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A New Edition of The New England Journal of Medicine Is Now Available

October 11, 2017

The New England Journal of Medicine (vol. 376, no. 21, 2017) is available online by subscription only.

Articles include:

  • “Accelerated Approval and Expensive Drugs — A Challenging Combination” by W.F. Gellad and A.S. Kesselheim
  • “Sharing Clinical and Genomic Data on Cancer — The Need for Global Solutions” by The Clinical Cancer Genome Task Team of the Global Alliance for Genomics and Health

 

Doctors Get Their Own Second Opinions

October 10, 2017

(The Atlantic) – Human Dx might help doctors confirm their suspected diagnoses or think of things to rule out. At Mary’s Center, one man came in complaining of headaches and nausea, and the Human Dx physicians suggested a blood test called an ESR. Another time, Nundy used it to confirm a suspected case of rheumatoid arthritis before putting a low-income patient on a heavy-duty course of medications. Experienced doctors use Human Dx for their most difficult cases, and newer providers use it to hone their skills. Johns Hopkins Hospital and other teaching hospitals are now using it to train medical residents.

Doctors May Fear Losing Their License for Seeking Mental Health Care

October 10, 2017

(Reuters) – Nearly 40 percent of U.S. physicians are reluctant to seek mental health care out of fear that it might imperil their medical license, a recent study suggests. The reluctance was more pronounced in states where licensing applications questioned doctors about mental health conditions going back more than a year. Physicians in those states were at least 20 percent more likely to report they would be reluctant to seek psychological treatment than doctors in states that asked only about current impairment.

Fertility MOT Tests ‘A Waste of Money’

October 10, 2017

(BBC) – Fertility tests marketed at women worried they have left it too late to have a baby, can be a “waste of money”.  Ovarian reserve tests, which can cost £100 or more, measure hormones in blood to give an idea of how many eggs a woman has. Latest research in the Journal of the American Medical Association found the tests did not predict a woman’s chance of conceiving, however. Women must be told this, experts say. The tests were originally developed by IVF clinics to predict how a woman having fertility treatment might respond to the drugs used to stimulate the ovaries to produce eggs.  But some companies have been marketing them to women as a fertility MOT.

“Runnin”: A Preview of a New Documentary from STAT

October 10, 2017

(STAT News) – Almost a year ago I began thinking about how to tell the story of what happened to my circle of friends. I hoped that by examining how the drugs took hold in my hometown, I could illustrate how the same thing can and does happen everywhere. The new STAT documentary, “Runnin’,” includes candid and thoughtful interviews with friends who lost family members and others who abused opioids themselves.

Researcher Looks at Racial Differences in End-of-Life Care

October 10, 2017

(UPI) – Researchers at the University of Washington analyzed survey data from the National Health and Aging Trends Study for racial disparities in end-of-life care, reporting no significant differences in the quality of end-of-life-care among patients. Analysis of the survey, which included more than 1,700 interviews of Medicare enrollees age 65 and older as part of the National Health and Aging Trends Study from 2011 to 2015, showed no significant racial differences in the quality of end-of-life care among patients.

Anti-Doping Agency to Ban All Gene Editing in Sport from 2018

October 10, 2017

(New Scientist) – The battle between sports cheats and testers is poised to enter a whole new arena. The World Anti-Doping Agency has extended its 2003 ban on “gene doping” to include all forms of gene editing – but it is not clear the agency has the means to enforce this ban. WADA already bans the use of genetically modified cells and gene therapy if they have “the potential to enhance sport performance”. From 2018, the list will also include “gene editing agents designed to alter genome sequences and/or the transcriptional or epigenetic regulation of gene expression”.

Seeing Hope: FDA Panel Considers Gene Therapy for Blindness

October 10, 2017

(ABC News) – On Thursday, U.S. Food and Drug Administration advisers will consider whether to recommend approval of a gene therapy that improved vision for these three youths and some others with hereditary blindness. It would be the first gene therapy in the U.S. for an inherited disease, and the first in which a corrective gene is given directly to a patient. Only one gene therapy is sold in the U.S. now, a cancer treatment approved in August that engineers patients’ blood cells in the lab.

Technology Speeds Access to Patients’ End-of-Life Wishes

October 10, 2017

(CNN) -POLST forms, formally known as Physician Orders for Life Sustaining Treatment, have become a staple in care for the fragile or seriously ill. They document in detail what kind of medical treatments patients want — or don’t want — at the end of life. Nearly every state in the U.S. has a program; dozens are established or developing. But in Oregon, where the documents were developed in the early 1990s, organizers have taken a step to ensure that final medical wishes are honored. Officials at OHSU have partnered with a California technology firm, Vynca, to allow health care providers to electronically find any of the 172,000 active forms in Oregon’s POLST registry with a single click, no matter where they were filed.

