Mathematical Tools For Predicting Facial Surgery

Cosmetic Medicine

Cranio-maxillofacial surgery is a medical specialty focusing on facial and skull reconstruction. This surgery can help patients with such disorders as cleft palate, malformations of the upper or lower jaw, and problems with the facial skeleton due to injury.

Intensive pre-operative planning is needed not only to ensure that the medical purposes of the surgery are achieved, but also to give patients a sense of what their faces will look like after the surgery is performed. In their article "Mathematics in Facial Surgery," Peter Deuflhard, Martin Weiser, and Stefan Zachow (of the Konrad Zuse Zentrum (ZIB), Berlin) describe the mathematical techniques they have used to assist cranio-maxillofacial surgeons to predict the outcomes of surgery.

These techniques have proven to be quite successful in producing predictions that end up matching well the post-operative outcomes. The first step in the planning paradigm for such surgery is to use medical imaging data of the patient to construct a 3-dimensional computer model, called the "virtual patient". The second step, which is the one the article focuses on, uses the data to create a "virtual lab" in which various operative strategies can be tested. The last step is to play back to the patient the outcomes of the various strategies. The second step in the paradigm requires modeling and solving partial differential equations (PDEs), which are equations that represent changing physical systems.

One must identify which PDEs are appropriate for biomechanical modeling of soft facial tissue and bone. Standard methods for handling the equations need to be adapted for this particular application. One must also formulate ways to represent the interface between tissue and bone, as well as their interactions. Generally such PDEs cannot be solved exactly in closed form, so mathematics enters the picture once again to provide numerical techniques for producing approximate solutions. With the "virtual patient" data as input, one can use the approximate solutions to generate an individualized model for that particular patient.

The surgeons can then use the model as a "virtual lab" to predict the effects of surgical procedures and options, and patients can get a picture of approximately how they will look after the surgery. The article by Deuflhard et al states that qualitative comparisons between the outcomes predicted by the model, and the actual surgical outcomes, have been surprisingly good. The authors have also made quantitative comparisons, by creating a post-operative model of the patient and comparing it quantitatively to the predicted outcome.

They found a mean prediction error of between 1 and 1.5mm for the soft tissue, which they write "seems to be a fully acceptable result." "Even though biomechanical tissue modeling turns out to be a tough problem, we are already rather successful in predicting postoperative appearance from preoperative patient data," the authors write. "For the surgeon, our computer assisted planning permits an improved preparation before the actual operation."

Reduce form and cell mathmatical tools...

Best tools of Mathematical and Computer

To intelligently and effectively use crystallographic databases, mathematical and computer tools are required that can elucidate diverse types of intra- and interlattice relationships. Two such tools are the normalized reduced form and normalized reduced cell. Practical experience has revealed that the first tool--the normalized reduced form--is very helpful in establishing lattice metric symmetry as it enables one to readily deduce significant relationships between the elements of the reduced form.

Likewise research with crystallographic databases has demonstrated that the second tool--the normalized reduced cell--plays a vital role in determining metrically similar lattices. Knowledge of similar lattices has practical value in solving structures, in assignment of structure types, in materials design, and in nano-technology. In addition to using the reduced cell, it is recommended that lattice-matching strategies based on the normalized reduced cell be routinely carried out in database searching, in data evaluation, and in experimental work.

Key words: identification; lattice-matching strategies; lattice relationships; lattice similarity; metric lattice; normalized reduced cell and form; symmetry. **********

1. Introduction

The various crystallographic databases [1] now available constitute a large, comprehensive, and rapidly growing scientific resource, serving as an invaluable source of data for the intelligent design of materials, for crystal engineering, and for nanotechnology. To evaluate data entering these databases and to intelligently and effectively use this resource, diverse mathematical tools are required that can establish intralattice relationships or elucidate various types of interlattice relationships. Two such tools are the normalized reduced form and the normalized reduced cell--tools that are ideal for elucidating certain types of intra- and interlattice relationships. For example, with the normalized reduced form, one can determine lattice-metric symmetry and deduce other types of intralattice relationships.

With the normalized reduced cell, one can determine metrically similar lattices (1) via lattice matching techniques against the lattices in the crystallographic databases. Practical experience has revealed that these tools are very useful for routine and complex lattice analyses. Before proceeding with applications of these tools, it is necessary to define the normalized reduced cell and form.

1.1 Definitions

The reduced cell is a unique primitive cell of the lattice, which is based on the three shortest lattice translations. For the precise mathematical definition of the reduced cell and form and for procedures to calculate this cell, see [2] and NBS Technical Note 1290 [3].

The normalized reduced cell of a lattice is determined simply by dividing the cell edges of the reduced cell by the a-cell edge. The normalized reduced form is calculated from the normalized reduced cell and is defined by the vector dot products of the normalized reduced cell edge vectors:

a * a b * b c * c

b * c a * c a * b

As an example, consider the reduced cell for a typical triclinic crystal structure reported in the recent literature [4]:

[a.sub.t] = 9.6907[Angstrom] [b.sub.t] = 10.3119[Angstrom] [c.sub.t] = 11.2549[Angstrom]

[[alpha].sub.t] = 63.954[degrees] [[beta].sub.t] = 70.282[degrees] [[gamma].sub.t] = 87.414[degrees]

The corresponding normalized reduced cell and form are: Cell: a = 1.0000 b = 1.0641 c = 1.1614

[alpha] = 63.954[degrees] [beta] = 70.282[degrees] [gamma]...

Three Funny Jokes

Things to say if caught sleeping at your desk

Face it, we all feel sleepy the moment we enter the office premises. But what if your boss caught you sleeping at your desk? Here is what you can tell him:

• "They told me at the blood bank this might happen."

• "This is just a 15 minute power-nap as described in that time management course you sent me."

• "Whew! Guess I left the top off the White-Out You probably got here just in time!"

• "I wasn't sleeping! I was meditating on the mission statement and envisioning a new paradigm."

• "I was testing my keyboard for drool resistance."

• "I was doing Yoga exercises to relieve work-related stress."

• "Damn! Why did you interrupt me? I had almost figured out a solution to our biggest problem."

• "The coffee machine is broken..."

• "Someone must've put decaf in the wrong pot..."

• " ... in Jesus' name. Amen."

School Gifts

It was at the end of the school year, and a kindergarten teacher was receiving gifts from her pupils. The florist's son handed her a gift. She shook it, held it overhead, and said, "I bet I know what it is. Some flowers." " That's right" the boy said, "but how did you know?"

"Oh, just a wild guess," she said.

The next pupil was the candy shop owner's daughter.

The teacher held her gift overhead, shook it, and said, "I bet I can guess what it is. A box of sweets."

"That's right, but how did you know?" asked the girl.

"Oh, just a wild guess," said the teacher.

The next gift was from the son of the liquor store owner. The teacher held the package overhead, but it was leaking. She touched a drop of the leakage with her finger and touched it to her tongue.

"Is it wine?" she asked.

"No," the boy replied, with some excitement.

The teacher repeated the process, taking a larger drop of the leakage to her tongue.

"Is it champagne?" she asked.

"No," the boy replied, with more excitement.

The teacher took one more taste before declaring, "I give up, what is it?"

With great glee, the boy replied, "It's a puppy!"

Marketing Concepts

You see a gorgeous girl at a party.

You go up to her and say, "I am very rich.Marry me!"

That's Direct Marketing.

You're at a party with a bunch of friends and see a gorgeous girl.

One of your friends goes up to her and pointing at you says, "He's very rich.Marry him.

"That's Advertising.

You see a gorgeous girl at a party.

You go up to her and get her telephone number. The next day you call and say "Hi,I'm very rich.Marry me.

"That's Telemarketing.

You're at a party and see a gorgeous girl. You get up and straightenyour tie, you walk up to her and pour her a drink. You open the door for her, pick up her bag after she drops it, offer her a ride, and then say, "By the way, I'm very rich.Will you marry me?

"That's Public Relations.

You're at a party and see a gorgeous girl. She walks up to you andsays, "You are very rich.." That's Brand Recognition.

You see a gorgeous girl at a party. You go up to her and say, "I'mrich.Marry me" She gives you a nice hard slap on your face.That's Customer Feedback !!!!!

You see a gorgeous girl at a party. You go up to her and say, "I am very rich.Marry me!" And she introduces you to her husbandThat's demand and supply gap.

You see a gorgeous girl at a party. You go up to her and before yousay, "I am very rich.Marry me!" she turns her face towards you ------------ she is your wife !

That's competition eating into your market share

Job Prospects: Librarian

Librarian

If books are your obsession and you love the company of these true silent companions a library is the best place you can be at and what more if you all get the opportunity to work in one. It is a place for those who love the serene work environment and definitely have an analytical mind to absorb large quantity of information.

