MENTAL HEALTH campaigners expressed dismay yesterday after it was claimed that people with Down syndrome are being refused the right to vote in Northern Ireland.
Patsy McGlone, an SDLP Assembly member, said a constituent with the condition had been refused a place on the electoral roll even though he had been on it as recently as the Assembly elections last November and had voted in the past.
“The Electoral Office is now saying that because he has Down syndrome, he is not entitled to vote. This fellow wants to go out and vote with everyone else and I know fine well that he knows who he wants to vote for,” said Mr McGlone.
The Mid-Ulster MLA claimed that his constituent was not alone and that he knew - through fellow Assembly members - of hundreds of people across the province who were suddenly in the same position. Mr McGlone has been in contact with the Equality Commission, seeking to challenge the issue under disability legislation. He said it could also be a matter for the Human Rights Commission.
“The Electoral Office has made a quite arbitrary decision and I think it is very, very unfair,” Mr McGlone said. “He is entitled to everything else but the Electoral Office is saying that just because he has Down syndrome he is less of a citizen than anyone else and has less of a right to vote.”
The Electoral Office was not available for comment yesterday.
David Congdon, Mencap’s head of policy, said: “People with a learning disability are equal citizens and should be allowed the same civil rights as everyone else, including the right to vote.”
Copyright 2004 Independent Newspapers UK Limited
Provided by ProQuest Information and Learning Company. All rights Reserved.
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* Context.-Several studies report the role of dimeric inhibin-A in assessing risk for fetal Down syndrome. The majority, however, use the Serotec inhibin-A assay and not the newer Diagnostic Systems Laboratories inhibin-A enzyme-linked immunosorbent assay (ELISA).
Objectives.-To establish normal gestational age day-specific medians, to compare our results against previous studies pertaining to the inhibin-A ELISA, and to evaluate long-term assay performance.
Design.-Using the inhibin-A ELISA, 100 specimens were assayed for each completed week of gestation for weeks 15 to 20, 50 specimens for 14 weeks, and 54 specimens for 21 weeks or older. Regressed inhibin-A medians were calculated employing a second-degree polynomial fit of the arithmetic medians. Thereafter, inhibin-A ELISA lot comparisons were performed to evaluate consistency.
Results.-Regressed values of 182, 174, 175, 184, 201, and 226 pg/mL resulted for weeks 15 to 20, respectively [pg/mL inhibin-A = 4.1528(gestational age)^sup 2^ - 136.49(gestational age) + 1294.9]. A comparison with 2 other studies shows our values to be lower overall by 15 ± 11.4% and 16 ± 2.6%. However, variability between kit lots was as high as 30%.
Conclusions.-The equation derived provides for the calculation of gestational age day-specific inhibin-A medians for integration into maternal serum screening programs with a subsequent decrease in false-positives expected and observed. Our medians differ considerably from those of other studies, with limited data, using the Diagnostic Systems assay. However, lot changes since the initial analysis have exhibited similar inconsistencies. Therefore, we recommend that others incorporating the assay into their screening programs carefully establish, monitor, and adjust their medians accordingly as a result of potential variations.
(Arch Pathol Lab Med. 2004;128:415-420)
Inhibin-A is a 32-kd glycoprotein hormone secreted by the ovaries, testis, and the placenta.1-3 The active form of the hormone, known as dimeric inhibin-A (DIA), consists of two protein subunits designated as [alpha] and [beta]A and is characterized by its ability to inhibit the secretion of follicle-stimulating hormone.1
In women, DIA is produced by the corpus luteum during the menstrual cycle and in early pregnancy.4 Although the function of DIA in pregnancy is unknown, it is suggested that DIA may be involved in the establishment of pregnancy, including fetal and placental development.5
During pregnancy, the secretion of DIA by the placenta and other sources, such as the fetus, placental and fetal membranes, and the ovaries, augments circulating levels in the maternal serum.3-5 Maternal serum DIA levels rise during the first trimester and then decline after approximately 10 weeks. The maternal levels then remain fairly stable at 15 to 25 weeks of the pregnancy and then increase, reaching maximum levels at term.4
Several studies have revealed a correlation between second-trimester maternal serum DIA concentration and fetal Down syndrome, with affected subjects having an approximately 2-fold or greater increase.4,6-10 Dimeric inhibin-A has also been shown to be of value in predicting other aneuploidies, such a trisomy 18.11-15
Early inhibin-A assays had difficulty in identifying DIA from precursor forms of the protein, free circulating [alpha]-subunits, and inhibin-B, thus producing inconsistencies in screening performance.16,17 However, with the advent of a monoclonal antibody pair specific for DIA, the ability to exclusively measure DIA is now feasible.18-21
Two commercial assays specific for DIA have generally been used: the Serotec Inhibin-A Dimer Assay Kit (Serotec Ltd, Kidlington, Oxford, United Kingdom) and the Diagnostic Systems Laboratories (DSL) ACTIVE Inhibin-A enzyme-linked immunosorbent assay (ELISA) (Diagnostic Systems Laboratories Inc, Webster, Tex). The advantages of using the DSL assay are that serum pretreatment by boiling in sodium dodecyl sulfate is not required and pretreatment with hydrogen peroxide is performed directly in the microwell of the 96-well microtiter plate, thus significantly reducing assay time and labor.22
The majority of published studies have used the Serotec assay and not the DSL assay. In addition, the few studies using the DSL assay lack adequate observations at various weeks of gestational age (GA), with as few as 4 observations for a given week (Table 1). Therefore, the purpose of our study was 3-fold. First, we wanted to establish our own normal day-specific GA-based medians for the DSL DIA assay for incorporation into a maternal serum quadruple screening test ([alpha]-fetoprotein, human chorionic gonadotropin, unconjugated estriol, and DIA) for fetal Down syndrome. Second, we sought to compare and evaluate our resultant medians with those of 2 recently published studies that also used the DSL DIA assay.22,23 Third, we wanted to evaluate the lot-to-lot consistency of the DSL assay in order to implement contingencies for maintaining reliability in reporting fetal Down syndrome risk. All of these objectives were achieved.
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