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Medical & Health

WRT 160
by

Brianna Jaczynski

on 4 December 2014

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Transcript of Medical & Health

Holistic, Alternative and Complementary
Medicines
Animal Testing
BENEFITS
Animal testing has helped develop dozens of different medicines and treatments
Medical & Health
Problem:
Patients are using treatments that have not been effectively evaluated
Recommendation:
Conduct more specific research in correlation to a treatment's popularity among patients
Are We Overprescribed in America?
Genetic Testing’s Ethical and Psychological Effects on Patients
Designer Babies
Brianna Jaczynski
Why
Intro
Ethics
Possible Negative Psychological Effects
Caitlyn Theis
Sources
Conclusion
Recommendations
Genetic testing has taken a significant role in the health and medical field.
These investigations into the genes of individuals can be very helpful to see if a person has or may eventually have a disease.
Genetic tests have become less expensive and have increased in availability.

Possible Positive Psychological Effects
More Effects and Their Implications
And now, more in depth on genetics and babies...
Bradley, A. N. (2005). Utility and limitations ofgenetic testing and information. Nursing standard, 20(5), 52-55.

Cizmeli, C., Lobel, M., Franasiak, J., & Pastore, L. M. (2013). Levels and associations among self-esteem, fertility distress, coping, and reaction to potentially being a genetic carrier in women with diminished ovarian reserve. Fertility and Sterility, 99(7), 2037-2044. doi:10.1016/j.fertnstert.2013.02.033

Duncan, R. E., Gillam, L., Savulescu, J., Williamson, R., Rogers, J. G., & Delatycki, M. B. (2008). “You're one of us now”: Young people describe their experiences of predictive genetic testing for Huntington disease (HD) and familial adenomatous polyposis (FAP). American Journal of Medical Genetics Part C, 148C(1), 47–55.

Melas, P. A., Öhman, S. G., Juth, N., & Bui, T.-H. (2011). Information related to prenatal genetic counseling: Interpretation by adolescents, effects of risk perception and ethical implications. Journal of Genetic Counseling, 21(4), 536-546. http://dx.doi.org/10.1007/s10897-011-9418-1

Sturm, A. C., Manickam K. (2012). Direct-to-consumer personal genomic testing: a case study and practical recommendations for “genomic counseling.” Journal of genetic counseling, 21(3), 402-412. http://dx.doi.org/10.1007/s10897-012-9489-7

Techniques
in vitro fertilization (IVF)


embryo is created and genetically modified in a petri dish then implanted into the mother’s uterus.
Costs

My mother has had a lot of family member who have had breast cancer.
In 2012, my mother decided to receive a test to see if she had breast cancer associated genes.
Before and after she obtained the positive results of the BRCA1 gene, she seemed to be acting and feeling differently.
This made me curious about how individuals are affected by these tests so I researched into this.
What type of effects can influence the patients of genetic testing, how many of these effects are present, and what is this information’s implications?

Example Pedigree and Lineage

Intro
3.65 billion drugs were prescribed in the last year and that number is predicted to continue to increase every year.
Studies show that the majority of patients leave a doctor's appointment having been given a prescription.
Current Ability?
May be closer than we think...
Gene therapy is a one-time treatment of about $1 million.





Hemophilia B affects about 1 in 20,000 males.

Therapy consists of treatment with an average price of $200,000–300,000 per year, or $4–6 million in therapy costs (given 30–40 years of treatment).



What is it?

Testing of medical, scientific and any product on an animal
Has been used for centuries
Dozens of different products have been developed using animal testing
WHY?
Without animal testing developing medicine in a timely manner is near impossible
Drug companies save money and therefore develop more affordable medication
Recommendation
We must continue animal testing to continue making timely advancements in science
Animal testing protects humans and animals alike
How Can we work around animal testing?
What is Being Changed?
School lunches
According to Michelle Obama's initiative to provide healthier lunches,the grains should be at least 50% whole, and each student must take a side of vegetables or fruits with each lunch
LetsMove
LetsMove gives a guideline of the three A's for physical activity, "Active families, Active schools, and Active Communities
Active families: Children should exercise at least 60 minutes a day, and adults should exercise 30 minutes.
Active Schools: Add more physical activity into the school day, such as additional physical education classes, recess, and opening school facilities after school hours for student and family recreation.
Active Communities: Safe routes for kids to walk and ride to school; renovating parks, playgrounds, and community centers; and by providing fun and affordable sports and fitness programs.
• Lots of ethical questions and effects to consider
• Presymptomatic Testing - implications of a diagnosis of a gene that gives a patient a risk of a disease that may or may not ever occur (Bradley, 2005, p. 53). If knowing an individual has a predisposition that is more worrying than it is worth, it may be a better idea not to take part in the genetic test.
• Incurable Disease - should the person wait until a date closer to when the disease would take effect or do they want to know and worry without anything to do about it?
• These give people a lot to think about as their ethics and beliefs are tested.
• Ethics must be considered to bring as little negative effects on patients as possible.