A library is described as the 'reservoir of knowledge' hence the people who are trained to work in such places are taught how to handle, maintain and improve the knowledge bank. Several institutes today offer courses in 'library science' to students who wish to pursue a career in the field. The course majorly teaches the technique to catalogue books, journals and audio-visual material in the library. It teaches one the skill to acquire and make information available to library members in a limited time span.

A library is one of the places that maintain a very typical and unique work ethics that are seldom altered and is maintained across the globe in a similar fashion. Students of the course are also taught these mannerisms and policies. With the world gradually shifting into the technology era, libraries worldwide too, are concentrating on attaining technological assistance to maintain their knowledge bank and provide accurate information to their members. The librarians therefore, are taught how to use various technology and extract required information from them. The job profile of a librarian is divided into three broad categories namely, customer service, administration and technical assistance.

The customer service part of their job is to help users locate their requirement either on the shelves or from the Internet that is proficiently a part of the knowledge bank these days. The administrative part of a librarian's job involves planning and management. The librarians are expected to negotiate buy and sell from wholesalers, publishers, distributors etc. While managing the smooth running of the library they are supposed to supervise the library physically, set budgets for the library stock and maintenance etc. Activities such as fund raising and public relations are also put under the job responsibility of a librarian.

In a small library set-up all responsibilities are shouldered by one person or sometimes by two librarians who divide their responsibilities, whereas in a larger set up there are a number of people appointed with specific area of functioning depending on their qualification. Apart from being appointed in a library a person with the a similar job profile can also stand chance of being absorbed by other organizations like information centers run by organizations like government aided agencies, museums, professional associations and corporate houses, law firms, ad agencies, medical research centers, hospitals, religious organizations, and various research laboratories.

Sport Personalities: Pete Sampras

Pete Sampras

Pete Sampras known for his aggressive serves and flinging swings carries an easy going straightforward and an extremely candid personality. His competitive style has won him several Grand Slam titles and a vast fan following too. Born on 12th August 1971 in Washington DC, Pete is a Greek immigrant by origin.

Sampras began his professional journey in the game of tennis at the tender age of 17 in 1988 and in only two years he smoothly moved his way up to the top ten strata. He won his very first Grand Slam title the U.S. Open in 1990. His serves in the tournament were such that impressed players like Agassi, Lendl, and McEnroe too. Pete was announced the youngest tennis player ever to win the U.S. Open cup.In 1991, Pete won the IBM World Championship followed by the Davis cup in 1992, where he helped the US regain its first position.

In 1993 he made a record of 1000 aces in a single season that also helped him to win the Wimbledon and the US opens in the same year. Pete's victory in the Australian Open in 1994 made him the first player ever to win three Grand Slam Tournaments in a row. During his career Pete won a total of 64 singles titles, with 14 Grand Slam titles. He won Wimbledon title seven times, the U.S. Open five times and the Australian Open twice in his 15 years of career. Though Pete could never win the French Open tournament ever the fact remains that he is an astounding player who exhibited great caliber on court.

Much on the contrary is his otherwise low-key behaviour and sportsmanlike attitude that kept him from becoming a major celebrity beyond the court. At the age of 32, in August 2003 Pete officially announced his retirement from the game at the US Opens and was the only player in history whose final match was a victory in the Grand Slam Finals so far. Apart from playing tennis professionally Pete is also known to have a liking for Golf as a game and also plays the game as a hobby.

Sport Personalities

Sunil Gavaskar- The Little Master

'The Little Master' as he was fondly called by his co-players and commentators, Sunil Gavaskar was born in 1949. He started playing cricket at the early age of 17 in the year 1966/67. He played in the 1970s and 80s for Bombay and then for India too. He was regarded as the greatest opening batsman of his time. To Gavaskar's credit are world records for the most runs and most centuries ever by a batsman. Gavaskar spent his childhood days in Mumbai where he developed his interest in the game and started playing for the state (Maharashtra) at a very young age. He was given the title of the 'Best Schoolboy Cricketer of the Year' in 1966.

After making a few consecutive centuries in state level matches for the Ranji Trophy team from Mumbai. Gavaskar made his entry into team India in a tour to West Indies. Sunil Gavaskar was the first batsman to score 10,000 runs. Gavaskar started playing his test matches for India in 1971 during India's tour to West Indies where he scored a spectacular 774 runs. Gavaskar's unique techniques and long concentration abilities proved beneficial for his games. Gavaskar holds the record for the highest number of test series – 34 until 2005 when Sachin Tendulkar broke his record. Apart from the numerous records and awards that are credited to his name, Gavaskar has also attained the prestigious 'Padma Bhushan' award. In the year 1994, he was appointed the honorary 'Sheriff of Mumbai' for a year.

Sunil Gavaskar retired from the game in the 1986-87 season of test cricket. But such was his love for the game that he took up TV and print commentary after retirement and also became an active executive member of the ICC board where he serves till date. Even after a decade of retirement from the field, the 'Little Master' still stands an example to young cricketers across the globe. Several records by the player are still unbroken by any player national or international. This makes it reason enough to call the all rounder a 'Living Legend in Cricket' today.

Article About Education and Healthcare by Anjali Prayag

`Education is the best investment'

Entrepreneurship in education and healthcare is a tricky business. Without compromising on quality, cost and pricing parameters have to be carefully watched. While an innovative idea gets applauded, an expensive one will be frowned upon. So how does one tread this difficult path?
"Let me tell you about our business model," says Dr Ramdas Pai, Chairman and President, Manipal Education and Medical Group (MEMG). At the group's medical colleges, one-third of the students are NRIs admitted only on merit. In turn, they subsidise the education of the other two-thirds who cannot afford expensive medical education, he explains.

The same principle holds good in their hospitals too, says Dr Pai. About 80 per cent of the patients in the general wards only pay about 10-15 per cent of the cost and about 10 per cent of the beds are offered free. "We believe that both in education and healthcare, nobody should be stranded or turned away because of lack of money," he says.

He narrates the story of a vegetable vendor who came to him decades ago pleading for a job for his son, who was an SSLC pass. "We could have easily given him a small-time job in one of our set-ups and be done with it. Instead, I advised the young boy to take a loan in a bank and continue his education in our college." He now lives and works in the UK.

Dr Pai firmly believes that the only thing that can change the face of this country is education. Human resource is our country's greatest asset and it's time to tap the potential of the two billion hands, he feels.

"Right now, our population is a liability, but with education and good healthcare we can turn it into an asset." He feels that there is no investment as good as education because of its yield.
MEMG's foray into the two high-pulse sectors began more than half a century ago when Dr Pai's father, Dr T M A Pai, started the Kasturba Medical College in Manipal. The first batch comprised 34 young men.

Today, students from 31 countries come to this university town in the South Kanara district of Karnataka, every year. In fact, the town is known to have more foreign nationals than any other region in the country — about 75,000 at any given point of time.

Kasturba Medical College is also the country's first self-financed college. For its first batch itself, the college was awarded recognition by the Indian Medical Council and the General Medical Council of Great Britain. After taking over the mantle of the group from his father in 1979, Dr Pai decided that MEMG's commitment to education and healthcare would move beyond South Kanara.

Institutes of learning were set up in various fields such as health sciences, technology and management. Dr Pai was responsible for establishing the first joint venture between the State Government and the private sector. The Sikkim Manipal Univeristy was set up with a medical college in Gangtok. This was just the beginning. Next came a teaching hospital and then an engineering college, with the group contributing nearly Rs 200 crore in these projects. Today, all these are part of the Sikkim Manipal University.

Dr Pai had earlier been invited by the Government of Nepal to start a medical school in Pokhara. In 1995, the Melaka Manipal Medical College was set up in Malaysia. Students of the college study in Manipal for two-and-a-half years and continue their clinical training for the same duration at the Melaka General Hospital in Malaysia.

The Manipal Academy of Higher Education was the first private university recognised by the Government of India, in 1993. Today, MEMG has two universities, 24 professional colleges, 11 hospitals (including 6 teaching hospitals) and 33,000 students from over 48 countries.

Technology and innovation have not been ignored here, he says. Through its distance education wing, designed to scale down the cost of education, the Manipal University reaches out to 39,000 students studying in 400 centres — the largest after IGNOU.

New business trends like outsourcing have to be tapped to our advantage, says Dr Pai. For instance, MEMG's healthcare BPO, employing around 1,000 people, has just been launched and business is `just picking up,' he says.

