regional Sites Late fee through December 1 cost-effectiveness studies, and survey-based • Chronic Abdominal Pain: Tips for the Primary Care Provider studies. The OFP will accept basic scientific research Cognitive Exam April 28, 2018 • Combating the Opioid Prescription Epidemic: only if the work has clear clinical applications. For randomized controlled trials, study flow diagrams Appropriate vs. Inappropriate Prescribing must be submitted. For all other types of original Family Medicine / OMT Electronic Testing November 1, 2017 • CPPD: Common and Under Recognized contributions, flow diagrams are encouraged. OCC (Recertification) Only Regional Sites Late fee through December 1 Original contributions should be 3000 words with Cognitive Exam May 26, 2018 • Direct Primary Care: Emerging Practice Alternative no more than 50 references and 5 tables or figures. OFP requires you to submit a 250-word abstract, • The Food Allergy Revolution along with four to six keywords. Family Medicine / OMT Electronic Testing April 1, 2018 • Gas, Bloating and Belching: Tips for the Primary Care Physician Certification / OCC Regional Sites Late fee through June 1 The content should include the following: • Irregular Menstrual and Postmenopausal Bleeding: Now What? Cognitive Exam September 22, 2018 Abstract Discussion • Newborn Disorders & Nutritional Guidance Introduction Conclusions Methods Acknowledgments • Patient Engagement Results (Help define the science of engaged research, provide tangible examples of the impact of engaged research, or answer a question or controversy related to patient engagement.) • Vaccinations: Past the Misinformation & Reaching Patients • Working Effectively with Patients with Borderline personality AMERICAN OSTEOPATHIC BOARD OF FAMILY PHYSICIANS Amy Keenum, DO, PharmD Ronald Januchowski, DO, FACOFP If you have questions, please call 847.640.8477 or email [email protected]. Editor-in-Chief Associate Editor Guide for... READERS AUTHORS Osteopathic Family Physician (ISSN 1877-573X) is published For a full and complete Guide for Authors, please go to: bimonthly by the American College of Osteopathic Family mc04.manuscriptcentral.com/ofp. Physicians. Periodicals postage paid at Arlington Heights, IL and additional mailing offices. REPRINTS: USA POSTMASTER For queries about author reprints, or to order 100 or more reprints for education, commercial or promotional use, Send address changes to: contact ACOFP at 800.323.0794 or email [email protected]. American College of Osteopathic Family Physicians Membership Department: 330 East Algonquin Rd, Suite 1 This journal and the individual contributions contained in Arlington Heights, IL, 60005 it are protected under copyright by ACOFP. The following [email protected] terms and conditions apply: CUSTOMER SERVICE PHOTOCOPYING (orders, claims, online, change of address) Single photocopies of single articles may be made for personal use as allowed by national copyright laws. Permission of the American College of Osteopathic Family Physicians Publisher
Recommended publications
  • IS CIRCUMCISION a FRAUD? FRAUD? a IS CIRCUMCISION Peter W
    cjp_30-1_42664 Sheet No. 27 Side A 11/12/2020 09:05:36 \\jciprod01\productn\C\CJP\30-1\CJP102.txt unknown Seq: 1 11-NOV-20 14:50 IS CIRCUMCISION A FRAUD? Peter W. Adler, Robert Van Howe, Travis Wisdom & Felix Daase* This Article suggests that non-therapeutic male circumcision or male genital cutting (MGC), the irreversible removal of the foreskin from the penises of healthy boys, is not only unlawful in the United States but also fraudulent. As a German court held in 2012 before its ruling was effectively overturned by a special statute under political pressure, cir- cumcision for religious or non-medical reasons is harmful, violates the child’s rights to bodily integrity and self-determination (which super- sedes competing parental rights), and constitutes criminal assault. MGC also violates the child’s rights under U.S. law, and it constitutes a bat- tery, a tort and a crime, and statutory child abuse. Building upon a 2016 case in the United Kingdom, we make the novel suggestion that when performed by a physician, MGC is a breach of trust or fiduciary duty, and hence constructive fraud, where courts impute fraud even if intent to defraud is absent. We reprise and build upon the argument that it is unlawful and Medicaid fraud for physicians and hospitals to bill Medi- caid for unnecessary genital surgery. Finally, we suggest that MGC con- stitutes intentional fraud by the American Academy of Pediatrics (AAP) and most physicians who perform circumcisions in the United States. They have long portrayed MGC as medicine when it is violence, and as a parental right when males have the right to keep their penile foreskin, and physicians are not allowed to take orders from parents to perform cjp_30-1_42664 Sheet No.
