Tag: cardiovascular diseases

Bioethics Blogs

A CRISPR View of Life

By Shweta Sahu
Image courtesy of Wikimedia Commons

We now live in a society where many are trying to get a leg up where they can, whether it be through pharmacological neuroenhancement (like Ritalin and Adderall) or other neurotechnologies (like transcranial direct current simulation). Technology also allows us to exert an even earlier influence on neurodevelopmental disorders through prenatal genetic testing for fetuses. Such technologies include amniocentesis and chorionic villus sampling, that screen for Down’s, Edwards’ and Patau’s syndromes, and give parents the chance to decide whether they would like to terminate or continue with their pregnancy. One article even claims 53% of all pregnancies were aborted following prenatal diagnoses of Down’s Syndrome, though there is still much dispute over the exact numbers.

More recently, research has turned to looking into how to intervene at even earlier stages with gene editing of embryos. CRISPR (clustered regularly interspaced short palindromic repeats) is a naturally occurring bacterial defense mechanism, that when combined with certain enzymes, like “Cas” (CRISPR associated proteins), enable scientists to manipulate the gene sequence of an organism. CRISPR technology brings to life the idea that we can edit genes by either inserting or cutting out specific DNA sequences. Among the vast, exciting biomedical applications of this CRISPR/ Cas system are some promising leads, such as developing CRISPR based disease models. Diseases like schizophrenia and autism involve many genes and using CRISPR, one lab has been able to recreate the genetic mutations and investigate the “faulty” neurons that play a role in these conditions in animal models more efficiently.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Study Finds No Safe Level of Smoking

ThinkstockNastco

Many Americans who’ve smoked cigarettes have been successful in their efforts to quit. But there’s some bad news for those who’ve settled for just cutting back: new evidence shows there’s no safe amount of smoking. One cigarette a day, or even less than that, still poses significant risks to your health.

A study conducted by NIH researchers of more than 290,000 adults between the ages of 59 and 82 found that those who reported smoking less than one cigarette per day, on average, for most of their lives were nine times more likely to die from lung cancer than those who never smoked. The outlook was even worse for those who smoked between one and 10 cigarettes a day. Compared to never-smokers, they faced a 12 times greater risk of dying from lung cancer and 1½ times greater risk of dying of cardiovascular disease.

The findings, reported by Maki Inoue-Choi of NIH’s National Cancer Institute, Rockville, MD, and colleagues, come from an analysis of data from the NIH-AARP Diet and Health Study. The study is evaluating the effects of diet and lifestyle on cancer risk over many years in a large group of seniors from across the country.

The study began about 20 years ago, when a team of NIH researchers mailed questionnaires to 3.5 million members of AARP.  More than a half million people answered the original survey. Since then, these respondents have completed two follow-up surveys about their lifestyle and behaviors, including their smoking patterns from ages 15 to 70.

As published in JAMA Internal Medicine, the latest analysis included more than 290,000 seniors who answered a survey conducted from 2004 to 2005 [1].

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The dirt on ‘clean’ energy: #MakeMuskratRight

Debbie Martin criticizes large-scale industrial and energy developments, such as the Muskrat Falls hydroelectric project, that are threatening Indigenous territory.

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Nova Scotia aims to reduce greenhouse gas emissions by 80% below 1990 levels by 2050. This is an ambitious but important goal – unmatched virtually anywhere else in Canada.

Historically, Nova Scotia has relied heavily upon coal for energy and has had a poor track record when it comes to renewable sources of electricity and energy.

In 2013 Nova Scotia penned an agreement with the Province of Newfoundland and Labrador, in which it agreed to purchase hydroelectricity from Muskrat Falls.  This electricity, which is expected to flow to Nova Scotia via a subsea cable by 2019, is an important part of Nova Scotia’s plan to reach its clean energy targets.

Although setting renewable energy targets is laudable, and certainly needs to happen in this era of climate devastation, the benefits of reducing greenhouse gas emissions must be weighed against associated social and ecological harms.

