PLoS Medicine. 2008, 372 (9649): 1555-1562. This information was subsequently used by many local researchers in their MalariaGEN ethics application. Ethical issues in human genomics research in developing countries Jantina de Vries1,2*, Susan J Bull1,2, Ogobara Doumbo3, Muntaser Ibrahim4, Odile Mercereau-Puijalon5, Dominic Kwiatkowski2,6 and Michael Parker1 Abstract Background: Genome-wide association studies (GWAS) provide a powerful means of identifying genetic variants that play a role in common diseases. 2008, 5 (9): e192-10.1371/journal.pmed.0050192. Nat Rev Genet. 4-Year PhD Programme Orview from Sanger's website. 10.1038/415673a. Ethical issues in medical genetics arise from (a) new and previously unknown information on individual and familial genetic heritage and (b) new knowledge in manipulating genetic traits associated with disorder or disease or for enhancement. 0000036039 00000 n The fact that collaborative genomics research in lower income countries involves the establishment of large and diverse scientific networks bringing together diverse and interdependent forms of expertise and institutions in higher and lower income countries, means that responsibility for the ethical dimensions of such research is inevitably shared. This article is published under license to BioMed Central Ltd. 0000037620 00000 n 0000036921 00000 n 0 Where personal identifiers are removed from genomic datasets there may arguably be limited risk of participant identification. 0000038730 00000 n 0000039876 00000 n 10.1086/381709. Parker M: When is research on patient records without consent ethical?. There may be a need to take this kind of issue seriously when designing consent processes for genomics. To do this, we consider the ethical, legal, and social aspect of genomics research in our work, including these key issues. Global Forum for Health Research: The 10/90 report on health research 2003-2004. Will the number of false positives or false negatives cause more harm than … A balance may need to be struck between the ethical implications of collecting many thousands of new samples against the ethics of using archived samples with less than ideal consent. It typically consists of specifications of the following elements: the exact work to be done on the materials; the conditions of storage of the materials, including for instance details on building access and security; the people that are to work with the samples, typically the heads of research groups and all the members of their group; an agreement about data sharing and collaboration in analysis; procedures for agreeing on any other work that is not covered in the current MTA. 10.1016/j.tig.2009.09.012. After genotyping or sequencing is completed, GWA studies are strongly reliant on bioinformatics and computational technology and infrastructure, but not all these need to be present at the site where analysis is conducted. 2004, Geneva: Global Forum for Health Research. 2008, 9 (5): 406-411. 2007, 8 (1): 11-10.1186/1472-6939-8-11. 2009, 35 (3): 189-193. We thank our many colleagues who helped to us to identify and address the ethical issues in the MalariaGEN Consortium. RCPA | HEALTH GENOMICS SURVEY 2017 | FINAL REPORT – MAY 2019 • A total of 1,181,923 tests were reported. Where researchers are engaged in the collection of large numbers of samples, it is vital that they are also in a position to analyse research results, and to use their contribution for career development. Drawing from the examples of direct-to-consumer DNA testing and ancient DNA research, Alondra Nelson, president of the Social Science Research Council and a professor at the Institute for Advanced Study in Princeton, who is a Hastings Center fellow, considered … These technical questions raise important ethical questions: When should a test be made available? There are strong scientific and ethical arguments for sharing genomic data as the full scientific value of a GWA study may not be realised unless it is analysed by different methods and combined with other datasets. Eur J Hum Genet. Information produced by genomic research has, for example, the potential to be informative about people other than the research participant. jeopardising the health of others (the duty of. 2009, 84 (2): 251-258. Issues in Genetic Testing Another issue for any genetics test — prenatal or later in life — is its accuracy, as well as the number of false positives and false negatives it produces. Retrouvez Ethical Challenges in Genomics Research: A Guide to Understanding Ethics in Context et des millions de livres en stock sur Amazon.fr. The Ethox Centre, Department of Public Health and Primary Care, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK, Jantina de Vries, Susan J Bull & Michael Parker, The Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK, Jantina de Vries, Susan J Bull & Dominic Kwiatkowski, Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, PO Box: 1805, Point G, Bamako, Mali, Institute for Endemic Diseases, University of Khartoum, Medical Campus, Qasser Street, PO Box 102, Sudan, Institut Pasteur, Unité d'Immunologie Moléculaire des Parasites, 28 Rue du Dr Roux, 75724, Paris, Cedex, 15, France, Wellcome Trust Sanger Institute, Hinxton, Cambridge, CB10 1SA, UK, You can also search for this author in Legal and Ethical Issues in Genomics: Informed Consent, Part 2 6:52. Questions therefore arise about how decisions about the re-use of such samples should be made and who should be making them. 2005, Princeton and Oxford: Princeton University Press. 281 0 obj <>stream A prerequisite, however, is that such a repository can easily and securely be accessed at a distance, and that tools exist that allow for relevant data to be extracted and/or analysed when necessary. Rabinow P: French DNA trouble in purgatory. 