MEMG has also tied up with the National Health Service (NHS) of the UK to send its doctors and nurses abroad for short stints in the areas of ophthalmology and orthopaedics. "So far, NHS was outsourcing medical talent from Canada, Australia, South Africa and New Zealand. Now Indian doctors are getting globally recognised."

Commenting on the opening up of the education sector early next year, Dr Pai says, "I don't know what will happen. Personally I feel it will be good because competition is good for any business. In fact, it is an opportunity for us to benchmark with the world's best schools." Good institutions should not worry, "but unfortunately, the Government's regulations are not very clear," he says, adding, "There are a lot of grey areas which need to be cleared."

Dr Pai was recently awarded the Ernst & Young `Entrepreneur of the Year' 2004 in the services category. The award, celebrates entrepreneurs who are building and leading successful, growing, and dynamic businesses, recognising them through regional, national, and global award programmes in more than 115 cities and 35 countries.

Comments of Higher Education

Jennifer Harris

She hadn’t even started high school yet, but Jennifer Harris decided back in 1999 that she wanted to play basketball at Pennsylvania State University. Her mother had gone to Penn State, her older sister had gone to Penn State, and she would too. Now, she’s left the university, as have other players, because they maintain the coach is against lesbians — and people assumed to be lesbians.

But looking back on her first conversation that year with Penn State women’s basketball coach, Rene Portland, Pearl Harris, Jennifer’s mother, recalls a passing comment by Portland that she took little note of at the time, but which she now sees as a sign of events that culminated in her daughter leaving Penn State last spring, toward the end of her sophomore year.

“She said I could rest assured that there were no gay individuals on her basketball team,” Pearl Harris recalled. At the time, Jennifer was also considering another university, and Portland told her that the coach at the other institution recruited lesbians – a scare tactic that may not be uncommon.

“I hear about that kind of negative recruiting all the time,” said Pat Griffin, a professor of social justice education at the University of Massachusetts at Amherst, and director of It Takes a Team, a project from the Women’s Sports Foundation that promotes education about sexual orientation issues in women’s sports. “It’s very common that if the coach knows that athlete is considering another team, they’ll tell them not to go because they have lesbians in their program,” Griffin said. “What’s changed is that some athletes and their families won’t tolerate it anymore, and speak up, like Jennifer Harris.”

Portland is known as a top women’s basketball coach. She’s also known for her anti-gay comments, which go back much further than Harris. In the late 1980s and up until 1991, Portland acknowledged in newspaper articles that she did not want lesbians on her team. A profile of Portland in 1991 by The Philadelphia Inquirer prompted Penn State to expand its anti-discrimination policy to cover sexual orientation. After that, Portland, the two-time Women’s Basketball Coaches Association coach of the year, said she would abide by the policy.

But Tuesday, the National Center for Lesbian Rights sent a letter to Graham B. Spanier, the president of Penn State, charging that Portland told players not to associate with other players who Portland thought were lesbians, including Harris. The center threatened to sue if something is not done about Portland.

A university official said Portland was not available for comment Wednesday. Spanier reviewed the letter late Wednesday and made a brief statement that “the university legal counsel will certainly follow up with the center to learn more about Jennifer Harris’ complaint.” Bill Mahon, a university spokesman, said that the university found out about the issue from reporters, and that neither Harris, nor any other player, had ever lodged a complaint about Portland since the expansion of the antidiscrimination policy. “We don’t have any record that she went to anyone in the athletic department, or the Affirmative Action Office, or the Office for Educational Equity,” Mahon said.

Harris said the she was afraid to make a complaint. “There are consequences when you go above your coach,” she said.

During her freshman year, Harris said that Portland told her and other players not to associate with a player who Portland said was a lesbian, a practice of Portland’s reported in an article in 1991. “She told all of us,” Harris said. “It was like an unwritten rule.”

Pearl Harris still remembers the phone call she got from Portland. “She said she had proof this player was gay, and she didn’t want her to influence other players,” Pearl Harris said. “She wanted the parents’ support.” Last year, Jennifer Harris said, her teammates told her that Portland said players should stop associating with Harris, even though Harris says she is not a lesbian, and that Portland also “warned” the team about two other players she suspected were lesbians. All three of the players have left Penn State.

Karen Doering, a lawyer with National Center for Lesbian Rights, said that Harris never made a complaint within the university because the power dynamic between coaches and players is such that players feel they are putting their playing careers and scholarships on the line by speaking up. Doering noted that, in response to a discrimination complaint by a softball player at the University of Florida last year, that institution now informs athletes that they should feel free to make grievances about coaches to offices outside of the athletics department. Said Lynda Tealer, the associate athletic director for women’s administration at Florida, “it’s in case they don’t feel comfortable going to somebody in athletics.”

Doering hopes that Penn State will consider making its grievance procedures better known to student-athletes. If insufficient action is taking, Doering said she will not hesitate to take the matter to court, “where it will be painful for everybody involved.”

Mahon said that he thought the issue was more a question of whether Portland violated university policy, and that he was not sure the legal threat has much strength. Pennsylvania does not have a law specifically barring all discrimination based on sexual orientation.
But Doering said that, while she was not aware of any cases involving college athletics, she said there have been cases of high school students who have won in court under “equal protection clauses,” she said, and noted that the U.S. Supreme Court has ruled that an employee could not be discriminated against for not conforming to gender stereotypes.

Harris was released from her scholarship commitments by Penn State last year after Portland told her she would not be invited back, but gave no reason, an event documented in a letter Harris got from the university. She has since transferred to James Madison University, where she is a member of the basketball team. According to her mother, though, even though she left Penn State, she followed up with the issue when alumni referred her to the lesbian rights group because “she has a cousin and a niece who want to play at Penn State,” Pearl Harris said, “and Jen decided the behavior she had to go through isn’t right.”

Jennifer Harris added that she has been getting a lot of support from people who know about the “unwritten rule,” and said that “there are people who think I’m just trying to get revenge. I just don’t want anybody else to go through this.”

Features of Human Rights: NEPAL

Tool of terror : TADA

The Terrorist and Disruptive Activities (Control and Punishment) Act, 2002 (TADA), was Nepal’s reaction to a global apprehension of terrorism since the events of 11 September 2001, and localised in Nepal through continued State conflict with the pro-republic Communist Party of Nepal (CPN-Maoists).

The comprehensive and convoluted coverage of terrorist and disruptive acts under TADA Section 3(2) targets persons that conspire, cause, compel, commit, instigate, establish, remunerate or publicise acts of terrorism, or harbour persons involved with terrorist and disruptive activities. Terrorist or disruptive activities include damage, destruction, injury, death, kidnapping and threats, and the production, distribution, storage transport, export, import, sale, possession or installation of explosive or poisonous substances, or the assembly and training of persons for these purposes.

One of the dangers of TADA is the inclusion of disruptive activities within the broad definition of terrorist acts. This allows for the application of TADA to political acts that, whilst distinct from terrorism, are determined by the State to have a disruptive effect on the operation of the government or public order. TADA provides that acts covered in Section 3(2) will be taken to have been committed with an intention to undermine or jeopardise the sovereignty and security of Nepal, or committed in a manner to create an environment of public fear.

The National Human Rights Commission of Nepal (NHRC) reports the widespread use of abduction and ‘disappearances’ by both the government and the Maoist insurgents; the government is estimated to have been responsible for 170 insurgency-related disappearances. According to Amnesty International, this figure branches into the arrest of 9,900 Maoists (at August 2002) and the extra-judicial execution of an estimated 2,000 Maoists since November 2001. The NHRC has observed that “TADA aids and abets those who, under the guise of maintaining ‘law and order’ or ‘security concerns’, continue to violate the human rights of the citizens of Nepal”.

Further, the Observatory for the Protection of Human Rights Defenders reports that since the 29 August 2003 breakdown of the seven-month cease-fire between the State of Nepal and CPN-Maoists, incidents of the arbitrary detention, torture, enforced disappearances and extra-judicial killings of pro-Maoists and governmental dissidents have risen dramatically.