More than 2,000 Canadians Have Died with Medical Assistance Since Legalization

October 9, 2017

(CBC News) – More than 2,000 Canadians have ended their lives legally with the help of a doctor, and most of them were suffering from terminal cancer. According to the latest report from Health Canada, there were 1,982 medically assisted deaths in the one-year period after it became legal in June 2016. There have been another 167 in Quebec since it was legalized in that province in December 2015, the report said. The total has been rising faster, with 803 assisted deaths in the first six months after it became legal nationally and 1,179 in the following six months from January to June 2017.

Nigeria Already Has So Many Children But Fixing Infertility Is a Fast-Growing Business

October 9, 2017

(Quartz) – Nigeria’s population of over 190 million, the highest on the African continent, is projected to hit 397 million by 2050, making it the world’s third most populous country after China and India. But there are still thousands of Nigerian couples, like Adamu and Fibi, unable to conceive naturally and for a long time they suffered in silence. Infertility is not an openly-discussed topic in modern Nigerian cultures. It is rare to find couples willing to acknowledge their struggle to conceive. There is often a lot of pressure to have children from society and extended family. And in many of Nigeria’s mostly patriarchal cultures a lot of that pressure falls on the woman.

Test for Breast Cancer Risk Could Reduce Pre-Emptive Masectomies

October 9, 2017

(The Guardian) – A genetic test that accurately predicts the risk of developing breast cancer could soon be used on high-risk groups. Researchers behind the test say it could reduce the number of women choosing pre-emptive mastectomy surgery as they will be able to make more informed decisions about their care.  The blood test looks at 18 genetic variations, or single-nucleotide polymorphisms (SNPs), known to affect the chances of getting breast cancer.

Navajo Nation Reconsiders Ban on Genetic Research

October 9, 2017

(Nature) – When the Navajo Nation opens its first oncology centre next year in Tuba City, Arizona, clinicians there may be able to offer a service that has been banned on tribal lands for 15 years: analyzing the DNA of Navajo tribe members to guide treatments and study the genetic roots of disease. That’s because the Navajo, the second-largest Native American group in the United States, are considering whether to lift their longstanding moratorium on genetic research. The tribal government banned DNA studies in 2002 to prevent the misuse of its members’ genetic material.

Research Assistantship Opportunity – Graduate Research Assistantships in Research Ethics: The Rotman Institute of Philosophy, Western University

October 6, 2017

Job category: Graduate fellowship / Fixed term
AOS: Research ethics
AOS categories: Philosophy of Science, Applied Ethics, Biomedical Ethics, Ethics
AOC: Open
Workload: Part time
Vacancies: 2
Location: London, Ontario, Canada
Start date: September 2018

 

Job description

Graduate Research Assistantships in Research Ethics at Western University

We are seeking two doctoral students interested in the ethics of pragmatic randomized controlled trials (RCTs) to pursue their graduate education in the Department of Philosophy at Western University. The Graduate Research Assistantships in Research Ethics are research positions that run concurrently with the philosophy graduate programme. Students will be expected to contribute to a Canadian Institutes of Health Research funded project that includes a competitive stipend to supplement the funding package from Western University. The successful candidates will join our diverse research team, comprising philosophers, trialists and biostatisticians from five countries, who are developing guidance for the ethical design and conduct of pragmatic RCTs. Pragmatic RCTs test if an intervention works in real-world conditions and support decision-making by patients, providers and health system managers. A description of the project is available at the Rotman Institute of Philosophy website.

Core members of our research team have worked together for a decade. Previous work explored ethical issues in cluster randomized trials (CRTs). CRTs differ from conventional randomized trials in that intact social units—rather than individuals—are randomly allocated to study interventions. Our research team analyzed the ethical issues in CRTs in a series of articles in the journal Trials. Empirical studies included interviews with trialists, a systematic review of published CRTs and a survey of research ethics committees in three countries. In 2012, we published the world’s first ethical guidelines for CRTs, the Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials. Our trainees have benefitted from mentoring by diverse faculty members in the research team. Our trainees have gone on to research and faculty positions at Harvard University, the University of Oxford and other excellent institutions. Our new project will build and expand upon our previous work and address the clear need for ethics guidance for pragmatic RCTs.

Successful candidates will have a strong background in moral theory or philosophy of science, and will be expected to participate fully in the activities of our interdisciplinary research team. These activities include research on ethical issues specific to pragmatic RCTs, collaborations with scholars from other disciplines, presenting work at conferences, writing academic papers for philosophy and medical journals, and engaging the public through education and social media.

