In previous articles I discussed the ethics of human reproductive cloning, focusing on a possible future scenario in which reproductive cloning can be accomplished without an elevated risk of anomalies to the children who are created. I argued that in such a scenario it would be ethically permissible for infertile couples to use cloning as a way to have genetically related children and that such use should not be prohibited. In 'Reproductive Cloning and a (Kind of) Genetic Fallacy', Neil Levy and Mianna Lotz raise objections to my conclusions. They disagree with the view, for which I argued, that some couples can have defensible reasons for desiring genetically related children. They also offer several new arguments against reproductive cloning, including an argument that it would diminish the number of adoptions, thereby adversely affecting the welfare of children who need to be adopted. In this paper I point out that Levy and Lotz's criticisms misconstrue my arguments and that there are serious problems with their arguments for prohibiting infertile couples from using cloning, including their argument from adoption.

Background The World Health Organization's "Coordinated Global Research Roadmap: 2019 Novel Coronavirus"outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID- 19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health. Method This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged. Results Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection. Conclusion The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally. / Revisión por pares

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Early life adversity (ELA) is a prevalent experience in young populations worldwide and can come in many forms, including limited access to resources as in many low socio-economic status households. ELA in humans has been linked to a variety of negative psychiatric outcomes including increased risk for psychiatric disorders such as schizophrenia, major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and substance use disorder (SUD). One characteristic that these disorders share is a disruption in motivational processes. Motivation is largely regulated by the mesocorticolimbic dopamine (DA) system but is also modulated by other brain regions including the medial preoptic area (mPOA) and is crucial for processing of natural rewards such as sexual reproduction. This circuitry is sensitive to estrogenic and androgenic signaling in both males and females. Interestingly, estrogens and androgens can be modulated by the experience of ELA, pointing to gonadal hormones as a potential mediator for the impact of ELA on motivation and risk for psychiatric disorders. In the first set of experiments presented here, we characterize the limited bedding and nesting model (LBN) of early life adversity in rodents, in which rat dams and their pups are housed in a limited resource environment from postnatal day (PND) 2 through 9. LBN dams exhibited less self-care behaviors and more pup-directed behaviors, including grooming and nursing, compared to control dams. This type of maternal care is not characteristic of healthy rat dam behavior and may represent a compensatory mechanism to combat the lack of resources. However, LBN-raised pups still exhibit developmental alterations, notably a decrease in body weight that persisted into adulthood and an increase in adult plasma estradiol levels specifically in males. We build on these findings in the second set of experiments, which explores whether changes in development and gonadal hormones may also impact male reproductive behavior. We found that LBN males have a shorter latency to engage in sex behaviors at earlier timepoints in the sex assay compared to controls, suggesting an enhancement in the acquisition of this repertoire of behaviors. This enhancement in behavior was accompanied by highly sex-specific changes in gene transcription in the mPOA which underlies reproductive behaviors. The identification of genes and signaling pathways that are altered by LBN in the male mPOA lays the groundwork for future studies investigating the mechanisms by which ELA alters reproductive behaviors and underlying motivational processes. / Psychology

With nearly 13% of maternal deaths being attributed to unsafe abortion there is a need to implement new strategies to improve access to safe services. As developing regions and legally restricted areas lead these numbers, further evidence must be presented demonstrating tailored and actionable strategies for these settings. In Pakistan abortion is legally restricted and the country continues to face a high burden of maternal death and disability, much of which is directly or indirectly attributable to unsafe abortion. The community-based distribution of misoprostol for early abortion has the potential to reduce harm from unsafe abortion in Pakistan and other low-resource settings where abortion is legally restricted. This study employed a multi-methods approach to evaluate this intervention in Sindh, Pakistan and consisted of a logbook review, interviews with lay providers, and in-depth interviews with program beneficiaries. Our results suggest that the community-based distribution of misoprostol is an effective and promising strategy for improving access to safe abortion care. Efforts to implement or strengthen similar programs appears warranted.

Sammanfattning Bakgrund: Senaste tjugo åren har en succesiv minskning av andelen helammade barn i Sverige skett. Kvinnor kan uppleva ett outtalat krav från samhället att amma sitt barn, att hon är en sämre mamma om hon inte lyckas med amningen. Amning kan beskrivas som naturlig och lätt men många kvinnor upplever problem under amningsperioden. Amningsvägledningen tycks inte i tillräckligt stor utsträckning betona de komplikationer som kan uppstå och hur dessa kan hanteras. Syfte: Att kartlägga kvinnors erfarenheter av bristande amningsvägledning i relation till utebliven eller tidigt avslutad amning. Metod: Kvantitativ metod genom webbaserad enkätundersökning. Dataanalys med deskriptiv statistik. Resultat: Totalt inkluderades 116 kvinnor. Majoriteten (75%) rapporterade en positiv inställning till att amma. Tidigare amningserfarenhet har betydelse för amningen av nästkommande barn. Amningsvägledningen från barnmorskan upplevs som bristfällig genom hela vårdkedjan. Över hälften av kvinnorna (55%) ammade inte sitt barn alls eller upp till en månad. Slutsatser: Amningsvägledningen saknade information om eventuella problem som kan uppstå och hur dessa kan hanteras, konkreta tips för att få till en fungerande amning samt stöd och närvaro av barnmorskan vid amningssituationerna. Resultatet kan ge ökad kunskap och förståelse kring kvinnors erfarenheter av amning vilket kan stärka barnmorskor i deras arbete och bemötande av kvinnor. Nyckelord: amningsvägledning, avslutad amning, barnmorska, kvantitativ metod / Abstract Background: Over the past twenty years, there has been a gradual decrease in the proportion of fully breastfed children in Sweden. The woman may experience an unspoken demand from society to breastfeed her baby, that she’s not as good mother if she doesn’t succeed in breastfeeding. Breastfeeding can be described as natural and easy but many women experience problems during the breastfeeding period. The breastfeeding guidance might not sufficiently emphasize the complications that may arise and how these can be addressed. Purpose: To identify women's experiences of lack of breastfeeding guidance in relation to no breastfeeding or early cessation of breastfeeding. Method: Quantitative method through a web-based survey. Data analysis with descriptive statistics. Results: A total of 116 women were included in the study. A majority (75%) reported having positive attitudes towards breastfeeding. Previous breastfeeding experience is important for the outcome of breastfeeding the next child. The breastfeeding guidance from the midwife is perceived as deficient throughout the care chain. Over half of the women (55%) didn´t breastfeed their baby at all or up to a month. Conclusion: The breastfeeding guidance lacked information about problems that may arise and how these can be handled, concrete tips for getting a functioning breastfeeding and support and presence of the midwife in breastfeeding situations. The result can provide increased knowledge and understanding of women's experiences of breastfeeding which can strengthen the midwives in their work and treatment of the woman. Keywords: breastfeeding support, breastfeeding cessation, midwife, quantitative method

