Exercising Agency in Medical Decision-Making Processes Conventional and Traditional Medicine -A Case Study of 67ha, Antananarivo-

The formal integration of traditional and conventional medicine has been touted as a prime method to improve access to quality healthcare in Madagascar. This study draws on interviews with both traditional and conventional medical professionals as well as 100 residents of 67ha, Antananarivo to critically analyze the advantages of each sector in order to understand how integration can be used to strengthen the medical-decision making capacities of marginalized populations. Currently the ability for millions of Malagasy to exercise their freedom of choice in seeking their treatment method of choice is seriously compromised not only by cost and accessibility but by widespread mistrust and misinformation surrounding conventional medicine, caused in large part by the corrupt actions of healthcare professionals, particularly in the public sector where individuals lacking in financial resources are most likely to seek treatment. On the other hand, traditional medicine empowers marginalized populations to take control of their own health with readily accessible resources that can be used with knowledge passed down from their ancestors. Further investment in the regulation and research of traditional medicine is necessary in order to validate traditional medicine in the eyes of conventional healthcare providers, both in Madagascar and abroad. Such efforts need to be implemented in a responsible manner that ensures the conservation of national medicinal plant resources for generations to come

Exercising Agency in Medical Decision-Making Processes: A Case of 67ha, Antananarivo

From the Washington University Senior Honors Thesis Abstracts (WUSHTA), 2017. Published by the Office of Undergraduate Research. Joy Zalis Kiefer, Director of Undergraduate Research and Associate Dean in the College of Arts & Sciences; Lindsey Paunovich, Editor; Helen Human, Programs Manager and Assistant Dean in the College of Arts and Sciences Mentor: Carolyn Sargen

Lack of effect of bone marrow transplantation on airway hyperresponsiveness in an asthmatic

ABSTRACTBronchial asthma has been recognized as an inflammatory disorder in this past decade. This leads to an assumption that perfect control of inflammatory cells may cure this disease. However, herein we report on an asthmatic whose airway hyperresponsiveness (AHR) did not change after bone marrow transplantation (BMT). The concentrations of acetylcholine to produce a 20% fall in forced expiratory volume in 1 s 15 days before and 98 days after BMT were 900 and 480 μg/mL, respectively. Asthma treatment with beclo-methasone dipropionate and theophylline was continued before and after BMT and a conventional supporting therapy for BMT with cyclosporine A and methylprednisolone, followed by oral administration of tacrolimus hydrate alone inhibited graft-versus-host disease. Plasma interleukin (IL)-4, IL-5 and IgE, but not interferon-γ, levels decreased after BMT. Note that the second measurement of airway sensitivity was performed under systemic administration of tacrolimus. The presented case suggests that replacement of bone marrow-derived inflammatory cells is not enough to reverse once-established AHR. Hence, AHR and airway inflammation may develop independently in some part, but both need to be present for asthma to be present in this asthmatic

Brown adipose expansion and remission of glycemic dysfunction in obese SM/J mice

We leverage the SM/J mouse to understand glycemic control in obesity. High-fat-fed SM/J mice initially develop poor glucose homeostasis relative to controls. Strikingly, their glycemic dysfunction resolves by 30 weeks of age despite persistent obesity. The mice dramatically expand their brown adipose depots as they resolve glycemic dysfunction. This occurs naturally and spontaneously on a high-fat diet, with no temperature or genetic manipulation. Removal of the brown adipose depot impairs insulin sensitivity, indicating that the expanded tissue is functioning as an insulin-stimulated glucose sink. We describe morphological, physiological, and transcriptomic changes that occur during the brown adipose expansion and remission of glycemic dysfunction, and focus on Sfrp1 (secreted frizzled-related protein 1) as a compelling candidate that may underlie this phenomenon. Understanding how the expanded brown adipose contributes to glycemic control in SM/J mice will open the door for innovative therapies aimed at improving metabolic complications in obesity

A Portable Luminometer with a Disposable Electrochemiluminescent Biosensor for Lactate Determination

A hand-held luminometer for measuring electrochemiluminescence (ECL) for lactate determination and based on one-shot biosensors fabricated using screen-printed electrodes is described. The lactate recognition system is based on lactate oxidase and the transduction system consists of electro-oxidation of luminol, with all the reagents immobilized in a Methocel membrane. The membrane composition and reaction conditions have been optimized to obtain adequate sensitivity. The luminometer is based on a large silicon photodiode as detector and includes a programmable potentiostat to initialize the chemical reaction and signal processing circuitry, designed to acquire a low level photocurrent with offset cancelation, low pass filtering for noise attenuation and adjustable gain up to 1012 V/A. The one-shot biosensor responds to lactate rapidly, with an acquisition time of 2.5 min, obtaining a linear dependence from 8 × 10−6 to 2 × 10−4 M, a detection limit of 2.4 × 10−6 M and a sensor-to-sensor reproducibility (relative standard deviation, RSD) of around 7–10 % at the medium level of the range

Fluctuating asymmetry, a marker of poor growth quality, is associated with adult male metabolic rate

ObjectivesLife history theory, a branch of evolutionary theory, predicts the existence of trade‐offs in energetic allocation between competing physiological functions. The core metabolic cost of self‐maintenance, measured by resting metabolic rate (RMR), represents a large component of human daily energy expenditure. Despite strong selective pressures for energetic frugality and high observed interindividual variation in RMR, the link between RMR and energetic allocation to life‐history traits remains understudied in humans.MaterialsIn a sample of 105 (m = 57, f = 48), we investigated the relationship between adult RMR and investment in growth quality, as measured by fluctuating asymmetry (FA).ResultsMeasurement of RMR and FA in university rowers revealed a significant positive correlation amongst males (n = 57, r = 0.344, p = 0.005, 1‐tailed; standardized 95% CI, 0.090 to 0.598). Convincing evidence for a correlation among females was not found (n = 48, r = 0.142, p = 0.169, 1‐tailed, standardized 95% CI, −0.152 to 0.435).DiscussionThe data suggest that low‐quality asymmetrical growth is associated with later‐life metabolic inefficiencies in males. Energetic investment in processes (likely concerning the stress‐response) unrelated to growth during childhood may thereby trade‐off against adult metabolic efficiency. We suggest that the presence of a relationship between RMR and FA in males but not females may be explained by the additional metabolic strain associated with larger body size and increased male muscularity, which may amplify the inefficiencies arising from low‐quality growth.</div