    [Show full text]
  • “I'm Not Missing Anything by Being Circumcised; Why Should I Restore
    “I’m not missing anything by being Pleasure. The foreskin is a unique structure filled with which they had always believed was irreversible. circumcised; why should I restore?” delicate nerves and a rich blood supply. The foreskin enhances sexual pleasure, especially as it glides over the Resentment. A 1991 survey of 301 males seeking corona (ridge of the glans) during sexual activity. restoration information showed that almost 70% of those With no accurate means of comparison, the typical circumcised as infants or children resent their parents for circumcised man does not know what he is missing. A Sensitivity. The foreskin is a highly nerve-laden structure, their circumcision. Regaining power over their bodies man, colorblind from birth and thinking his sight is containing approximately 10,000 nerve endings. It is this reduces resentment. normal, might also never question his condition. structure that gives the man his most pleasurable However, as a man ages, he loses sensitivity of the penis. sensations. It also helps to retain glans sensitivity. Empowerment. Victims of rape, crime and child or Many men have difficulty achieving sufficient Circumcision removed this structure and over time spousal abuse typically report a deep sense of stimulation to reach orgasm. The foreskin is a definite sensitivity decreases, making it more difficult to achieve helplessness and vulnerability. Who is more helpless and asset in maintaining this sensitivity. satisfactory stimulation. vulnerable than a restrained newborn having part of his penis amputated? Men restore to take back control of Foreskin restoration is a logical process of returning the Lubrication. Much as the way your eyelid lubricates and their bodies from the damage done by parents, their penis to as close to its original condition as possible.
    [Show full text]
  • Owners Manual
    Penisownersinstructionmanual INTRODUCTION Welcome to the world-wide family of penis owners. We trust that you will enjoy many years of trouble-free service from yours. To help ensure that you will, we encourage you to familiarise yourself with the following equipment descriptions, operating instructions and maintenance requirements. BODY AND INTERIOR SPECIFICATIONS (all model years) PENIS Average length and diameter (flaccid) 3.5 x 1.25 inches Average length and diameter (erect) 5.1 x 1.6 inches Average percent increase in volume, flaccid to erect 300% (wow!) Longest medically recorded erection 12 inches Amount of blood in erect penis 8 to 10 x normal Average erections per night (while sleeping) 5 Average duration of each nocturnal erection 20 to 30 minutes Estimated replacement value (good condition model) £50,000 CAUTION! The following can shrink a relaxed penis by two inches or more:- Cold weather, chilly baths or showers, sexual activity, exhaustion, excitement (non sexual), illness and Richard Branson. TESTICLES Average length and width 1.4 x 1 inch Average weight 0.875 x 1.75 ounces Temperature 94.6 degrees Fahrenheit Compartments within each 400 SPERM Average body's production 50,000 per minute/72 million per day (and remember lads, it only takes 1!) Days to maturity 84 Number in ejaculate of average fertile 200 to 600 million man Number of ejaculate of infertile man less than 50 million Percentage of total ejaculate 3% Average swimming speed 1 to 4 millimetres per minute Average life span once mature 1 month in you, 1 to 2 days in woman, 2 minutes on sheets CAUTION! The testicles need to be slightly cooler than normal body temperature for optimum sperm production.
    [Show full text]
  • European Urology Today Official Newsletter of the European Association of Urology Vol
    European Urology Today Official newsletter of the European Association of Urology Vol. 25 No.6/Vol. 26 No.1 - Dec. 2013/Jan. 2014 What to expect in Stockholm 9th SEEM in Greece From max to mini Get a preview of what’s on during the From ‘country debates’ to research awards, Needlescopic surgery is back and the interest is 4/5 EAU Congress in Stockholm 14 the SEEM takes a new turn 30 growing Urologists, medical and radiation oncologists come together 5th EMUC in Marseille gathers delegates from 61 countries By Loek Keizer Over the course of three days, three separate but intrinsically linked disciplines attended a scientific meeting and exchanged views on the treatment of radiotherapists approach tumours with probabilities urological cancers. The 5th edition of the European and sigmoid curves. I’m convinced that by learning Multidisciplinary Meeting on Urological Cancers each other’s language and working together in (EMUC) was organised by the EAU, the European multidisciplinary teams is the future for the treatment Society for Medical Oncology (ESMO) and the European of urological cancers.” Society for Radiotherapy and Oncology (ESTRO). On the current state of urological cancer treatment: The meeting took place at in Marseille from 15-17 “We shouldn’t be working as separate, sometimes November, at the capable facilities of the Palais des opposing columns within medicine: collaboration is Congrès at the Parc Chanot. The congress centre was a vital to receive funding and improve care for the brief boulevard stroll away from the Mediterranean patient. We are starting to see multidisciplinary coast, with a temperate breeze being a warm clinics in the United States, where urologists buy their welcome to visitors from Northern Europe.