The Cape ground squirrel, Xerus inauris, is a highly social cooperative breeder that forms groups containing multiple breeding females. While the distribution of reproduction among group members is fairly even (i.e. exhibits low reproductive skew), previous studies of Cape ground squirrels suggest the reproductive development of sub-adult females is inhibited by the presence of adult breeding female group mates. As reproductive delay is known to be influenced by a number of different parameters, my goal was to determine if other factors affected the timing of sexual maturity, and if so, which factors are the most influential. In this study, I simultaneously test the relative power of seven different social and environmental parameters at explaining the variation in the female age of sexual maturity in two populations of Cape ground squirrels. Field work was conducted at two study sites in southern Africa, where trapping, behavioral and hormonal data were collected to determine the timing of reproductive development. Hormonal data was analyzed through the use of steroid enzyme immunoassay analysis to quantify the concentration of gonadal hormone in fecal samples which indicate the onset of sexual maturity. Prior to the start of the field season, I conducted an initial experiment to determine the best alternative form of fecal storage if freezing was unavailable. I found that drying feces provides a more reliable method for long-term preservation of fecal steroid concentrations when compared to storing fecal samples in alcohol. Data associated with each of the seven parameters was analyzed using model selection to simultaneously measure the ability of different combinations of parameters to explain the observed variation in female age of sexual maturity. I found that an increase in the number of adult breeding female group mates and related adult male group mates resulted in a substantial inhibition of female reproductive maturity. I concluded that a female Cape ground squirrel's age of sexual maturity is principally a result of the interaction between adult breeding females' capacity for reproductive suppression and sub-adults' ability to maximize lifetime reproductive success while minimizing inbreeding. The overall reproductive dynamics of each social group results from the tug-of-war between the adult and sub-adult female group mates to control breeding within the group, with minimal direct influence on sexual maturity by environmental factors.

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Zearalenone (ZEN) is an estrogenic mycotoxin produced by fungi in the genus Fusarium. Fusarium species commonly occur in cereal crops such as corn, wheat, barley, and rice which are used in swine feed. In addition to cereals, co-products of ethanol distillation, brewing, and baking are frequently re-purposed as swine feed. ZEN contamination has been related to severe reproductive issues including pelvic organ prolapse (POP), which describes the displacement of pelvic floor organs from their healthy anatomical positions. A recent rise in the rate of POP in sows highlights a need for more information surrounding the occurrence of ZEN in swine feed and the possible role of ZEN in POP. This research aims to understand the relationship between ZEN contamination in swine feed and swine reproductive health. The primary objectives of this work are to (1) characterize the stress relaxation behavior of vaginal tissue in the swine model, (2) determine how ZEN consumption effects the elasticity of pelvic support tissue. (3) determine where ZEN and a related metabolite accumulate in the swine reproductive tract, (4) evaluate the prevalence of ZEN and related Fusarium mycotoxins in swine feed and ingredients, and (5) track ZEN and related Fusarium mycotoxins throughout production of beer and brewers' spent grains (BSG). Results from this work can help stakeholders to mitigate mycotoxin contamination in swine feed, evaluate swine for ZEN toxicosis, and provide care for animals experiencing POP. / Doctor of Philosophy / Under certain conditions, some fungi produce harmful toxins (mycotoxins) that can compromise the health of humans and animals. Mycotoxin-producing fungi are common in cereal crops such as corn, wheat, and barley which may be fed to humans or animals. Swine are especially sensitive to mycotoxins, making feed composition important for animal welfare and profitability. Zearalenone (ZEN) is a mycotoxin that behaves like estrogen, a hormone frequently associated with female reproductive health. Pelvic organ prolapse (POP) is a condition, common in women, wherein organs in the pelvic floor such as the vagina, rectum, and uterus, descend from their healthy anatomical position. Swine herds are experiencing higher rates of POP, which may be related to ZEN contamination in feed. The overall goal of this research is to understand the relationship between mycotoxin contamination in feed and swine reproductive health. The specific objectives of this research are to (1) characterize the mechanical properties of vaginal tissue in swine, (2) characterize mechanical properties of pelvic support tissue associated with POP, in swine fed ZEN, (3) determine which reproductive tissues which accumulate ZEN in swine, (4) evaluate the prevalence of ZEN and related mycotoxins in swine feed, and (5) track ZEN and related mycotoxins throughout production of beer and brewers' spent grain, a co-product used in animal feed. This research can help animal producers develop strategies to mitigate mycotoxin contamination in feed and improve veterinary care.