Direct-to-consumer genetic testing: where and how does genetic counseling fit?

Direct-to-consumer genetic testing for disease ranges from well-validated diagnostic and predictive tests to ‘research’ results conferring increased risks. While being targeted at public curious about their health, they are also marketed for use in reproductive decision-making or management of disease. By virtue of being ‘direct-to-consumer’ much of this testing bypasses traditional healthcare systems. We argue that direct-to-consumer genetic testing companies should make genetic counseling available, pre- as well as post-test. While we do not advocate that mandatory genetic counseling should gate-keep access to direct-to-consumer genetic testing, if the testing process has the potential to cause psychological distress, then companies have a responsibility to provide support and should not rely on traditional healthcare systems to pick up the pieces

The Parthenon Marbles Case and the Universal Museum Myth: Policies and Politics

This symposium will bring together scholars and advocates to discuss the history of cultural property, its rightful owners, and whether the property should be returned to its original creating country. Professor David Rudenstine will present his decades-long historical research challenging the British Museum’s claim in the cultural property dispute between Greece and Great Britain over the Parthenon Sculptures taken to London in the early 1800s by the British ambassador, Lord Elgin.https://larc.cardozo.yu.edu/flyers-2021-2022/1045/thumbnail.jp

The use of point-of-care ultrasound in Tshwane public and private sector emergency units

Background: The use of point-of-care ultrasound (POCUS) is an essential skill in the practice of emergency medicine (EM), with benefit to patient care by improving diagnostic accuracy. Despite this, there exists little data evaluating the use of POCUS in South African emergency units (EUs.). Methods: One hundred and seventeen doctors working in 12 public and private sector EUs in Tshwane were included. A questionnaire was used comprising of descriptive data regarding doctor demographics, levels of experience, and outcome data including POCUS frequency use, training level, indications for, and barriers to its use. Results: Many participants were general practitioners working in EUs (58.1%) followed by EM specialists and EM registrars. Of these participants, 88% used POCUS. Seventy one percent received informal POCUS training only. The indications for POCUS use were similar for both public and private sector, with no significant differences in overall use. The only significant association to POCUS use was age ( 33.3 years) and number of years since qualification ( 6.9 years.) Lack of and/or access to training were the main reasons for not using POCUS (18.8%.) There were no significant differences in the barriers to the use of POCUS between the sectors. Conclusion: Point-of-care ultrasound is used similarly in both public and private sector EUs in Tshwane. Lack of and/or access to POCUS training are the main barrier to its use. Contribution: This study underlines the state of POCUS use in Tshwane and highlights the barriers to its use, thus allowing academic heads and hospital managers to address them

Standard epidemiological methods to understand and improve Apis mellifera health

In this paper, we describe the use of epidemiological methods to understand and reduce honey bee morbidity and mortality. Essential terms are presented and defined and we also give examples for their use. Defining such terms as disease, population, sensitivity, and specificity, provides a framework for epidemiological comparisons. The term population, in particular, is quite complex for an organism like the honey bee because one can view “epidemiological unit” as individual bees, colonies, apiaries, or operations. The population of interest must, therefore, be clearly defined. Equations and explanations of how to calculate measures of disease rates in a population are provided. There are two types of study design; observational and experimental. The advantages and limitations of both are discussed. Approaches to calculate and interpret results are detailed. Methods for calculating epidemiological measures such as detection of rare events, associating exposure and disease (Odds Ratio and Relative Risk), and comparing prevalence and incidence are discussed. Naturally, for beekeepers, the adoption of any management system must have economic advantage. We present a means to determine the cost and benefit of the treatment in order determine its net benefit. Lastly, this paper presents a discussion of the use of Hill’s criteria for inferring causal relationships. This framework for judging cause-effect relationships supports a repeatable and quantitative evaluation process at the population or landscape level. Hill’s criteria disaggregate the different kinds of evidence, allowing the scientist to consider each type of evidence individually and objectively, using a quantitative scoring method for drawing conclusions. It is hoped that the epidemiological approach will be more broadly used to study and negate honey bee disease.The COST Action FA0803http://www.ibra.org.uk/am201

The Global Fund to Fight AIDS, Tuberculosis and Malaria's investments in harm reduction through the rounds-based funding model (2002-2014)

