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Public's attitudes on participation in a biobank for research: an Italian survey
Porteri, Corinna
Pasqualetti, Patrizio
Togni, Elena
Parker, Michael
BMC Medical Ethics
The creation of biobanks depends upon people's willingness to donate their samples for research purposes and to agree to sample storage. Moreover, biobanks are a public good that requires active participation by all interested stakeholders at every stage of development. Therefore, knowing public's attitudes towards participation in a biobank and biobank management is important and deserves investigation.
A survey was conducted among family members of patients attending the outpatient department of our institute for a geriatric or neurological visit, documenting their willingness to participate in a biobank and their views on the legal-ethical aspects of biobank management. Information regarding subjects' attitudes on biomedical research in general and genetic research in particular was also collected. Participants' data on biobanks were compared with data previously collected from the Italian ethics committees (ECs) to evaluate the extent to which lay people and ethics committees share views and concerns regarding biobanks.
One hundred forty-five subjects took part in the survey. The willingness to give biological samples for the constitution of a biobank set up for research purposes was declared by 86% of subjects and was modulated by subjects' education. People in favour of providing biological samples for a biobank expressed a more positive view on biomedical research than did people who were not in favour; attitude towards genetic research in dementia was the strongest predictor of participation. Different from ECs that prefer specific consent (52%) and do not choose the option of broad consent (8%) for samples collection in a biobank, participants show a clear preference for broad consent (57%), followed by partially restricted consent (16%), specific consent (15%), and multi-layered consent (12%). Almost all of the subjects available to contribute to a biobank desire to receive both individual research results and research results of general value, while around fifty per cent of ECs require results communication.
Family members showed willingness to participate in a biobank for research and expressed a view on the ethical aspects of a biobank management that differ on several issues from the Italian ECs' opinion. Laypersons' views should be taken into account in developing biobank regulations.
Electronic supplementary material
The online version of this article (doi:10.1186/1472-6939-15-81) contains supplementary material, which is available to authorized users.
Public attitudes; Biobanks; Genetic research; Bioethics; Ethical policy
Related Articles
The Establishment of an ISO Compliant Cancer Biobank for Jordan and its Neighboring Countries Through Knowledge Transfer and Training
Barr, Martin
Souan, Lina
MacGabhann, Peadar
Müller, Jeanette
Al Ashhab, Maxim
Jasser, Mohammed
Hamza, Khetam
Al Hassoon, Sallam
Kuhn, Uwe
Infante, Daniela
Lawlor, Denise
Gately, Kathy
Amireh, Eyad
O'Byrne, Kenneth
Sughayer, Maher A.
Biopreservation and Biobanking
Research studies aimed at advancing cancer prevention, diagnosis, and treatment depend on a number of key resources, including a ready supply of high-quality annotated biospecimens from diverse ethnic populations that can be used to test new drugs, assess the validity of prognostic biomarkers, and develop tailor-made therapies. In November 2011, KHCCBIO was established at the King Hussein Cancer Center (KHCC) with the support of Seventh Framework Programme (FP7) funding from the European Union (khccbio.khcc.jo). KHCCBIO was developed for the purpose of achieving an ISO accredited cancer biobank through the collection, processing, and preservation of high-quality, clinically annotated biospecimens from consenting cancer patients, making it the first cancer biobank of its kind in Jordan. The establishment of a state-of-the-art, standardized biospecimen repository of matched normal and lung tumor tissue, in addition to blood components such as serum, plasma, and white blood cells, was achieved through the support and experience of its European partners, Trinity College Dublin, Biostór Ireland, and accelopment AG. To date, KHCCBIO along with its partners, have worked closely in establishing an ISO Quality Management System (QMS) under which the biobank will operate. A Quality Policy Manual, Validation, and Training plan have been developed in addition to the development of standard operating procedures (SOPs) for consenting policies on ethical issues, data privacy, confidentiality, and biobanking bylaws. SOPs have also been drafted according to best international practices and implemented for the donation, procurement, processing, testing, preservation, storage, and distribution of tissues and blood samples from lung cancer patients, which will form the basis for the procurement of other cancer types. KHCCBIO will be the first ISO accredited cancer biobank from a diverse ethnic Middle Eastern and North African population. It will provide a unique and valuable resource of high-quality human biospecimens and anonymized clinicopathological data to the cancer research communities world-wide.
Related Articles
REXIC Project: Retrospective Cross-Sectional Study of Documentation of Informed Consent for Research Biobanking in A Public Research and Teaching Hospital
Nobile, Marta
Garavelli, Elena
Gagliardi, Barbara
Giovanelli, Silvia
Rebulla, Paolo
Caccami, Concetta
Iemmi, Diego
Saibene, Federico
Castaldi, Silvana
Journal of Public Health Research
The Center for Transfusion Medicine, Cell Therapy and Cryobiology, Milan, Northern Italy, is the headquarter of the POLI-MI biobank. It co-ordinates the biobank activities of the Fondazione Ca' Granda Ospedale Maggiore Policlinico of Milan. Such activities require specific safeguarding of donors' rights and protection of sensitive and genetic data. The Fondazione Ca' Granda Ospedale Maggiore Policlinico has set up a project on informed consent with the aim of developing awareness and understanding of this issue. Within this project, it has been decided to evaluate how consent for biobanking material is expressed.
Design and methods
The aim of the study was to evaluate the quality and completeness of consent to biobanking in the POLI-MI biobank. This was a retrospective study carried out in 2012 on samples of consent declarations collected by biobank units in 2011. Some units used a single, standard consent model available from a previous POLI-MI biobank workgroup. Other units used models which had been previouly formulated. Evaluation was made using a form that indicated the essential elements of consent.
A total of 48 consent declarations were collected using the single, standard model and 84 were collected using other models. The consent declarations that used the single, standard model were found to be the most complete and were filled in better than other models.
Progressive adoption of a simple, standard consent model is expected to improve the quality of consent acquisition. Regular audit of the compliance of consent practices with ethical and legal requirements is mandatory to improve the quality of research biobanking.
biobanks; informed consent; ethics; research; public health
Related Articles
Development and Progress of Ireland's Biobank Network: Ethical, Legal, and Social Implications (ELSI), Standardized Documentation, Sample and Data Release, and International Perspective
Mee, Blanaid
Gaffney, Eoin
Glynn, Sharon A.
Donatello, Simona
Carroll, Paul
Connolly, Elizabeth
Mc Garrigle, Sarah
Boyle, Terry
Flannery, Delia
Sullivan, Francis J.
McCormick, Paul
Griffin, Mairead
Muldoon, Cian
Fay, Joanna
O'Grady, Tony
Kay, Elaine
Eustace, Joe
Burke, Louise
Sheikh, Asim A.
Finn, Stephen
Flavin, Richard
Giles, Francis J.
Biopreservation and Biobanking
Biobank Ireland Trust (BIT) was established in 2004 to promote and develop an Irish biobank network to benefit patients, researchers, industry, and the economy. The network commenced in 2008 with two hospital biobanks and currently consists of biobanks in the four main cancer hospitals in Ireland. The St. James's Hospital (SJH) Biobank coordinates the network. Procedures, based on ISBER and NCI guidelines, are standardized across the network. Policies and documents—Patient Consent Policy, Patient Information Sheet, Biobank Consent Form, Sample and Data Access Policy (SAP), and Sample Application Form have been agreed upon (after robust discussion) for use in each hospital. An optimum sequence for document preparation and submission for review is outlined. Once consensus is reached among the participating biobanks, the SJH biobank liaises with the Research and Ethics Committees, the Office of the Data Protection Commissioner, The National Cancer Registry (NCR), patient advocate groups, researchers, and other stakeholders. The NCR provides de-identified data from its database for researchers via unique biobank codes. ELSI issues discussed include the introduction of prospective consent across the network and the return of significant research results to patients. Only 4 of 363 patients opted to be re-contacted and re-consented on each occasion that their samples are included in a new project. It was decided, after multidisciplinary discussion, that results will not be returned to patients. The SAP is modeled on those of several international networks. Biobank Ireland is affiliated with international biobanking groups—Marble Arch International Working Group, ISBER, and ESBB. The Irish government continues to deliberate on how to fund and implement biobanking nationally. Meanwhile BIT uses every opportunity to promote awareness of the benefits of biobanking in events and in the media.