Recent examples, reported by organisations such as the Center for Human Rights and Democratic Studies (CEHURDS), Reporters Sans Frontières, and the World Organisation Against Torture, include:

· 19 December 2003: Indian police arrested journalist Marika Poudel of the Nepal One television station, New Delhi. Poudel’s current whereabouts remain unknown;

· 10 December 2003: Nepali security forces detained at least 15 journalists, among them Ram Krishna Adhikari of the Sanghu publication and Times FM radio station. Adhikari was apprehended shortly after attending a Human Rights Organisation of Nepal (HURON) meeting. The Government has provided no information as to the current whereabouts of the journalists;

· 18 November 2003: Dhan Bahadur Magar, a former journalist with the pro-Maoist Janadesh newspaper and an employee of the Federation of Nepalese Journalists (FNJ) in Kathmandu, was arrested by Nepalese security forces. Previously detained for nearly four months in 2002 for writing pro-Maoist articles, Magar remains in solitary confinement;

· 27 September 2003: 17-year-old Manoj Raj, a student from Naxal, was arbitrarily detained and severely tortured in the Hanumandhoka District Police office. Despite the lodging of habeas corpus claims against the detention, Hanumandhoka authorities continue to refuse to release the boy;

The following sections in TADA are of prime concern:

· Section 5(a): The grant of ‘special power’ to authorities to arrest without warrant persons suspected of involvement in terrorist or disruptive acts, allowing for the arbitrary, capricious and prejudicial application of TADA in violation of Article 9(1) of the International Convention on Civil and Political Rights (ICCPR);

· Section 5(m): The grant of ‘special power’ to authorities to place surveillance upon

‘suspicious’ persons and places, including the arrest, lock-out or blockade of the person or place, contravening the Article 12(2)(d) constitutional provision of freedom of movement and Article 12(1) of the ICCPR. Whilst Article 12 of the Constitution allows for reasonable restrictions to be placed on freedom of movement, the restriction provided for in TADA, predicated on the existence of ‘suspicion’, is far from reasonable and is not in the interest of the general public;

· Section 5(n): The grant of ‘special power’ to authorities to freeze the bank accounts and assets and confiscate the passports of any persons suspected of involvement in a terrorist or disruptive act for a ‘certain period’, contravening the Article 17 constitutional provision of the right to property. Article 17(2) of the Constitution does allow for the requisition, acquisition or encumbrance of property by the State in the public interest, and the freezing of bank accounts and assets is an anti-terrorism measure endorsed by the United Nations Counter Terrorism Committee (UNCTC). However, the use of ‘suspicion’ as the determinant threshold for the exercise of the power, and the unspecific designation of the suspension period are not in the public interest and are insufficient justification for the suspension of a constitutional right. This power also arguably constitutes State interference per Article 17 of the ICCPR;

· Section 7: The grant of power to the Government to declare any person, organisation, association or group ‘involved’ in terrorist or disruptive activities as terrorist in nature. Whilst Article 12 of the Constitution and Article 22(2) of the ICCPR allow for certain reasonable restrictions to be placed on the freedom of association, TADA is unreasonably imprecise in that it criminalises membership of associations and organisations deemed to be ‘involved’ in terrorism without providing an adequate explanation of the process through which involvement in terrorist or disruptive activities is determined;

· Section 9 and Section 17(5): The detention of persons for periods of up to ninety days on the basis of ‘a reasonable ground for believing’ that the person has to be prevented from committing acts that ‘could’ result in a terrorist or disruptive act. Whilst Article 15(1) of the Constitution allows for the preventative detention of persons on the basis of the existence of an ‘immediate threat to the sovereignty, integrity or law and order situation’ within Nepal, the ‘reasonable grounds for belief’ test is an insufficient threshold for suspension of a constitutional right and is a dangerously imprecise reflection of Article 15(1) of the Constitution. Further, the arbitrary detention of a person on a preventative basis for such an extensive period clearly negates due process and retracts the ICCPR Article 14(2) provision of presumption of innocence;

· Section 10(3): The imprisonment of persons for a term of five to ten years for the harbouring or hiding of any person involved in terrorist or disruptive acts. It is an accepted principle of law that the commission of a crime requires evidence of both mens rea and actus reus: intention and action. Further clarification of Section 10(3) is therefore required, as, prima facie, it appears that the mens rea element to this offence has been omitted from the calculation of criminal liability. Accordingly, there is a real danger of the conviction and imprisonment of persons who unknowingly house persons involved in terrorist or disruptive acts;

· Section 18: The grant of control to the Government of means of communication such as letters, telephones and faxes that belong to persons involved in terrorist or disruptive activities. This is a clear violation of the right to privacy outlined in Article 17 of the ICCPR. It is also contrary to the principle contained in Article 22 of the Constitution, which states that ‘Except as provided by law…privacy…is inviolable’;

· Section 20: The grant of immunity to investigating authorities for any activity carried out or attempted to be carried out in good faith under TADA. The grant of immunity provides vast potential for the use of torture, contravening the right against torture and inhuman treatment [Article 14(4) of the Constitution and Article 7 of the ICCPR]; the right not to be compelled to testify against oneself [Article 14(3) of the Constitution]; the prohibition against coerced confessions [Article 14(3)(g) of the ICCPR]; and the Convention Against Torture and Other Cruel, Inhuman or Degrading Punishment or Treatment (CAT) Article 2(2) provision that ‘no exceptional circumstances whatsoever, whether a state of war or a threat of war, internal political instability or any other public emergency, may be invoked as a justification of torture’;

· Section 22: The grant of rewards to any person who arrests or renders assistance in the arrest of persons who play the main role in the commission of terrorist or disruptive acts. The offering of reward for the apprehension of suspects opens TADA to possible acts of corruption and abuses of authority in contravention of Article 7 of the Code of Conduct for Law Enforcement Officials.

Acts of terrorism are a direct assault on basic human rights and the sovereignty and integrity of States, and the importance of effective legal instruments in the fight against terror must be acknowledged. However, the Kingdom of Nepal must fulfill its obligations under international human rights instruments and its Article 25(1) constitutional declaration, which states that:

The chief objective of the State [is] to promote conditions of welfare on the basis of the principles of an open society, by establishing a just system in all aspects of national life, including social, economic and political life, while at the same time protecting the lives, property and liberty of the people.

As stated by the United Nations Secretary General’s statement at the 4453rd Meeting of the Security Council on Threats to International Peace and Security Caused by Terrorist Acts:

We should all be clear that there is no trade-off between effective action against terrorism an

d the protection of human rights. On the contrary, I believe that, in the long term, we shall find that human rights, along with democracy and social justice, are one of the best prophylactics against terrorism.

Institute of Medical Sciences: MGIMS

Mahatma Gandhi Institute of Medical Sciences

Mahatma Gandhi Institute of Medical Sciences (MGIMS) was started as Gandhi Centenary Project in the year 1969. In mid sixties it was realised that 80% of rural India was bereft of health care despite increase in number of medical colleges and Primary Health Centres and Sub-centres. Most of the medical graduates remained in urban area or went abroad for seeking greener pastures. “Why not to have a medical college in rural area? This will enable the medical students to understand the problems of rural people in a better way and some of them will definitely get motivated to work in the villages”.

This noble ideal was conceived by the then Prime Minister Shri Lal Bahadur Shastri, who put this idea to Dr. Sushila Nayar, Union Health Minister. She selected Sevagram for such an experiment. After leaving Sabarmati Ashram, revered Shri Mahatma Gandhi, set up Ashram in Sevagram in 1936. Dr. Sushila Nayar joined Bapuji in 1938, especially to look after him on the suggestions of Dr. B. C. Roy. Since other patients also started coming to her in Ashram, which disturbed the serenity of the Ashram, Bapuji asked her, “You go and start your clinic in the Birla Guest House”, (It was built by Shri G. D. Birla for Bapuji’s guests, about 1 km. away from Ashram).

Thus, a small hospital for women and children of surrounding villages was started. Kasturba Hospital, thus, was founded by Father of Nation, Mahatma Gandhi in 1945. Because of this background of Sevagram, it was chosen for the medical college.Kasturba Health Society registered in September 1964, as a Trust; is the Apex body which runs the Institute. Kasturba Hospital has now 640 beds and all the disciplines. For providing nursing services, Auxillary Nurse Midwifery (ANM) course was started in 1945 and it was replaced by Kasturba Nursing School in 1973 as a Nursing Diploma Course and has trained so far about 1000 nurses.

Recently, Kasturba Nursing College for Post Basic B.Sc. Nursing course has also been started.MGIMS admits 64 students per year and has turned out about 1800 graduates and about 600 post-graduates in different disciplines so far. Admission to MBBS course is made through All India Premedical Entrance Test. Initial finances were met from USAID as grant-in-aid for building and equipments. The recurring expenses are shared by Central Government, Maharashtra Government and Kasturba Health Society.

• Aims and objecties

1. To demonstrate that medical education at undergraduate and postgraduate levels can be made for the delivery of health care to the community at their door steps.

2. Training of young doctors can be carried out in the community to a large extent.

3. To show that the cost of medical education can be reduced without sacrificing academic standards .

4. To evolve a pattern of medical education and delivery of total health care to the community suitable for developing countries.

