Difference between revisions of "Team:Austin LASA/Human Practices"

 
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   h(g.Section, {title: 'INTEGRATION'},
 
   h(g.Section, {title: 'INTEGRATION'},
 
     p('When conducting any research, it is important to understand the extent of its repercussions on various groups in society. In the planning stages of the project, we had a plan for the type of protocols we wanted to test, but we were looking for the correct purpose to use it for. With the tools in hand, we had discussed various diseases that we could target, but agreed upon focusing on HIV-1 detection in infants specifically. The reason was simple. HIV is a global health problem that affects millions all over the world. Its impact is especially prevalent over disadvantaged groups in low and middle-income countries. Thereby, we decided to improve the already existing tests available in these locations, by creating one better suited to the needs of the patients.'),
 
     p('When conducting any research, it is important to understand the extent of its repercussions on various groups in society. In the planning stages of the project, we had a plan for the type of protocols we wanted to test, but we were looking for the correct purpose to use it for. With the tools in hand, we had discussed various diseases that we could target, but agreed upon focusing on HIV-1 detection in infants specifically. The reason was simple. HIV is a global health problem that affects millions all over the world. Its impact is especially prevalent over disadvantaged groups in low and middle-income countries. Thereby, we decided to improve the already existing tests available in these locations, by creating one better suited to the needs of the patients.'),
     p('The current antibody tests are not suited to testing newborn infants for HIV. In order to create a more accurate test, we used a different method of detection. Our proposed kit relies on HIV viral DNA and utilizes protocols that can be replicated in low resource environments as well. In order to better understand the currents testing protocols in rural locations, we discussed with Dr. Leautaud (who works with Rice Global Health) and a research fellow, Jessie Anderson on the current conditions. After reviewing the issues faced by patients in these locations, we were better able to focus our project to handle the problems. We learned that the hospitals were regularly understaffed, and the hospitals in the area (district hospitals) did not have adequate resources in the lab either. According to Dr. Leautaud’s experience, “In Malawi, there is no lab. They had a separate room with a fridge, centrifuge, agar plates, did not have pipettes or a vortexer; Eppendorf tubes and gloves were scarce.” In order to corroborate her statements, we discussed with Jessie who stated, “The neonatal wards for both QECH and KCH seemed understaffed, even for this season which is not the busiest of the year. There were two short (10-30 seconds long) power outages within 20 minutes in the KCH ward. KCH had more equipment available to them than QECH (much more incubators, radiant warmers, blue-lights, etc; I think also a higher proportion of the room heaters was working), but the flow and size of space available seemed better at QECH. Still not ideal at either location.” Throughout our conversations, it became increasingly clear that local hospitals did not have any substantial equipment.')
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     p('The current antibody tests are not suited to testing newborn infants for HIV. In order to create a more accurate test, we used a different method of detection. Our proposed kit relies on HIV viral DNA and utilizes protocols that can be replicated in low resource environments as well. In order to better understand the currents testing protocols in rural locations, we discussed with Dr. Leautaud (who works with Rice Global Health) and a research fellow, Jessie Anderson on the current conditions. After reviewing the issues faced by patients in these locations, we were better able to focus our project to handle the problems. We learned that the hospitals were regularly understaffed, and the hospitals in the area (district hospitals) did not have adequate resources in the lab either. According to Dr. Leautaud’s experience, “In Malawi, there is no lab. They had a separate room with a fridge, centrifuge, agar plates, did not have pipettes or a vortexer; Eppendorf tubes and gloves were scarce.” In order to corroborate her statements, we discussed with Jessie who stated, “The neonatal wards for both QECH and KCH seemed understaffed, even for this season which is not the busiest of the year. There were two short (10-30 seconds long) power outages within 20 minutes in the KCH ward. KCH had more equipment available to them than QECH (much more incubators, radiant warmers, blue-lights, etc; I think also a higher proportion of the room heaters was working), but the flow and size of space available seemed better at QECH. Still not ideal at either location.” Throughout our conversations, it became increasingly clear that local hospitals did not have any substantial equipment.'),
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    p('Additionally, when discussing with Dr. Leautaud, she mentioned that “One major problem in Africa or Malawi is that there is no communication and follow up with patients and the hospital, so even if a child is diagnosed the parent will not know. The hospitals don’t have the manpower to do that.” The mother’s that came to the hospitals often left soon after delivery, hence any testing results may not reach the mother, nor any future precautionary measures.  On top of short-staffed hospitals, many of the nurses or lab technicians that ran the test were not trained adequately. During discussions with Dr. Leautaud, she mentioned, “The nurse or lab technician, who is not as highly trained as they are in America. Instead, they have technical degrees. You need to teach them to not contaminate the test.” Upon learning of these various problems, we began integrating it into our project.'),
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    p('Taking this into consideration, challenged ourselves to design a detection protocol that would utilize the least parts and would be able to withhold the most severe conditions. This would accommodate for the lack of resources that was discussed earlier with Dr. Leautaud. In order to integrate her advice into our lab work, we designed protocols utilizing lyophilized cellular reagents and decided to use LAMP for amplification purposes. The lyophilized reagents are stable as they do not need to be frozen, and LAMP amplification would only need a constant water bath, not a thermocycler like with PCR. Not only would this take the hospital’s capabilities into consideration, but it would offer our kit a competitive edge in the market as advised by Ms. Dawson. She recommended that in creating our kit to take into consideration the comfort level of the patient, but also to ensure that the kit is unique. The reason being, it would increase the chances for the kit to be sponsored by organizations, allowing the kit to be used by a larger clientele.'),
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    p('Previously, Dr. Leautaud stated that “The test needs to be under 3 or 4 hours for the mother to stay in the hospital. In order to integrate this into our project, we designed a protocol that would fit this limit. The final protocol we decided upon would take about 3 hours to complete, allowing the mother to receive the results before her exit from the hospital. This would allow the hospital to provide additional information and would aid in the treatment of the infant.'),
 +
    p('In terms of sterility, we created an educational training protocol to include with the kit which would help equalize any differences in training. In order to do so successfully, we reached out to a safety officer for advice (Dr. Singh) and consulted with an NGO official (Ms. Dawson) who offered information regarding HIV kits. Dr. Singh recommended that “ The best you can do there would be best practice or universal precautions, the idea being that you would treat all samples as potentially pathogenic or infectious, but there would likely not be an opportunity to set up a BSC or any type of clean workspace.  You would want proper PPE which at a minimum would be clothes that cover skin (long sleeve etc.) gloves, eye protection, and a lab coat. All the waste should be hazardous material/biowaste, this means for the research side it will need to be autoclaved or disposed of in biohazard boxes.”  This information proved valuable when creating our sample training protocol. Ms. Dawson provided us comparisons of HIV tests in order to differentiate ours and sent us example home tests that were on the market. After reviewing these existing solutions, we were able to clearly define the differences and advantages in our kit. With the information procured from the human practices part of the project, we were able to adapt our research to best suit the needs of the target group.')
 
