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At least 235 records · Page 13Linked to original sources

Social issues in perinatal screening for sickle cell anemia.

We are living in a time of fascinating scientific achievement in the biomedical field of genetics. The revolutionary methodologies of this biomedical technology produce new ideas and new options for the quality of our life. While this paper is focused on prenatal testing for sickle cell anemia, it simultaneously illustrates the general complexity of public health issues and points out that some emerging scientific values may be more harmful than beneficial to the public because they are inappropriate priorities and do not deal with problems that truly affect the public's health. Special attention is given to issues of ethical significance demonstrating that scientific objectives have been emphasized and that beneficence and respect for persons are principles that have been neglected in Prenatal Sickle Cell interventions. Lastly, this paper advocates social policy to protect the at risk groups from what may become irresponsible public health paternalism.

Anemia, Sickle Cell↗

Understanding external controls over the commercial introduction of engineered human tissues. Assessing regulatory and liability issues.

Emerging biomedical technologies present a new order of magnitude of complexity in their interactions with human patients. As such, they challenge established processes for protecting patients and the public health, while testing the capacity of those processes to ensure timely access to beneficial therapies--especially those representing significant advances over existing therapies. This article reviews the Food and Drug Administration (FDA) regulatory process--including the classification of medical products, the marketing review and approval pathways, and the 1997 FDA Modernization Act--and discusses other legal and policy considerations relevant to engineered tissues.

Biotechnology↗

Death, dying and emotional labour: problematic dimensions of the bone marrow transplant nursing role?

Bone marrow transplantation (BMT) is an established intervention for a range of conditions including those of a serious, life-threatening nature such as leukaemias. The experience of those who fail to respond to such aggressive treatment, however, or those who die as a result of treatment-induced complications, is currently under-researched. In this paper the authors suggest that despite the relatively high mortality associated with BMT, cultural, biological and professional factors have contributed to a lack of attention on issues of death and dying and emotional labour within BMT care settings. Current technological, biomedical and quality of life discourses which characterize much of the BMT literature are problematic and, we suggest, may serve to disadvantage those who will not survive such procedures. In addition, the provision of effective palliative care in BMT settings remains open to review through further research and development. As a first step, the authors argue that the role of nursing needs to be reconceptualized within BMT to allow key humane concerns such as suffering and the emotional labour of care to be explored and better understood.

Attitude of Health Personnel↗

Bioethics for clinicians: 21. Islamic bioethics.

Islamic bioethics derives from a combination of principles, duties and rights, and, to a certain extent, a call to virtue. In Islam, bioethical decision-making is carried out within a framework of values derived from revelation and tradition. It is intimately linked to the broad ethical teachings of the Qur'an and the tradition of the Prophet Muhammed, and thus to the interpretation of Islamic law. In this way, Islam has the flexibility to respond to new biomedical technologies. Islamic bioethics emphasizes prevention and teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account. Because Islam shares many foundational values with Judaism and Christianity, the informed Canadian physician will find Islamic bioethics quite familiar. Canadian Muslims come from varied backgrounds and have varying degrees of religious observance. Physicians need to recognize this diversity and avoid a stereotypical approach to Muslim patients.

Abortion, Induced↗

Impact of terrorist acts on HIV care: opportunities for program assessment and strategic planning.

HIV/AIDS providers need to take the time now to assess the current and future impact of the recent terrorist acts and biologic events on HIV programs. In addition to the efforts of HIV providers, both the public and private sectors have made an investment of billions of dollars since the start of the epidemic. We cannot afford to lose ground in the fight against HIV/AIDS. It is critically important to sustain and build on the improved outcomes--decreased mortality and fewer hospitalizations--that we have seen during the past 10 years. Access to care, advances in treatment, and biomedical technology have evolved to the point where HIV can be a chronic medical problem for many patients. Now, it is up to us as a medical community to continue this work.

Bioterrorism↗

Environmental factors influencing public health and medicine: policy implications.