5. To determine the role of the community leaders and para medical staff in the delivery of primary health care and the extent to which other system of medicines such as Ayurveda, Yoga and Nature Cure can be utilized for this purpose.

6. To develop research programmes for understanding and control of community health problems and communicable diseases such as Filariasis, Leprosy, Tuberculosis, etc.

7. To demonstrate that adequate resources for the promotion of physical and emotional health care can lead to all round development of rural communities.

The Institute has evolved a number of unique innovations in medical education, health care delivery system and research to give a rural bias to the work and also to promote greater involvement of the community in improving their own health.

Sports Article: London Olympics 2012

Olympics is not a sprint : Andrew Culf

With 2,290 days to go until the London 2012 Olympics, the organisers yesterday warned that the project would be a marathon rather than a sprint. The first nine months of preparations came under scrutiny with the visit of the International Olympic Committee's coordination commission.

The 16-member commission, led by the chairman, Denis Oswald, toured sites in east London. From a tower block, they got a bird's-eye view of the Olympic Park, and they visited the O2 Centre, formerly the Millennium Dome, which will be home to gymnastics and basketball.

The team also saw the new Channel tunnel rail link at Stratford International, and last night dined at the National Maritime Museum in Greenwich. The commission will deliver a verdict on its visit today, but London 2012 officials said the talks had gone well and it appeared the IOC was impressed by the speed with which the project had got off the starting blocks.

Lord Coe, chairman of the organising committee, dismissed a report in the French newspaper Le Monde that six members of the IOC had taken bribes when London was awarded the games ahead of the favourite, Paris, in Singapore last July. "I would be more concerned about the report if it had not been rubbished by the bid team in Paris themselves." A No 10 spokesman insisted "there was a lot of bloody hard work by people to win the bid", and that Tony Blair had "carved out time in his diary" to lobby delegates in Singapore.

Jack Lemley, chairman of the Olympic Delivery Authority, warned: "This project is a marathon, not a sprint, and it will take a gold medal performance to deliver what we set out to deliver. We are making a start on that and that is in no small part down to what was done in the planning phase." Mr Lemley said the project would face difficulties. "We are putting in programmes and resources to work around those negative surprises ... I believe we can achieve this within the time."

He forecast there would be minor changes to plans for the Olympic Park: "I think there will be some venues moved around on the plot of land." Although the organisers claim not to be concerned by the cost and delay problems which have blighted the new Wembley stadium, Lord Coe said the lessons had been learned. Wembley had "not been dealt the best deck of cards" because the project had initially lacked the unanimity of purpose that surrounds the Olympics.

Lord Coe caused surprise when, in an apparent U-turn, he said that the Olympic Stadium could become the home of a Premiership football team after reports of interest from West Ham United. Previously, officials have insisted the 80,000-seater stadium would be used as an athletics venue with a scaled-down 25,000 capacity. Lord Coe said "nothing has been ruled out", hinting it could double as a football stadium with a running track.

Tessa Jowell, the Olympics minister, said the government was determined to keep the £2.375bn costs under control. "We are carrying out a review of all the costs, not as a one-off, but as a continuing discipline. Delays cost money."

Ken Livingstone, the London mayor, believed remaining wrangles with small businesses facing eviction from the Olympic site would be resolved by the end of the year. A public inquiry begins next month, but by then London 2012 will control around 80% of the land.There are about 400 complaints from 100 objectors.

Sex Education in Nepal

TEACHERS' SPEAK ON SEX EDUCATION

Round Table Meeting - The regular feature of Young Herald this time met with the most sensitive topic ‘sex ‘ . Should sex education be introduced in the school curriculum or not was the topic of this month’s round table meeting held at Young Herald ‘s conference room. Our cultured and traditional society have very much influence over the education system so the topic itself was explosive.

However we accomplished to discuss, evaluate and conclude it in an absolute free and frank manner.Incidentally most of the participants were teaching EPH, who were Mr. Binod Pokhrael of Baba Boarding High School, Mr. Javahar Maharjan of Campion Academy, Ms. Aruna Thapa of Chandbagh School, Mr. Sashi Sharma of Galaxy Public School, Ms. Bharati Chhetri of GEMS, Mr. Paras Sharma of DAV and Ms. Geeta Karki of Little Angels.

They unanimously agreed to the need of incorporating sex education in school. Despite their knowledge of positive merit of imparting sex education in schools, they however categorically pointed out some impending factor of general ignorance from the mainstream, ‘We cannot instantly change the general attitude of the our society, they hold a very typical and conservative perspective when it comes to sex’. Nevertheless the teachers admitted that today there is clear indication of change in the people’s perception on sex, which can also support in the induction of sex education in school.

When asked, what should be the aim of sex education, the teachers responded that the students should atleast have a basic knowledge of sex organ and its functioning in order to avoid some embarrassing situations like sometimes students do ask their parents about how they were born. The teachers thinks that it is very erroneous for parents, teachers or elders to misinterpret the student’s curiosity by giving some mythical stories. They were of the opinion that, ‘The more we hide the more complications emerges’. Education should start right from home and if we slowly make our own children familiar with some basic knowledge about sex, we can overcome most of the complications,they percieved .

The teachers were of the opinion that most of the time students spend with their teachers, so school can be the best institution to start the program. When asked about its objectives they responded, ‘To help them understand the pros and cons and its use and abuse’. The school can cover more in-depth topic on sex to make things understandable to students according to their class, which they think should start from class V onwards.

They also stressed the need of experts hands in preparing the course considering the cultural values of our society. Moreover the teachers should also be medically and physiological trained, they suggested. Regarding the existing school course (EPH), the teachers considered it as not sufficient, which according to them offers half the dose and throw them into confusion that compels the students to incline to other medium, which may prove wrong and sometimes damaging too.

When asked what other medium can be of help to disseminate awareness, they suggested the need for general awareness through media including discussion and interaction programs, which they think are the best mediums to wipe out the general misconceptions about the negative aspect of sex education in school. But they fiercely expressed their anger and discomfort about the existing commercials on safe sex (HIV and other STDs) that is compelling them to skip the channels or stations, which they think is not effective but rather very vulgar. They blamed that the media is not acting responsibly and urged them to mould their approach more sensibly.

The teachers even plead the policy makers to come out with such a course that is acceptable to all and they even made an appeal to the concerning people to help the students to get their right for education /information.

Education aticle about Nepal

Carrier Choice

Amid a bevy of flashy advertisements of educational institutions, many students are bewildered.Studetns who have just managed to get in through the so-called "iron-gate" the School Leaving Certificate examination are now in search of suitable institututes that would help them to shape up their intended career. These days they are running from institution to institution, taking entrance tests and giving interviews, in a determined effort to build their future.

In the hot pursuit of the proper institution, the studetns are seeking advice from all possible quarters. Indeed, they need to draw from all possible quarters. Indeed, they need to draw from wisdom and prudence during this cruicial period to take a proper decision. failure to do so today could impede their progress tomorrow.

The relatively immaturity of the students, lack of knowledge about the education systems here and abroad and lack of self-confidence pose a big hurdle in making the right decision. That is the reason they are vigorously seeking proper guidance. Be it choosing the proper stream of study (subject) or identifying the suitable institution, the experience of seniors will be of grear help to these students. Parents, high school teachers and senior relatives all can give them proper suggestions. Education consultancies, too, offer proper counceling on various career oppertunities availabnle in the country and abroad.

These days, newspaper are filled with advertisements of colleges and other institutes that provide higher secondary education. The state of electronic media is no different. The time before, after and in between every program, particularly popular ones, is filled with "admission open" notices.

The myriad colleges mushrooming in the cities have posted flashy advertisement deliberately designed to attract the attention of the tender minds. While they provide information in different options available to students, they are also pushing many into greater perplexity. The credibility of many adverstisement is poor.

The colleges, when visited, turn out to be different from what is shown or stated in the advertisement. "Many institutes I visited were nothing more than a rented building with some furniture," says Pratikshya Shrestha of Patan. "They were not as good as they had been shown in the advertisements."

The rhetorically explained teaching strategy is lacking in most colleges. Many institutions do not have essential physical infrastructure. Some are reported to have exaggerated the faculty line-up just as to attract students.

The service of education is conspicuously different from other commodities, which demand attractive ads to reach customers. For this reason, educational institutions should have made a trend of publicaticizing themselves by simple notices. Governmental officials, who have recognized the necessity of banning health-related advertisement, have not felt the need for a similar policy in the education sector.

At this stage of life, students are in dire need of suggestions and counceling about life and career. Obviously it is the responsibility of the parents to show their children the way. However, in an underdeveloped country like ours, most of the parent are so ignorant of the changing that they can hardly help their children in any education related problems. It is therefore more important for the schoold from which students have graduated and their teachers to provide proper guidance.