    [Show full text]
  • Non-Surgical Foreskin Restoration
    February 2016 Non-surgical Foreskin Restoration A publication of Doctors Opposing Circumcision www.doctorsopposingcircumcision.org Seattle, Washington Foreskin restoration cannot truly replicate what was stolen, but it can and does provide a vast improvement on the circumcised state. Re-covering my glans improved my sexual function, my body image, and my sense of well-being. There was also a sense of alchemy, of personal victory over something that had seemed hopeless. ‒ J.L., Vancouver, B.C., born 1954 A significant number of circumcised men – in the U.S. and around the world – feel loss, resentment, betrayal, and anger over the violation of their bodies at birth. It takes only a minimal understanding of normal anatomy and function of the normal penis, and of the tawdry social history of circumcision in English language medicine, to understand these feelings of regret and the motivation these men have to restore. Doctors Opposing Circumcision heartily recommends foreskin restoration for those who feel drawn to restore. We estimate that more than 100,000 North American men have completed or are currently engaged in non-surgical foreskin restoration. We are available to advise those of our medical colleagues who encounter patients interested in non-surgical foreskin restoration. We will also gladly counsel men who have questions about restoration, or refer them to a knowledgeable medical professional in their region. Restoration, a safe and proven technique, does not require medical monitoring; however, a restorer may seek medical reassurance. D.O.C. is not alone in recommending against surgical foreskin restoration,[1] which may, we believe, lead to further scar tissue and nerve damage.
    [Show full text]
  • Male and Female Circumcision
    Male and Female Circumcision Medical, Legal, and Ethical Considerations in Pediatric Practice Male and Female Circumcision Medical, Legal, and Ethical Considerations in Pediatric Practice Edited by George C. Denniston. University of Wmhington Seanle, Washington Frederick Mansfield Hodges Wellcome Unitfor the History of Medicine University of O.$onl Oxford, England and Marilyn Fayre Milos National Organization of Circumcision Information Resource Centers San Anselmo, California Kluwer Academic /Plenum Publishers New York, Boston, Dordrecht, London, Moscow Llbrary of Congress Cataloglng-in-Publication Data Male and fenale circumcision : medical, legal. and ethical considerations in pediatric practice / edited by George C. Oenniston. Frederick Mansfield Hodges. andMarilyn Fayre Milos. p. cn.. "Proceedings of the Fifth International Synposiua onSexual Mutilations: Medlcal. Legal. andEthical Considerations in Pediatric Practice, held August 1998. in Oxford, Eng1and""T.p. verso. 5-7. Includes bibliographical references and index. ISBN 0-306-46131-5 1. Circumcision Congresses. 2. Fenale clrcumclsion Congresses. 3. Circumcision--Moral and ethical aspects Congresses. 4. Fenale circuncision--Moral and ethical aspects Congresses. I. Denniston. George C. 11. Hodges. Frederick Mansfield. 111. Milos, Marilyn IV. Fayre. International Symposium on Sexual Mutilations (5th : Oxford. England) l998 : GN484.H35 1999 172'.2--dc21 99-37490 CIP Proceedings of the FiInternational Symposium on Sexual Mutilations: Medical, Legal, and Ethical Considerations in Pediatric Practice, held August 5-7.1998, in Oxford, England ISBN. 0-306-46131-5 0 1999 Kluwer Academiclplenum Publishers 233 Spring Street, New York, N.Y. 10013 l0987654321 A CAP. record for this book is available fromthe Library of Congress. All rights reserved No part of this book may be reprodud, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying.
    [Show full text]
  • Is Circumcision for Everyone?
