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Lange V, Kappel K. CRISPR Gene-Therapy: A Critical Review of Ethical Concerns and a Proposal for Public Decision-Making. Canadian Journal of Bioethics 2022. [DOI: 10.7202/1089787ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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2
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Salim T, Pedersen P, Østgaard S, Kappel K, Blom C, Zinolabedinbik P, Simonsen O. Dissatisfaction and persistent post-operative pain following total knee replacement – A 5 year follow-up of all patients from a whole region. Scand J Pain 2017. [DOI: 10.1016/j.sjpain.2017.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Introduction
Total knee replacement (TKR) is the treatment of choice for the millions of individuals whose osteoarthritis related pain can no longer be managed through non-invasive methods. Although most patients report improvement in pain and functioning following TKR, up to 30% report after 1–2 years persistent pain that interferes with their daily function. Further knowledge on long term results are highly demanded. The present study is the first 5 year follow-up of all patients from a whole region.
Methods
Patients were interviewed by letter concerning pain, overall satisfaction and forgotten joint score (FJS). In 2011, 607 patients in the region of North Denmark had a primary TKR, of which 20 was bilateral. Still alive are 546 patients. A total of 498 answered by letter (91%) of which 13 were not able to answer detailed due to psychological reasons.
Results
A total of 290 (59%) patients were very satisfied with their TKR, 140 (30%) were satisfied and 58 (12%) dissatisfied. Pain free were 269 (55%). 163 patients (33%) experienced moderate pain and 55 (11%) had strong pain. Dissatisfaction and pain were highly correlated, especially pain at walking: Among patients reporting strong pain, 35 (64%) scored higher than 6 on the VAS-average pain last 24 h versus 46 (84%) that scored higher than 6 on the VAS-pain after 30 min’s walk.
Conclusions
Among an unselected series of patients having TKR, 12% were dissatisfied and 11% still had strong pain 5 years later. Dissatisfaction was especially correlated with pain when walking. Thus, the association between dissatisfaction, pain at activity and the individual expectations should be further focused.
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Affiliation(s)
- T. Salim
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
| | - P. Pedersen
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
| | - S.E. Østgaard
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
| | - K. Kappel
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
| | - C.S. Blom
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
| | | | - O. Simonsen
- Ortopædkirurgisk Forskningsenhed , Aalborg , Denmark
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Abstract
Informed consent is considered by many to be a moral imperative in medical research. However, it is increasingly acknowledged that in many actual instances of consent to participation in medical research, participants do not employ the provided information in their decision to consent, but rather consent based on the trust they hold in the researcher or research enterprise. In this article we explore whether trust-based consent is morally inferior to information-based consent. We analyse the moral values essential to valid consent - autonomy, voluntariness, non-manipulation, and non-exploitation - and assess whether these values are less protected and promoted by consent based on trust than they are by consent based on information. We find that this is not the case, and thus conclude that trust-based consent if not morally inferior to information-based consent.
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Østerberg JT, Xiang W, Olsen LI, Edenbrandt AK, Vedel SE, Christiansen A, Landes X, Andersen MM, Pagh P, Sandøe P, Nielsen J, Christensen SB, Thorsen BJ, Kappel K, Gamborg C, Palmgren M. Accelerating the Domestication of New Crops: Feasibility and Approaches. Trends Plant Sci 2017; 22:373-384. [PMID: 28262427 DOI: 10.1016/j.tplants.2017.01.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 12/09/2016] [Accepted: 01/16/2017] [Indexed: 05/19/2023]
Abstract
The domestication of new crops would promote agricultural diversity and could provide a solution to many of the problems associated with intensive agriculture. We suggest here that genome editing can be used as a new tool by breeders to accelerate the domestication of semi-domesticated or even wild plants, building a more varied foundation for the sustainable provision of food and fodder in the future. We examine the feasibility of such plants from biological, social, ethical, economic, and legal perspectives.
