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Chapter 1

HSS 3332 Chapter Notes - Chapter 1: Human Genome Project, Coronary Artery Disease, Angioplasty


Department
Health Sciences
Course Code
HSS 3332
Professor
Sarah Fraser
Chapter
1

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Reading 1
Technology and Health Reading 1: Webster Ch. 1 and 2
Chapter One:
Understanding Innovative Health Technologies
- We shouldn’t assume that all new technologies are progressive, valuable or always of utility.
- We shouldn’t expect that it will be made equally available to all, or that it will always be happily embraced.
- Sociological skepticism knows that although many technological changes have global reach, they will be subject to
vastly different local interpretations and uses.
- A sociological perspective
Technologies and the techniques, models, and assumptions on which they are based, are given meaning
through the way they are tied into other technologies and social practices.
- The meaning of health technologies will vary in different settings (clinic, home, internet)
- Technologies are understood as an expression of, and thereby always expressed through, social relationships.
- They’re not materialized configurations but they bring together material, people and social meanings as “congealed
social relations”
- Medical technologies are two-sided: they provide new, more detailed sources of information about our illnesses but
at the same time they also bring new forms of uncertainty and risk.
- It’s not just about the way we understand the illness, but also about the expectations that inform and guide the social
relationships through which we define and manage it.
- Technologies can reinvent boundaries of the body in space and time by reducing them to their basic biochemical or
anatomical constituents and reconstructing them in novel ways.
- Over time the value of technologies changes, maybe because of better ways of getting patient information or
delivering the treatment they provide, or though changing social expectations about treatment.
- The “value” of a medical technique or technology is subjected to national and even international evaluation,
regulation, and monitoring, which are anchored in social and political cultures.
- There’s much global diversity in the regulation of field like stem cell research.
- Ethical debated about new technologies and different perspectives between and within countries.
- A sociological perspective is also interested in the process through which new technologies are introduced and what
factors have shaped their introduction.
- The meaning of health depends on the person’s sense of well-being as well as powerful professional, commercial and
institutional interests that capture health in order to define, control, exploit or deliver ‘it’
- Therefore some health technologies may emerge from fields that have nothing directly to do with the conventional
clinical management of health.
- For example, the introduction into health systems of information and communication technologies (ICTs) developed
elsewhere and now deployed for information management purpose and treatment.
- Blurring the boundaries of what is regarded exclusively as a ‘health’ technology
- As consumers of health, people capture health innovations for their own personal use, especially in fee-based health
markets such as the US
- The Internet has helped to drive the expansion of consumer-led health.
- The body itself has become a site of consumption through cosmetic surgery
- Biomedical enhancements drugs, surgery, and other medical interventions aimed at improving mind, body, or
performance.
- The boundaries between biomedical enhancements and health treatments are moveable and highly contested.
- There is a strong relationship between the profile of disease in modern day society, and the clinical technologies that
are seen as most important and effective in managing disease.
- Physicians identified the top 5 technologies according to their importance in treatment: MRI/CTC scanning, ACE
inhibitors, Balloon angioplasty, the Statin drugs and mammography.
- All the above technologies are related to the most common chronic/high mortality illnesses (heart disease, cancer,
hypertension)
- In market-based health care societies where health care is fee-based and specialist, doctors are competing with each
other in terms of which state of the art technologies they have and they may suggest to patients more procedures and
tests in order to make more profit. Technologies are also taken up more easily in such societies.
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Reading 1
- All the above conditions are related to aging, which means that a large proportion of the health resources are aimed
to older members of the population.
- Peri-natal care up to the first few weeks of life also account for a large investment in health technologies (screening,
diagnostics, testing, life support, etc.)
- Obesity is growing rapidly
- Who should pay for health interventions? Consumer or state?
Socialized systems (UK and Australia) and mixed systems (Netherlands and Sweden): State takes care of it
to a certain extent where beyond that the consumer must meet their own needs.
They still encourage their citizens to buy into private health insurance.
As the population grows older and puts more demand on the healthcare system, the shift towards a more
privatized system will increase
Governments are encouraging patients to become more responsible for their health through devices used in
the home. Especially chronic illnesses.
New Technologies, new health?
- What do people perceive as new about new developments and why?
- To figure out what is seen as good candidates for innovative technology, we can look at which areas are receiving a
lot of attention and funding both from private and public funding in research labs.
- Which technologies are often in science journals, TV, press, and the Internet?
- The more common areas are:
Genetics-related developments (genetic testing, screening, and gene therapy)
Informatics-based systems used for monitoring individuals (tele-care and information systems used to
manage clinical data about patients)
Tissue-related (tissue engineering), stem cell research
We must look at why these are regarded as “transformative”
- Genetics-related developments
The main focus has been the inheritability of a single gene mutation whether dominant, recessive, or X-
linked (found only in the sons of women with the single gene mutation)
Tests are used to determine the likelihood of getting the disease and its severity.
Reproductive genetics microscopy is used to see if there are additional chromosomes, and blood tests are
used to see if there is overexpression of any enzymes produced by a mutation.
Family history is important for late-onset diseases (ex. Breast cancer)
Human Genome Project sequencing of the long chains of deoxyribonucleic acid (DNA) that make up the
human genome
Began in 1990, drafted in 2000 and a more developed version came out in 2004
This mapping project inspired claims that new genetic information would transform medicine.
Genetics now can be used to work on multifactorial disease, which are caused by gene-gene or gene-
environment interactions more understanding of such diseases.
More focus on preventing disease rather than managing it
If the mutation existed, it can be prevented through gene therapy, modifying a person’s DNA so they no
longer produce a mutation
Phamacogenetics has also been transformed by the Human Genome Project because they have identified the
genotypes that are more, or less responsive to drugs era of personalized medicine
Food and genetics = nutrigeneomics (applies genomics to diet)
Seeks to understand the relationship between a person’s genome and how a specific diet might help to
mitigate or pre-empt the onset of genetic disease
Examines the genetic basis of food organisms themselves in order to produce ‘functional’ food products
that have a beneficial effect on health emergence of hybrid food
Three changes that receive the most attention
1. The diagnosis and treatment of both single and multifactorial disease
o “The brilliant machinery of being is undone by the tiniest of faulty cogs, the insidious whisper of
ruin, a single bad idea lodged in every cell”
o Single gene disorders like Huntington’s can’t be treated just managed by palliative care and the
onset of the disease is inevitable.
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find more resources at oneclass.com
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