Related Articles
Ethical issues relating to the banking of umbilical cord blood in Mexico
Serrano-Delgado, V Moises
Novello-Garza, Barbara
Valdez-Martinez, Edith
BMC Medical Ethics
Umbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico.
A number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord.
Conflicts between moral principles and economic interests (non-moral principles) cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks' performance.
Related Articles
Evolutionary concepts in biobanking - the BC BioLibrary
Watson, Peter H
Wilson-McManus, Janet E
Barnes, Rebecca O
Giesz, Sara C
Png, Adrian
Hegele, Richard G
Brinkman, Jacquelyn N
Mackenzie, Ian R
Huntsman, David G
Junker, Anne
Gilks, Blake
Skarsgard, Erik
Burgess, Michael
Aparicio, Samuel
McManus, Bruce M
Journal of Translational Medicine
Medical research to improve health care faces a major problem in the relatively limited availability of adequately annotated and collected biospecimens. This limitation is creating a growing gap between the pace of scientific advances and successful exploitation of this knowledge. Biobanks are an important conduit for transfer of biospecimens (tissues, blood, body fluids) and related health data to research. They have evolved outside of the historical source of tissue biospecimens, clinical pathology archives. Research biobanks have developed advanced standards, protocols, databases, and mechanisms to interface with researchers seeking biospecimens. However, biobanks are often limited in their capacity and ability to ensure quality in the face of increasing demand. Our strategy to enhance both capacity and quality in research biobanking is to create a new framework that repatriates the activity of biospecimen accrual for biobanks to clinical pathology.
The British Columbia (BC) BioLibrary is a framework to maximize the accrual of high-quality, annotated biospecimens into biobanks. The BC BioLibrary design primarily encompasses: 1) specialized biospecimen collection units embedded within clinical pathology and linked to a biospecimen distribution system that serves biobanks; 2) a systematic process to connect potential donors with biobanks, and to connect biobanks with consented biospecimens; and 3) interdisciplinary governance and oversight informed by public opinion.
The BC BioLibrary has been embraced by biobanking leaders and translational researchers throughout BC, across multiple health authorities, institutions, and disciplines. An initial pilot network of three Biospecimen Collection Units has been successfully established. In addition, two public deliberation events have been held to obtain input from the public on the BioLibrary and on issues including consent, collection of biospecimens and governance.
The BC BioLibrary framework addresses common issues for clinical pathology, biobanking, and translational research across multiple institutions and clinical and research domains. We anticipate that our framework will lead to enhanced biospecimen accrual capacity and quality, reduced competition between biobanks, and a transparent process for donors that enhances public trust in biobanking.
Related Articles
Practice variation across consent templates for biobank research. a survey of German biobanks
Hirschberg, Irene
Knüppel, Hannes
Strech, Daniel
Frontiers in Genetics
Introduction: Informed, voluntary, and valid consent from biomaterial donors is a precondition for biobank research. Valid consent protects donors' rights and helps maintain public trust in biobank research. Harmonization of consent procedures in biobank research is needed, because of the widely shared vision on national and international networking of biobanks including data and sample sharing. So far, no study has assessed and compared the content of current consent forms especially for biobank research. The objective of this study was to perform a content analysis of consent forms in German biobanks.
Methods: Based on ten guidelines for biomedical research, we developed an assessment matrix with 41 content issues that are potentially relevant for consent forms in biobank research. This assessment matrix was applied in a thematic text analysis to 30 consent documents of German biobanks identified via the German Biobank Registry in July 2012.
Results: Coverage of the 41 items in the assessed consent forms varied widely. For example, the items "Right to withdraw consent (without disadvantage)," "Policy for genetic information/consent to genetic analyzes" and "International cooperation/transborder use" were addressed in 97, 40, and 23% of all 30 consent forms respectively. The number of items covered by a single consent form ranged from 9 to 36 (22–88% out of 41 items).
Discussion: Our findings serve as a starting point to reflect upon the spectrum of consent issues that must be addressed in biobank research. The findings show that the majority of consent forms for German biobanks, if not all, should be improved and harmonized to better support an informed and balanced choice of potential donors and to facilitate networking of biobanks. Best practice models for consent forms in biobank research should be developed and biobank operators need to be more aware of relevant consent issues.
biobank; tissue bank; broad consent; informed consent; survey; thematic text analysis; research ethics
Related Articles
Biobanking research on oncological residual material: a framework between the rights of the individual and the interest of society
Caenazzo, Luciana
Tozzo, Pamela
Pegoraro, Renzo
BMC Medical Ethics
The tissue biobanking of specific biological residual materials, which constitutes a useful resource for medical/scientific research, has raised some ethical issues, such as the need to define which kind of consent is applicable for biological residual materials biobanks.
Biobank research cannot be conducted without considering arguments for obtaining the donors' consent: in this paper we discuss to what extent consent in biobank research on oncological residual materials has to be required, and what type of consent would be appropriate in this context, considering the ethical principles of donation, solidarity, protection of the donors' rights and the requirements of scientific progress. Regarding the relationship between informed consent and tissue collection, storage and research, we have focused on two possible choices related to the treatment of data and samples in the biobank: irreversible and reversible anonymization of the samples, distinguishing between biobank research on residual materials for which obtaining consent is necessary and justified, and biobank research for which it is not. The procedures involve different approaches and possible solutions that we will seek to define. The consent for clinical research reported in the Helsinki Declaration regards research involving human beings and for this reason it is subordinate to specific and detailed information on the research projects.
An important ethical aspect in regard to the role of Biobanks is encouraging sample donation. For donors, seeing human samples being kept rather than discarded, and seeing them become useful for research highlights the importance of the human body and improves the attitude towards donation. This process might also facilitate the giving of informed consent more willingly, and with greater trust.
Biobanks; Consent; Oncological residual material; Cancer biobanks; Residual materials biobanks; Informed consent; Ethics; Research; Solidarity
Related Articles
Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy
Parco, Sergio
Vascotto, Fulvia
Visconti, Patrizia
Journal of Blood Medicine
In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC). Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU]) population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC) counts in the CB-SC bags that are required for validation of the collection.
Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6%) were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC) interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate.
Of the 772 pregnant women, 648 (84.0%) accessed the public collection system, which is free of charge, and 124 (15.0%) accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA) and Venereal Disease Research Laboratory (VDRL) tests were the main tests performed (66.0% of total cases) because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best determination method. We found that the chemiluminescence method was more specific (97.0%) than the TPHA (83.0%) and nontreponemal rapid plasma reagin VDRL (75.0%) tests (P < 0.05, χ2 test). The specificity link between the two automatic methods versus microscopes for WBC dosing and NRBC interference was r2 = 0.08 (ADVIA 120) and r2 = 0.94 (XE-2100). The public system does not include human T-cell lymphotropic virus testing; this is reserved for the population from endemic zones.
In northeastern Italy current legislation prevents the establishment of private fee-based banks for storage of CB-SC. The cryopreservation, for future autologous personal or family use, is possible only by sending to foreign private banks, with a further fee of €300. These regulations confirm that Italian legislation tries to increase the anonymous allogenic donations and the number of CB-CS bags stored in the free-cost public system, that are available to anyone with therapeutic needs. Private banking is used almost exclusively by the wealthier local population. In the public system, many physicians continue to use older Italian laws regarding syphilis diagnosis, and NRBC interference on WBC count may have an impact on cord blood harvesting. Our findings suggest that in the EU there is no consensus policy on donor management. The value of storage for potential use within the family is useful only with collaboration between the public and the private systems.
cord blood collection; public system; private system; pregnant women's choice
Related Articles
Who's minding the shop? The role of Canadian research ethics boards in the creation and uses of registries and biobanks
Gibson, Elaine
Brazil, Kevin
Coughlin, Michael D
Emerson, Claudia
Fournier, Francois
Schwartz, Lisa
Szala-Meneok, Karen V
Weisbaum, Karen M
Willison, Donald J
BMC Medical Ethics
The amount of research utilizing health information has increased dramatically over the last ten years. Many institutions have extensive biobank holdings collected over a number of years for clinical and teaching purposes, but are uncertain as to the proper circumstances in which to permit research uses of these samples. Research Ethics Boards (REBs) in Canada and elsewhere in the world are grappling with these issues, but lack clear guidance regarding their role in the creation of and access to registries and biobanks.