Background: Harm reduction is an evidence-based, effective response to HIV transmission and other harms faced by people who inject drugs, and is explicitly supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In spite of this, people who inject drugs continue to have poor and inequitable access to these services and face widespread stigma and discrimination. In 2013, the Global Fund launched a new funding model-signalling the end of the previous rounds-based model that had operated since its founding in 2002. This study updates previous analyses to assess Global Fund investments in harm reduction interventions for the duration of the rounds-based model, from 2002 to 2014. Methods: Global Fund HIV and TB/HIV grant documents from 2002 to 2014 were reviewed to identify grants that contained activities for people who inject drugs. Data were collected from detailed grant budgets, and relevant budget lines were recorded and analysed to determine the resources allocated to different interventions that were specifically targeted at people who inject drugs. Results: 151 grants for 58 countries, plus one regional proposal, contained activities targeting people who inject drugs-for a total investment of US 620. million. Two-thirds of this budgeted amount was for interventions in th

Chapter 11 Families and physical health

This chapter focuses on the physical health of families. The components of physical health discussed in this chapter include diet and nutrition, physical activity, sleep patterns, medical self-care, smoking as well as alcohol and drugs. Family members’ health behaviors (e.g., smoking, alcohol consumption, eating, exercise, and sleep) show more similarity than would be expected by chance. An individuals’ quality of life (QoL) is closely related to the QoL of those around them, be it their spouse, children, or parents. As a result, any kind of chronic sickness present within the family has the potential to affect the lives of the other members. Health problems in any family member were associated with a high incidence of mental health issues in other family members. Involvement of families can be effective in health promotion programs

Design and implementation of a generalized laboratory data model

<p>Abstract</p> <p>Background</p> <p>Investigators in the biological sciences continue to exploit laboratory automation methods and have dramatically increased the rates at which they can generate data. In many environments, the methods themselves also evolve in a rapid and fluid manner. These observations point to the importance of robust information management systems in the modern laboratory. Designing and implementing such systems is non-trivial and it appears that in many cases a database project ultimately proves unserviceable.</p> <p>Results</p> <p>We describe a general modeling framework for laboratory data and its implementation as an information management system. The model utilizes several abstraction techniques, focusing especially on the concepts of inheritance and meta-data. Traditional approaches commingle event-oriented data with regular entity data in <it>ad hoc </it>ways. Instead, we define distinct regular entity and event schemas, but fully integrate these via a standardized interface. The design allows straightforward definition of a "processing pipeline" as a sequence of events, obviating the need for separate workflow management systems. A layer above the event-oriented schema integrates events into a workflow by defining "processing directives", which act as automated project managers of items in the system. Directives can be added or modified in an almost trivial fashion, i.e., without the need for schema modification or re-certification of applications. Association between regular entities and events is managed via simple "many-to-many" relationships. We describe the programming interface, as well as techniques for handling input/output, process control, and state transitions.</p> <p>Conclusion</p> <p>The implementation described here has served as the Washington University Genome Sequencing Center's primary information system for several years. It handles all transactions underlying a throughput rate of about 9 million sequencing reactions of various kinds per month and has handily weathered a number of major pipeline reconfigurations. The basic data model can be readily adapted to other high-volume processing environments.</p

Review of childcare educators’ practices

Abstract: The role of childcare educators is important given that 81% of preschoolers living in developed countries receive childcare outside their home. Since children learn by observing and imitating others, childcare educators may play a role in promoting healthy eating behaviours and physical activity in young children. Six databases were searched for quantitative peer-reviewed, English or French primary studies reporting the correlates, predictors or effectiveness of childcare educators’ practices and behaviours on preschoolers’ healthy eating and physical activity behaviours. Risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. Fifteen articles were included in this review: ten measured physical activity levels and five assessed eating behaviours. The quality score was rated as low for eight of these articles, and as moderate for the remaining seven. Two of four cross-sectional studies reported a positive relationship between educators and children’s behaviours. Eleven intervention studies reported significant favourable effects of interventions. Educators may play a positive role in promoting healthy behaviours in children, but this is mainly based on few intervention type studies of low or moderate quality. The influence of specific components of educators’ practices and behaviours on children’s healthy eating and physical activity behaviours remains inconclusive