Matching Items (33)

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Personalized Medicine and the Concept of Empowerment

Description

With advances in biotechnology, personalized medicine has become an ever-expanding field. Even with so much growth, the critics equally match the proponents of personalized medicine. The source of their disagreement

With advances in biotechnology, personalized medicine has become an ever-expanding field. Even with so much growth, the critics equally match the proponents of personalized medicine. The source of their disagreement is rooted in the concept of empowerment. This analysis utilizes the personal genomics company 23andMe and their relationship with the Federal Food and Drug Administration to illustrate varying views of empowerment. Specifically, the case study focuses on the ability to provide direct-to-consumer health reports to patients independent of physicians. In doing this, larger issues of what is at stake in personalized medicine are uncovered. These include but are not limited to: who determines what individuals get empowered and what information is determined good versus bad.

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Date Created
  • 2015-05

Three-Parent Babies or 2.001-parent Babies?: A Scientific and Bioethical Examination of Mitochondrial Replacement Therapy

Description

This thesis critically examines the scientific and ethical dimensions of the novel and controversial technology of mitochondrial replacement therapy (MRT). The first portion provides a background on mitochondrial diseases and

This thesis critically examines the scientific and ethical dimensions of the novel and controversial technology of mitochondrial replacement therapy (MRT). The first portion provides a background on mitochondrial diseases and examines how these organelles (mitochondria) have left humans vulnerable to disease. The second portion of the thesis examines the technology of mitochondrial replacement therapy and what research contributed to the development of MRT. Finally, the third section responds to the ethical and legal concerns proposed and outlined by the Nuffield Council of Bioethics. After careful consideration of all legal and ethical concerns, it is concluded that the technology of MRT should be pursued under careful foresight with the idea that the technology is already happening and we must move forward in a way that provides the greatest information.

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Date Created
  • 2017-05

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Diagnosing Autism Spectrum Disorder: Implications for Research, Medicine, and Patients

Description

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis a difficult and rarely uniform task. Currently, ASD is behaviorally diagnosed based on criteria defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Recently, a change was made in the criteria from more lenient criteria in DSM-IV-TR, to more narrow criteria laid out by the DSM-V, which supersedes the DSM-IV-TR. This drastic change raised many questions and debates about which set of criteria are better. The more lenient criteria offers a more inclusive diagnosis giving greater access to therapies; while the narrow diagnostic criteria excludes some individuals, creating a more uniform diagnosis that's easier to use in research. This thesis analyzes the change in diagnostic criteria from the DSM-IV-TR to the DSM-V and the effects of these changes on the practices of diagnosis. In addition, it explores the implications of this change for the families of children with autism and for those involved in autism research, examining their respective opinions and interests pertaining to narrow verses broad diagnostic criteria. Building on this analysis, the thesis offers recommendations about diagnostic criteria should be set. It argues that the wellbeing of patients takes priority over the interests of researchers, and thus diagnosis should be done in a way that offers the best prognosis for all children who suffer from autistic symptoms.

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Created

Date Created
  • 2016-12

The Utilization and an Evaluation of Health Services Provided by the Flying Samaritans at the Laguna de San Ignacio Clinic in Baja California Sur, Mexico

Description

The Flying Samaritans is a group of volunteers who provide health care on a monthly basis at the Laguna de San Ignacio Clinic in Baja California Sur, Mexico. The purpose

The Flying Samaritans is a group of volunteers who provide health care on a monthly basis at the Laguna de San Ignacio Clinic in Baja California Sur, Mexico. The purpose of this study was to gather demographic information about the patients at the clinic as well as to determine why the patients need to use a free clinic, how they use other health care facilities that are available to them, how well they take care of themselves in terms of exercise, nutrition, and care of chronic disease, and how the Flying Samaritans can improve their care for this population. This information was gathered using an extensive patient survey as well as through interviews with both patients and health care providers at this clinic. Based on the data gathered, it was determined that some health problems present in the population could be prevented with education about daily health and dental care. The Flying Samaritans could implement some forms of patient education in order to minimize chronic health problems and to continue to improve the overall health of this population. The data also demonstrated that the patients rely heavily on the Flying Samaritans services, as the town in very isolated and does not offer any other medical or dental facilities. The Flying Samaritans are essential to the well-being of this town and provide services that the patients may not otherwise receive.