Chairs of 34 REBS and/or REB Administrators affiliated with Faculties of Medicine in Canadian universities were interviewed. Interviews consisted of structured questions dealing with diabetes-related scenarios, with open-ended responses and probing for rationales. The two scenarios involved the development of a diabetes registry using clinical encounter data across several physicians' practices, and the addition of biological samples to the registry to create a biobank.
There was a wide range of responses given for the questions raised in the scenarios, indicating a lack of clarity about the role of REBs in registries and biobanks. With respect to the creation of a registry, a minority of sites felt that consent was not required for the information to be entered into the registry. Whether patient consent was required for information to be entered into the registry and the duration for which the consent would be operative differed across sites. With respect to the creation of a biobank linked to the registry, a majority of sites viewed biobank information as qualitatively different from other types of personal health information. All respondents agreed that patient consent was needed for blood samples to be placed in the biobank but the duration of consent again varied.
Participants were more attuned to issues surrounding biobanks as compared to registries and demonstrated a higher level of concern regarding biobanks. As registries and biobanks expand, there is a need for critical analysis of suitable roles for REBs and subsequent guidance on these topics. The authors conclude by recommending REB participation in the creation of registries and biobanks and the eventual drafting of comprehensive legislation.
Related Articles
Retrospective access to data: the ENGAGE consent experience
Tassé, Anne Marie
Budin-Ljøsne, Isabelle
Knoppers, Bartha Maria
Harris, Jennifer R
European Journal of Human Genetics
The rapid emergence of large-scale genetic databases raises issues at the nexus of medical law and ethics, as well as the need, at both national and international levels, for an appropriate and effective framework for their governance. This is even more so for retrospective access to data for secondary uses, wherein the original consent did not foresee such use. The first part of this paper provides a brief historical overview of the ethical and legal frameworks governing consent issues in biobanking generally, before turning to the secondary use of retrospective data in epidemiological biobanks. Such use raises particularly complex issues when (1) the original consent provided is restricted; (2) the minor research subject reaches legal age; (3) the research subject dies; or (4) samples and data were obtained during medical care. Our analysis demonstrates the inconclusive, and even contradictory, nature of guidelines and confirms the current lack of compatible regulations. The second part of this paper uses the European Network for Genetic and Genomic Epidemiology (ENGAGE Consortium) as a case study to illustrate the challenges of research using previously collected data sets in Europe. Our study of 52 ENGAGE consent forms and information documents shows that a broad range of mechanisms were developed to enable secondary use of the data that are part of the ENGAGE Consortium.
Related Articles
A perpetual source of DNA or something really different: ethical issues in the creation of cell lines for African genomics research
de Vries, Jantina
Abayomi, Akin
Brandful, James
Littler, Katherine
Madden, Ebony
Marshall, Patricia
Ouwe Missi Oukem-Boyer, Odile
Seeley, Janet
BMC Medical Ethics
The rise of genomic studies in Africa – not least due to projects funded under H3Africa – is associated with the development of a small number of biorepositories across Africa. For the ultimate success of these biorepositories, the creation of cell lines including those from selected H3Africa samples would be beneficial. In this paper, we map ethical challenges in the creation of cell lines.
The first challenge we identified relates to the moral status of cells living in culture. There is no doubt that cells in culture are alive, and the question is how this characteristic is relevant to ethical decision-making. The second challenge relates to the fact that cells in culture are a source of cell products and mitochondrial DNA. In combination with other technologies, cells in culture could also be used to grow human tissue. Whilst on the one hand, this feature increases the potential utility of the sample and promotes science, on the other it also enables further scientific work that may not have been specifically consented to or approved. The third challenge relates to ownership over samples, particularly in cases where cell lines are created by a biobank, and in a different country than where samples were collected. Relevant questions here concern the export of samples, approval of secondary use and the acceptability of commercialisation. A fourth challenge relates to perceptions of blood and bodily integrity, which may be particularly relevant for African research participants from certain cultures or backgrounds. Finally, we discuss challenges around informed consent and ethical review.
In this paper, we sought to map the myriad of ethical challenges that need to be considered prior to making cell line creation a reality in the H3Africa project. Considering the relative novelty of this practice in Africa, such challenges will need to be considered, discussed and potentially be resolved before cell line creation in Africa becomes financially feasible and sustainable. We suggest that discussions need to be undertaken between stakeholders internationally, considering the international character of the H3Africa project. We also map out avenues for empirical research.
Cell lines; H3Africa; Africa; Ethics; Consent; Sample ownership; Immortalisation
Related Articles
Ethical and legal considerations regarding the ownership and commercial use of human biological materials and their derivatives
Petrini, Carlo
Journal of Blood Medicine
This article considers some of the ethical and legal issues relating to the ownership and use – including for commercial purposes – of biological material and products derived from humans. The discussion is divided into three parts: after first examining the general notion of ownership, it moves to the particular case of possible commercial use, and finally reflects on the case in point in the light of the preceding considerations. Units of cord blood donated altruistically for transplantation and which are found unsuitable for storage and transplantation, or which become unsuitable while stored in biobanks, are taken as an example. These cord-blood units can be discarded together with other biological waste, or they can be used for research or the development of blood-derived products such as platelet gel. Several ethical questions (eg, informed consent, property, distribution of profits, and others) arise from these circumstances. In this regard, some criteria and limits to use are proposed.
bioethics; biological specimen banks; cord-blood stem cell transplantation; ethics; informed consent; legislation
Related Articles
Challenges of Biobanking in South Africa to Facilitate Indigenous Research in an Environment Burdened with Human Immunodeficiency Virus, Tuberculosis, and Emerging Noncommunicable Diseases
Abayomi, Akin
Christoffels, Alan
Grewal, Ravnit
Karam, Locunda A.
Rossouw, Catherine
Staunton, Ciara
Swanepoel, Carmen
van Rooyen, Beverley
Biopreservation and Biobanking
The high burden of infectious diseases and the growing problem of noncommunicable and metabolic disease syndromes in South Africa (SA) forces a more focused research approach to facilitate cutting-edge scientific growth and public health development. Increased SA research on these diseases and syndromes and the collection of associated biospecimens has ensured a plethora of biobanks created by individuals, albeit without the foresight of prospective and collective use by other local and international researchers. As the need for access to high-quality specimens in statistically relevant numbers has increased, so has the necessity for the development of national human biobanks in SA and across the Continent. The prospects of achieving sustainable centralized biobanks are still an emerging and evolving concept, primarily and recently driven by the launch of the H3Africa consortium, which includes the development of harmonized and standardized biobanking operating procedures. This process is hindered by a myriad of complex societal considerations and ethico-legal challenges. Efforts to consolidate and standardize biological sample collections are further compromised by the lack of full appreciation by national stakeholders of the biological value inherent in these collections, and the availability of high quality human samples with well-annotated data for future scientific research and development. Inadequate or nonexistent legislative structures that specifically regulate the storage, use, dispersal, and disposal of human biological samples are common phenomena and pose further challenges. Furthermore, concerns relating to consent for unspecified future uses, as well as access to information and data protection, are all new paradigms that require further consideration and public engagement. This article reviews important fundamental issues such as governance, ethics, infrastructure, and bioinformatics that are important foundational prerequisites for the establishment and evolution of successful human biobanking in South Africa.
Related Articles
Emerging issues in paediatric health research consent forms in Canada: working towards best practices
Dove, Edward S
Avard, Denise
Black, Lee
Knoppers, Bartha M
BMC Medical Ethics
Obtaining a research participant's voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements.
Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada dated from 2008–2011, which were purposively selected to reflect different types of research ethics boards, participants, and studies. The studies included biobanking, longitudinal studies, and gene-environment studies. Our purpose was to explore the following six emerging issues: (1) whether the scope of parental consent allows for a child's assent, dissent, or future consent; (2) whether the concepts of risk and benefit incorporate the child's psychological and social perspective; (3) whether a child's ability to withdraw is respected and to what extent withdrawal is permitted; (4) whether the return of research results includes individual results and/or incidental findings and the processes involved therein; (5) whether privacy and confidentiality concerns adequately address the child's perspective and whether standard data and/or sample identifiability nomenclature is used; and (6) whether retention of and access to paediatric biological samples and associated medical data are addressed.
The review suggests gaps and variability in the consent forms with respect to addressing each of the six issues. Many forms did not discuss the possibility of returning research results, be they individual or general/aggregate results. Forms were also divided in terms of the scope of parental consent (specific versus broad), and none discussed a process for resolving disputes that can arise when either the parents or the child wishes to withdraw from the study.