Most school, however, do noot provide councling service while the students are there, much less after they have grduated. They feel their job accomlished once the student have graduated. In most cases, it is the senios' experience that has the most effect on students.

Some education consultancies have opened in hte cities lately, but very few provide real counceling. Most of them are replicas of the manpower companies that send people abroad to work without providing proper guidance. As a result, students have little idea of what to expect or do.

Science in Nepal

As we emerge into a new era, it is due time for the scientific and technological community in Nepal to lead the path towards the development of this country. At the start of this new millennium must begin to improve lives and living conditions of the ordinary Nepali people. It must contribute to the development of Nepal because a strong and vibrant scientific research community can make its contribution to the economy. At the same time, science must strive for excellence and be, at all times, answerable to the citizens of Nepal.

The realisation is growing that the growth of science and technology is one of the primary instruments for the much-needed development towards a self-reliant and self-confident Nepal. However, it is not enough.

We need to understand that science and technology depend completely on each other; they are in a symbiotic relationship. Technology cannot advance without science, nor can science develop without technology. With the advancement of both science and technology concurrently, it would be possible to stamp out hunger, feed people adequately, contain epidemics, render strenuous physical labour unnecessary and, above all, enable Nepali people to lead a substantially more comfortable life.

The Ministry of Science and Technology, Royal Nepal Academy of Science and Technology (RONAST), Nepal Agricultural Research Council (NARC), The National Council for Science and Technology (NCST), Research Centre for Applied Science and Technology (RECAST), HMG universities technical department and laboratories, and host of other research institutes in the country have to play a central role.

They have now become an inefficient organization in terms of technology and human scientific activities potential. They depend fully on HMG’s budget for their daily administrative work and have now emerged as an unproductive white elephant whose sole duty is to give jobs (an employment agency). In the minds of the general public, they have steadily lost their credibility and their research activities have been reduced almost to nil or insignificance.

The scientific and technological group must play wholeheartedly a significant role in the science and technology aims and objectives of the Five Year Plan of HMG of Nepal. This will help enhance the prestige of these bodies both nationally and internationally. This involves the promotion of highly motivated, intelligent and imaginative Nepali scientists and strategists who can integrate their research efforts with those of the scientific community, national and international.

This requires bringing together top-ranking Nepali scientists and technologists-a team engaged in the technological community in the tasks of socioeconomic development and poverty alleviation. These scientific bodies need to take steps to drastically lower dependence on financial assistance from the Government of Nepal. They must gain financial assistance through foreign donors in research and development to promote science and technology in Nepal. This requires active international interchange and mutual cooperation in view of the country’s requirement to foster the development of strategically specialised scientific research.

It is through extensive research and development in biotechnology, information technology, agricultural and forestry research, bio-diversity, environmental science and scientific instrumentation that Nepal will be able to stand side by side with other countries in this millennium. There is a need for Nepali scientists and technologists to immediately play a role in the advancement of scientific research in rural engineering, basic science research (eg, nano-technology, plant science, earth science etc), mitigation of natural hazards, medicine and health services.

Nepali science needs to promote indigenous technology by pursuing a national and international Intellectual Property Rights of Nepali Indigenous Knowledge and Technology to preserve the uniqueness of our country. The primary goal should be to maintain self-reliance and individuality by selling abroad Nepali indigenous technologies and export locally developed scientific research. There has to be a coordination amongst the scientist and technologist to improve and promote research and development in traditional and indigenous crafts, Nepali traditional and Ayurvedic Medicines through which Nepal will be able to gain international recognition.

Nepali scientists must strive for hard-core active scientific research activities that are capable of yielding fruits of science and technology beneficial to the rural Nepali people. They must make an important contribution to raise the quality of rural life, provide powerful tools to overcome the worst aspects of poverty and strive for poverty alleviation in the emerging scenario because it relates directly with the lives of the ordinary Nepali people and the country’s economy.

Blurring the Lines in Networks

Once the network was considered a separate and distinct part of the IT infrastructure, but as more and more Web-based applications are produced, the lines of distinction between the application, physical hardware, and network become blurred.

Networks - Blurring the Line

As data centers become more centralized so that management costs can be reduced, and synergies extracted from the physical hardware, then the network suddenly becomes an extension of the data center, with the WAN being central to its use. When this is combined with the increasing demands being placed upon the network, and the diversity of uses that it is now supporting - such as VoIP, streaming video, and continuous data protection, for example - it is not surprising to hear that many in the industry are looking at the next generation of WAN optimization technologies as a more holistic solution than those currently deployed.

Currently, WAN optimization is provided by three separate approaches, all of which solve part of the problem, but do not address the whole issue of how to optimize the WAN. How do we know that it is running any better than it was previously for all users?

However, another complication for WAN optimization is the fact that application development protocols such as CiFS and MAPI were all designed for LAN and not WAN traffic. Even the newer protocols like HTTP, XML, and SOAP are not designed for the WAN; these new development protocols are focused on ease of development, and not designed to ease the pressure on the network.

Therefore, the challenge is to design a method that can measure the end-to-end response time from client to server so that pre- and post-optimization can be seen. It is only when WAN optimization takes this complete perspective that we will witness the convergence of networks and data centers into a single entity.

BUTLER GROUP OPINION

Butler Group considers that WAN optimization is a rapidly evolving technology, which is currently made-up of many different point or segment-based solutions. We believe that as users become more sophisticated, and demand increasing levels of evidence to support the claim that the network is delivering more performance without increasing allocated resources, then we will witness a new breed of optimization technology.

About Mahabir Pun who has established wireless network Nepal

MAHABIR PUN

After receiving his Master’s Degree in Education at the University of Nebraska at Kearney, Mahabir Pun returned to his native village, Nangi, and founded the HImanchal Education Foundation. Mr. Pun is currently at work establishing wireless networks in rural Nepal.

About the physical process of setting up the remote villege

The network has been set up in five villages, located in different ridges of the mountain ranges through two relay stations. The elevation of Relay Station 1 is 10,800 ft and that of the Relay Station 2 is 12,000 ft. The villages that are networked are lying between 6,000 ft and 7,500 ft. Relay Station 1 is connected to the nearest ISP through dial-up networking, which is about 22 air miles away.
The relay tower at Relay Station 1 is actually a tall tree. We have tied antennas on the top of the tree pointing to different directions. The radios, laptops, and other accessories at Relay Station 1 and Relay Station 2 are powered by a 75w photo voltaic panel and a 400w wind generator.
Even with the two sources of power, it has been very difficult to run the radios all day at relay stations because of the lack of power. It is because this is monsoon time and there is almost no sunshine and no wind. The power problem will be for three months. Right now we are running the radios at the relay stations about four hours a day.

About the project

Mahabir Pun: We tested 802.11b wireless equipment in 2002 between two villages with the help of a Belgian and a Finnish volunteer. They decided to come to our village after they read about us in the BBC news in 2001. Before that I did not know anything about 802.11b wireless technology. After the testing, we were quite hopeful that the technology would work to network the villages. Therefore we tried to find financial support to install the network. A student at the University of California at Los Angeles got a grant from the Donald Strauss Foundation, which made the project come into a reality. We bought the equipment needed from the grant money.

About day-to-day life

Whatever you hear about the Maoists fighting and power struggle in Nepal from the media should be mostly true. I live in the mountain and I don’t get to read any news from the newspapers. Perhaps you hear more news about Nepal than the people in the mountains hear.
The Maoists don’t shoot people randomly. As long as they think that there is no threat from an individual or group, one can stay in the villages and work. It is very true that the life has been very difficult to live with the Maoists because they force people to support them. They vitually have control in the rural areas. They are free to move almost everywhere in the mountains because the security forces can’t patrol all the villages. The only way one can survive in the mountain villages is that one should not speak and act anything against them. Even if people don’t agree with or support the Maoists, they have to shut their mouth up to keep themselves alive.
Take my example: I am working in the mountains trying to set up wireless network and trying to bring better educational opportunities for the children living there. The reason I am alive in the mountain and the Maoists have let me stay there is because I have shut my mouth up. Keeping my mouth shut has been the hardest thing for me to do.

About the villagers use the Network

Mostly for communication purposes, since the network is the only means of communication available. The distance from one village to another village is from 8 to 15 miles. The distance to a yak farm from our village is two days walk. The communication between the villages and with the yak hearders has been so easy now. It has saved so much of the villagers’ time.

