LKCMedicine Guest Lecture Date: Time: Venue: 24 June 2015, Wednesday 3.00pm - 5.00pm Matrix Building, Level 2M, Aspiration Theatrette 30 Biopolis Street, Singapore 138671 Chaired by Prof Philip Ingham, Lee Kong Chian School of Medicine, NTU No Decision about Me, Without Me Liberating Power of Co-Design and Crowdsourcing in Healthcare Dr Lorainne Tudor Car, Clinical Research Fellow, Imperial College London Synopsis Singapore’s commitment to provision of world-class healthcare is unique and distinctly demonstrated in the tripling of its healthcare budget in less than a decade. This has an ultimate triple aim of better, more person-centred healthcare, improved population health and simultaneous reduction of per capita cost of care. The pinnacle of the first aim, person-centeredness, is empathic, participatory decision-making (i.e. a collaborative process in which patients and clinicians make health care decisions together). The principles underpinning participatory decision-making are as important for shaping an individual patient-doctor interaction as they are for co-design of health systems. A paramount example of the importance of engagement and partnership of all healthcare participants is patient safety. This central pillar of highquality healthcare is though very difficult to measure and monitor. Crowdsourcing represents a novel, evolving, simple and cost-efficient solution to this. Dr Car will present how crowdsourcing was implemented to identify and prioritise patient safety-related problems and respective solutions in NW London, and how it could play a role in Singapore. Next, using an example of working population with diabetes, she will illustrate how crowdsourcing and a user-centred healthcare co-design that bring together people, healthcare staff, families and communities are central for world-class health system delivery, its innovation, sustainable transformation and, at individuals’ level, empathic, participatory decision making. Ground State Adult Stem Cells: New Potential for Patient-Specific Disease Models, Regenerative Medicine, and Cancer Therapeutics Dr Wa Xian, Founder, MultiClonal Therapeutic, Inc., Farmington, Connecticut, USA Synopsis The discovery of induced pluripotent stem cells by Yamanaka in 2006 now dominates the stem cell landscape for prospective regenerative medicine and disease models. In contrast, tissue-specific or adult stem cells, especially for columnar epithelial organs such as the gastrointestinal tract, liver, pancreas, and kidney, have been relegated to the backwater due to the lack in methods to clone and propagate them. Efforts by Dr Xian’s laboratory to mitigate this problem have led to new technologies to capture stem cells specific for each of the columnar epithelial tissues in their most immature, undifferentiated states. Now that they have had the opportunity to examine the basic properties of such ground state stem cells, it is clear that they will play a major role in medicine. In addition to their rapid proliferative expansion with minimal mutations, these stem cells show remarkably stable programs of commitment to precisely the epithelial from which they were derived. For the gastrointestinal tract stem cells for instance, those from the duodenum are poised to differentiate only to duodenum, while those from the transverse colon only yield transverse colon. Using stem cells derived from standard endoscopic biopsies, Dr Xian and her team show that they can readily recapitulate the C. difficile toxin-induced pseudomembranous colitis in vitro as well as provide unique insights into the role of the gastrointestinal epithelia in the etiology and/or chronic features of Crohn’s disease. Their work with exogenous lung stem cell transplantation for lung regeneration further underscores the potential utility of adult stem cells in regenerative medicine, which they are presently expanding for potential treatments of liver and inflammatory bowel disease. Finally, Dr Xian will discuss the adaptation of this same technology for generating libraries of patient-specific cancer stem cells, and how these can be mined for understanding and treating pre-existing chemotherapy resistance in high-grade ovarian cancer.
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