The analysis provides valuable insight and evidence into how consent forms address current ethical issues. While we do not thoroughly explore the contexts and reasons behind consent form gaps and variability, we do advocate and formulate the development of best practices for drafting paediatric health research consent forms. This can greatly ameliorate current gaps and facilitate harmonised and yet contextualised approaches to paediatric health research ethics.
Children; Confidentiality; Consent; ELSI; Paediatric research; Research ethics; Return of results; Withdrawal
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"Who owns your poop?": insights regarding the intersection of human microbiome research and the ELSI aspects of biobanking and related studies
Hawkins, Alice K
O'Doherty, Kieran C
BMC Medical Genomics
While the social, ethical, and legal implications of biobanking and large scale data sharing are already complicated enough, they may be further compounded by research on the human microbiome.
The human microbiome is the entire complement of microorganisms that exists in and on every human body. Currently most biobanks focus primarily on human tissues and/or associated data (e.g. health records). Accordingly, most discussions in the social sciences and humanities on these issues are focused (appropriately so) on the implications of biobanks and sharing data derived from human tissues. However, rapid advances in human microbiome research involve collecting large amounts of data on microorganisms that exist in symbiotic relationships with the human body. Currently it is not clear whether these microorganisms should be considered part of or separate from the human body. Arguments can be made for both, but ultimately it seems that the dichotomy of human versus non-human and self versus non-self inevitably breaks down in this context. This situation has the potential to add further complications to debates on biobanking.
In this paper, we revisit some of the core problem areas of privacy, consent, ownership, return of results, governance, and benefit sharing, and consider how they might be impacted upon by human microbiome research. Some of the issues discussed also have relevance to other forms of microbial research. Discussion of these themes is guided by conceptual analysis of microbiome research and interviews with leading Canadian scientists in the field.
human microbiome; health research; consent; privacy; ownership; return of results; policy; biobanks; ELSI; research ethics
Related Articles
Open consent, biobanking and data protection law: can open consent be 'informed' under the forthcoming data protection regulation?
Hallinan, Dara
Friedewald, Michael
Life Sciences, Society and Policy
This article focuses on whether a certain form of consent used by biobanks – open consent – is compatible with the Proposed Data Protection Regulation. In an open consent procedure, the biobank requests consent once from the data subject for all future research uses of genetic material and data. However, as biobanks process personal data, they must comply with data protection law. Data protection law is currently undergoing reform. The Proposed Data Protection Regulation is the culmination of this reform and, if voted into law, will constitute a new legal framework for biobanking. The Regulation puts strict conditions on consent – in particular relating to information which must be given to the data subject. It seems clear that open consent cannot meet these requirements. 4 categories of information cannot be provided with adequate specificity: purpose, recipient, possible third country transfers, data collected. However, whilst open consent cannot meet the formal requirements laid out by the Regulation, this is not to say that these requirements are substantially undebateable. Two arguments could be put forward suggesting the applicable consent requirements should be rethought. First, from policy documents regarding the drafting process, it seems that the informational requirements in the Regulation are so strict in order to protect the data subject from risks inherent in the use of the consent mechanism in a certain context – exemplified by the online context. There are substantial differences between this context and the biobanking context. Arguably, a consent transaction in the biobanking does not present the same type of risk to the data subject. If the risks are different, then perhaps there are also grounds for a reconsideration of consent requirements? Second, an argument can be made that the legislator drafted the Regulation based on certain assumptions as to the nature of 'data'. The authors argue that these assumptions are difficult to apply to genetic data and accordingly a different approach to consent might be preferable. Such an approach might be more open consent friendly.
Genetics; Genomics; Data protection; Data protection regulation; Consent; Open consent; Biobanks
Related Articles
Challenges in biobank governance in Sub-Saharan Africa
Staunton, Ciara
Moodley, Keymanthri
BMC Medical Ethics
Biological sample and data transfer within and out of Africa is steeped in controversy With the H3Africa project now aiming to establish biobanks in Africa, it is essential that there are ethical and legal governance structures in place to oversee the operation of these biobanks. Such governance is essential to ensuring that donors are protected, that cultural perspectives are respected and that researchers have a ready availability of ethically sourced biological samples.
A literature review of all legislation, regulations, guidelines and standard operating procedures on informed consent, confidentiality and the transfer of biological samples amongst countries in Sub-Saharan Africa was conducted. In addition, an examination of the websites of departments of health and national ethics committees was performed. Researchers and research ethics scholars in the field in various African countries were contacted for assistance. A literature review of all studies examining participants views on issues related to biobanking in Africa was carried out and five separate studies were found.
It was found that biobanking guidelines differ substantially across Sub-Saharan Africa regarding biobanking and often conflicted across borders. This has the potential to negatively impact collaboration. Furthermore, the guidelines in place often do not recognise the ethical difficulties arising from the transfer of biological samples and are unsuitable to regulate biobanks. Additionally, there is insufficient research into the views of research participants and stakeholders on the use of biological /samples.
Collaboration is necessary to ensure the success of biobanking projects in Africa. To achieve this, there should be some harmonization of guidelines across Africa which would aid in transferring biological samples across borders. These guidelines should reflect the unique ethical issues arising out of the storage and secondary uses of biological samples. Finally, further research into the views of research participants is necessary. Such studies should aid in the drafting of any new harmonization guidelines.
Related Articles
US Public Cord Blood Banking Practices: Recruitment, Donation, and the Timing of Consent
Broder, Sherri
Ponsaran, Roselle
Goldenberg, Aaron
Cord blood has moved rapidly from an experimental stem cell source to an accepted and important source of hematopoietic stem cells. There has been no comprehensive assessment of US public cord blood banking practices since the Institute of Medicine study in 2005.
Of 34 US public cord blood banks identified, 16 participated in our qualitative survey of public cord blood banking practices. Participants took part in in-depth telephone interviews in which they were asked structured and open-ended questions regarding recruitment, donation, and the informed consent process at these banks.
13 of 16 participants reported a variably high percentage of women who consented to public cord blood donation. 15 banks offered donor registration at the time of hospital admission for labor and delivery. 7 obtained full informed consent and medical history during early labor and 8 conducted some form of phased consent and/or phased medical screening and history. 9 participants identified initial selection of the collection site location as the chief mode by which they recruited minority donors.
Since 2005, more public banks offer cord blood donor registration at the time of admission for labor and delivery. That, and the targeted location of cord blood collection sites, are the main methods used to increase access to donation and HLA diversity of banked units. Currently, the ability to collect and process donations, rather than donor willingness, is the major barrier to public cord blood banking.
Related Articles
Spanish regulatory approach for Biobanking
Arias-Diaz, Javier
Martín-Arribas, María C
García del Pozo, Javier
Alonso, Carlos
European Journal of Human Genetics
The Spanish regulatory framework for storage of samples for research responds to most issues raised by both researchers and society regarding biobanking. The Spanish regulation currently foresees three possible ways in which these samples are to be handled: (a) gathering for use in a specific project, (b) storage in a collection, and (c) storage in a Biobank. Samples incorporated into a 'collection' can only be used by the investigator who requested them and cannot be transferred to third parties or used in research projects outside the particular research line foreseen in the original consent. On the other hand, the legal entity 'Biobank' refers not only to a set of physical facilities but to the management of the samples stored under that label, and particularly to the requirements for their cession. An approach based on putting most of the regulatory weight on the biobank side has been chosen in order to guaranty the rights of the donors as well as to ease the task of the researchers. A Biobank requires both to be authorized and to be registered in a public Registry. The requirements are quite stringent, allowing for the consent to be given as 'broad' in scope without implying being 'blank.' In this regard, for Biobanks to justify the taking on of some of the donors' rights, a key requirement is to have an external ethics committee supervising the adequacy of samples cession and use, notwithstanding the need for a previous bioethical supervision of the target protocol.
