Sunday, April 23, 2006
The Juvenile Diabetes Research Foundation is launching a series of independent studies designed to test manufacturer claims about the new devices and provide information on their worth. Among the big questions are how much they can cut rates of hospitalization, car accidents caused by drivers with low blood sugar and the many other problems attributable to diabetes.
Wednesday, April 19, 2006
But that is not the primary reason why McGee claims that Gandhi would have led a protest march against clinical trials if he had been alive. McGee points out that a majority of the enrollees in these clinical trials have no idea what drugs they are taking. Even though these subjects are giving their consent, they have no idea to what they are consenting. In some cases, the drug has not been proven safe before the trials. McGee mentions the case of the unapproved clinical trial in which 435 women were given a fertility drug that was not cleared for testing on human subjects. Clinical trials too offensive to American research subjects are being proffered to the residents of India. McGee wonders how long until the people of India rise up against this new form of imperialism.
Roberts reports that Guatemala has one of the worst records in Central America for reproductive health with high rates of maternal and infant mortality and low levels of knowledge about contraception. (She cites: In some parts of the country, 42·1% of the population had not heard of HIV/AIDS; 2·3% of the women chose condoms as their preferred method of contraception; just over 40% of women had used any form of contraception at all.) This situation is referred to as a crisis.
While activists campaign for stronger legal regulation of reproductive-health information and services, and have support for such in the Guatemala Parliament, the President of the country and the Roman Catholic church are thwarting efforts towards the goal of women’s reproductive health.
Guatemala has a population of approximately 13 million people and is the most populous country in Central America. The population is approximately half indigenous, Mayan. Spanish is the official language but Mayan languages are spoken alongside Spanish. The distribution of income is highly unequal with perhaps 75% of the population below the poverty line. From 1960, the people of Guatemala endured 36 years of bloody civil war between a series of military regimes and anti-government guerrillas which left up to 200,000 people dead and many “disappeared.” According to MADRE, “Behind the smokescreen of "fighting communism," military groups trained and funded by the US killed mostly Indigenous people and destroyed 440 Mayan villages. More than a million people were uprooted from their homes and over a quarter million became refugees in surrounding countries.” In 1992, Rigoberta Menchu, a Mayan rights activist was awarded the Nobel Peace Prize. In 1996, Guatemalans celebrated the signing of Peace Accords, however, the country is still marked by violence and corruption and according to Amnesty International, has witnessed over 1500 brutal killings of women since 2001. There has been a marked lack of thorough and impartial investigation into these and other violent crimes against women. The recent AA report (April 1 2006) concludes that: ”the State of Guatemala is not taking effective action to eliminate gender discrimination in the criminal justice system, ensure proper investigations and bring those responsible for the killing of women to justice. This failure has meant increased suffering on the part of relatives of women killed, which Amnesty International believes amounts to cruel, inhuman and degrading treatment.”
During the civil war, the Roman Church and other religious organizations took a leadership role in giving material, psychological and spiritual aid to victims; sometimes it engaged in political activities and church members were disappeared and murdered. But Church teachings about the morality of reproduction are affecting public health policy in the country to the detriment of women’s reproductive health. Women of the country overwhelming want access to family planning information and services, but it is not being provided. Moreover, international funding for reproductive health programs has been cut off as a consequence of the current US administration's hostility to modern family-planning methods. See: http://www.reproductiverights.org/pdf/guatemala.pdf
Tuesday, April 18, 2006
Noelle, the first lifelike, birthing simulator is being used in a growing number of medical schools and hospital maternity wards.
The full-sized mannequin is in demand because medicine is rapidly abandoning the ethically questionable centuries-old tradition of using patients as guinea pigs, turning instead to high-tech simulations.
The Institute of Medicine estimates that as many as 98,000 U.S. patients die annually from preventable medical errors. Obviously, it's better to make a mistake on a $20,000 robot than a live patient -- Other companies make lifelike mannequins to train paramedics in emergencies, but Noelle appears to be the only high-tech, pregnant model available. Noelle models range from a $3,200 basic version to a $20,000 computerized Noelle that best approximates a live birth.
[image from http://ctheory.concordia.ca/hacking/pregnant.html]
Because an estimated 500,000 women use raloxifene to reduce the risk of osteoporosis, many will be more comfortable using it for breast cancer protection, several experts predicted.
"It's terrific," said Susan Love, a breast cancer expert at the University of California at Los Angeles. "This gives us another drug that we can use to prevent breast cancer that is less risky than the only other drug we had."
Several experts, however, urged caution, saying that the advantage of raloxifene remains unclear and that more research is needed to prove the drug reduced the overall risk over longer periods.