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Created

Date Created
  • 2016-12

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Understanding Bioethical Concerns of Laboratory Research: A Case Study On Discovering Programmed Necrosis Pathways

Description

The concept of “good” research is concrete in terms of technique, but complex in theory. As technology advances, the complexity of problems we must solve also grows. Research is facing

The concept of “good” research is concrete in terms of technique, but complex in theory. As technology advances, the complexity of problems we must solve also grows. Research is facing an ethical dilemma—which projects, applied or basic, should be funded. Research is no longer an isolated sector in society, and the decisions made inside of the laboratory are affecting the general public more directly than ever before. While there is no correct answer to what the future of research should be, it is clear that good research can no longer be only defined by the current classification system, which is rooted in antiquated, yet ingrained, social status distinctions.
Differences between basic and applied research were explored through a wet-lab case study. Vaccinia virus (VACV) infections are a prime model of the competition between a virus and its host. VACV contains a gene that is highly evasive of the host immune system, gene E3L. The protein encoded by E3L is E3, which contains two highly conserved regions, a C-terminus, and a N-terminus. While the C-terminus is well-understood, the mechanism by which the N-terminus grants IFN resistance was previously unknown. This project demonstrated that the N-terminus prevents the initiation of programmed necrosis through host-encoded cellular proteins RIP3 and DAI. These findings provide insight into the function of the N-terminus of E3, as well as the unique functions of induced programmed necrosis.
This project was an example of “basic” research. However, it highlights the interconnectivity of basic and applied research and the danger in isolating both projects and perspectives. It points to the difficult decisions that must be made in science, and the need for a better research classification system that considers what makes science “good” outside of antiquated social class ideologies that have shaped science since ancient Greece. While there are no easy answers to determine what makes research “good,” thinking critically about the types of research projects that will be pursued, and the effects that research has on both science and society, will raise awareness, initiate new conversations, and encourage more dialogue about science in the 21st century.

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Date Created
  • 2016-12

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Examining the Modern System of Animal Testing, its Translational Challenges, and its Potential Solutions

Description

Animal testing is a long-running institution in biomedical research that is seen as a necessary step in the development of new drugs and treatments in the United States. Using animal

Animal testing is a long-running institution in biomedical research that is seen as a necessary step in the development of new drugs and treatments in the United States. Using animal models that have biological similarities to humans, it is assumed that we can ethically perform basic research that is translatable to human health. However, recent years have seen this assumption challenged by the fact that most preclinical research fails to survive the gauntlet of human trials into a functioning treatment on the market. This has marked ethical implications for both the people that depend on new treatments for their health, and the animals used in the research themselves. The purpose of this thesis is to develop solutions for the problems facing animal testing in the United States. First, I identify the political and economic basis of the modern system of animal testing by examining legislation and the IACUCs that govern animal research to understand why the practice continues to be used despite its low rate of success. I then examine factors such as epigenetics and the laboratory environment to explain reasons why animal research fails to translate to humans. Finally, I cover new in-vitro methods such as organoids and organ-on-a-chip technologies to show the potential that alternatives hold for biomedical research. As a result of this analysis, I propose the further integration of alternatives into our system of animal testing to make up for the translational failures the field currently experiences. I also highlight the importance of having IACUCs balanced between animal researchers and members of the public to improve the welfare of animals used in research and increase the transparency of their work. Including more animals into the Animal Welfare Act is also proposed to better standardize our treatment of them and keep experimental results more consistent.

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Date Created
  • 2020-12

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Yuma, Arizona Pediatric Oncology Capacity Needs Assessment

Description

Yuma County, a primarily agricultural community on the border of Mexico and Arizona, has been deemed a “medical island surrounded by a sea of sand.”17 Yuma, Arizona consists of

Yuma County, a primarily agricultural community on the border of Mexico and Arizona, has been deemed a “medical island surrounded by a sea of sand.”17 Yuma, Arizona consists of over 200,000 people, with an additional 80,000 to 100,000 winter visitors.17 An extra 41,000 farm workers from California and 50,000 Mexicans on work visas travel to Yuma during the winter harvest season.17 Additionally, approximately 20% of residents live below the poverty line and 60% of the population is Hispanic in 2016.17 Unemployment in Yuma is also 50% higher than the national average, and has a 20% unemployment rate in 2016.17 Because these statistics are higher than the state and national averages, the Department of Health and Human Services have declared Yuma County as a “high needs area.”17 For all of these residents in Yuma County, Yuma Regional Medical Center is the sole healthcare provider.