Muskrat Falls, Labrador (Photo Credit: Google Maps and Donald Atkinson, 2001)

Consider, for example, the Lower Churchill Hydroelectric Generation project – a multi-billion dollar project that is currently under construction in Labrador. This project involves the construction of two large dams, the first one (which is currently under construction) at Muskrat Falls and the other at Gull Island. The reservoirs created from damming these two sites will completely obliterate 100 square kilometers of pristine wilderness. This land is owned by the Innu, and is upstream from where approximately 2000 Inuit live.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Comprehensive and thorough study of the relationship between attendance at religious services and reduction in mortality

The authors concluded consider that religiousness and spirituality are undervalued in relation to morbidity and mortality, so physicians should take this into account in their patients

The World Health Organization defines health as “a state of complete physical, mental and social well-being”.

Some religious groups say that within a holistic concept of the human person, the unity of body, mind and spirit can affect health, while others go even further by stating that religious practice can influence individual behaviour by modifying its development. However, with respect to mortality and morbidity, this does not appear to be scientifically demonstrated as yet.

Thus, in an article published in 2011 (Explore 7; 234-238, 2011) that analysed meta-analyses performed between 1994 and 2009, evaluating the possible relationship between attendance at religious services and mortality, the authors concluded that in the group who attended religious services, mortality was reduced by 18% compared to non-attendees.

However, some authors question the validity of these studies, arguing that the evidence is often weak due to the poor study methodology and design, so causality between religiousness and decreased mortality cannot be claimed.

In relation to this, last 16 May, a study was published (JAMA 176; 777-785, 2016) that looked at this topic in more depth, trying to avoid some of the shortcomings of previous studies, especially the fact of not having taken into account certain confounding factors.

Data from the study in question

In order to conduct the study, the authors used data from the “Nurses’ Health Study”, which included a large cohort of North American women who attended or did not attend religious services, carefully assessing the so-called confounding factors, such as diet, lifestyle, medical history and race, as well as carrying out long-term follow-up.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals December 2015 – Part II by Melanie Boeckmann

Find the first half of December’s post here.

New Genetics and Society

Beyond and within public engagement: a broadened approach to engagement in biobanking

Jose A. Cañada, Aaro Tupasela, Karoliina Snell

Social studies on biobanking have traditionally focused on public engagement, that is, engagement with donors, patients and the general public as an important factor of sustainability. In this article, we claim that, in order to fully understand the way biobanks work, it is necessary to pay attention to a number of other actors, which have an equal, if not greater, impact on their practices and strategies. This means taking a broadened approach to biobank engagement. By using data collected from interviews with different biobank experts based in five different countries (UK, Canada, Finland, Spain and Iceland), we identify seven communities, including the public, that emerge as relevant. Such relationships condition the way biobanks develop, act and plan. The discussion illustrates how the relationships with those seven communities are articulated. We conclude that there is a need for a broadened approach to biobank engagement in order to understand biobank sustainability.

Adoptable packages and the cost of their adoption: the craftwork of making the right cells for regenerative medicine in Japan

Koichi Mikami

The goal of regenerative medicine is to utilize biological properties of cells for therapeutic purposes. Although substantial international investment has been made in this biomedical technology, the issue of which type of cells best serves for these purposes still remains unsettled. Adopting a conceptual framework from Clarke and Fujimura that the rightness of “tools” needs to be socially constructed, this paper examines the interactions of various actors in Japan and demonstrates two kinds of craftwork as examples of attempts to construct the rightness of the cells for the technology.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Lungs are unique that can regenerate iself after an injury

Lung diseases are a major cause of morbidity and mortality worldwide, after cardiovascular diseases and cancer. The lungs are unique in that they can regenerate after an injury, which could permit this pulmonary ability to be used to regenerate damaged lung tissue. A recent study (Nature Medicine 20; 822-832, 2014) evaluated this capacity for regeneration in a review that tackled this subject in depth. Advances made in this field, and discussed in this review, shed light on new techniques that could be used in the regeneration of damaged lungs, an encouraging prospect.