Related Articles
Biobanks for Genomics and Genomics for Biobanks
Cambon-Thomsen, Anne
Ducournau, Pascal
Gourraud, Pierre-Antoine
Pontille, David
Comparative and Functional Genomics
Biobanks include biological samples and attached databases. Human biobanks occur in research, technological development and medical activities. Population genomics is highly dependent on the availability of large biobanks. Ethical issues must be considered: protecting the rights of those people whose samples or data are in biobanks (information, autonomy, confidentiality, protection of private life), assuring the non-commercial use of human body elements and the optimal use of samples and data. They balance other issues, such as protecting the rights of researchers and companies, allowing long-term use of biobanks while detailed information on future uses is not available. At the level of populations, the traditional form of informed consent is challenged. Other dimensions relate to the rights of a group as such, in addition to individual rights. Conditions of return of results and/or benefit to a population need to be defined. With 'large-scale biobanking' a marked trend in genomics, new societal dimensions appear, regarding communication, debate, regulation, societal control and valorization of such large biobanks. Exploring how genomics can help health sector biobanks to become more rationally constituted and exploited is an interesting perspective. For example, evaluating how genomic approaches can help in optimizing haematopoietic stem cell donor registries using new markers and high-throughput techniques to increase immunogenetic variability in such registries is a challenge currently being addressed. Ethical issues in such contexts are important, as not only individual decisions or projects are concerned, but also national policies in the international arena and organization of democratic debate about science, medicine and society.
Related Articles
Bridging consent: from toll bridges to lift bridges?
Budin-Ljøsne, Isabelle
Tassé, Anne Marie
Knoppers, Bartha Maria
Harris, Jennifer R
BMC Medical Genomics
The ability to share human biological samples, associated data and results across disease-specific and population-based human research biobanks is becoming increasingly important for research into disease development and translation. Although informed consent often does not anticipate such cross-domain sharing, it is important to examine its plausibility. The purpose of this study was to explore the feasibility of bridging consent between disease-specific and population-based research. Comparative analyses of 1) current ethical and legal frameworks governing consent and 2) informed consent models found in disease-specific and population-based research were conducted.
Ethical and legal frameworks governing consent dissuade cross-domain data sharing. Paradoxically, analysis of consent models for disease-specific and population-based research reveals such a high degree of similarity that bridging consent could be possible if additional information regarding bridging was incorporated into consent forms. We submit that bridging of consent could be supported if current trends endorsing a new interpretation of consent are adopted. To illustrate this we sketch potential bridging consent scenarios.
A bridging consent, respectful of the spirit of initial consent, is feasible and would require only small changes to the content of consents currently being used. Under a bridging consent approach, the initial data and samples collection can serve an identified research project as well as contribute to the creation of a resource for a range of other projects.
Related Articles
A Strategic Plan for the Second Phase (2013–2015) of the Korea Biobank Project
Park, Ok
Cho, Sang Yun
Shin, So Youn
Park, Jae-Sun
Kim, Jun Woo
Han, Bok-Ghee
Osong Public Health and Research Perspectives
The Korea Biobank Project (KBP) was led by the Ministry of Health and Welfare to establish a network between the National Biobank of Korea and biobanks run by university-affiliated general hospitals (regional biobanks). The Ministry of Health and Welfare started the project to enhance medical and health technology by collecting, managing, and providing researchers with high-quality human bioresources. The National Biobank of Korea, under the leadership of the Ministry of Health and Welfare, collects specimens through various cohorts and regional biobanks within university hospitals gather specimens from patients. The project began in 2008, and the first phase ended in 2012, which meant that there needed to be a plan for the second phase that begins in 2013. Consequently, professionals from within and outside the project were gathered to develop a plan for the second phase. Under the leadership of the planning committee, six working groups were formed to formulate a practical plan. By conducting two workshops with experts in the six working groups and the planning committee and three forums in 2011 and 2012, they have developed a strategic plan for the second phase of the KBP. This document presents a brief report of the second phase of the project based on a discussion with them.
During the first phase of the project (2008–2012), a network was set up between the National Biobank of Korea and 17 biobanks at university-affiliated hospitals in an effort to unify informatics and governance among the participating biobanks. The biobanks within the network manage data on their biospecimens with a unified Biobank Information Management System. Continuous efforts are being made to develop a common standard operating procedure for resource collection, management, distribution, and personal information security, and currently, management of these data is carried out in a somewhat unified manner. In addition, the KBP has trained and educated professionals to work within the biobanks, and has also carried out various publicity promotions to the public and researchers. During the first phase, biospecimens from more than 300,000 participants through various cohorts and biospecimens from more than 200,000 patients from hospitals were collected, which were distributed to approximately 600 research projects.
The planning committee for the second phase evaluated that the first phase of the KBP was successful. However, the first phase of the project was meant to allow autonomy to the individual biobanks. The biobanks were able to choose the kind of specimens they were going to collect and the amount of specimen they would set as a goal, as well as being allowed to choose their own methods to manage their biobanks (autonomy). Therefore, some biobanks collected resources that were easy to collect and the resources needed by researchers were not strategically collected. In addition, there was also a low distribution rate to researchers outside of hospitals, who do not have as much access to specimens and cases as those in hospitals. There were also many cases in which researchers were not aware of the KBP, and the distribution processes were not set up to be convenient to the demands of researchers.
Accordingly, the second phase of the KBP will be focused on increasing the integration and cooperation between the biobanks within the network. The KBP plans to set goals for the strategic collection of the needed human bioresources. Although the main principle of the first phase was to establish infrastructure and resource collection, the key objective of the second phase is the efficient utilization of gathered resources. In order to fully utilize the gathered resources in an efficient way, distribution systems and policies must be improved. Vitalization of distribution, securing of high-value resource and related clinical and laboratory information, international standardization of resource management systems, and establishment of a virtuous cycle between research and development (R&D) and biobanks are the four main strategies. Based on these strategies, 12 related objectives have been set and are planned to be executed.
biobank; biobank network; biospecimen; Korea Biobank Project; National Biobank of Korea
Related Articles
The Italian Hub of Population Biobanks as a Potential Tool for Improving Public Health Stewardship
Bravo, Elena
Napolitano, Mariarosaria
Santoro, Filippo
Belardelli, Filippo
Federici, Antonio
Biopreservation and Biobanking
In Italy, a country that is experiencing the decentralization of health services from central to regional level of government, the Minister of Health is proposing stewardship as a model of governance for the public health system. Stewardship favors efficiency in the policy decision-making process, based on reciprocal trust, and tends to be more ethical. The embryonic proposal to test stewardship in the field of population-based research was advanced during the launching conference Challenges and Opportunities of the Italian Hub of Population Biobanks (HIBP) held in 2012 in Rome. Resources collected by population biobanks (i.e., blood and its derivatives, and/or DNA isolated from any type of biological samples and relative associated data) have, in fact, a recognized scientific value for the investigation of links between genetics, health and life style, and epidemiological outcomes through population biobank-based studies, and are essential to planning effective and qualified interventions for public health. The current economic crisis requires a strong push to rationalize investment in health policies. In particular, population biobank-based studies require financial commitment, often of long duration, for the realization of their goals. Thus, innovative solutions to allow fast integration of scientific knowledge into political health strategy are required. During the conference in Rome, it was proposed to test the stewardship model by its application to the inter-relationship between population biobank-based studies and disease prevention. Stewardship minimizes barriers to innovation and uses information more effectively to better develop new strategies for prevention and/or treatment. In the months following the conference, the proposal was defined more clearly, and the HIBP network became a potential tool for testing and implementing this model in the Italian Public Health prevention system.
Related Articles
Community perspectives on public health biobanking: an analysis of community meetings on the Michigan BioTrust for Health
Thiel, Daniel B.
Platt, Tevah
Platt, Jodyn
King, Susan B.
Kardia, Sharon L. R.
Journal of Community Genetics
Biobanks raise challenges for developing ethically sound and practicable consent policies. Biobanks comprised of dried bloodspots (DBS) left over from newborn screening, maintained for long-term storage, and potential secondary research applications are no exception. Michigan has been a leader in transforming its DBS collection, marketing its biobank of de-identified samples for health research use. The Michigan BioTrust for Health includes approximately 4 million unconsented retrospective samples collected as early as 1984 and prospective samples added since the fall of 2010 with blanket parental consent. We engaged Michigan citizens to ascertain public attitudes, knowledge, and beliefs about the BioTrust and informed consent. A convenience sampling of 393 participants from communities around the state of Michigan (oversampling for minority populations) participated in meetings addressing newborn screening, the BioTrust and informed consent, yielding quantitative and qualitative survey and discussion data. Participants affirmed the principle of voluntary informed participation in research and advocated for greater public awareness of the existence of the BioTrust. Most expressed support for the use of DBS for research and a desire for greater involvement in granting permission for research use. Opinions varied as to which specific research uses were acceptable. Participants indicated a desire for greater engagement, public awareness, and more active decision making on the part of biobank participants and parents. Diversity of opinion over which research areas were deemed acceptable problematizes the blanket consent model that currently applies to the BioTrust's prospective DBS collection and that could become the new norm for research using de-identified data under proposed changes to the Common Rule.