Human germline engineering
Cloning


Preimplantation genetic diagnosis (PGD)

Embryos are created in petri dish; embryos without the genes for a particular disease will be implanted into the mother’s uterus

Causes of Overprescription

Doctor's First Choice: Prescribe
More than half of patients are prescribed some type of drug after their diagnosis.
While a number of drugs are extremely helpful, many of them are not needed.
Many doctors fail to look into alternative methods to help the patient.
Financial Incentive
Organizations employing doctors have ties with drug companies.
Companies offer financial benefits to doctors for prescribing their drugs.
Patients are not told about the incentives their doctors are offered.
Patients' Expectations
In an appointment, patients expect/ want to be prescribed.
Doctors more likely to give prescriptions when patients give the idea that that is what they want.
TV ads causing people to try to diagnose themselves.
Effects of Overprescription
Medical Bills
Possible Mixtures
Ethics
Sources
Significant role in the health and medical field.
Helpful to see if a person has or may eventually have a disease.
Have become less expensive and have increased in availability.

Mother -family history of breast cancer
2012 - genetic testing
Before and after she obtained the positive results of the BRCA1 gene, she seemed to be acting and feeling differently.
Curiosity!

Time to research:
What type of effects can influence the patients of genetic testing
How many of these effects are present
What is this information's implications?
Bradley, A. N. (2005).
Cizmeli, C., Lobel, M., Franasiak, J., & Pastore, L. M. (2013).
Duncan, R. E., Gillam, L., Savulescu, J., Williamson, R., Rogers, J. G., & Delatycki, M. B. (2008).
Melas, P. A., Öhman, S. G., Juth, N., & Bui, T.-H. (2011).
Sturm, A. C., Manickam K. (2012).

Examples:
Presymptomatic testing
– risk of getting a disease in the future even though it may or may not ever occur - May be more worrying than it is worth.
Incurable Diseases
– Always wondering vs. finding out an answer that may not be beneficial.
Ethics and beliefs are tested - must be considered to bring as little negative effects on patients as possible.

Research - Genetic testing’s effects on patients and its implications
There are many different positive and negative effects
Can be produced by the genetic testing process, not just the results.
Also, there are many ethics to consider.

Deliberate if the benefits out way the costs
Psychological counselors
Education aids
research to see more on how it is affecting us

Stress on patient and family
Anxiety
Not felling in command
Interference with day to day live
Feelings of regret
Patient asking for unneeded subsequent tests
Relief of knowing results
Finding support
Increased bonds with relatives
Optimism
Feeling more knowledgeable on the subject
Questions?
Problems
1. Scientists are unable to insert the DNA copy into a specific point in the DNA strand

2. A single gene can control multiple traits

3. Many traits are the product of multiple genes working together.
Ethics
Eliminate fatal disease in child

How to define disease?
Disease
Safety
Safer than getting fatal genetic disease

Relatively new & much unknown

Mice study: Increased learning/memory, pain sensitivity

Societal
Implementation
Visible & cognitive disabilities fixed

No uniqueness

Rich vs poor gap


Funding
Definition:A Child who is considered overweight is in the 85th percentile and is considered obese in the 95th percentile
32% of children in America are overweight, 17% being obese
Complications
National Institutes of Health (NIH)
Children do not like the food

More food is then thrown out, costing the schools money

parents are unaware or cannot afford a healthier lifestyle
Recommendation
Inform parents of methods they can follow so their children have a healthier life

start at younger ages

Not as much government control, more help
Childhood Obesity
Side-Effects
Many Americans with large amounts of debt from medical bills.
Patients prescribed medications they can not afford.
Doctors try out multiple medications to see what will work causing patients to pay for many unneeded medications.
Patients prescribed for every problem they come in with.
Many people are on numerous medications for different problems.
Certain mixtures of medications can be dangerous or can cause the other medications to stop working.
Many patients exposed to side-effects, sometimes fatal, when their medication is not actually helping them.
Addiction to medications has become a lot more common as the number of prescriptions given out continues to increase.
Conclusion/ Recommendation



Patients should look into the drugs they are being prescribed.
They should ask their doctors about their prescriptions.
There should be transparency between the patients and doctors.
Sources
Wolfe, S. (2010) "Misprescribing and Overprescribing of Drugs"
Smith, B. (2012) "Inappropriate Prescribing"
Wen, L. (2013) "Before the Prescription, Ask About Your Doctor's Finances"
Britten, N. (1997) "The influence of Patient's Hopes of Receiving a Prescription on Doctors' Perceptions"
Wallace, E. (2009) "Health Care in Crisis: Overmedicating America"
What are the differences?
Holistic Healing
Emphasizes on overall balance of the mind, body and emotions
Complementary Medicine
Used in conjunction with modern medicines
Alternative Medicine
Generally untested healing methods
Benefits Regardless of Opinion:
More research would separate methods that have potential from faulty treatments
Full transcript