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Artificial Liver For Drug Tests
If you have hay fever, headaches or a cold, it"s only a short way to the nearest chemist. The drugs, on the other hand, can take eight to ten years to develop. Until now animal experiments have been an essential step, yet they continue to raise ethical issues. "Our artificial organ systems are aimed at offering an alternative to animal experiments," says Professor Heike Mertsching of the Fraunhofer Institute for Interfacial Engineering and Biotechnology IGB in Stuttgart. "Particularly as humans and animals have different metabolisms. 30 per cent of all side effects come to light in clinical trials." The test system, which Professor Mertsching has developed jointly with Dr. Johanna Schanz, should in future give pharmaceutical companies greater security and shorten the path to new drugs. Both researchers received the "Human-centered Technology" prize for their work.
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Minister Brady Launches The "Directory Of Services For Older People In The Stoneybatter" Area, Ireland
Aine Brady, T.D., Minister for Older People, officially launched the "Directory of Services for Older People in the Stoneybatter Area".
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ACOG Issues New Guidelines On Fetal Monitoring To Resolve Inconsistencies In Interpretation
The American College of Obstetrics and Gynecology recently published new guidelines on electronic fetal monitoring in an attempt to increase consistency in the way physicians interpret and act on the results, the New York Times reports. Electronic fetal monitoring, which was introduced in the 1970s, is used during labor for more than 85% of the four million infants born alive in the U.S. annually, the Times reports. According to the Times, use of fetal monitors became standard obstetrical practice before it was known if the benefits outweighed the risks. The new guidelines refine the meaning of various readings from fetal monitors and could help doctors make better decisions about whether to intervene during labor.According to experts, the widespread adoption of fetal monitoring has produced both negative and positive consequences, including significant increases in caesarean deliveries and the use of forceps during vaginal deliveries. Monitoring has not been found to reduce the risk of either cerebral palsy or fetal death resulting from inadequate oxygen to the fetal brain, as it was intended to do. Furthermore, lawyers commonly use monitoring results to support malpractice cases that might have little merit, which in turn has driven rising malpractice insurance costs and prompted some obstetricians to stop delivering infants.The new guidelines divide monitor readings into three categories to help doctors interpret readings more consistently. The old guidelines had two categories -- reassuring and non-reassuring -- and it was up to the obstetrician to determine whether a non-reassuring reading required intervention. Under the new guidelines, the first category applies when tracings of the fetal heart rate are normal and no specific action is required. The second category is for indeterminate tracings that require evaluation, continuous surveillance and re-evaluation. Obstetricians treating patients in this category should consider other clinical factors that could affect the fetus and whether the patient could be safely moved to category one, according to Catherine Spong of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which produced recommendations on which the guidelines are based. The final category is for abnormal tracings that require immediate evaluation and efforts to reverse the abnormal heart rate. The Times reports that more refinements to the guidelines are expected to be released in 2010 (Brody, New York Times, 7/7).
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Doctor Knows Best - Royal College Of Obstetricians And Gynaecologists

In a commentary published in BJOG: An International Journal of Obstetrics and Gynaecology, doctors discuss the types of information pregnant women would welcome and why the advice provided to women by doctors is considered trustworthy. Although NICE maternity care guidelines state that women should "be offered information based on the current available evidence together with support to enable them to make informed decisions about their care", there is little guidance on the best ways to provide such information. Research suggests women want information and involvement in decision-making. When appropriately provided by credible s, women"s experiences of childbirth have been shown to improve. However, the proliferation of online information has meant that women are now overwhelmed by information. In some cases, advice is inaccurate and dubious. Consultant obstetrician Andrew Weeks and Specialist Registrar Linda Watkins, both at the Liverpool Women"s Hospital, refer to two studies published in the same edition of BJOG which demonstrate how good quality and structured information can reduce feelings of uncertainty in women. More importantly, women showed they were willing to rely on clinicians to make the most appropriate decisions for them, in recognition of the expertise of doctors. Provided care was tailored to their individual needs, and it was a collaborative effort between doctor and patient, women are appreciative of the advice received from senior clinicians. True informed consent can only be given if women are aware and comprehend the risks and benefits they face before choosing a particular mode of treatment. The authors suggest that in providing information to this very specific group of patients, some broad principles are needed: - Information should include detailed information about risks in mid-late pregnancy. Information increases knowledge and reduces uncertainty. - Systematic data provision is beneficial to women. These could take the form of step-by-step aids to help in the decision-making process. Dr Watkins said, "When it comes to the crunch, most women just want a good outcome for themselves and their babies. And they will usually accept the advice of the professionals who have the training and experience to make the right decision. Furthermore, many do not want the responsibility of making a life or death clinical decision regarding their baby. "As a doctor, a large part of the job is about taking responsibility. That is not to say we should not help and support patients to make important decisions about healthcare but I think at the end of the day that is what we are paid to do. And the women in these surveys seemed to agree. As Kingdon states in her paper "whilst women want to be informed and involved in the decision-making process surrounding birth method, it does not necessarily follow that they want the final say"." Michael Marsh, a consultant obstetrician and gynaecologist and BJOG deputy editor-in-chief said "Pregnant women wish and need to make decisions about childbirth based on impartial information from reliable s, whether this is an information leaflet, a computerised decision aid or a knowledgeable clinician. "Information aids may help to ensure consistent facts are given, but it seems clear that the degree to which women like to have guidance from midwives and obstetricians about "what is best" varies greatly. Information aids should enhance the factual quality of advice, but will not replace informed discussion between the woman and her midwife or obstetrician." References Watkins L, Weeks A. Providing information to pregnant women: how, what and where? BJOG 2009;116:1-3. The two papers referenced by the authors are: Frost J, Shaw A, Montgomery A, Murphy D. Women"s views on the use of decision aids for decision making about the method of delivery following a previous caesarean section: qualitative interview study. BJOG 2009; 116: 1-10. Kingdon C, Neilson J, Singleton V, Gyte G, Hart A, Gabbay M, Lavender T. Choice and birth method: mixed-method study of caesarean delivery for maternal request. BJOG 2009;116:1-10. Royal College of Obstetricians and Gynaecologists


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