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Affiliation(s)
- Jeppe Thulin Østerberg
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
| | - Wen Xiang
- Center for Public Regulation and Administration, Faculty of Law, University of Copenhagen, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Lene Irene Olsen
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
| | - Anna Kristina Edenbrandt
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Suzanne Elizabeth Vedel
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Andreas Christiansen
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, 2300 Copenhagen S, Denmark
| | - Xavier Landes
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, 2300 Copenhagen S, Denmark
| | - Martin Marchman Andersen
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, 2300 Copenhagen S, Denmark
| | - Peter Pagh
- Center for Public Regulation and Administration, Faculty of Law, University of Copenhagen, Studiestræde 6, 1455 Copenhagen K, Denmark
| | - Peter Sandøe
- Department of Large Animal Sciences, University of Copenhagen, 1870 Frederiksberg C, Denmark
| | - John Nielsen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Østerbro, Denmark
| | - Søren Brøgger Christensen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Østerbro, Denmark
| | - Bo Jellesmark Thorsen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Klemens Kappel
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, 2300 Copenhagen S, Denmark
| | - Christian Gamborg
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Michael Palmgren
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark.
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Andersen MM, Landes X, Xiang W, Anyshchenko A, Falhof J, Østerberg JT, Olsen LI, Edenbrandt AK, Vedel SE, Thorsen BJ, Sandøe P, Gamborg C, Kappel K, Palmgren MG. Feasibility of new breeding techniques for organic farming. Trends Plant Sci 2015; 20:426-34. [PMID: 26027462 DOI: 10.1016/j.tplants.2015.04.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 05/18/2023]
Abstract
Organic farming is based on the concept of working 'with nature' instead of against it; however, compared with conventional farming, organic farming reportedly has lower productivity. Ideally, the goal should be to narrow this yield gap. In this review, we specifically discuss the feasibility of new breeding techniques (NBTs) for rewilding, a process involving the reintroduction of properties from the wild relatives of crops, as a method to close the productivity gap. The most efficient methods of rewilding are based on modern biotechnology techniques, which have yet to be embraced by the organic farming movement. Thus, the question arises of whether the adoption of such methods is feasible, not only from a technological perspective, but also from conceptual, socioeconomic, ethical, and regulatory perspectives.
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Affiliation(s)
- Martin Marchman Andersen
- Department of Media, Cognition and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Xavier Landes
- Department of Media, Cognition and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Wen Xiang
- Centre for Public Regulation and Administration, Faculty of Law, University of Copenhagen, Studiestræde 6, DK-1455 Copenhagen K, Denmark
| | - Artem Anyshchenko
- Centre for Public Regulation and Administration, Faculty of Law, University of Copenhagen, Studiestræde 6, DK-1455 Copenhagen K, Denmark
| | - Janus Falhof
- Center for Membrane Pumps in Cells and Disease - PUMPKIN, Danish National Research Foundation, Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Jeppe Thulin Østerberg
- Center for Membrane Pumps in Cells and Disease - PUMPKIN, Danish National Research Foundation, Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Lene Irene Olsen
- Center for Membrane Pumps in Cells and Disease - PUMPKIN, Danish National Research Foundation, Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Anna Kristina Edenbrandt
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Suzanne Elizabeth Vedel
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Bo Jellesmark Thorsen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark; Center for Macroecology, Evolution and Climate, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Peter Sandøe
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark; Department of Large Animal Sciences, University of Copenhagen, DK-1870 Frederiksberg C, Denmark
| | - Christian Gamborg
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Klemens Kappel
- Department of Media, Cognition and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Michael G Palmgren
- Center for Membrane Pumps in Cells and Disease - PUMPKIN, Danish National Research Foundation, Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark.
