The bridging of pluralistic visions of science and ethics for bioethics - Tibetan medicine as compared with the Western research on longevity and human genetic enhancement

La thèse examine les liens entre la vision pluraliste de la science et l’éthique de la médecine tibétaine et les nouvelles pratiques en médecine occidentale, soit la longévité et la recherche sur la génétique amélioratrice. Elle cherche à cerner l’apport que la médecine tibétaine peut apporter aux recherches occidentales sur la longévité et la génétique humaine amélioratrice. Elle traite donc d’un enjeu social clé et du débat qui s’y rattache. La découverte et la description sont centrales à la méthodologie et informent l’analyse. Nous avons examiné dans un premier temps, les travaux de recherche sur la longévité reliée à la génétique amélioratrice (mémoire et muscles). Nous nous sommes penchés également sur les fondements de la médecine tibétaine en tant que système intégré. Pour ce faire, nous avons traité des notions telles que la santé, l’identité, la perfection et l’immortalité. Notre cadre conceptuel repose sur la théorie bouddhiste de l’interdépendance qui se caractérise par la formulation de catégories qui ensuite sont synthétisées dans l’essence; les deux niveaux d’interprétation de la théorie sont décrits en détail avant de passer à une comparaison avec la notion de complexité occidentale. La médecine tibétaine de fait présente un système où l’éthique et la science sont intégrées et se prête bien à une comparaison avec la vision pluraliste de la science à partir d’une perspective éthique/bioéthique. Les commentaires recueillis auprès des experts nous ont permis de cerner comment la science, l’éthique et l’amélioration de la longévité sont définies au sein des deux paradigmes de l’Est et de l’Ouest. Nos résultats montrent six points qui se dégagent au terme de cette recherche permettent de jeter un pont sur la vision pluraliste de ces paradigmes. Ceux-ci transcendent les points de vue doctrinaux individuels de religions ainsi que du monde scientifique occidental. Plus que tout, ils laissent entrevoir un cadre de références novatrices qui contribuera à la prise de décision à l’égard de questionnements bioéthiques.

Graphic medicine from library to classroom

Introduction. Graphic medicine is defined as the use of comics in health sciences education and patient care. Graphic stories about personal experiences of illness from patients and their families can be used to illustrate distress, empathy and collaboration between family members and health professionals and thus give students a broader experience of disease. We present a collection of graphic novels and outline collaboration with professors from various faculties in order to use comics as teaching material in health sciences. Method. The university has health sciences faculties of Nursing, Medicine, Pharmacy, Dentistry, Veterinary Medicine and schools of Public Health, Optometry and Kinesiology. The Health Library is offering its patrons a collection of 40 comics mainly on the theme of patient and family illness experience. An ongoing survey gathers feedback from users; results will help us promote the collection. A librarian is working with professors from the facultiesof Nursing, Medicine and Pharmacy in order to integrate comics’ excerpts into e-learning modules for three health and social services interprofessional courses reaching more than 1000 students annually. Other courses teaching empathy and partnership with patients will be identified and professors will be approached to raise awareness of the collection’s potential as teaching material. Results. The collection has been available to patrons since October 2012. Survey responses collected so far are very positive and titles are regularly borrowed. The collection has been added as suggested reading in a physiotherapy course outline. Discussion. The comics’ collection is already widely used by our patrons. Steps are being taken to integrate the collection into more health sciences courses and thus define graphic medicine as teaching material in health sciences education at the university.