La entrada Lungs are unique that can regenerate iself after an injury aparece primero en Observatorio de Bioética, UCV.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Risks are not just about numbers

On a daily basis, we are informed about risks. The media tell us that obesity increases the risk of cardiovascular diseases and that we can reduce the risk of Alzheimers by eating the right kind of food. We are confronted with the potential danger of nanoparticles and mobile phone radiation. Not to mention the never ending discussion about nuclear power. Some news are more serious than others, but we cannot avoid risk information as such.

In addition to the media, government agencies inform the public about risks. The Swedish National Food Agency encourages people to eat fish because of its potential to reduce the risk of cardiovascular disease. But we should also reduce the intake of wild-caught salmon and herring due to the health risks associated with mercury.

Contemporary society has been described as a risk society, simply put a society preoccupied with risks. We invest a great amount of our common resources in risk management and communication. Sometimes, it appears as though risks are communicated in a hasty way. As soon as a risk is “found,” it is assumed that the responsibility of the government and possibly of the media is to inform the public. It is not acknowledged that what is considered to be a risk is not always straightforward and value neutral.

Whereas experts define risk as probability multiplied by negative outcome and weigh risks against benefits, several studies have shown that lay people conceive of risk in a much more complex and nuanced way. According to the expert notion, a risk is acceptable if the benefits outweigh the risks.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals – March 2015 by Anna Zogas

Here are some of the journal articles that have been published in March 2015. Enjoy!

New Genetics and Society

Origin stories from a regional placenta tissue collection (open access)
Maria Fannin and Julie Kent

Twenty-three years ago when women and their children were recruited to a longitudinal genetic epidemiological study during pregnancy, placentas were collected at birth. This paper explores the history of a regional placenta biobank and contemporary understandings of its value for the constitution of a research population. We draw on interviews with some of the mothers and those responsible for the establishment and curation of the placenta collection in order to explore the significance and meaning of the collection for them. Given its capacity to stand in for the study cohort of mothers and children, we argue that the material significance of the placenta biobank as a research tool seems far less important than the work it does in constituting a population. The stories about this collection may be understood within the wider context of developments in biobanking and the bioeconomy.

Standardizing work as a recursive process: shaping the embryonic stem cell field
Lena Eriksson and Andrew Webster

In this paper, we examine processes of standardization and their role in helping to stabilize human embryonic stem cells as biological objects and in building the stem cell field itself. Drawing on empirical data from the emerging embryonic stem cell field, we explore the various arenas within which standardizing work goes on and how these relate to each other as different types of labour within and beyond the lab, one to do with stabilizing the bio-object and a second to do with its comparability and identity within a wider domain.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Role Of Black Box Warnings In Safe Prescribing Practices

In the Health Affairs article, “Era of Faster Drug Approval Has Also Seen Increased Black-Box Warnings and Market Withdrawals,” published in the August issue, Cassie Frank and coauthors compare the number of approved prescription drugs that received black-box warnings or were withdrawn from the market for safety-related reasons prior to the 1992 Prescription Drug User Fee Act (PDUFA) with black-box warnings and safety-related withdrawals in the post-PDUFA era.

PDUFA for the first time authorized FDA to collect user fees from brand-name manufacturers that submitted New Drug Applications, with the funds being earmarked for more review staff (not until 2007 were funds also permitted to be used to expand post-approval safety surveillance capacity).

As a quid pro quo, the FDA was required to act on all new drugs within a fixed deadline: drugs given priority review designations because they were particularly promising therapies offering substantial improvements in treating serious conditions were to be reviewed within 6 months and standard review drugs were to be reviewed within 12 months (later shortened to 10 months in 2002). By all accounts, PDUFA substantially expedited the review process. The review times for new molecular entities decreased from an average of 33.6 months between 1978 and 1986 to about 10 months for drugs approved between 2001-2010.

Frank and coauthors found that drugs approved in the 16 years after PDUFA were more likely to have a black-box warning or be withdrawn from the market for safety reasons than drugs approved prior to PDUFA between 1979-1986 (26.7 percent vs. 21.2 percent; odds ratio 1.35,

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.