The Public and Care by Non-Physicians: Health Policy Consideration

In an effort to resolve what some define as a crisis in health care, medical paraprofessionals have become an increasing part of the primary care scene. As the training and use of paraprofessionals expands there has been growing insistence that much of what office-based physicians do could be handled as well or better by these non-physicians. If it is health policy to encourage the use of paraprofessionals to alleviate the shortages and maldistribution of primary care doctors, acceptance of these personnel by the public is a critical issue. A study of the public in a Midwest area suggests considerable variability in willingness to accept a trained person other than a doctor to do several tasks usually considered within the domain of the physician. The findings show that the typical demographic and attitudinal variables do little to explain differences in public willingness to accept paraprofessionals. However, the context in which service is delivered is suggested as a possible explanation of acceptance. Several policy relevant issues are discussed, including the need to provide settings for medical care that will maximize public willingness to be treated by non-physicians

Exploring Life and Death at the Cellular Level: An Examination of How Our Cells Can Live Without Us

During the academic year (2012–2013) students and faculty in the Farquhar College of Arts and Sciences focused on the annual theme of “Life and Death.” To this end, we have been focusing all aspects of academic growth around this theme. It has guided our coursework, study groups, invited lecture series, Faculty Lecture Series, and even our Commencement speaker’s address (Farquhar College of Arts and Sciences, 2013). In this paper the idea of life and death will be examined from a cellular and molecular level, and the idea of what happens to our biological pieces (cells, proteins, tissues, etc.) once they are separated from our bodies will be explored. This idea has become increasingly more intriguing as humanity has discovered ways of keeping these biological parts viable and useful while outside of the original body from which they were derived (Lodish et al., 2012). When thinking about how to approach the annual theme from a biological point of view, I began asking students and community members, “Do you really think that a person’s cells can live outside the body?” Most had not given the idea much thought and were astonished to learn that the answer was a resounding, “Yes!” Although it is not that likely, even your own cells could be living in a culture dish somewhere right now without your knowledge! (Eiseman and Haga, 1999). This paper explores the history of cell culture, including cell strains and lines, their purpose in basic research and medical advances, and some of the legal and ethical underpinnings surrounding their development and use

Exploring Identity Through Genetic and Genealogical Research: Development of a Collaborative Course Between Humanities and Biology

In this paper, data from student projects completed in their HONR 1000N: Genetics and Genealogy course, taught during winter 2010, are presented. Students traced their deep ancestry through mitochondrial and Y-chromosome DNA analysis, as well as more recent ancestry, using genealogical databases and family histories. Frequently, students were challenged or pleasantly surprised by the information they gleaned. Genetic and genealogical research can provide clues to one’s identity and ethnic background, as well as potential medical conditions

Two distinct forms of Chlamydia psittaci associated with disease and infertility in Phascolarctos cinereus (Koala)

While several diseases associated with Chlamydia psittaci infection have been reported in Phascolarctos cinereus (koala), it is still unclear whether one or more chlamydial strains are responsible. In this study, we provide evidence, obtained by restriction enzyme and gene probe analysis, that two quite distinct strains of C. psittaci infect koalas; one strain was isolated from the conjunctivae, and the other was isolated from the urogenital tract and the rectum. A gene probe, pFEN207, containing the coding sequence for an enzyme involved in the biosynthesis of the chlamydial genus-specific lipopolysaccharide antigen, and a separate probe, pCPML-4N, prepared from a DNA fragment of a koala-infecting strain of C. psittaci, were used to determine the patterns of hybridization in the koala-infecting strains; these patterns were found to be quite distinct from those observed with C. psittaci isolates from other animals. We also demonstrated by hybridization analysis with an avian strain plasmid that all three koala urogenital isolates contain a plasmid and that there is no evidence for the presence of a homologous plasmid in any of the ocular isolates

Topoisomerase activity assays in Neurospora

DNA topoisomerases are enzymes capable of altering the topological conformation of DNA by inducing transient single (Topoisomerase I) and double strand (Topoisomerase II) breaks

A response-adaptive randomization procedure for multi-armed clinical trials with normally distributed outcomes.

We propose a novel response-adaptive randomization procedure for multi-armed trials with continuous outcomes that are assumed to be normally distributed. Our proposed rule is non-myopic, and oriented toward a patient benefit objective, yet maintains computational feasibility. We derive our response-adaptive algorithm based on the Gittins index for the multi-armed bandit problem, as a modification of the method first introduced in Villar et al. (Biometrics, 71, pp. 969-978). The resulting procedure can be implemented under the assumption of both known or unknown variance. We illustrate the proposed procedure by simulations in the context of phase II cancer trials. Our results show that, in a multi-armed setting, there are efficiency and patient benefit gains of using a response-adaptive allocation procedure with a continuous endpoint instead of a binary one. These gains persist even if an anticipated low rate of missing data due to deaths, dropouts, or complete responses is imputed online through a procedure first introduced in this paper. Additionally, we discuss how there are response-adaptive designs that outperform the traditional equal randomized design both in terms of efficiency and patient benefit measures in the multi-armed trial context