Could Staying Human in Medical Training Help Make Medicine Humane? Review of Allan D. Peterkin, Staying Human During Residency Training

Compte-rendu / Review

2D, 3D and 4D active compound delivery in tissue engineering and regenerative medicine

Recent advances in tissue engineering and regenerative medicine have shown that controlling cells microenvironment during growth is a key element to the development of successful therapeutic system. To achieve such control, researchers have first proposed the use of polymeric scaffolds that were able to support cellular growth and, to a certain extent, favor cell organization and tissue structure. With nowadays availability of a large pool of stem cell lines, such approach has appeared to be rather limited since it does not offer the fine control of the cell micro-environment in space and time (4D). Therefore, researchers are currently focusing their efforts on developing strategies that include active compound delivery systems in order to add a fourth dimension to the design of 3D scaffolds. This review will focus on recent concepts and applications of 2D and 3D techniques that have been used to control the load and release of active compounds used to promote cell differentiation and proliferation in or out of a scaffold. We will first present recent advances in the design of 2D polymeric scaffolds and the different techniques that have been used to deposit molecular cues and cells in a controlled fashion. We will continue presenting the recent advances made in the design of 3D scaffolds based on hydrogels as well as polymeric fibers and we will finish by presenting some of the research avenues that are still to be explored.

A FRAMEWORK FOR ACHIEVING LIFECYCLE VALUE IN AEROSPACE PRODUCT DEVELOPMENT

Creation of lifecycle value - a balance of performance with cost and other attributes - represents a challenge for the development of aerospace products in the twenty-first century. This paper examines the concept of lifecycle value that stems from existing approaches of value management and analysis, lifecycle costing, and systems engineering. To ascertain common characteristics of lifecycle value creation, case studies were done for four aircraft programs: F/A- 18E/F, JAS 39 Gripen, F-16C/D, and B-777. A lifecycle value creation framework is introduced, comprised of three phases: value identification, value proposition, value delivery. Based upon observed practices in the four case studies, six value creation attributes were identified. Capability maturity models for the six attributes and three value creation phases are presented. The resulting framework represents a starting point for programs seeking to create lifecycle value for aerospace products.

A HOLISTIC APPROACH TO MANUFACTURING SYSTEM DESIGN IN THE DEFENSE AEROSPACE INDUSTRY

Manufacturing has evolved to become a critical element of the competitive skill set of defense aerospace firms. Given the changes in the acquisition environment and culture; traditional “thrown over the wall” means of developing and manufacturing products are insufficient. Also, manufacturing systems are complex systems that need to be carefully designed in a holistic manner and there are shortcomings with available tools and methods to assist in the design of these systems. This paper outlines the generation and validation of a framework to guide this manufacturing system design process.

A Proposal for Enterprise Value Phase of the Lean Aerospace Initiative

The Massachusetts Institute of Technology (MIT) submits this proposal for the Enterprise Value Phase of the Lean Aerospace Initiative (LAI) in response to the October 9, 2002 Request for Proposal (RFP) F33615-02-2-5501 from the Air Force Research Laboratory (AFRL/MLKT), Wright-Patterson Air Force Base, Ohio. This proposal addresses the conduct of the LAI as set forth in the Enterprise Value Phase Concept of Operations (final draft dated 5 June 2002. The creation of this Enterprise Value Phase Concept of Operations (ConOps) was the result of extensive interaction among all stakeholders in the LAI consortium. The proposed products and research topics have been developed by the MIT LAI team based on this extended interaction with the Lean Aerospace Initiative consortium members during the concept of operations development. This proposal is in consonance with the Enterprise Value Phase vision, and mission as set forth in the concept of operations so as to meet stakeholder needs to achieve the goals and deliverables desired, prioritized to fit available funding.

An Assessment of the Degree of Implementation of the Lean Aerospace Initiative Principles and Practices within the US Aerospace and Defense Industry

This report is a formal documentation of the results of an assessment of the degree to which Lean Principles and Practices have been implemented in the US Aerospace and Defense Industry. An Industry Association team prepared it for the DCMA-DCAAIndustry Association “Crosstalk” Coalition in response to a “Crosstalk” meeting action request to the industry associations. The motivation of this request was provided by the many potential benefits to system product quality, affordability and industry responsiveness, which a high degree of industry Lean implementation can produce.