Although there is a shortage of power at the schools, relay stations, and proxy server station, the villagers still can send and receive their messages through [Microsoft] NetMeeting or through e-mails using our POP server. The POP server is run by Jonni Lehitranta in Finland. We have provided NepalWireless.com accounts to seventy eight people so far and will provide more. Students from two high schools are using the network to write e-mails to each other and to their pen-pals abroad.

Paudwar and Nangi villages are using the network to run their income-producing projects such as yak farming and camping grounds located in the high mountains. Now the management committee of the projects are using the network to communicate with each other and with the yak herders through NetMeeting or email. For that we have given laptops to the camping ground and Yak farming staff. The interesting thing is that the yak herders and the camping ground staff have almost no formal education, and they had never touched the computers before last September.

About similar patterns of social mobility in Nepal

Right now the school has been the center for the connection in each village. Therefore one teacher at each school has been working as the “incharge” of the connection. However, our plan is to build a communication center in each village and give the village committee full responsibility to run the center. The committee will choose a person as an “incharge” of the center.
There aren’t much social levels in our society in the mountain villages because most of the people come from the same tribe. All the villagers are farmers and have about the same level of economic status. Therefore I don’t think that the people in our villages will think about moving one step upward in their social status.

Compare his observations on social mobility in Europe and in Nepal?

The community in the villages in our region belong to mostly one tribe – Pun Magar. Over 98% of the population in a village come from this tribe. In some of the villages there area few people from other tribe too.
We don’t have any written history of our tribe. Based on the folk tales and oral history our people were originally nomads and used to travel in the mountains hunting wild animals for food. Later they settled in villages and started farming because there were not many wild animals available for hunting. Our people mostly rely on sustainable farming to these days too. Each family have their own land. They raise cattle, goat, and chicken. They grow corn, potato, vegetables, beans, etc, for food. Other than rice, they don’t have to buy food from outside.
Military service is the only source of cash income for the villages. During the First World War and Second World War, the British had recruited young people from our tribe in their army. Since then joining the army has been the main occupation of our people to bring cash income. In the past few years, people have also started going to Gulf countries for work. Other than that there is no source of cash income for the people.
In this way there is not much social levels in term of economic possession in the villages. Moreover, they have the same level socially because they come from the same tribe. They have enough food to eat and they somehow make some money needed to buy clothes and other stuffs for their living. Most of them so far are satisfied with what they have with them.
Therefore most of the people had not thought seriously about sending their children to schools for higher education until two decades back. However, the situation is changing very fast with the coming of new information technologies and building of highways. People in the villages are also learning about different ways of living from different media. Now they are getting more interested about sending their children for higher education so that they can have “better life” other than farming. So far they are not haunted much to make a lots of money and get to higher social status. In this way I can say that our people have just started to think about moving up in social status in term of economic gain.
In this context, my goal of introducing the computers and wireless technology in the rural schools is to provide opportunities for the students to learn about the new technologies and to provide better formal education using the wireless networking technology. That will help to prepare them to compete in the materialistic world to find better jobs. I know how important it is to have better education in order to get better jobs because I have been to school in the US and I have seen it there.
Another goal to bring the technology is to use it for communication purpose. So far the only means of communication that exists is post office. However, not all the villages have post office. The existing rural post offices are not functioning well because of the Maoists rebels. There are no telephones in the mountain villages and it is hard for us to communicate with each other and with the outside world. The reason I am working very hard to network the villages is because I believe that better communication system is important for the overall development of a community and a nation.
However, the fact is that it will take several years for people to seriously think and work hard to adopt the new technologies and get full benefit from them. Even if it is going slow, I would keep working on the project.

About obstacles in launching the program

Right now there is no main obstacle aside from funding. The Maoists and security forces have let us use the wireless network so far. However, they might come any day and ask us to bring down the connection citing the security reason. If they ask, we have to bring the network down.
The reason we have this fear is that both the security forces and the Maoists have shut down the rural telephone centers if they think that there is danger from the centers for them. There are virtually no rural telephone centers in Nepal now. Some places the maoists have bombed the telephone towers and centers and some places the army has ordered to shut down the centers.

Carrier testing in minors

Introduction

While a great deal of information has been published on the ethical aspects of predictive genetic testing of minors, much less has been written on the ethical aspects of carrier testing of children or adolescents. Carrier tests are performed to determine whether a person carries a mutated gene or balanced chromosomal rearrangement and are relevant for autosomal recessive and X-linked disorders as well as for chromosomal abnormalities.

Various agencies have underscored the need for comprehensive and consistent policies that regulate genetic services, in general, and that normalise genetic testing of minors, in particular, and the need for all testing agents to apply these policies. The objective of this article is to promote the latter through a review of all published normative ethical and clinical guidelines on carrier testing of minors in families affected by autosomal recessive or X-linked disorders or by balanced chromosomal rearrangements. Our focus is on cascade screening in which carrier testing is offered to those with a family history of such a disorder and not on general or unfocused population screening. We start with the assumption that it is desirable and possible for healthcare professionals to work towards a consensus on these issues.

METHOD

Data sources

We searched the databases Medline, Philosopher's Index, Biological Abstracts, Francis, Web of Science, Current Contents, and Google Scholar using the following search strategy: (Child OR childhood OR adolescen* OR infant OR young OR paediatric OR pediatric OR newborn OR minor) AND (genetic OR carrier) AND (ethic* OR guideline OR position OR bioethic* OR moral OR autonomy OR normative OR statement OR report OR recommendation). We also searched the websites of numerous national bioethics committees (listed on the websites of WHO and the German Reference Center for Ethics in the Life Sciences), the websites of the Human Genetics Societies of different nations (listed on the website of the International Federation of Human Genetics Societies and related links), and the websites of several national medical associations (listed on the website of the World Medical Association).

Study selection

Articles were eligible for inclusion in our review if they were position papers or reports, or if they contained guidelines or statements emanating from international and national organisations, bioethics committees, and professional associations that explicitly addressed carrier testing of children and/or adolescents in families affected by an autosomal recessive or X-linked disorder or by balanced chromosomal rearrangements. We focused our search on general, not disease-specific, statements and excluded guidelines that focused on genetic testing related to adoption. We included in our study only guidelines written in English or guidelines translated into English.

Data extraction and synthesis

In contrast to systematic reviews focusing on the relevant research involving the accuracy and precision of diagnostic tests; the power of prognostic markers; and the efficacy and safety of therapeutic, rehabilitative and preventive regimens, our systematic review of normative positions has two aims: (1) to assemble 'a reliable and comprehensive account of the facts of the matter and to identify and clarify concepts that are relevant to the valuation of the ethical implications of those facts', and (2) to organise 'these concepts into an argument (a coherent set of reasons that together support a conclusion for how one should or should not act)'. This systematic review of normative ethical positions towards carrier testing is based on a formal tool developed by McCullough.

RESULT

Recommendations from ethical guidelines

In total, we retrieved 14 guidelines emanating from 24 different groups. The guidelines originated from genetic associations and societies (11), medical and paediatric associations and institutes (10), and government-related organisations (2). Only one originated from a consumer group. All the guidelines were in agreement that children preferably should not undergo carrier testing and that testing of children ideally should be deferred. All guidelines stated that it is in a child's best interest for him to decide whether to be tested at some stage later in life. The child's future autonomy tended to be the main ethical argument at stake. As carrier testing has the potential of affecting the future reproductive prospects of a child, the guidelines emphasised that the decision to test should be made by the child when he reaches reproductive age.

This view is based on the basic ethical principle of informed consent, by which an individual can freely and voluntarily give, without external pressure, his consent to be tested after being informed of the benefits, risks, procedures, and other pertinent information relating to the carrier test. As carrier testing performed during childhood only affects the future of that child, not that of his parents or guardians, the guidelines stated that it is wiser to defer testing until the child himself is able to give proper informed consent than to acquiesce to the wishes of his parents or guardians to go forward with testing. The child's personal consent takes precedence over the wishes of third parties, including parents, either to carry out or to refuse genetic testing. Knowledge of carrier status critically impacts future decisions concerning reproduction (eg, carrier testing of partner, prenatal diagnoses, artificial insemination, preimplantation genetic diagnoses, adoption, not to have children). Some guidelines suggested that carrier testing performed during childhood also denies the child of confidentiality, a right he would expect if tested as an adult.

Recommended age for carrier testing

All guidelines agreed implicitly that the legal standard of 18 years of age represents the borderline between childhood and adulthood. While several guidelines made a distinction between childhood and adolescence, an exact range of ages was not attached to this distinction. The differences that distinguish children from adolescents refer to the gradual development of a child's cognitive skills and moral reasoning and the fact that 'as children progress through successive states of development, they become capable of greater participation in decisions about their own welfare'.

