Intervention at any cost? The Charlie Gard case

cgardBroadcaster: Channel 4

Genre: News

Length: 3:16 mins

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/95288

When an infant has an illness that will, in all probabilities, prove fatal their parents face an agonising choice. Do you follow all possible interventions, or do you reach a point where you recognise that it is in the best interests of the child to withdraw treatment?

This dilemma is brought into stark relief by Charlie Gard who, at the time of writing, is the subject of a High Court case at the Royal Courts of Justice. There are several aspects that make this case particularly tricky, and particularly interesting from a medical ethics standpoint.

Charlie was born in August 2016 with a rare mitochondrial DNA depletion syndrome. He is deaf and blind, it is tricky to know how much pain he is aware of at present. Doctors at Great Ormond Street Hospital want to move to a regime of palliative care only. A crowdfunding project has raised over a million pounds parents and his parents want to take Charlie to the USA where a doctor is willing to enrol him on a trial of nucleoside bypass therapy, an experimental treatment which has an extremely low probability of alleviating some of his symptoms. He will almost certainly still die.

The case shines a spotlight on different medical culture in the UK and the USA. In the UK doctors tend to take a more cautious approach whereas doctors in America are more willing to try experimental procedures if the patient (or in this case, their parents) want to try and have the money to do so.

For further coverage of the case see: The Guardian and ITV News and a later report from the BBC.

 

A History of the Brain

radioBroadcaster: BBC Radio 4
Year: Originally broadcast 2011 (repeated periodically)
Genre: Radio, Documentary, History of Science
URLs: See below for each episode

Review by Eunice Muruako
Dr Geoff Bunn (Manchester Metropolitan University) presents a series of ten 15-minute programmes spanning 5000 years of cultural and scientific progress in understanding how the brain works.

Episode 1: A Hole in the Head (https://learningonscreen.ac.uk/ondemand/index.php/clip/90227)
The series begins with an introduction to one of the earliest forms of brain surgery, trepanation (3.00). Trepanation was the process by which a small piece of skull was cut away to relieve pressure believed to be caused by the build-up of fluid. Bunn explains that, even in the ancient world, connections were being made with how particular areas of the brain affected certain functions. We learn that Egyptian physician, Imhotep, understood that injury to one side of the brain could paralyse limbs on the opposite side (10.38).

Episode 2: The Blood of Gladiators
(https://learningonscreen.ac.uk/ondemand/index.php/clip/90228)
Various philosophers had conflicting ideas about the role of the brain and its connection to the location of the soul. Aristotle, for example, considered the heart to have primacy over the brain because it was centrally located and developed first in the embryo (9.09). Whereas Galen agreed with Hippocrates that the body was ruled by the brain (12.37). Ailments which were previously attributed to the gods could instead be understood in terms of natural causes affecting the brain. Continue reading

Phage therapy as an alternative antibiotics

phage3Broadcaster: BBC2

Year: 2016

Genre: Magazine

Length: 7 mins 17 secs

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/89648

The growing menace of antibiotic resistance has been the subject of increasing press attention in recent years. In this clip from the BBC’s medical magazine show Trust Me I’m A Doctor surgeon Gabriel Weston investigates a potential alternative to antibiotics, the use of bacteriophage in an approach known as Phage Therapy. This apparently novel approach has actually been the subject of extensive research over many decades in the former Soviet Union, especially in the Republic of Georgia. Patients whose diseases are proving resistance to more traditional Western treatments based on antibiotics are now travelling to the Eliava Institute in Tbilisi to try this alternative. Continue reading

Grow your own fillings? (Inside Science)

radioBroadcaster: BBC Radio 4

Year: 2017

Genre: Radio magazine

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/86523

Review by Eunice Muruako

In this 4 minute clip from Inside Science, presenter Adam Rutherford interviews Professor Paul Sharpe from King’s College London about the use of stem cells to regrow damaged dentine. Sharpe and his team have used Tideglusib, a drug originally as a treatment for Alzheimer’s disease in order to regrow teeth.

Below a thin layer of enamel, there is a thicker layer of another material called dentine. Although enamel cannot be regrown, it is possible to stimulate immature stem cells to become dentine, offering a natural alternative to metal or porcelain fillings.

After the rotten area of the tooth has been drilled out, Sharpe and his team insert a swab impregnated with the drug Tideglusib into the hole. The drug stimulates the Wnt signalling pathway, activating more stem cells. So far the work has been done in mice. In doing so they are taking advantage of the fact that the drug has previously been put through extensive safety trials when being considered as a treatment for neurological diseases such as Alzheimer’s. Sharpe hopes this might speed the process to clinical trials for this novel dental application, though even then clinical trials are unlikely to start before 2018 at the earliest.

For further information see this press release from the King’s College website.

Is burnt toast *really* a cancer threat? (News)

toastNew “go for gold” advice from the Food Standards Agency is warning people not to overcook foods such as roast potatoes, chips and toast, as it increases their risk of cancer. The story was widely reported in the press on 23rd January 2017 (e.g. Browned toast and potatoes are ‘potential cancer risk’, say food scientists).