    Is Circumcision for Everyone? by J.K. McKee A commonly quoted Scripture in the Messianic movement, in relation to Torah observance, has become Exodus 12:49: “The same law shall apply to the native as to the stranger who sojourns among you.” This Scripture is touted as meaning that all, both Jew and non-Jew, who follow the God of Israel, are applicable to torah echad or “one law.” This is used as a support to mean that all who follow the Holy One of Israel, are to follow the Torah or the Law of Moses. We most certainly agree with this conclusion and strongly believe that all Believers are to follow the “The same teaching” (CJB). However, if we place Exodus 12:49 in context, we will see that this specific instruction relates to Passover, and more specifically to the rite of circumcision: “But if a stranger sojourns with you, and celebrates the Passover to the L ORD , let all his males be circumcised, and then let him come near to celebrate it; and he shall be like a native of the land. But no uncircumcised person may eat of it” (Exodus 12:48). The issue of circumcision is one of the most hotly debated and discussed in the Messianic community today, with extremes on both the Left and the Right. On the Left, you have Messianic liberals who believe that physical circumcision is unimportant by any means, and then on the Right there are some Messianic extremists who believe that physical circumcision is required for salvation. There has to be a fair-minded perspective of this issue that seeks to be Biblical, not looking for loopholes in regard to Torah observance, but at the same time recognizes that circumcision of the flesh is not a salvation issue .
    [Show full text]
  • The Studies That Launched a Thousand Snips
    Early release, published at www.cmaj.ca on December 12, 2011. Subject to revision. CMAJ News December 6, 2011 The studies that launched a thousand snips Medical researchers may hope their work will eventually give rise to large-scale, well- funded health programs, but those dreams rarely come true. Though it can happen and indeed did happen to three sets of researchers who conducted clinical trials in Africa several years ago. Their research, which linked circumcision to lower rates of HIV transmission, drew support from high-profile luminaries, donations from well-heeled philanthropists and resulted in mass circumcision programs in several African countries. Opponents of circumcision, however, claim those much-praised trials aren’t all they were cracked up to be. “For the past 100 years, advocates for circumcision have been coming up with ideas of why to circumcise boys,” says Dr. George Denniston, founder of Doctors Opposing Circumcision, based in Seattle, Washington. “There was cancer of the penis, and then it was cancer of the cervix for their partners, and on and on. Now they have HIV. But the HIV studies are extremely flawed.” The first trial, published in 2005, was conducted on 3271 uncircumsized men in South Africa, and found that circumcision can reduce HIV transmission in heterosexual men by up to 61% (PLoS Med 2: e298. doi: 10.1371/journal.pmed.0020298). “The first and obvious consequence of this study is that MC [male circumcision] should be recognized as an important means to reduce the risk of males becoming infected by HIV,” the study states. “As shown by our study, MC is useful and feasible even among sexually experienced men living in an area with high HIV prevalence.” The second clinical trial was conducted in Rakai, Uganda, on 4996 uncircumcised men and found a reduction in HIV transmission of about 50% (Lancet 2007;369:643-56).
    [Show full text]
  • On the Foreskin Question Circumcision and Psychoanalysis
    On the Foreskin Question Circumcision and Psychoanalysis Jordan Harold Osserman 2017 A thesis presented for the degree of Doctor of Philosophy University College London Centre for Multidisciplinary and Intercultural Inquiry I, Jordan Harold Osserman, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. Signed, ______________________ Abstract Male circumcision is a potent receptacle for fantasy. Whatever its medical benefits or harms, the significance of the practice has always extended to questions beyond the purely organic. By placing specific moments in the history of circumcision into dialogue with psychoanalytic theory, this dissertation demonstrates how circumcision is an inherently ambivalent procedure that enables multitudinous and contradictory responses to the constitutive encounter with lack to be played out on the site of the penis. Through circumcision – whether actual or spectral – the penis is put into relation with the symbolic phallus, allowing the organ to function as an image upon which fundamental questions of subjectivity may be posed. The dissertation begins with an introduction to the relevant psychoanalytic theory on castration, sexual difference, and the phallus, and then examines the extant historical, critical, and psychoanalytic literature relating to circumcision. Subsequently, three case studies are explored, over the course of four chapters: First, St. Paul’s abrogation of Jewish circumcision and its undertheorized role in debates surrounding “Pauline” universalism, considered from the divergent perspectives of Alain Badiou and Daniel Boyarin. Second, the nineteenth-century Anglo-American medicalization of circumcision (promoted as a cure for nervous illness), and the relationship between the “talking cure” and the “circumcision cure.” Finally, the libidinal undertones of contemporary political discourse, activism, and popular sentiment on circumcision.