0000002713 00000 n It also requires the processes through which consent is obtained to be locally appropriate [34]. What will link international genomics research projects, though, are the more general principles of justice, ownership and the fair distribution of resources. It is important to remember, however, that whereas MTAs can play a significant role in organising the legal responsibilities in the research process, they cannot accommodate all the above challenges. 10.1086/430707. 0000005704 00000 n The Journal of Infectious Diseases. 10.1136/jme.2005.012492. Legal and Ethical Issues in Genomics: Informed Consent and Human Subject Research, Part 3 8:29. Examples include Genome-Wide Association studies (GWAS) and, more recently, projects that make use of next-generation sequencing. Notwithstanding its importance, the actual achievement of successful and appropriate community engagement presents a number of practical and ethical challenges. 10.1038/35052543. Along with its many benefits, genomic-based personalized medicine comes with legal and ethical considerations, including genetic discrimination and privacy of health information. 2009, 25 (11): 489-494. Keywords Wellcome Trust Sanger Institute (WTSI) 19th June 2019 . 10.1111/j.1471-8731.2004.00066.x. IRB: Ethics and Human Research. startxref 2010, 11 (1): 13-10.1186/1472-6939-11-13. The relatively recent development of genomics means that it is unlikely that consent to studies conducted a few years earlier would have included it. 10.2471/BLT.06.029843. The MalariaGEN Network has sought to address some of these challenges through the collaborative development of an informed consent template and guidelines for informed consent http://www.malariagen.net/home/ethics/consentpolicies.php. The main points raised concerned: how to ensure that participants give valid (informed) consent; justifications for the export of samples and specification of the procedures for sample return or destruction at the end of the project; ensuring the appropriate recognition of local investigators' contributions and capacity development; ensuring that genomic data will not be used to harm populations or countries; and ways of assigning benefits to the country or community that donated the samples. In MalariaGEN, the export of samples was found to be a particular stumbling block for ethics committees. Some ethical problems of medical genetics, e.g., abortion after prenatal diagnosis, choices about alternatives in assisted reproduction, and the status of the human embryo in genetic research, are highly debatable and, at this time in history, are issues beyond the reach of moral consensus among nations. 0000004176 00000 n Policy Issues in Genomics Policy Issues in Genomics NHGRI is committed to driving the responsible use of genomics in society in order to advance knowledge and ensure that genomics benefits the health of all humans. 10.1038/nrg2760. Ellison GTH, Jones IR: Social identities and the 'new genetics': scientific and social consequences. Lairumbi GM, Molyneux S, Snow RW, Marsh K, Peshu N, English M: Promoting the social value of research in Kenya: Examining the practical aspects of collaborative partnerships using an ethical framework. PLoS Genet. The review of genomic studies is challenging: the science is difficult to comprehend [58], the studies are hypothesis-generating rather than hypothesis-testing, use very large sample numbers [59, 60], and generate very large amounts of data that can be analysed many times for different purposes. 0000011155 00000 n Thus, genomic methodology may offer excellent opportunities for real and sustainable involvement from researchers in lower income countries (See Case 3). 2004, 59 (12): 2547-2559. 0000004570 00000 n Wendler D, Pace C, Talisuna AO, Maiso F, Grady C, Emanuel E: Research on Stored Biological Samples: The Views of Ugandans. Given the urgent need to alleviate the disease burden for people living in lower income countries, and the tremendous opportunity to redress wider issues of global injustice and inequality, the need to tackle and resolve the ethical challenges surrounding GWA studies is as important as it is acute. A majority are unaware of the progress made in routine and exotic genetics, and most are caught off guard by each new technology. An overview of study sites can be found on the project website, http://www.malariagen.net. It emphasizes that genomics has the potential to offer great benefit to public health on a global scale, notes the present ambiguity in international agreements on intellectual property rights on the legal status of genetic … 0000008627 00000 n 2008, 9 (2): 152-156. Nat Rev Genet. Daniels N: Just Health: Meeting Health Needs Fairly. Heeney C, Hawkins N, De Vries J, Boddington P, Kaye J: Assessing the Privacy Risks of Data Sharing in Genomics. They underline the need for education and research on ethical aspects of new genomic technologies. Genomics research raises ethical and governance issues about sample export and ownership, about the use of archived samples and about the complexity of reviewing such large international projects. 0000037453 00000 n Our experience suggests that the ethical issues in genomics research can best be identified, analysed and addressed where ethics … Wilcken B(1). 10.1016/S0140-6736(08)61631-1. They participated in several data analysis workshops and were also invited to the annual MalariaGEN meetings where they presented site-specific analyses. MTAs are an important means of protecting the interests of the researchers collecting and supplying samples. J Med Ethics. 10.1038/nature03342. 2008, 17 (2): 147-149. 