Useful broadcast media coverage includes:

BBC News at One: Is burnt toast a cancer risk?
URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/87866
(2 mins 40)

Channel 4 News: Feeling the burn URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/87907
(3 mins)

Today (BBC Radio 4): Can overdone toast be a cancer risk?
URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/87258
(4 mins 30)

Concern focuses on acrylamide, a chemical that is naturally produced when starchy foods (particularly those rich the amino acid asparagine, such as potatoes and cereals) are cooked at high temperatures (see Mottram et al and Stadler et al for underlying science, which actually dates from 2002). Continue reading

Life Story: Solving the structure of DNA

lifestory

Watson and Crick discuss whether to tell Maurice Wilkins and Rosalind Franklin about their research

Broadcaster: BBC4

Year: 2004
(originally broadcast 1987 on BBC2)

Genre: Dramatisation

Length: 01:46:24

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/30025
In the late 1980s, Horizon, the BBC’s flagship science series, took the unusual step of producing a feature length retelling of the events of 1951-52 leading to James Watson and Francis Crick solving the structure of DNA.

Inspired by Watson’s memoir The Double Helix, and with a screenplay by  William Nicholson (who later went on to write the script for Gladiator), the production starred Jeff Goldblum as Watson, Tim Pigott-Smith as Crick and Juliet Stevenson as Rosalind Franklin.

A colleague recommends that students watch this on their own as a “flipped teaching” exercise prior to more academic sessions on DNA structure.

The film is known in the USA as “The race for the double helix” and is listed on IMDB under that name. The most recent transmission of this programme pre-dates Box of Broadcasts, and this copy is uploaded from a VHS copy. In consequence, the quality is sub-optimal, but clear enough.

Certification System for Genetic Testing (Science View)

genetestnhkBroadcaster: NHK World

Year: 2017
(originally broadcast Aug 2015)

Genre: News

Length: 1:45

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/85837

Review by June Adams

This short clip from the English-speaking Japanese channel announces the introduction of a regulatory body for genetic testing in Japan. Establishment of The Council for Protection of Individual Genetic Information (CPIGI) was prompted by a number of concerns. For example, companies offering tests Direct-to Consumer (DTC) genetic testing have not necessarily given sufficient diligence to the security of private genetic information, or to the interpretation of the results. This is especially true for diseases that result from the interaction of multiple gene products as well as the influence of environment on expression of those genes (so called GxE interactions). The clips cites diabetes and Alzheimer’s disease as examples where a correlation with a particular allele at a particular gene may be hard to quantify.

The CPIGI, which launched in Oct 2015 (after the initial broadcast of this episode) is an umbrella group for 25 companies and offers a checklist of over 200 items intended to enhance trust between genetic test providers and clients. This includes the importance of genetic counselling. The launch of CPIGI has been controversial (e.g. see here), especially regarding the lack of consultation.

See this post for details of clips from Newsnight and BBC Breakfast in 2014, regarding the UK launch of DTC genetic service 23andMe.

 

Tackling tuberculosis (Countryfile)

cowtbBroadcaster: BBC1
Year: 2016
Genre: Magazine

URLs: (full episode) https://learningonscreen.ac.uk/ondemand/index.php/prog/0D9D7D7F
Clip 1 (6:43): https://learningonscreen.ac.uk/ondemand/index.php/clip/23517
Clip2 (6:16): https://learningonscreen.ac.uk/ondemand/index.php/clip/23518

The BBC’s rural affairs programme Countryfile (first broadcast on 9th October 2016) looked at ongoing issues with TB infection cattle populations. The topic was covered in two sections. The first focuses on the current tests for TB infection. The second looks more closely at the science being used to develop new tests and better vaccines against TB. Continue reading

Second Opinion: Review of 2016 health news

secondopinionBroadcaster: BBC2

Year: 2017

Genre: Humour, Magazine

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/85802

Review by June Adams and Eunice Muruako

Dr Xand van Tulleken hosts this satirical show  (30 mins) taking a look back at some health news from 2016. He elaborates on potentially misleading news headlines and explains the research behind them. Tulleken is keen to push the message that the unsubstantiated claims of pseudo-science detract from the credibility of real science that could actually help people. The humorously presented topics range from scaremongering health claims and celebrity endorsed miracle cures, to squat toilets and cigarette packaging; he even uses cheese as a visual aid to illustrate the factors behind the junior doctors’ strikes.

How are memories formed? (All in the mind)

radioBroadcaster: BBC Radio 4

Year: 2016

Genre: Panel discussion, Fire-side chat

URL: https://learningonscreen.ac.uk/ondemand/index.php/clip/31636

In this special episode of the BBC radio programme All in the mind (28 mins), host Claudia Hammond discusses the basis of memory formation with three leading researchers Tim Bliss, Graham Collingridge and Richard Morris who have been major players in developing our understanding of memory.

Tim Bliss draws attention to Donald Hebb’s pivotal book The Organization of Behavior and the aphorism “Cells that fire together, wire together”. Graham Collingridge then introduces the notion of long-term potentiation (LTP) as the molecular basis of memory, and particularly the role played by NMDA receptors in learning and AMPA receptors in memory. Errors in the functioning of any of hundreds of proteins can have detrimental impact on memory. Under-activation of LTP can be a contributory factor to schizophrenia. Continue reading