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Palmgren MG, Edenbrandt AK, Vedel SE, Andersen MM, Landes X, Østerberg JT, Falhof J, Olsen LI, Christensen SB, Sandøe P, Gamborg C, Kappel K, Thorsen BJ, Pagh P. Are we ready for back-to-nature crop breeding? Trends Plant Sci 2015; 20:155-64. [PMID: 25529373 DOI: 10.1016/j.tplants.2014.11.003] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 11/05/2014] [Accepted: 11/10/2014] [Indexed: 05/03/2023]
Abstract
Sustainable agriculture in response to increasing demands for food depends on development of high-yielding crops with high nutritional value that require minimal intervention during growth. To date, the focus has been on changing plants by introducing genes that impart new properties, which the plants and their ancestors never possessed. By contrast, we suggest another potentially beneficial and perhaps less controversial strategy that modern plant biotechnology may adopt. This approach, which broadens earlier approaches to reverse breeding, aims to furnish crops with lost properties that their ancestors once possessed in order to tolerate adverse environmental conditions. What molecular techniques are available for implementing such rewilding? Are the strategies legally, socially, economically, and ethically feasible? These are the questions addressed in this review.
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Affiliation(s)
- Michael G Palmgren
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark.
| | - Anna Kristina Edenbrandt
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Suzanne Elizabeth Vedel
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Martin Marchman Andersen
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Xavier Landes
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Jeppe Thulin Østerberg
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Janus Falhof
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Lene Irene Olsen
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, DK-1871 Frederiksberg C, Denmark
| | - Søren Brøgger Christensen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø, Denmark
| | - Peter Sandøe
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark; Department of Large Animal Sciences, University of Copenhagen, DK-1870 Frederiksberg C, Denmark
| | - Christian Gamborg
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Klemens Kappel
- Department of Media, Cognition, and Communication, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen S, Denmark
| | - Bo Jellesmark Thorsen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, DK-1958 Frederiksberg C, Denmark
| | - Peter Pagh
- Centre for Public Regulation and Administration, Faculty of Law, University of Copenhagen, Studiestræde 6, DK-1455 Copenhagen K, Denmark
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Hansen K, Kappel K. Pre-trial beliefs in complementary and alternative medicine: whose pre-trial belief should be considered? Med Health Care Philos 2012; 15:15-21. [PMID: 20820925 DOI: 10.1007/s11019-010-9279-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Subjective probabilities play a significant role in the assessment of evidence: in other words, our background knowledge, or pre-trial beliefs, cannot be set aside when new evidence is being evaluated. Focusing on homeopathy, this paper investigates the nature of pre-trial beliefs in clinical trials. It asks whether pre-trial beliefs of the sort normally held only by those who are sympathetic to homeopathy can legitimately be disregarded in those trials. The paper addresses several surprisingly unsuccessful attempts to provide a satisfactory justification for ignoring the pre-trial beliefs of the homeopathic community. The ensuing diagnosis of the difficulties here emphasizes that the reason the arguments for choosing the pre-trial beliefs of the conventional community seem insufficient is not the arguments per se. It is rather that there is no cogent argument for choosing the conventional stance which would at the same time rationally persuade a member of the homeopathic community. The paper concludes that, once we understand that this is the predicament, there is no genuine reason to doubt the reasoning that leads us to reject the pre-trial beliefs of the homeopathic community.
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Affiliation(s)
- Kirsten Hansen
- Department of Public Health, Section for Health Services Research, Unit of Medical Philosophy and Clinical Theory, University of Copenhagen, Øster Farimagsgade 5, Building 5, P.O. Box 2099, 1014 Copenhagen K, Denmark.
