Abandoning clinical trial safeguards won\u27t boost local industry

CLINICAL TRIALS - Human clinical trials are an important last hurdle in the development of new drugs and therapies. Today, The Conversation takes a closer look at this vital scientific endeavour with three articles that look at different aspects of the process

Medicine and the Task of Healing

To understand the traditional description of medicine as a practice of healing, it is necessary to examine its relationships with both science and ethics. The “scientific” component of medicine includes an acknowledgment of the influence of social, cultural and environmental factors on the functioning of the organism. The “ethical” component is often presented as merely supplementary but actually provides the conditions of possibility of knowledge. “Healing” then appears as what joins the two together: the site where science is applied in the service of ethics and where ethics encounters science. This perspective allows us to reconsider medicine as a project to healing complex wounds that manifest themselves at the physical, psychological, emotional and cultural leve

The lived experiences of families and individuals affected by haemophilia in relation to the availability of genetic testing services

Ill health may be related to a combination of genetic and environmental factors. Haemophilia, a rare congenital bleeding disorder, predominantly affects males and females may be identified as carriers. Genetic testing is available for individuals and family members who are interested to know their predisposition to the condition Thirty-nine members of a cohesive haemophilia community in Victoria, Australia, were interviewed about their attitudes towards genetic testing. The transcripts were analysed using thematic and narrative analysis techniques. The themes reflected the meanings people attached both to the disease itself and to the use of genetic testing to detect it. Narrative analysis was then employed to investigate these patterns of meaning further. We identified three typical narratives models within this haemophilia community: those of a male with haemophilia, of a female carrier and of a female non-obligate carrier (female without a familial predisposition to haemophilia). Close examination revealed a distinct pattern where aspects of the narratives tended to ʻclusterʼ according to thematic categories. While people in the haemophilia community are broadly in favour of genetic testing and genetic counselling, males with haemophilia have concerns that arise in relation to biological data banks, female carriers are cautious about antenatal testing and support greater communication of risk within families, and female non-obligate carriers are specially concerned about the safety of obstetric practices. The pattern of responses we have identified indicates that, despite the proliferation of issues and themes across the narratives, the number of possible personal narratives in which they are embedded is in fact quite limited. In this sense narrative analysis offers a supplementary dimension to thematic analysis in the elucidation of qualitative data

A qualitative investigation of obese men\u27s experiences with their weight

Objectives: To investigate obese men\u27s health behaviors and strategies for change. Methods: Qualitative interviews with 36 men (BMI 30 and over). Results: All men felt personally responsible for their weight gain. Sedentary lifestyles, stress, lack of worklife balance and weight-based stigma were all significant causes of weight gain and barriers to weight loss. These factors also contributed to men\u27s unwillingness to seek help for their overweight. Conclusion: Addressing the self-blame and stigma associated with obesity is important in developing strategies to improve the health and well-being of obese men

'It's communication between people who are going through the same thing': experiences of informal interactions in hospital cancer treatment settings

PURPOSE: In hospital settings, patients, visitors, and staff engage in many interactions outside formal clinical encounters. Whilst many of these may be inconsequential, others contribute significantly to how patients and their carers experience cancer and its treatment. This article aims to explore the experiences and significance of interactions that occur outside formal clinical encounters in hospital cancer treatment settings. METHODS: Semi-structured interviews were conducted with cancer patients, carers, and staff recruited from two hospital sites and cancer support groups. Hermeneutic phenomenology informed lines of questioning and data analysis. RESULTS: Thirty-one people participated in the study: 18 cancer patients, four carers, and nine staff members. The experiences of informal interactions were grouped into three themes: connecting, making sense, and enacting care. The participants described how these encounters allowed connection with others in the hospital spaces, facilitating a sense of belonging, normality, and self-worth. Through these interactions, individuals participated in making sense of their experiences, to better anticipate the decisions and challenges that might lie ahead. By connecting with other individuals, they cared for others and felt cared for themselves, and were able to learn from, teach, and support each other. CONCLUSIONS: Outside the confines of the clinical discourses participants negotiate terms of engagement, sharing of information, expertise, and their own personal stories that they may employ to contribute to the individuals around them. These interactions occur within a loose and evolving framework of social interactions, an 'informal community', in which cancer patients, carers, and staff members play active and meaningful roles

A Chinese Herbal Preparation Containing Radix Salviae Miltiorrhizae, Radix Notoginseng and Borneolum Syntheticum Reduces Circulating Adhesion Molecules

Circulating adhesion molecules (CAMs), surface proteins expressed in the vascular endothelium, have emerged as risk factors for cardiovascular disease (CVD). CAMs are involved in intercellular communication that are believed to play a role in atherosclerosis. A Chinese medicine, the “Dantonic Pill” (DP) (also known as the “Cardiotonic Pill”), containing three Chinese herbal material medica, Radix Salviae Miltiorrhizae, Radix Notoginseng and Borneolum Syntheticum, has been used in China for the prevention and management of CVD. Previous laboratory and animal studies have suggested that this preparation reduces both atherogenesis and adhesion molecule expression. A parallel double blind randomized placebo-controlled study was conducted to assess the effects of the DP on three species of CAM (intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 and endothelial cell selectin (E-selectin)) in participants with mild-moderate hypercholesterolemia. Secondary endpoints included biochemical and hematological variables and clinical effects. Forty participants were randomized to either treatment or control for 12 weeks. Treatment with DP was associated with a statistically significant decrease in ICAM-1 (9% decrease, P = .03) and E-Selectin (15% decrease, P = .004). There was no significant change in renal function tests, liver function tests, glucose, lipids or C-reactive protein levels and clinical adverse effects did not differ between the active and the control groups. There were no relevant changes in participants receiving placebo. These results suggest that this herbal medicine may contribute to the development of a novel approach to cardiovascular risk reduction