Electronic supplementary material
The online version of this article (doi:10.1007/s12687-013-0162-0) contains supplementary material, which is available to authorized users.
Biobank; Public health; Informed consent; Newborn screening; Community engagement
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Hotels in Puchheim, Germany
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- Most bookeddas seidl Hotel & Tagung
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"This was the first time in Germany for us. The hotel is in a good location if you are fine taking public transportation. It is a 10 minute walk to the train station which will have you downtown in 15 minutes. The check in was quick and easy. The lady at the front desk spoke English and was very h..."
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"Nice room, bathroom a little on the small side. Very friendly staff. Breakfast plentiful. Loads of tv channels, wi-fi worked like a charm - loved it. There is no restaurant at the hotel, but I knew that before I came, and it is pretty much the only down point. Pets welcome, it was quiet and I had..."
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"Quick and friendly check-in (my son wanted the large bed in the bedroom so the sofa bed was set up for me in the living room - sofa was, to my surprise, comfortable.) The kitchen was small but more than adequate for our visit (we just made hot water and used fridge for beer and some meat/cheese)..."
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"They are in the preparation of renovating. Free parking great. Dinner on the terrace was fantastic"
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"Convenient location and well kept property. Train station to Munich is walkable."
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"Great hotel. Friendly staff. Clean comfortable rooms. Close to the train to Munich. Not very much to see around the hotel but it does have a few restaurants."
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"The hotels downtown during Oktoberfest were very expensive. We chose this efficiency style apartment on the outskirts of town. It was new, comfortable, and modern. The train station was not walking distance, but very close, and a direct shot to Oktoberfest and downtown. A McDonalds, several baker..."
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"The hotel is about 45 minutes out from Oktoberfest. Small but nice rooms that have everything you need. Great price. Need to catch the bus to get to the train station but a great value hotel for Oktoberfest."
A Traveller, Oct 2015, US
Best hotels in Puchheim
If you are looking for Puchheim hotels in a particular area, you can use the search feature at the top of the page to search by neighborhood, landmark, address or zip code, or you can search by using the built-in map feature. You can also browse hotels in Puchheim by type, amenities, and star-rating so that you can find the best hotel. Currently, top rated hotels in Puchheim are:
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The location of your Puchheim hotel is important. If you are traveling to Puchheim, &StateorCountry for business, you may want to consider getting a hotel close to the airport or near your meeting venue. By doing so, you can really cut down on transportation costs and time. You may also want to book a hotel that offers free wifi just in case you need to get some work done.
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subset: commoncrawl


text:
Tired of the tedious conversion process it takes to get your iOS device to play back videos? Want to watch your videos in more than just the handfull of proprietary file formats? Fortunately, there's an app for that. You can play almost any video format under the sun on your iPad with the PlayerXtreme app. Read on to learn how.
What You Need:
>> iPad with iOS 4.0 or later
>> PlayerXtreme (free, for limited time)
1. Round up your files
PlayerXtreme supports many different file formats right out of the box. Here's a full list of all of the video files you'll be able to play: 3gp, asf, avi, divx, dv, dat, flv, gxf, m2p, m2ts, m2v, m4v, mkv, moov, mov, mp4, mpeg, mpeg1, mpeg2, mpeg4, mpg, mpv, mt2s, mts, mxf, ogm, ogv, ps, qt, rm, rmvb, ts, vob, webm, wm, and wmv.
Think that's a lot? Yeah, we think so too!
2. Transferring your videos into iTunes
Getting videos into the PlayerXtreme application is an easy thing to do with iTunes. With the application installed on your iPad, and your iPad connected to your Mac, launch iTunes.
Click on your device in under the "Devices" section, and then click on the Apps tab. Under the "File Sharing" heading, locate the PlayerXtreme application, and then drag and drop a video file with one of file formats listed in the section above. After adding the files, sync your device to transfer the video files.
3. Transferring your videos over Wi-Fi
If both your Mac and iPad are connected to the same network, then you can easily transfer videos over Wi-Fi. To do this, open the PlayerXtreme application, and navigate to the Settings tab. Once there, locate the "Wifi" settings, and slide the switch to "ON" for the Wi-Fi Server.
Next, type the "Browser Address" that gets generated into your Mac's web browser. In the page that is displayed, you can upload files to your device by clicking on "Add files," then locating the file in the file browser. To begin the file transfer, you'll then need to click on "Start upload."
In addition, you can download any of the videos stored on your iPad to your computer by clicking on the filename in the "Shared Files" section.
4. Playing Your Videos
After launching the PlayerXtreme application on your iPad, ensure that the Library tab is selected. Here, you can see all of the videos have been loaded onto your device, and can organize the videos with folders, or search through your library by tapping on the small magnifying glass at the top, right-hand side of the screen.
Tapping on a video file will bring up a list of options: Play, Cut, Rename, Delete, and Info.
Tap on Play to open the video in the player view. In this view, you can use the scrubber at the top of the screen to advance to a particular part of the video. You can also tap on the small "i" (Info) button in the top, right-hand corner of the screen to view things like title, duration, start time, end time, and your device's battery life. If your video supports multiple audio tracks, then you can switch between them by tapping on the Menu button in the lower, right-hand corner of the player view. To exit the view and return to your video library, tap on the Done button.
Cory Bohon is a freelance technology writer, indie Mac and iOS developer, and amateur photographer. Follow this article's author, Cory Bohon on Twitter.


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Richard Siken
|Richard Siken
Richard Siken is an American poet, painter, and filmmaker. He is the author of the collection Crush (Yale University Press, 2005), which won the Yale Series of Younger Poets Competition in 2004. His second book of poems, War of the Foxes, was released from Copper Canyon Press in 2015.
Life and work[edit]
Siken received a Literature Fellowship in Poetry from the National Endowment for the Arts, and his book Crush was awarded the Lambda Literary Award for "Gay Men's Poetry" in 2005,[1] and the Thom Gunn Award from Publishing Triangle. The 1991 death of his boyfriend influenced his writing of the book.[2]
Siken's most recent book, War of the Foxes,[3] was published in 2015 by Copper Canyon Press and was a Lannan Literary Selection.[4]
Siken currently lives in Tucson, Arizona.
Crush won the 2004 Yale Series of Younger Poets prize, selected by Louise Glück. It was also a finalist for the National Book Critics Circle Award, the Lambda Literary Award and the Thom Gunn Award.
Siken is also the recipient of a Pushcart Prize, two Arizona Commission on the Arts grants, and a fellowship from the National Endowment for the Arts.[5]
- Crush (Yale University Press, 2005)
- War of the Foxes (Copper Canyon Press, 2015)
- ^ "Previous Lammy Award Winners". Lambda Literary Foundation. Archived from the original on 2008-05-04. Retrieved 2008-08-06.
- ^ Schuman, Joan (2006-04-13). "Poetry Personas: Three well-known writers reflect on new, contemporary work". Tucson Weekly.
- ^ https://www.coppercanyonpress.org/pages/browse/book.asp?bg=[permanent dead link]{15A55214-5F48-4E0E-81D8-F256D3FFC4CA}
- ^ http://www.lannan.org/programs/literary/
- ^ "Richard Siken".
External links[edit]
|This American poet–related article is a stub. You can help Wikipedia by expanding it.


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2012 Cloudy Bay Vineyards Sauvignon Blanc Marlborough
Producer: Cloudy Bay Vineyards
Style: White Wine
Grape Type: Sauvignon Blanc
Origin: New Zealand
Region: New Zealand
89 Points | Stephen Tanzer's IWC - September/October 2013
Pale, bright yellow. Lemon, gooseberry, green pepper, caraway seed and a hint of asparagus on the nose. Then round, silky and horizontal, with mouthfilling flavors of green tropical fruits and fresh herbs. Not the most intense vintage for this bottling but supple and alive. Finishes with very good length and lift.
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The Prius v is a bigger, wagon-variant of the Prius hybrid. It's intended to offer more room for families than the standard Prius; the "v" stands for versatility. The added usability comes in the form of more backseat space and cargo room. It competes with the Ford C-Max Hybrid.
The v is part of the growing "Prius family," which also includes the Prius c city car and Prius Plug-in. Those models are covered separately in the Cars.com Research section.