Environmental health threats are increasing throughout the United States, particularly in low-income populations and in communities of color. Environmental science researchers are investigating plausible associations between the environment and human health. As a result, the role and responsibility of the primary care physicians and other health care providers are changing. This paper highlights selected lines of evidence suggesting that clinicians should now consider interactions between humans and their environment as central to providing effective primary care. Subject areas include: exposure to environmental agents, reproductive toxicity, pulmonary disease, neurobehavioral toxicity, endocrine disruptors, mechanisms of environmental disease, and cultural competence. Concerns about these and other environmentally related issues influence the manner in which primary care is practiced now, and will be practiced in the future. Biomedical technology and community awareness demand that physicians pay more attention to advances in environmental medicine. Ironically, one of the least taught subjects in medical school is environmental medicine. To effectively respond to growing concerns about the role of the environment in human health, clinicians, researchers, educators, public policy officials, and the general public must join together to reduce the risk of environmental health threats and improve quality of life.

Environmental Exposure↗

[Significance of tissue engineering in clinical practice of regenerative medicine].

It is undoubtedly important for regenerative medicine to discover and use the cells of high proliferation and differentiation potentials. However, there are numerous cases where the tissue regeneration cannot be always achieved only by using the cells. Thus, an environmental site suitable for enabling cells to induce tissue regeneration is highly required for successful tissue regeneration. Tissue engineering is the biomedical technology or methodology indispensable to create this regeneration site while it makes use of the scaffold for cell proliferation and differentiation, the drug delivery system of biological signals, and their combination with cells. This paper describes the present status and research data of tissue engineering to emphasize the considerable significance in regenerative medicine.

Animals↗

Toward a good death: an interpretive investigation of family practice residents' practices with dying patients.

BACKGROUND: Physicians' encounters with dying patients are often problematic. This study was designed to facilitate understanding of what happens when residents encounter dying patients. METHODS: The research involved observing and interviewing 28 family practice residents as they worked with dying patients. The primary research technique was that of a grounded interpretive investigation. RESULTS: We found that working toward a "good death" was a central theme of the residents' everyday actions. At critical points, however, two important forces steered residents away from this central theme: biomedical technology and anxiety. Residents reacted to these forces by distancing, moving back toward a good death, or moving further from a good death. CONCLUSION: Understanding the oscillating course toward a good death will help residents, medical educators, and other physicians deal with dying patients and their families in more meaningful and satisfying ways.

Attitude of Health Personnel↗

The HIPAA Security Rule: implications for biomedical devices.

The HIPAA Security Rule, with which hospitals must become compliant by April 2005, is broad in scope. Some aspect of this rule will affect virtually every function and department within a healthcare organization. The functions and departments that deal with biomedical technologies face special challenges due to the great diversity of technologies, the variety of data maintained and transmitted, and the risks associated with compromises to data security--combined with the presence of older technology and the absence of integrated expertise. It is essential that hospitals recognize this challenge and initiate steps now to implement appropriate information security management.

Computer Security↗

Industry and dermatology research: how well can they work together?

Nursing roles in clinical research are expanding as biomedical technology advances and corporate funding for patient-oriented research increases. Collaboration between nurse investigators and industrial sponsors can lead to the successful application of new knowledge and improved health care if the objectives of both parties are understood and appropriate agreements ensue.

Clinical Trials as Topic↗

Codman Award paper--the experience of intensive care unit nurses providing care to the brain dead patient.

The brain dead patient is a by-product of advances in biomedical technology and the findings of this study confirm the view in the literature that caring for the brain dead patient is an emotionally laden process. This personal distress is directly related to two sources of inconsistencies. First, the nurse may possess coexisting beliefs, perceptions, values, opinions, knowledge and actions which are discrepant. Second, the nurse's personal values, knowledge, and behaviours may be in direct opposition to those of her nursing and medical colleagues and those of the family. The presence of the subjective tension results in the use of distancing tactics and/or the designation of a third person as the target of nursing care in an effort to reduce the personal and interpersonal dissonance.

Adult↗

Geriatric hearing loss: myths, realities, resources for physicians.

The recommended protocol for receiving a hearing aid is: a hearing evaluation to determine candidacy for a hearing aid and/or ALD; an examination by a physician to rule out medical contraindication to hearing aid use; hearing aid selection and fitting by a dispensing audiologist or a hearing aid dealer; hearing aid orientation/counseling. It is well accepted that sensorineural hearing loss is one of the most frequent by-products of the aging process, with prevalence ranging from 30 to 50%. The hearing loss and resulting difficulty understanding speech can have a negative effect on the quality of one's daily activities and, hence, can interfere with the enjoyment of an elderly individual's remaining years. The myths of "hearing loss as an inevitable part of aging" no longer prevail, however. Advances in biomedical technology have enabled the development of smaller hearing aids with wide fitting ranges, making hearing aids a realistic option for the majority of elderly hearing-impaired individuals. To maximize benefit from hearing aids, the elderly must be identified early via routine hearing screening and referred to an audiologist for evaluation and management.