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Created

Date Created
  • 2020-05

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Morality of the Past: How Two Committees Judged Past Human Subject Experiments

Description

In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation

In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation experiments ranging from 1944 to 1974. The goal of this thesis is to analyze the ways in which that committee formed moral evaluations and the extent to which its strategies related to a broader historical and philosophical discourse. Here I attempt to describe two specific techniques of simplification the committee deploys in order to make a retrospective moral analysis possible. Although the techniques comprise specific problems, frameworks, subjective perspectives, and conceptual links, their unifying principle is the field of choices the techniques produce. In the first technique I outline, I argue that by focusing on the problem of historical relativism, the committee gains a platform through which it would be granted flexibility in making a distinction between moral wrongdoing and blameworthiness. In the second technique of simplification I outline, I argue that the committee's incorporation of a principle to reduce uncertainty as an ethical aim allow it to establish new ways to reconcile scientific aims with moral responsibility. In addition to describing the structure of these techniques, I also demonstrate how they relate to the specific experiments the analysts aim to evaluate, using both the ACHRE experiments as well as the Nuremberg Trial experiments as my examples. My hope is not to show why a given committee made a particular moral evaluation, or to say whether a decision was right or wrong, but rather to illustrate how certain techniques open up a field of choices that allow moral analysts to form retrospective moral judgments.

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Created

Date Created
  • 2015-05

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Reproduction in Science Fiction

Description

Science fiction works can reflect the relationship between science and society by telling a story set in the future of ethical implications or social consequences of scientific advancement. This thesis

Science fiction works can reflect the relationship between science and society by telling a story set in the future of ethical implications or social consequences of scientific advancement. This thesis investigated how the concept of reproduction is depicted in popular science fiction works. I reviewed and analyzed four popular science fiction works that all showed fear over the government controlling our choices in reproductive technology. The analysis of my thesis can be used as a way to understand how we view the ideas and the consequences of reproductive technology through concepts of reproduction. These perspectives and ideas as a reflection of society's concerns as we discuss the future of the ethics and politics of reproductive technology and reproductive issues.

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Date Created
  • 2016-05

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Reliability of Real-Time Video Smartphone for Assessing National Institutes of Health Stroke Scale in Stroke Patients: The Next Generation of Telestroke

Description

Telestroke networks reduce disparities in acute stroke care between metropolitan primary stroke centers and remote hospitals. Current technologies used to conduct remote patient assessments have very high start-up costs, yet

Telestroke networks reduce disparities in acute stroke care between metropolitan primary stroke centers and remote hospitals. Current technologies used to conduct remote patient assessments have very high start-up costs, yet they cannot consistently establish quality connection in a timely manner. Smartphgones can be used for high quality video teleconferencing (HQ-VTC). They are relatively inexpensive and widley used among healthcare providers. We aimed to study the reliability of HQ-VTC using smartphones for conducting the NIHSS. Two vascular neurologists (VNs) assessed 83 stroke patients with the NIHSS. The remote VN assessed patients using videoconferencing on a smartphone with the assistance of a bedside medical aide. The bedside VN rated patients ontemporaneously. Each VN was blinded to the other's NIHSS scores. We tested the inter-method agreement and physician satisfaction with the device. We demonstrated high total NIHSS score correlation between the methods (r=0.941, p<0.001). The mean total NIHSS scores for bedside and remote assessments were 7.3 plus or minus 7.9 and 6.7 plus or minus 7.6 with ranges of 0-30 and 0-37, respectively. Seven NIHSS categories had significantly high agreement beyond chance: LOC-questions, LOC-commands, visual fields, motor left arm, motor right arm, motor left leg, motor right leg; seven categories had moderate agreement: LOC-consciousness, best gaze, facial palsy, sensory, best language, dysarthria, extinction/inattention; one category had poor agreement: ataxia. There was high physician satisfaction with the device. The VNs rated 96% of the assessments as good or very good for "image quality," "sound quality," "ease of use," and "ability to assess subject using NIHSS," and 84% of the assesssments as good or very good for "reception in hospital." The smartphones with HQ-VTC is reliable, easy to use, and affordable for telestroke NIHSS administration. This device has high physician satisfaction. With the variety of smartphones and professional medical applications available today, the telestroke practitioner has all the tools necessary for fast clinical decision-makingby accessing electronic medial records, viewing images, and tracking patient vitals.

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Date Created
  • 2012-05