New for 2013
The Prius v Five now has a steering wheel trimmed in simulated leather, but there are no other significant changes for 2013.
There isn't a drastic departure in the styling department from the regular Prius. Toyota keeps the shape familiar while still adding a considerable amount of room inside. Overall length increases 6 inches over the regular Prius, and the v is about an inch wider. Toyota says the front bumper has "aero-corners" to improve aerodynamics, as well as a roof spoiler to improve airflow and help achieve low air drag for better fuel efficiency. Exterior features include:
- Standard 16-inch wheels; 17-inch wheels optional
- Rear window wiper
- LED taillights
- Available panoramic moonroof with sliding sunshades
All of the Prius v's changes create more room inside, where there's an additional 12.7 cubic feet of cargo space. Like the regular Prius, the v has room for five occupants; a third row was not added with the extra room behind the second row. With the second row folded, the Prius v offers 67.3 cubic feet of cargo space. A low cargo load-in height and a wide opening should be especially appealing to families that frequently use the cargo area.
The increased cargo room is teamed with more passenger room for rear occupants; headroom and legroom have been increased over the regular Prius. The 60/40-split rear bench slides forward and back and reclines up to 45 degrees. Interior features include:
- Standard cloth seats; simulated leather available
- Stereo with a 6.1-inch touch-screen
- Backup camera
- Sliding backseat
- Available heated front seats
- Available navigation system and Entune multimedia system
Under the Hood
The same hybrid system that powers the Prius hatchback is under the skin of the Prius v. A 1.8-liter four-cylinder engine makes 98 horsepower and 105 pounds-feet of torque, while the electric motor makes 80 hp and 153 pounds-feet of torque. Power is sent to the front wheels via a continuously variable automatic transmission. Mechanical features include:
- Uses regular gas
- Doesn't need to be plugged into an outlet
- Four driving modes: regular Drive; Eco mode, which optimizes settings for better mileage; Power mode, which increases gas-pedal sensitivity for better acceleration; and EV-Drive mode, which attempts to stay in electric mode as long as possible, provided the battery has enough power
Standard safety features include:
- Seven airbags
- Electronic stability system and traction control
- Antilock brakes with electronic brake-force distribution and brake assist
- Brake override system
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text:
Note: The opinions expressed here are the writer's own and are not meant to be from the Oakland Athletics Baseball Company.
Spring Training is so close we can almost taste it!
The trucks from each Cactus League team are on their way to the Valley of the Sun from Cleveland, Cincinnati, Denver, Chicago, etc. ... but the ones that you and I are most excited about, are on their way in from Oakland, right now! The long off-season is almost over. We fans (and by fans I mean those of us who would self-destruct if the off-season lasted one more day) cannot contain our excitement; and the ball players are excited, too ... kind of like the first day of a new school year. And, just like the first day of school - after a long summer off, there are basics that need to be reviewed before putting the pedal to the metal on a brand new season.
In the interest of supporting the farm system of the AL West champs, I thought I would help with the review process: by taking a page from the annual MLB Rookie Development Program held in January for several of the top prospects in the game. Each winter, the young men are counseled in important areas of development that have nothing to do with pitching, catching, or hitting.
The MLB program addresses smart, basic, common sense information; Social Skills, for lack of a better term. As one who has spent a decade at the rookie level of development, these skills/ reminders are vital to all; not just the top prospects.I understand the investment and reasoning of sending higher-level prospects to the MLB program, but this information – nay "gentle reminders" - would benefit every player in the organization. So, since the investment price is right, let's do our own version. We'll cover the basics, because, just like in baseball, if you master the basics, the rest tends to take care of itself.
Before I begin, keep this in mind: I care about you, even if I don't know you. If you are in the Oakland A's farm system, that's all I need to know. I know how hard you've worked to get where you are; I know (generally speaking) that your monthly income is 1/1,000th of what the general public believes it is; I know that if there's a game or workout or ... anything that the public views as "entertainment", for you, it's WORK. However, that being said, part of your JOB is to socialize, be kind, and be a good representative of your employer. I'm also not going to just tell you things you want to hear; you will find more than enough people to do that. I prefer honesty; life's too short.
Ok, here we go:
1) ALWAYS CONDUCT YOURSELF IN A PROFESSIONAL MANNER – You're on the Job 24/7
The moment you signed your contract with Oakland, you became a 24/7 employee. Each day that you are fortunate enough to be paid to wear a uniform, you are a representative of the organization. Whether it's on or off the field, your name is associated with the Oakland A's. For instance:
- If you go 4-4 (or 0-4) in a game or read books to local school children – it's on behalf of the Oakland A's. Always.
- When you're in the batting cages after you THINK everyone has gone, and talk in great detail about ... ummm ... "events" from last night, there will always be someone who hears you ... someone who doesn't want to hear it. You represent the Oakland A's.
Unfortunately, I've been that "someone" more often than I would like. The first time was very early on when I worked with the Mariners. Two major league players, in the batting cages, while the fields were still open to the public; and they weren't using their "indoor voices". I was relieved that no one else was around, but I made enough noise to alert them that they were not alone. ALWAYS REMEMBER THAT YOU ARE NOT ALONE; EARS ARE EVERYWHERE.
- When you're out for dinner and you leave a generous tip for a server, someone will know who you are and they will enjoy knowing that you are good tipper. Word will spread quickly! This is awesome!!
- If you are cheap (bad tipper), or disrespectful; word will spread even faster. Even if people don't remember your name, they'll know you as "the guy with the A's".
- If you are in the stands and not playing in the game, regardless of how many people are in attendance, keep this in mind: every four-letter word out of your mouth, every action, every bodily function is amplified; you are under a microscope, make no doubt about that. You represent the Oakland A's.
To the credit of the A's minor league staff, the first home game of the 2012 AZL season was the first and last time I experienced the need to point this out...
2) IT'S THE LITTLE THINGS THAT MATTER – Be Good to Your Fans – Especially the Little Ones
- Ask their name, write it legibly, and SIGN YOUR NAME LEGIBLY!
- Whatever else you are doing, unless you're playing in the game, is not as important as making eye contact and giving them your full attention.
- At that moment, you are the ENTIRE Oakland A's organization. (see Reminder #1).
- Their parents are watching.
Newly signed member of the A's bullpen, Eric O'Flaherty is a great example of one who does all of these things properly. In spring 2006, I was working with the Mariners and Eric was 21 and between AA and AAA. Many times throughout the spring, I remember him - specifically - taking the time to talk with young fans, asking questions, looking them in the eye, and doing it all with a smile on his face. I have used him as an example for years; in my book, it's wonderful that he is with Oakland for many reasons.
3) HASHTAG PLEASE/ HASHTAG THANK YOU – Remember to Use Your Manners IRL (In Real Life) and in Social Media
- Say Please and Thank you. Always. Always. Always. Always. Always. Always. Always. Always. Always.
- IRL: Remember that while yes, you have the ability and have the work ethic to be where you are, under no circumstance are you there solely because of yourself.
A great, real life example: Former MLB All Star second baseman and World Series Champ Freddy Sanchez was drafted in the 11th round of the 2000 draft by the Boston Red Sox. The scout who lobbied for drafting and then signed him is a good friend of mine, Ernie Jacobs. According to Ernie, Freddy was always mindful of – and expressed his gratitude for - those who helped him live his life as a professional ball player, including Ernie.
When Freddy made his MLB debut in 2002, he signed his game worn jersey, "thank you for believing in me" and presented it to the scout who believed in him. This became a ritual; including his first All-Star game in 2006 with the Pirates and one of his World Series jerseys from the 2010 San Francisco Giants. Ernie received a personally autographed jersey with a similar note: "Thanks for the opportunity, Thanks for believing in me, etc.". How can you not love Freddy Sanchez? Be like Freddy.
- Social media: Gentlemen: I have directed tweets to many of you whether it's after a game or to share something positive. I don't criticize; my feedback is always positive. Some of you wouldn't acknowledge me until we met in person. Ok ... but my positive feedback is no more important than it was before. However, there are a handful of you who have never even responded a simple "thank you"... even those of you who follow me.
However, I will see you've responded to the pal or pretty girl above or below my feedback. I notice those things. Most people do. If someone says something nice to you, do what your parents taught you: say thank you. At the very least acknowledge the nice things because YOU KNOW the cowards who will rip you behind the protection of anonymity. BE NICE TO THE PEOPLE WHO ARE NICE TO YOU!!