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9
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Kochzius M, Nölte M, Weber H, Silkenbeumer N, Hjörleifsdottir S, Hreggvidsson GO, Marteinsson V, Kappel K, Planes S, Tinti F, Magoulas A, Garcia Vazquez E, Turan C, Hervet C, Campo Falgueras D, Antoniou A, Landi M, Blohm D. DNA microarrays for identifying fishes. Mar Biotechnol (NY) 2008; 10:207-217. [PMID: 18270778 PMCID: PMC2263118 DOI: 10.1007/s10126-007-9068-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 11/05/2007] [Accepted: 11/07/2007] [Indexed: 05/25/2023]
Abstract
In many cases marine organisms and especially their diverse developmental stages are difficult to identify by morphological characters. DNA-based identification methods offer an analytically powerful addition or even an alternative. In this study, a DNA microarray has been developed to be able to investigate its potential as a tool for the identification of fish species from European seas based on mitochondrial 16S rDNA sequences. Eleven commercially important fish species were selected for a first prototype. Oligonucleotide probes were designed based on the 16S rDNA sequences obtained from 230 individuals of 27 fish species. In addition, more than 1200 sequences of 380 species served as sequence background against which the specificity of the probes was tested in silico. Single target hybridisations with Cy5-labelled, PCR-amplified 16S rDNA fragments from each of the 11 species on microarrays containing the complete set of probes confirmed their suitability. True-positive, fluorescence signals obtained were at least one order of magnitude stronger than false-positive cross-hybridisations. Single nontarget hybridisations resulted in cross-hybridisation signals at approximately 27% of the cases tested, but all of them were at least one order of magnitude lower than true-positive signals. This study demonstrates that the 16S rDNA gene is suitable for designing oligonucleotide probes, which can be used to differentiate 11 fish species. These data are a solid basis for the second step to create a "Fish Chip" for approximately 50 fish species relevant in marine environmental and fisheries research, as well as control of fisheries products.
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Affiliation(s)
- M Kochzius
- Centre for Applied Gene Sensor Technology (CAG), University of Bremen, Bremen, Germany.
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Norup M, Folker AP, Holtug N, Jensen AB, Kappel K, Nielsen JK. [Decisions about life and death. An empirical study of the position of Danish physicians concerning end-of-life decisions]. Nord Med 1998; 113:240-4. [PMID: 9755623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In a postal questionnaire investigation of experiences and attitudes concerning end-of-life decisions among Danish physicians, most of the respondents reported having made decisions involving the hastening of a patient's death, and considered this acceptable. Such decisions were more frequent, and were considered ethically more acceptable, when made with the patient's informed consent than without. Of the respondents, two per cent had participated in assisted suicide, and five per cent had administered a lethal injection at the patient's request, practices considered ethically acceptable by 37 per cent and 34 per cent, respectively, of the respondents. The most frequently cited reasons for opposing such practices were double effect principle, the active killing/allowed-death distinction, and the sanctity of life; and the most frequently cited justifications were respect for the patient's autonomy, the avoidance of unnecessary suffering, and the patient's right to a death with dignity.
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Affiliation(s)
- M Norup
- Afdeling for Medicinsk Videnskabsteori, Københavns Universitet
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Folker AP, Holtug N, Jensen AB, Kappel K, Nielsen JK, Norup M. Experiences and attitudes towards end-of-life decisions amongst Danish physicians. Bioethics 1996; 10:233-249. [PMID: 11657395 DOI: 10.1111/j.1467-8519.1996.tb00122.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In this survey we have investigated the experiences and attitudes of Danish physicians regarding end-of-life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non-resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two percent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self-determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death.
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Abstract
For a distribution of health care resources to be fair, it should consider the consequences for the whole lives of the affected persons and not just how badly off they are at the present moment. Since, other things being equal, a person is worse off if he dies young than if he dies old, it is fair to give scarce vital health care resources to young rather than to old persons. In the paper this ageist view is restated and defended against a number of objections raised by John Harris. According to Harris' so-called anti-ageist argument the only relevant consideration in the distribution of vital health care resources is people's desire to go on living. On reflection, this is highly counterintuitive. Instead, it is argued that both present desires to go on living and possible future happiness should weigh together with considerations of fairness. Both fairness and possible future happiness will in most cases speak in favour of saving the young before the old. A number of other problems for the ageist view are discussed, and solutions are suggested.
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Abstract
... We can therefore conclude that either we should go for equality; and in that case QALYs are unfair because they haven't got enough of an ageist bias. Or we should accept consequentialism; and in that case QALYs have just the right sort of ageist bias. No plausible case can, however, be made for the claim that QALYs have an unfair bias against old people. Other things being equal we ought when distributing resources essential for survival favour the young. This ethical claim can be supported both by reference to equality (the life-time-view) and by reference to consequentialism (and the premises that resources generally will be more useful when given to young people).
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