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   h(g.Section, {title: 'Human Practices in Our Kit'},
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   h(g.Section, {title: 'END RESULT'},
     h('p', null, 'We integrated human practices into our project throughout the iGEM season. Below we’ve summarized how our integrated human practices fits the requirements for the Gold Medal Integrated Human Practices criterion and the Best Integrated Human Practices Award.'),
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     h('p', null, 'Our project targets an expansive disease and provides an opportunity for the most vulnerable groups to receive effective care, increasing their chances of survival. In many rural areas, disease, lack of food, and stable living conditions hinder the ability of forthcoming generations to prosper. With proper detection technology like our project, the future of these individuals can be secured, allowing them to live out their lives with one less hindrance. Not only do we aim to affect society, but society plays a large role in our project. By interacting with and understanding the problems that affect others in less fortunate locations, we can create more influential projects. Listening to the issues with communication brought forth other useful solutions such as the development of an app to serve as a mediator between the individual and the hospital. It is only by interacting with the community that we are able to understand their needs and devise solutions and projects that benefit the most people. Even a simple change in plan, like the addition of a training guide, could mean a world of difference to those who go through these problems every day.'),
     h('p', null, 'For a much more detailed reference on the development of our kit and how our human practices played a role in that, please see our Kit Considerations page. For a much more detailed reference on how our human practices impact our wet lab work, please see our Design, Development, and Results page.')
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     h('p', null, 'It is idealistic to think that simply conducting research will result in the development of a detection kit. Even with our research, there is still much that would need to be tested and implemented. Additionally, in order to implement these kits, we would require the financial backing of individuals. Thereby, even with functioning equipment, the cost and marketability of such products are equally important. When conversing with the NGO official on HIV detection kits, a recurring point that was brought up, was how is this kit different from the market and what is the cost. In this manner, the cost is especially important because our kit was developed to target those in the rural location who have a higher risk of HIV. Thereby, in order for this kit to be able to reach its target audience, the cost must be competitive with other existing models. Creating a kit with an idealistic purpose, but in reality, using the kit for those that can afford it undermine both the purpose and the ethics of such a project. In an effort to keep costs low, we utilized methods to efficiently organize the materials such as aliquoting to prevent contamination and only provide the necessary quantities. Similarly, the protocols for our kit do not require expensive machinery like other tests. This helps to not only keep the overall price low but allows us to use the kit in laboratories without much equipment. Throughout our project we have kept the protocols minimalistic but efficient, with the majority of material including cellular reagents and CRISPR complexes that are combined in microcentrifuge tubes; we have devised a protocol that suits our target audience and all others involved.')
 
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Latest revision as of 03:57, 18 October 2018