- Selecting a positive example to highlight was difficult because many of you are so good ... but if there were one who consistently shares respectful, positive, insightful tidbits, and who also rivals Job in terms of patience with some well-meaning fans/followers, it is hands-down, Nick Rickles.
WWCK(DJ)T ~ WHAT WOULD Clayton Kershaw (Derek Jeter) TWEET --- Think before you tweet.
- To be fair, Kershaw has a twitter account, Jeter does not. But imagine if Jeter did. What kind of words he use? Would there be slang or disrespectful expressions used? Would either ever call one another the "N" word – no, I won't ever say that word. Ever. Would either refer to the other as an "F" word (slanderous expression for a homosexual ... another word I will never, ever use), or would they refer to women as anything other than a respectful term? Clearly the answer is no.
- If you think that reporters, scouts, team executives, your grandparents, and/or future in-laws aren't reading your tweets or Facebook posts, you're wrong. In the non-baseball world, future employers will often first look at someone's social media sites before considering an interview.
- If the focus of your expression is positive and respectful, you have nothing to worry about.
- If you feel cheated because all your friends back home get to post "whatever they want" and you don't ... that's' called First World Pains. Get over it.
- Again, the minute you signed a contract with the Oakland A's, you are no longer a "private" person. Then again, thanks to the internet, and now the super mega social media options, NOTHING is private, and NOTHING ever goes away. Think about what you send out. Before hit Enter to send a tweet, ask yourself if you could see Derek Jeter or Clayton Kershaw sending this.
- And for the record: if you're going to retweet a compliment that someone shares with you, be sure you REPLY a quick "Thank you" to that person as well. They took the time to share with you; take the time to personally thank them; not just boost your ego with the RT.
- PLLLLLLEEEEEEEASE know the difference between "you're" and "your". If you need to save characters, use "ur".
- Remember, the majority of your followers aren't there because you're brilliant and witty; they're following you because (all together now) you're a member of the Oakland A's.
- Be careful criticizing others: You're a professional athlete, and as we recently saw in the Super Bowl, even the great Peyton Manning has challenges.
In 2010, former Diamondbacks pitcher (and Stockton, CA native) Barry Enright, made his major league debut. This was the year manager AJ Hinch was fired, and Kirk Gibson took over the managerial duties mid-season. I am being kind when I say it was an "ugly" season. Unfortunately for their fans, the Arizona Cardinals had a similar season that same year. Whether or not Barry was a Cardinals fan, he was not shy about sharing, on Twitter, how hard it was to watch them lose so many games. There were many who were quick to remind Barry that – ahem – about those who live in glass houses, should not cast the first stone.
4) TO WHOM MUCH IS GIVEN, MUCH IS EXPECTED – Don't be cheap, but don't be stupid with your money, either.
- Be a good tipper. Everywhere. To everyone: In restaurants, hotels, hair salons, spas and taxi's; doormen, clubbies, you name it. If they're in a gratuity based profession, make them remember you for a good reason.
- Get involved in a cause that is close to your heart; you don't have to start your own foundation, but see the change you want to make in this world. Put your money where your heart is, but don't let the PR people know what you're doing.
- I have always subscribed to the "When you give, don't let your left hand know what your right hand is doing". I recommend it.
- Super Bowl Champ QB Russell Wilson agrees. ... Just sayin'
- Use your "fame" to help a cause, don't use the cause to help your fame.
- Even if you have a financial advisor, ALWAYS KNOW WHAT YOU HAVE AND WHERE IT GOES. Educate yourself and have others as advisors, but never, ever just turn over your bank account to anyone and trust them.
- Remember, the odds are stacked against you; and injuries have brought far too many careers to an early end. Be smart.
Enjoy your last few days of the off-season and we look forward to seeing you back at the fields at Papago very soon! Oh, and don't worry about what to wear on the first day; the A's have got that taken care of for you.
Kim Contreras
OaklandClubhouse.com ~ Arizona Staff Writer
On Twitter @Cu_As


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Healthcare spending in 2003
July 08, 2005
Consumer healthcare spending showed little change in 2003, rising 2.8 percent on average, following increases of 7.7 percent in 2002 and 5.6 percent in 2001.
Among the components of healthcare expenditures, spending on health insurance continued to increase significantly, with a 7.2-percent rise in 2003 following increases of 10.1 percent in 2002 and 7.9 percent in 2001.
The increase in health insurance spending in 2003 was offset somewhat by a 4.2-percent drop in spending on drugs. The decrease in spending on drugs in 2003 followed several years of relatively large increases: 8.6 percent in 2002, 7.8 percent in 2001, and 12.6 percent in 2000.
Spending on the other two components of healthcare—medical services and medical supplies—increased slightly in 2003, by 0.2 percent and 1.9 percent, respectively.
These data come from the Consumer Expenditure Survey. Find out more in "Consumer Expenditures in 2003," (PDF 129K), BLS Report 986.
Bureau of Labor Statistics, U.S. Department of Labor, The Economics Daily, Healthcare spending in 2003 on the Internet at http://www.bls.gov/opub/ted/2005/jul/wk1/art04.htm (visited September 30, 2016).
Recent editions of Spotlight on Statistics
A look at healthcare spending, employment, pay, benefits, and prices
As one of the largest U.S. industries, healthcare is steadily growing to meet the needs of an increasing population with an increasing life expectancy. This Spotlight looks at how much people spend on healthcare, current and projected employment in the industry, employer-provided healthcare benefits, healthcare prices, and pay for workers in healthcare occupations.
Employment and Wages in Healthcare Occupations
Healthcare occupations are a significant percentage of U.S. employment. Some of the largest and highest paying occupations are in healthcare. This Spotlight examines employment and wages for healthcare occupations.
Fifty years of looking at changes in peoples lives
Longitudinal surveys help us understand long-term changes, such as how events that happened when a person was in high school affect labor market success as an adult.


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Announcing the Twilio API Explorer
Need a hand with that app? At Twilio we pride ourselves on simple, easy to use APIs with great documentation. We try our best to ensure that building powerful telephony applications is a seamless process and to provide the right tools and libraries to make it easy to integrate Twilio into whatever application you are building. Today we're announcing a major enhancement to our developer tools,… Read More


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In other news Friday, airline pilots will be able to bypass full-body scans and pat-downs that are being implemented at airports across the country. In New Zealand, 29 miners are trapped after an explosion at a coal mine in a remote part of the country. Continue reading
In other news Wednesday, French President Nicolas Sarkozy made orders for riot police to clear blockades from the country's oil refineries while more gas stations ran dry due to protests. Union members also blocked access to several airports causing flight cancellations. Continue reading
Strikers in France defied a government order to stop blockading the country's oil refineries. Already 1,500 gas stations have nearly run out of fuel. Continue reading
The cost of living in the United States went unchanged in July, easing concerns among many experts that economic recovery will be hampered by rising inflation. Continue reading
Editor's Note: Robert Frank, author of The Economic Naturalist's Field Guide: Common Sense Principles for Troubled Times, recently guest-blogged for several weeks here at the Business Desk with answers to some of life's economic ironies: why brides buy dresses while … Continue reading
After a decade of economic growth due in large part to energy revenue, Russia is reeling from the global financial crisis and the drop in oil prices and production. Continue reading
As crude oil costs climb higher, summer travelers are watching the price of gasoline increase. Analysts examine the factors pushing oil prices up. Continue reading
Russia and Ukraine signed Monday a 10-year deal to resume natural gas supplies to Europe after a two-week shutoff due to a dispute over gas prices and the payment of other debts. Continue reading
Question/Comment: There was an article in the New York Times suggesting we peg gas prices at $3.50 and use the income to fund the Big Three bailout and future alternative energy research. This would also keep the pressure on to … Continue reading
Violent clashes between government supporters and opposition protesters in Bolivia have left at least eight dead and tipped off a diplomatic dispute culminating in U.S. diplomats being expelled from both Bolivia and Venezuela. Continue reading


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text: Thursday brings us the women's all-around gymnastics finals, and if Tuesday was any indication, we could be in for some outstanding performances from a wide range of nations. Join us starting at 11:15 a.m. Eastern as we live-blog the event as it happens. Note: THERE WILL BE SPOILERS, so watch at your own risk. (Or find out what happens early and bet your unknowing friends this evening, whichever.) Join us, won't you?