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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%.

Fetal Tissue Research Is Essential for Scientific Discovery and Improving Human Health

October 6, 2017

(STAT News) – Decades after the U.S. Congress repeatedly reaffirmed its support for publicly funded fetal tissue research, investigators find themselves facing efforts by this same body to prevent this kind of research. At issue is whether fetal tissue research continues to be necessary, whether it has the potential to contribute to new therapies, and whether sufficient safeguards are in place for the research to occur ethically. The answer to each of those is an unequivocal “yes.” Fetal tissue has been essential in research used to develop therapies that have saved millions of lives, and it continues to be necessary for the future of medicine.

Charlatans Threaten Stem Cell Research with Unproven Cures, Experts Say

October 6, 2017

(The Guardian) – The credibility of stem cell research is at risk because of charlatans and dodgy clinics peddling unproven cures for diseases, according to a group of eminent scientists in the field. Stem cell research, or regenerative medicine, has great potential and has already delivered some breakthroughs, but its future is threatened by poor science, unrealistic hopes, unclear funding models and unscrupulous private clinics, they say in the Lancet medical journal. A special Lancet commission made up of leading experts has reviewed the progress to date in a field that was once thought to offer answers potentially to all forms of disease and disability.

CRISPR Nanoparticles Repair Duchenne Muscular Dystrophy Gene

October 6, 2017

(GEN) – cientists have developed a gold nanoparticle technology for delivering the CRISPR/Cas9 gene-editing system to cells that, when tested in the mdx mouse model of Duchenne muscular dystrophy (DMD), repaired the faulty DMD gene, leading to improved strength and agility and reduced fibrosis. Professor Niren Murthy, Ph.D., the University of California, Berkeley (UC Berkeley) researcher who led development of the CRISPR-Gold platform, suggested to GEN that human clinical gene-editing trials using the system could feasibly start within the next few years.

Poll: Adult Caregivers Undertrained and Overwhlemed

October 5, 2017

(STAT News) – Adults in the United States who are providing long-term care for aging relatives and friends have little training for their stressful roles, but plenty of commitment, according to a poll. The Associated Press-NORC Center for Public Affairs Research survey finds that caregivers don’t just give rides to the doctor and go shopping. Nearly half provide some kind of medical care, from changing bandages (30 percent) to inserting catheters or feeding tubes (6 percent).

Study Questions European Approval Process for Cancer Drugs

October 5, 2017

(STAT News) – Only about half of the cancer drugs approved by the European Medicines Agency in the last few years were later shown to help patients live longer or improved their lives, a new study says. Scientists in Britain and Latvia analyzed reports from the European regulator on cancer approvals from 2009 to 2013. Many of the approvals were based only on initial measures that suggested the drug might improve health, like tumor shrinkage.

Experimental Drug That Mutes Defective Genes Raises New Hopes

October 5, 2017

(Scientific American) – The RNAi delivery systems remain highly complex—and the most effective technologies are still protected by patents that make it difficult for startups to get into the field. Safety concerns persist with other RNAi drugs in development: Last year, for instance, Alnylam had to scrap revusiran, one of its most advanced drugs. Rather than alleviating it, the drug exacerbated pain in a rare nerve disease called transthyretin amyloidosis. And several patients died in the clinical trial, though it’s still not clear exactly why. Alnylam’s stock plummeted by half on that news.

Gene Therapy Helps Boys with ‘Lorenzo’s Oil’ Disease

October 5, 2017

(ABC News) – The fledgling field of gene therapy has scored another win: An experimental treatment seemed to help boys with the inherited nerve disease featured in the movie “Lorenzo’s Oil.” Fifteen of the 17 boys treated in a study had no major disability two years later — remarkable for a disease that often causes swift decline and kills within a decade.

The Letters of an ‘Imbecile,’ the Sham, and Shame, of Eugenics

October 5, 2017

(Undark) – We now know that the Holmes opinion was both cruel and false — and is contradicted by a historic marker in Charlottesville, Virginia that has nothing to do with the Civil War, or the soldier-on-horseback monuments that have generated so much controversy recently. This much more obscure marker recalls Buck’s case and declares that she had no “hereditary defects.” Instead, she was the victim of a sham trial that began her trip to the Supreme Court, and provided justification for 60,000 poor or disabled people in 32 states who were sterilized under laws similar to Virginia’s Sterilization Act of 1924, which aimed to prevent people diagnosed with “insanity … idiocy, imbecility, feeble-mindedness or epilepsy” from reproducing.

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