Saturday, April 15, 2006
While the intent of the bill is noble, there are some obvious problems with the language of the bill and monitoring mechanisms --
First, postpartum depression can happen anytime within the first year after childbirth -- the language of screening "new mothers for postpartum depression symptoms prior to discharge from the birthing facility and at the first few postnatal check-up visits;" is pretty vague -- the first two, three visits? -- it deosn't create a specific standard of care.
Secondly, there is no follow-up or feedback mechanism --From a research ethics viewpoint, there needs to be put in a formalized report process which protects the anonymity and privacy of the individual, yet collects sufficient to data to indicate that program is being effective -- that the message is getting through to the intended audience -- otherwise, how can it be shown that the legislation will have any effect? Without that, it amounts to more of a 'political' issue than a 'medical' issue.
Finally, the part of the bill that requires "Physicians, nurse midwives and other licensed health care professionals providing prenatal and postnatal care to women shall include fathers and other family members, as appropriate, in both the education and treatment processes" doesn't address issues of medical confidentiality, an important issue with HIPAA (Health Insurance Portability and Accountability Act of 1996 ) these days. This is a particular difficulty with legislatures mandating certain actions -- the legislature is telling the professionals do something that could be contrary to other laws (such as HIPAA) .
Friday, April 14, 2006
Thursday, April 13, 2006
Parents doing this isn't new news--it's happened in the US and in the UK. What's new is a clinic designed for this specific purpose.
And while we're on the topic, if you haven't already read Jodi Picoult's book, My Sister's Keeper, this would be a good time . . . . check out the new WBP book club here.
Tuesday, April 11, 2006
WBP Launches Book Club Campaign: Stories about cloning and “designer babies” bring bioethical issues to life
“Through a series of interviews we’ve learned that women are eager to discuss bioethical issues if they are put in a context that shows how they directly affect their lives,” said Kathryn Hinsch, founder of the Women’s Bioethics Project. “Many women we spoke with said they wanted to participate in discussions about these topics, but only if it didn’t require additional time away from their families and their already loaded schedules. Furthermore, many said they wanted to go beyond merely raising difﬁcult questions to actually taking action on issues that they found personally meaningful.”
The ﬁrst novels in this book club series chosen by the WBP for this program include the following:
Never Let Me Go by Kazuo Ishiguro goes a step further, examining human cloning and organ donation from the perspective of an isolated community of human clones.
Oryx & Crake by Margaret Atwood presents a world so altered by the effects of genetic engineering that both society and the natural environment are profoundly affected.
When read in this order, the selected novels take readers along a continuum from technologically feasible issues surrounding organ transplants and genetic engineering to futuristic scenarios involving advanced applications of these and other biotechnologies that force us to examine many of the implications of what it means to be human.
Beyond the literary analysis and examination of important bioethical issues, another important aspect of the WBP book club program is that it ties the issues raised in these three books to current public policy debates. The book club materials provide women with guidance on how to get involved, share their thoughts with their legislators and help shape legislation.
part in that effort.”
All book club program materials are available on our Web site.
Monday, April 10, 2006
Friday, April 07, 2006
Because my culture says it’s ok seems to be the new catch phrase for behaviors all along the questionable behaviors continuum.
For instance, one of the lessons that has emerged from the ongoing rape trial of our ex-Deputy President, Jacob Zuma, is that If you don’t have sex with a woman (and they are wearing a skirt, so clearly wanting it), you are morally wrong and criminally accountable. Heck, you may even be charged with rape. His culture has taught him that leaving a woman in that state (of sexual arousal) was “the worst thing a man could do.” Funny that, I thought rape might have claimed that title. But then, I’m just a woman. And an outsider to the norms dictated by Zuma’s culture.
It seems that culture gives you an alibi for just about anything you feel like doing. In a recent survey of school boys in our KwaZulu-Natal province, beating girls and forcing them to have sex was all justifiable in cultural terms. While one boy said that beating a girl was acceptable practice to keep her in line, another said that hitting a girl meant that you loved her, because if you didn’t (love her), you wouldn’t bother (to hit her). Following this line of argument into marriage, most of the participants believed that forced sex within a marriage was not a problem: “When we are married, I can force you to have sex with me because I know that I pay my money to buy you…” Nor did the youngsters think it was a problem for a man to have sex whenever and with whomever he wanted, even if it was not with his wife.
And what about the risk of AIDS? Well, one can hardly blame young boys for being unconcerned about the possibility of contracting the virus if our former Deputy President, a man who continues to command a strong following and who, ironically, is the former head of the National AIDS Council, has openly admitted to engaging in unprotected sex with an HIV-positive woman. If boys – and girls – want to have unsafe sex, all they need to do is shower afterwards. During his trial, Zuma has testified that he showered after having consensual sex with the alleged rape victim to minimize his risk of contracting HIV from her. A revelation that is sure to set a good example for those who ardently follow and admire their leader: if you have unprotected sex with someone who is HIV-positive, you will be ok so long as you take an anti-HIV shower afterwards, wash all that yucky virus off of you.
