Spring 2009 Issue

TuftScope is pleased to bring you an interview with Professor Kevin Irwin, Lecturer in the Community Health Department of Tufts University. A former Research Associate at the Yale School of Public Health and member of the Methods and Biostatistics Core of the Yale Center for Interdisciplinary Research on AIDS (CIRA), Dr. Irwin is passionate about his teaching and research stemming from a principle of community involvement. In this abridged interview, Dr. Irwin discusses his work with Housing First, a model for serving the homeless population, as well as his opinions on the current health care system and health care reform in the United States. In addition, Dr. Irwin specializes in substance abuse and is involved in initiatives to expand access to Naloxone, which acts as an antidote to opiate overdose. The entire interview will be available on the TuftScope Weblog accessible via www.ase.tufts.edu/tuftscope.

Since 2001, Professor Ross Feldberg of the Biology Department of Tufts University has served as the principle Faculty Adviser for TuftScope. An Associate Professor of Biology, who has taught for over thirty years, Professor Feldberg will soon be retiring from his position. In this special commentary we provide a brief biographical perspective into the career and biosocial interests of Professor Feldberg.

Organ donation represents one of the most contentious and important topics in bioethics and modern biomedical discourse. As of 2009 more than 100,000 candidates were waiting for a compatible organ from a donor. Many individuals die before receiving an organ and outside of major advances in biotechnology allowing for in vitro organ development, no current technological solution exists for alleviating the shortage. In this Opposing View- points we present two perspectives on alternatives to the current organ donation system. A free market system compensating organ donors is presented in the first viewpoint and a required donation-benefits viewpoint is presented in the second. TuftScope welcomes letters on your opinions and thoughts on this issue.

This proposal outlines the negative costs, both economic and human, of the current employer-based health insurance system in the United States and offers a single payer solution that expands Medicare to the entire population. Though President Obama’s proposed healthcare plan might marginally improve our current system, reformers must continue to push for change that will improve and expand access to care. The Obama plan has been attempted on the state level in Massachusetts, Vermont, Tennessee, and Minnesota. All four attempts have failed, proving to be ineffective and leaving behind considerable statewide deficits. In a single payer system, on the other hand, private industry remains intact. Funding is provided by raising estate and income tax levels by 2 percent. A single payer solution would streamline health insurance funding and put an end to the regressive costs imposed on lower-income families and individuals by the current system. Though the single payer solution might not currently be politically viable in the United States, the potential it has to cure the fundamental problems of our employer-based system makes it the best long term option.

Western civilization has come to deem male circumcision an acceptable, normal medical practice and female circumcision as a violation of human rights. The religious roots of the former can be shown to have had a significant impact on the acceptance of male circumcision in society prior to comprehensive scientific studies favoring the practice, while the absence of female circumcision within religious works and its negative connotations within later medical studies have caused the practice to be largely avoided. This essay seeks to explore the underlying culture, religious, and medical factors that have led to the growth of male circumcision and the modern characterization of female circumcision.

Children have been dubbed “therapeutic orphans” due to limited labeling of drugs with pediatric uses. The FDA has made strides to combat this with the Best Pharmaceuticals for Children Act of 2002 and the Pediatric Re- search Equity Act of 2003, which provide incentives and mandates, respectively, for conducting pediatric drug trials. Such studies are necessary for determining appropriate pediatric dosages; the physiological and pharmacological differences between adults and children render it dangerous to estimate doses based on size alone, though this is com- mon practice. The greatest differences exist between adults and newborns/infants, thus more studies must target the latter group. Opposition to pediatric testing can be resolved by applying the Pediatric Pharmaceutical Research Unit model to increase patient recruitment and to utilize more child-friendly techniques, by understanding the financial advantages of pediatric trial, and by ensuring that patients are exposed to minimal risk of physical and psychological harm. Overall, pediatric studies are key in increasing the knowledge regarding pediatric drugs and improving the pediatric standard of care.

Proposition 71, an initiative that was passed by California voters in 2004, created a system of funding for stem cell research in the state of California. During that time, the use of federal money to fund such research was banned by executive order of former President George W. Bush. Proposition 71 created the California Institute of Regenerative Medicine (CIRM) to distribute funds to research institutions in California. To oversee this distribution, the Independent Citizens Oversight Committee (ICOC) was created. This paper examines the issues surrounding Prop 71 before its passage. Counter to the image largerly presented by the media, the opponents of Prop 71 were not solely religious conservatives. Many opponents focused on the large amounts of money involved and questioned the potential effectiveness of the ICOC. Additionally, there were concerns that supporters of Prop 71 exaggerated the benefits of stem cell research to the state of California. With the election of Barack Obama however, many foresee a change in the federal government’s attitude towards stem cell research. A lifting of the previous ban on federal funding will provide a further argument against the infrastructure created by Prop 71. Many now question the need for the California program and want to do away with it unless major reforms are enacted.

Despite scientific research that demonstrates that “breast is best” in infant feeding, both for mother and baby, many mothers still struggle with the choice of whether to breast or bottle-feed. This struggle has been created by a varied history of infant feeding that produced a capitalistic baby formula market and a culture of social pressures that have challenged the biological implications of infant feeding. These include the rise of medicine’s control over maternal care, the convenience of the bottle, and the sexualization of the breast, which have been able to popularize bottle-feeding despite its shortcomings. Such social pressures and aggressive marketing strategies by infant formula companies have had devastating consequences for maternal and child health, particularly in the developing world. U.S. government policies such as formula vouchers through low-income aid programs and laws around indecent exposure have worked both for and against the breastfeeding movement. Today, those involved in the pro-breastfeeding counter-movement, or “lactivists,” are working toward institutional changes that would create a breastfeeding-friendly climate and allow mothers to make an educated decision about how to best feed their infant.

The objective of the Princeton School Gardens Cooperative is to establish gardens at every Princeton public school in order to “re-connect students to the earth’s bounty in the garden, classroom, and cafeteria.”27 The members of the Cooperative hope that the gardens will increase students’ appreciation and intake of healthy foods such as vegetables and fruits. With the collaboration of principals, teachers, parent volunteers, and students, the organization has successfully designed and sustained gardens at six Princeton public schools. In addition, the Cooperative has written a guide to promote the in- tegration of the gardens with the classroom curriculum. The guide details the steps for composting, planning, and planting and also includes lesson plans and curriculum links for math, social studies, language arts, science, visual arts and health. In order to assist the Cooperative in its efforts to encourage healthy eating among the community’s schoolchildren, this paper: 1) outlines the unhealthy nature of child food preferences in schools; 2) provides an overview of the detrimental effects of poor nutrition on health, with an emphasis on the obesity epidemic; 3) offers evidence that healthy eating is correlated with increased cognitive performance; and 4) describes the success of garden projects across the country to highlight the importance and viability of the Princeton School Gardens Cooperative.