Aged↗

Social, economic, and political forces affecting the future of occupational health nursing.

1. By monitoring the major social, economic, and political forces affecting health care, one can predict how these forces may impact the role of occupational health nurses. 2. Nursing can and must chart its own course in the midst of these social, economic, and political changes. 3. Changes which have major implications for occupational health nurses are: health care needs, cost containment, multi-hospital chains, alternative approaches to health care, the workplace, ethical concerns, biomedical technology, nursing shortage, and oversupply of physicians. 4. Nursing implications can also be drawn in the areas of autonomy, political skills, and education. Active involvement and a desire to shape professional change and the future of nursing are keys.

Delivery of Health Care↗

[Nephrology].

Advances in biomedical technology have contributed effectively to the resolution of basic and clinical problems in Nephrology. Most of our insights on glomerular diseases come from animal models. Antibodies against components of the extracellular matrix have been shown to induce glomerular changes in vivo and the non-collagenous NC1 domain of type IV collagen has been demonstrated to contain the Goodpasture antigen. New pathogenetic mechanisms of glomerular injury are suggested by studies on the interaction of antibodies with glomerular cell surface antigens. Gp330, a glycoprotein expressed at the surface of glomerular visceral epithelial cells, has been recognized to be the most relevant antigen of Heymann nephritis. Antibodies able to crosslink gp330 bind to the antigen at the base of foot processes and the resulting immune complexes are shed into the subepithelial space where they form electron dense deposits. The complement membrane attack complex (C5b-9) is likely to be directly responsible for epithelial cell injury and proteinuria in this model. Other cell surface antigens of the glomerular capillary wall, such as dipeptidyl dipeptidase IV, podocalyxin, podoendin, have been characterized. A novel model of glomerular injury comes from the demonstration that a non-complement fixing monoclonal antibody to a surface sialo-glycoprotein (SGP-115/107) binds to glomerular visceral epithelial cells and causes morphological changes which appear epitope-specific and complement and leukocyte-independent. The mechanisms responsible for the progression of renal disease to glomerular sclerosis have been extensively explored in the last years. Among the hemodynamic factors intraglomerular hypertension has been established to play an important part, at least in some models.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Four immunoassay methods and standards compared for measuring fibronectin.

Several companies have developed commercial kits to measure plasma fibronectin rapidly and inexpensively with readily available laboratory equipment. In two of these kits (Cooper Biomedical and Boehringer-Mannheim) an immunoturbidimetric method is used. In a third kit (Biomedical Technologies, Inc.) an enzyme immunoassay method is used. To evaluate these commercial kits for fibronectin assay, we selected nephelometry as a comparison method for ranking the kits with regard to precision and accuracy. We also compared antibody and fibronectin cross reactivity. The antibodies from various manufacturers appear similar, but the fibronectin standards from different sources showed significant variation. Rate nephelometry and the Boehringer-Mannheim kit had the best within-run precision (CVs of 0.38% and 5.5% respectively). Between-run precision for nephelometry was excellent (CV = 1.9%) and somewhat high for the Boehringer-Mannheim kit (CV = 15.4%). This study demonstrates a need for further standardization of antigen (fibronectin) and antibody in commercial kits and the development of suitable stable quality-control material.

Antibodies↗

Current perspectives on medical imaging.

Advances in biomedical technology have expanded the potential of medical imaging. Selected aspects of developments in sonography, nuclear medicine, nuclear magnetic resonance and digital imaging are addressed, stressing the wide scope permitted by these newer modalities.

Angiography↗

[Surgery and medical ethics (author's transl)].

The article deals with problems caused by the new biomedical technology and its consequences for the surgical profession. The psychological situation of the surgical in-patient is analysed, especially that of the seriously ill and the dying. Medical ethical principles are defined as what we ought to do in a given situation and what should not be done. Many details of our medical philosophy have now to be reconsidered. Life saving procedures are not designed to maintain life at all costs. All these problems, concerning curricula until now neglected, should be paid more attention.

Education, Medical↗