When adolescents meet 'conditions of competence, voluntariness, and adequate understanding of information', are 'able to participate in the decision as an autonomous individual' have 'decision-making capacity' or are mature enough to take control of his or her own healthcare, they can be considered to be mature enough to request a carrier test. In this context, some have argued that further consultation with other genetic service providers, paediatricians, psychologists, and ethics committees may be appropriate to evaluate whether the adolescent in question fully meets these criteria. Moreover, it is clearly advisable that the adolescent has his parents' support.

Recommendations for informing the child

While these guidelines focused on the ethical aspects of performing carrier testing in minors, they failed to address the issue of informing them of their genetic risk. It is likely that most of these guidelines assumed that parents, being inherently responsible for the welfare of their children, are also responsible for informing their child of his genetic risk. The guideline penned by the French National Consultative Ethics Committee for Health and Life Sciences confirms this assumption, by stating that it is the duty of parents to inform their child of any genetic risk when that child reaches reproductive age Similarly, the guideline of the Canadian Paediatric Society encourages open discussion regarding familial genetic risk in an age-appropriate manner within the context of the family unit and the guideline of the German Society of Human Genetics bestows the duty of informing children of genetic risks on parents.

The latter limits the role of the genetic counsellor to educating parents about inherited disorders so that they clearly understand the significance of carrier testing and can responsibly inform their child about potential genetic risks at a later date. Only guidelines from the Working Party of the Clinical Genetics Society of the UK assigned a clear responsibility to genetic counsellors, stressing that it is the responsibility of both the family and the healthcare system to ensure that carrier testing is offered when the child is older.

Recommendations for exceptional cases

Five guidelines addressed circumstances by which the carrier status of a child can assist the genetic counselling of family members. These guidelines stipulated that such cases should be considered carefully, and indicated that, in the majority of cases, pertinent genetic information can be obtained without testing the child, that is, carrier testing of parents can also provide this information and thus should take precedence over the testing of children. These guidelines endorsed carrier testing of children only if the test results will provide critical information to a relative that cannot be obtained by other means. Two of these guidelines elaborated further, stating that carrier testing of children should be done if the test results will medically benefit family members (eg, by providing haplotype information). In this regard, the test results must prevent substantial harm to a family member and there must not exist any reasonable alternative to avoid harm.

Two guidelines, one published by the British Medical Association (BMA) and the other by the UK-based Genetic Interest Group (GIG), presented a more flexible view of the testing of children. These two guidelines primarily focused on family dynamics and the individual concerns of family members, stressing that the interests of a child cannot be considered separately from those of his parents and other family members. These guidelines posited that, in the vast majority of cases, agreement to defer carrier testing will be reached after healthcare professionals and parents openly discuss the positive and negative consequences of testing. These guidelines also underscored that the obstinate refusal to comply with a parental request for the carrier testing of a child (eg, in cases where the parents cannot deal with the anxiety of not knowing the carrier status of their child) may have a more negative impact on the child and his family than would complying with the request.

Both stated that having knowledge early on of one's carrier status could help a child to cope with this information starting in childhood and could reduce the anxiety and uncertainty experienced by parents about their child's carrier status. The two guidelines differed, however, in their interpretation of the term 'best interests'. The BMA guideline defined 'best interests' in a broad sense, incorporating psychological, social, familial, and medical factors to ascertain the most appropriate course of action. By contrast, the GIG guideline, defined 'best interests' in a narrow sense, arguing for the right of parents to have their children tested.

Recommendations for incidental discovery of carrier status

Four guidelines discussed the course of action in cases in which carrier status was discovered incidentally (eg, during diagnostic testing, screening, or prenatal diagnosis, or in a research context). While guidelines from the BMA and the American Academy of Pediatrics recommended that carrier status results obtained incidentally should be conveyed to parents, the American Medical Association and the German Society of Human Genetics recommended that this information should not be disclosed to parents or to other third parties. Rather, this information should be discussed with the child when he reaches reproductive age. The guidelines from the American Medical Association also provided instructions for maintaining the confidentiality of this genetic information, stating that this privileged information should be kept in a separate portion of a patient's medical record to prevent accidental disclosure.

DISCUSION

Several international organisations have emphasised the need to treat genetic testing with special care by drafting guidelines that outline rules to ensure respect for human dignity and to protect privacy, that make provision for pretest education and psychological counselling, and that require obtaining meaningful informed consent before genetic testing is performed Decisions regarding the testing of minors should be dealt with cautiously, taking into account the minors' best interests.

In addition, if possible the opinion of the minors should be taken into consideration as a determining factor of whether testing should be performed. Of course, the weight of a minor's opinion is proportionate to his age and degree of maturity. These basic principles frame the concrete recommendation that carrier testing of children should be deferred until a child is capable of deciding whether to be tested.

Although the great majority of ethical guidelines overseeing the carrier testing of children agree that testing should be deferred until the child is capable of making an informed decision of whether to be tested, two guidelines – those penned by the BMA and GIG – expressed concerns about the rigid interpretation of this general rule, proposing instead for flexibility when exceptional situations are encountered. An important distinction between the BMA and GIG guidelines and the other guidelines lies in how much weight each puts on the psychological and social impact of carrier testing on the children themselves.

Despite the lack of conclusive evidence that carrier testing performed during childhood harms children psychologically, the great majority of genetic testing guidelines espouse the premise that carrier testing might be detrimental to the mental well being of tested children, and as such, should be disallowed in children. Both the BMA and GIG, however, acknowledge that available evidence (that testing is neither beneficial nor detrimental) is insufficient to warrant the global prohibition of carrier testing of children.

Although acknowledging that empirical research can have an important role in developing policy guidelines and in affecting ethical decision-making processes, we stress that the results from empirical research alone cannot determine what is good or bad, right, or wrong. The absence of data that carrier testing during childhood is not harmful would be a poor reason to use to promote the carrier testing of minors. Ethically salient issues, such as maintaining the child's right for autonomy, confidentiality, and privacy, must be primarily considered when developing formal guidelines for the carrier testing of children.

These rights would be violated if a child was tested for no compelling reason and his carrier status information was relayed to his parents. Choices and actions involving sex and reproduction are part of the most personal and intimate aspects of life. As the ultimate purpose of carrier testing is to produce information that can guide future reproductive decisions, it is important that children, as they grow to adulthood, are given the opportunity to request testing and to have full control over their test information, sharing it with whom they desire. This viewpoint, however, should not restrain parents from openly discussing opportunities for carrier testing later in their children's life. Nonetheless, from a young age children should be advised of the risks associated with knowing one's carrier status, even though the actual testing is postponed. Next to the responsibility of parents, genetic service providers should follow up the genetic risk of a family. It is important to avoid situations by which minors are never informed about their genetic risk. In addition, genetic counselling should be made available to minors throughout the course of their lives, with the aim of helping them envisage undergoing carrier testing.

Limitations

Although we retrieved 14 different guidelines or statements that discussed the carrier testing of minors, only one statement was penned by a consumer group. This apparent lack of representation from patient organisations may be because we focused our search on general guidelines rather than on disease-oriented guidelines. Nevertheless, even after contacting various geneticists and important groups of patients organisations as the Genetic Interest Group (UK) and the Dutch Genetic Alliance (VSOP) we did not succeed in identifying any policy document on childhood genetic testing from disease-specific family support groups. Future research, for example surveying patient orgnisations on that issue could help identify if these groups have developed such policies, that maybe are not available online or not widely diffused.

Conclusion

As carrier testing has in most cases only implications for the reproductive health of the child, all guidelines recommend delaying carrier testing until the minors can participate themselves in these decisions that are affecting them. Several guidelines state that minors could request a carrier test from the moment they meet conditions of competence and have decision-making capacity. Most guidelines failed to address the issue of informing children of their genetic risk. The BMA and GIG presented a dissenting voice on carrier testing by stating that the obstinate refusal to comply with a parental request for the carrier testing of a child may have a more negative impact on the child and his family than would complying with this request.

Further discussion on carrier testing in minors may be useful and a guideline on genetic testing in minors from European geneticists is recommended.As carrier testing has in most cases only implications for the reproductive health of the child, all guidelines recommend delaying carrier testing until the minors can participate themselves in these decisions that are affecting them. Several guidelines state that minors could request a carrier test from the moment they meet conditions of competence and have decision-making capacity.

Most guidelines failed to address the issue of informing children of their genetic risk. The BMA and GIG presented a dissenting voice on carrier testing by stating that the obstinate refusal to comply with a parental request for the carrier testing of a child may have a more negative impact on the child and his family than would complying with this request. Further discussion on carrier testing in minors may be useful and a guideline on genetic testing in minors from European geneticists is recommended.