    [Show full text]
  • Wo 2007/087452 A2
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (43) International Publication Date (10) International Publication Number 2 August 2007 (02.08.2007) PCT WO 2007/087452 A2 (51) International Patent Classification: GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IS, A61K 8/20 (2006.01) JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK, LR, LS, LT, LU, LV,LY,MA, MD, MG, MK, MN, MW, MX, MY, (21) International Application Number: MZ, NA, NG, NI, NO, NZ, OM, PG, PH, PL, PT, RO, RS, PCT/US2007/002378 RU, SC, SD, SE, SG, SK, SL, SM, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (22) International Filing Date: 29 January 2007 (29.01.2007) (84) Designated States (unless otherwise indicated, for every (25) Filing Language: English kind of regional protection available): ARIPO (BW, GH, GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, (26) Publication Language: English ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), European (AT,BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, (30) Priority Data: FR, GB, GR, HU, IE, IS, IT, LT, LU, LV,MC, NL, PL, PT, 60/762,489 27 January 2006 (27.01.2006) US RO, SE, SI, SK, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, ML, MR, NE, SN, TD, TG). (71) Applicant (for all designated States except US): THER- AQUEST BIOSCIENCES, LLC [US/US]; 146 Medinah Declarations under Rule 4.17: Drive, Blue Bell, PA 19422-3212 (US).
    [Show full text]
  • Female Genital Mutilation and Male Circumcision: Toward an Autonomy-Basedethical Framework’ (2015) 5(1) Medicolegal and Bioethics 89
    Almenn hegningarlög (bann við umskurði drengja) 114. mál, 148. lögg'afarþing 2017-2018. Dear Esteemed Madam or Sir, I have read with interest about the proposed circumcision ban in Iceland. The law, ethics, and policy of male and female genital cutting are my main academic areas of expertise, and I thought I might provide a few resources that may be helpful in your governmental deliberations. I am Research Fellow at the Uehiro Centre for Practical Ethics at the University of Oxford and Associate Director of the Yale-Hastings Program in Ethics and Health Policy at Yale University and The Hastings Center. First, I am attaching an analysis of a recent court decision in England, in the matter of B and G, which classified male circumcision as a 'significant harm' but then tried to rescue the distinciton between it and female genital cutting by appealing to alleged health benefits and a distinction between religion and 'mere' culture. Since this will be a common objection to the proposed Icelandic law, I hope you will find this analysis especially helpful. In the essay, recently published in the Medical Law Review by Oxford University Press, I argue that the supposed distinctions concerning health and religion are not grounded in fact, but rather stereotypes about the two forms of genital cutting. That therefore, I conclude, if non-therapeutic female genital cutting is unlawful, then so must be non- therapeutic male genital cutting. This argument is explored further in the attached second essay, "In Defence of Genital Autonomy for Children," published by the Journal of Medical Ethics.
    [Show full text]
  • Fine-Touch Pressure Thresholds in the Adult Penis Sorrells
    Sexual Medicine FINE-TOUCH PRESSURE THRESHOLDS IN THE ADULT PENIS SORRELLS Fine-touch et al. pressure thresholds in the adult penis Morris L. Sorrells, James L. Snyder, Mark D. Reiss, Christopher Eden*, Marilyn F. Milos†, Norma Wilcox and Robert S. Van Howe‡ Retired, *HIV/AIDS researcher, San Francisco, CA, †National Organization of Circumcision Information Resource Centers, ‡Department of Paediatrics and Human Development, Michigan State University College of Human Medicine, MI, USA Accepted for publication 22 October 2006 OBJECTIVE last ejaculation, ethnicity, country of birth, circumcision had lower pressure thresholds and level of education. than the ventral scar of the circumcised penis. To map the fine-touch pressure thresholds of the adult penis in circumcised and CONCLUSIONS uncircumcised men, and to compare the two RESULTS populations. The glans of the circumcised penis is less The glans of the uncircumcised men had sensitive to fine touch than the glans of the significantly lower mean (SEM) pressure uncircumcised penis. The transitional region SUBJECTS AND METHODS thresholds than that of the circumcised men, from the external to the internal prepuce at 0.161 (0.078) g (P = 0.040) when controlled is the most sensitive region of the Adult male volunteers with no history of for age, location of measurement, type of uncircumcised penis and more sensitive than penile pathology or diabetes were evaluated underwear worn, and ethnicity. There were the most sensitive region of the circumcised with a Semmes-Weinstein monofilament significant differences in pressure thresholds penis. Circumcision ablates the most sensitive touch-test to map the fine-touch pressure by location on the penis (P < 0.001).
    [Show full text]