Thursday, April 06, 2006
Wednesday, April 05, 2006
Larry Cahill, an associate professor of neurobiology and behavior, and Lisa Kilpatrick, a former postdoctoral fellow in his laboratory, have found that the amygdala, an almond-shaped structure found on both sides of the brain, behaves very differently in males and females while the subjects are at rest. In men, the right amygdala is more active and shows more connections with other regions of the brain, even when there is no outside stimulus. Conversely, in women, the left amygdala is more connected with other regions of the brain. In addition, the regions of the brain with which the amygdala communicates while a subject is at rest are different in men and women.
The finding could be key to determining why gender-related differences exist in certain psychiatric disorders and how to treat a variety of illnesses.
The study appears in this week’s issue of NeuroImage.
“These findings are intriguing because they provide the first hint of what could be a fundamental difference in how the brain is wired in men and women,” said Cahill, a fellow at UCI’s Center for the Neurobiology of Learning and Memory. “If, even in a resting state, the brain shows such differences between the sexes, it could have far-reaching implications for our study of certain psychiatric and medical disorders.”
The researchers used Positron Emission Tomography (PET) scans to analyze the brains of 72 healthy, right-handed adults (36 men and 36 women). The subjects were instructed to relax with their eyes closed while being scanned. When the scans were later studied, researchers found that not only was there a difference between the men and women as to which hemisphere's amygdala was more active, but also that the regions of the brain that the amygdala “talked” with were also quite different. In men, the right-hemisphere amygdala showed more connectivity with brain regions such as the visual cortex and the striatum. In contrast, the left amygdala in women was more connected to regions such as the insular cortex and the hypothalamus.
The finding led to an unexpected discovery: Many brain areas communicating with the amygdala in men are engaged with and responding to the external environment. For example, the visual cortex is responsible for vision, while the striatum coordinates motor actions. Conversely, many regions connected to the left-hemisphere amygdala in women control aspects of the environment within the body. Both the insular cortex and the hypothalamus, for example, receive strong input from the sensors inside the body.
“Throughout evolution, women have had to deal with a number of internal stressors, such as childbirth, that men haven’t had to experience,” Cahill said. “What is fascinating about this is the brain seems to have evolved to be in tune with those different stressors.”
Cahill believes this study could be the basis for a fuller understanding and treatment of a number of disorders that affect one gender or the other. For example, in the study, one of the brain areas communicating with the amygdala in women is implicated in disorders such as depression and irritable bowel syndrome, which predominantly affect women.
Cahill has led the way in exploring gender-related differences in the brain. In a 2001 study, he showed that the sexes use different sides of their brains to process and store long-term memories. In another study in 2002, he demonstrated how a particular drug, propranolol, can block memory differently in men and women.
The original press release can be found here.
I love it, too, when Hollywood displays a conscience: Thank You for Smoking, a film now playing in selecting theatres, takes a critical and satirical look at the machinations of the tobacco industry and lobby. As Robert Duvall's character says: "We sell cigarettes... and they're cool, and they're available, and they're addictive... the job is practically done for us!" One of the funnier, albeit politically incorrect, scenes involves the MOD Squad -- that is, Merchants of Death -- lobbyists for the tobacco, alcohol, and gun industry.
One of my favorite actors, William H. Macy found the philosophical, ethical and political questions raised in the film to be among the most engaging elements of the project. "What authority does the government have to protect us from ourselves? I don't know the answer and I think it's constantly changing."
Director Jason Reitman even has his own blog about what it was like tackling these issues and making the movie.
In the meanwhile, one of the lines from the movie, should qualify as the quote of the day:
"99 percent of everything done in the world, good or bad, is done to pay a mortgage...perhaps the world would be a better place if everyone rented."
The bill does what health experts say no other state has been able to do: provide a mechanism for all of its citizens to obtain health insurance. It accomplishes that in a way that experts say combines methods and proposals from across the political spectrum, apportioning the cost among businesses, individuals and the government.
Tuesday, April 04, 2006
To create the new bladders, the researchers took a biopsy from patients whose bladders functioned poorly due to an inherited nervous system disorder. The team then placed muscle cells and cells from the bladder lining on a biodegradable bladder-shaped scaffold and allowed them to grow for about two months.
Scientists are also working on growing bio-engineered hearts and pancreases in the lab. In addition, an artificial womb is being tested at Cornell.