Given the interdisciplinary nature of the project, successful candidates must (1) be able to work within and across disciplinary boundaries, (2) communicate effectively, (3) be highly motivated and (4) demonstrate professionalism. A Master’s degree in applied ethics, bioethics or philosophy of science is preferred, but not required. Accomplished and exceptionally motivated individuals in relevant fields will also receive full consideration. Questions about the research positions may be addressed to Prof. Charles Weijer.

Applicants for the Graduate Research Assistantships in Research Ethics should send a cover letter, CV, university transcripts and writing sample to Prof. Charles Weijer on or before January 7, 2018. Applicants must (1) independently submit all required materials to the philosophy graduate programme by January 7, 2018 and (2) be selected for admission to the graduate program. Click here for more information on graduate studies in philosophy at Western University. Successful applicants for the Graduate Research Assistantships in Research Ethics will be notified in March 2018, and the positions begin in September 2018.

 

How to apply

Application type: Email
Instructions: Applicants for the Graduate Research Assistantships in Research Ethics should send a cover letter, CV, university transcripts and writing sample to Prof. Charles Weijer on or before January 7, 2018. Applicants must (1) independently submit all required materials to the philosophy graduate programme by January 7, 2018 and (2) be selected for admission to the graduate program.
Email to apply: cweijer@uwo.ca
Hard deadline: January 7, 2018, 11:59pm EST
Contact Web address for more information: www.rotman.uwo.ca/portfolio-items/pragmatic…
Contact name: Prof. Charles Weijer
Contact email: cweijer@uwo.ca

 

An Outbreak Waiting to Happen: Hepatitis A Marches through San Diego’s Homeless Community

October 6, 2017

(STAT News) – The hepatitis A outbreak now roiling this well-heeled, coastal city may have had its roots in a baseball game — when the city cleaned up for the 2016 All-Star Game by pushing its homeless out of the touristy areas downtown and into increasingly congested encampments and narrow freeway onramps just east of downtown. The lines of tents stretched for blocks. At the same time, the city was locking and removing bathrooms to help control the rampant drug and prostitution trade they’d spawned. Hepatitis A is transmitted through contact with feces from an infected person, and in close, unsanitary conditions, the highly contagious virus can spread explosively. So it was only a matter of time, experts say, before cases would surge among the homeless.

Silicon Isn’t Just for Computers. It Can Make a Pretty Good Kidney, Too

October 6, 2017

(Wired) – Now, after more than 20 years of work, one team of doctors and researchers is close to offering patients an implantable artificial kidney, a bionic device that uses the same technology that makes the chips that power your laptop and smartphone. Stacks of carefully designed silicon nanopore filters combine with live kidney cells grown in a bioreactor. The bundle is enclosed in a body-friendly box and connected to a patient’s circulatory system and bladder—no external tubing required.

Father Loses IVF Damages Claim

October 6, 2017

(BBC) – A father has lost a damages claim against a London IVF clinic after his ex-partner forged his signature to use frozen embryos. The High Court found IVF Hammersmith was not negligent. The couple broke up in 2010 but some months later the woman asked the clinic to implant an embryo, which they had stored. The man, who can only be identified as ARB, said he did not give his consent and was tricked by his former partner.

Operating-Room Videos a Bad Idea, Medical Paper Says

October 6, 2017

(Fox News) – Posting videos from the operating room may be a creative way for plastic surgeons to market their skills, but critics say some surgeons seem to place entertainment value ahead of medical ethics. A new paper published in the journal Plastic and Reconstructive Surgery takes aim at surgical staffs who appear to be more interested in singing and dancing in the ER than in treating patients.

CardioBrief: Some Doctors Reluctant to Deactivate LVADs

October 6, 2017

(MedPage Today) – Left ventricular assist devices (LVADs) are used increasingly as destination therapy instead of as a temporary bridge until a donor heart becomes available for transplantation. Now patients, their families, and their caregivers are forced to confront the extremely difficult question of when and how to turn off these devices at the end of life. “In the United States, the ethical and legal principles of LVAD deactivation are well-established,” Colleen K. McIlvennan (University of Colorado) and colleagues wrote in the Journal of Cardiac Failure.

The Murky Issue of Whether the Public Supports Assisted Dying

October 6, 2017

(The Conversation) – There have been numerous surveys and opinion polls on public attitudes towards assisted dying in recent years. The British Social Attitudes (BSA) Survey, which has asked this question sequentially since the 1980s, has shown slowly increasing public support. Asked: “Suppose a person has a painful incurable disease. Do you think that doctors should be allowed by law to end the patient’s life, if the patient requests it?” in 1984, 75% of people surveyed agreed. By 1989, 79% of people agreed with the statement, and in 1994 it had gone up to 82%.

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