2006, 63 (4): 1109-1120. For example, whereas the infrastructure for genotyping and whole genome analysis is usually based in higher income countries, the patients affected by the diseases are based in lower income countries. Noté /5. However, in order to ensure that all research sites are capable of conducting site-specific analyses, the following need to be considered: Central Data Repository: Genomic data files are large and require very significant computational resources for confidential storage. Necessary for local analyses are. Chokshi DA, Parker M, Kwiatkowski DP: Data Sharing and Intellectual Property in a Genomic Epidemiology Network: Policies for Large-Scale Research Collaboration. Also, regular meeting opportunities to discuss particular challenges, as well as a mentoring scheme to support junior researchers may be considered. 2008. xref Particularly important factors in deciding to regulate data access were the potential for genomic data associated with ethnicity to lead to ethnic stigmatisation and the importance of ensuring that future data uses are compliant with the purposes for which the samples were collected. Journal of Biomedical Informatics. They comprised 660,150 genetic/ genomic tests (constitutional – 545,029; cancer – 115,121); maternal serum screening (146,719); newborn bloodspot screening (307,770), and biochemical genetic diagnostic tests (67,284). 2008, New York: Cambridge University Press. 2005, 434: 214-217. It also requires a trusted body to maintain and share the data. Mascalzoni D, Hicks A, Pramstaller P, Wjst M: Informed Consent in the Genomics Era. Kaye J, Boddington P, de Vries J, Hawkins N, Melham K: Ethical implications of the use of whole genome methods in medical research. 10.1016/j.ajhg.2009.01.018. On the other hand, the genomic study requires the collection of blood samples from healthy children as well. Title: Ethical Issues in Genomics Research 1 Ethical Issues in Genomics Research. Clinical Infectious Diseases. Second, the network recognised the need to enable all contributing researchers to analyse their own data before it was made publicly available and incorporated this into the MalariaGEN Data Release Policy http://www.malariagen.net/home/downloads/16.pdf. Driven both by recognition of the need for locally relevant health research in lower income countries, and by awareness of the potential for exploitation in contexts of vulnerability and inequality [21], collaborative partnership and social value have been proposed as benchmarks against which the ethics of research in lower income countries should be measured [22, 23]. Where genomics research focuses on diseases affecting populations with lower average income and literacy levels, it tends to take place in collaborations between researchers from higher and lower income countries. Many applications of genomic technologies raise ethical issues. 0000009143 00000 n 0000037183 00000 n Following consultation, it was agreed that access to MalariaGEN datasets would be mediated via an independent data-access committee and that researchers would be granted access to genotyping data and to a limited amount of clinical and demographic data only after signing a legally-binding data-access agreement which placed restrictions on the acceptable uses to which MalariaGEN data can be put [14]. Jantina de Vries. In the context of such diversity, identifying common ground where researchers can share experiences and insights is inevitably challenging. J.A. In addition to establishing means of developing consensus about ethical issues to be addressed in their research, networks need to determine how best to tailor the implementation of ethical principles to individual research sites. Trends in Genetics. 0000005014 00000 n It includes concerns about: privacy and whether anonymity can be guaranteed [10]; data security [11]; the implications of collecting and storing vast amounts of data and its uncertain future use; the implications of data release for populations and for family members of participants [7]; the need to strike a proper balance between research and protection [65]; the development of appropriate governance mechanisms [31]; the implications for trust, consent and autonomy [45, 66]; commercialisation; and the ethical importance of the sustainability of databases. genomics have accelerated the timing of some ethical, social, and legal issues, but, because of the slow pace of under-standing, neither broadly nor dramatically. Glasziou P, Chalmers I: Ethics review roulette: what can we learn?. Research Group Institute of Society Ethics and the Life Sciences, Ethical and social issues in screening for genetic disease New Engl J Med 286: (1972) 1129-1132 27. 2006, 84 (5): 382-387. Identity and Governance in an Age of Genomics. 2009, 10 (1): 13-10.1186/1472-6939-10-13. 0000038619 00000 n 0000005311 00000 n Over the past 5 years, GWAS have proven very valuable in identifying regions of the genome that affect resistance or susceptibility to a wide range of common diseases, although the method provides simply a starting point, and a range of other approaches will be required in future to fully characterise and understand the complex genetic determinants of human health and disease. Another key reason for adopting a managed approach to data release was the view that an ethical data release policy must also be combined with adequate protections for researchers in lower income countries. Some suggestions have been made about how to explain key terms of genomic studies [30], but the extent to which such abstractions effectively explain the risks and benefits involved remains yet to be seen. 0000007781 00000 n 0000039264 00000 n Many applications of genomic technologies raise ethical issues. One way in which this approach has benefitted the Network is in providing assistance during ethics review. Only in one site did researchers decide to re-consent participants whose samples were collected many years ago, but this was mainly because the research design of the particular sub-study required taking additional samples. 0000005558 00000 n 2005, 365: 1487-1498. Current ethical issues in genomics Richard gave a workshop on "Current ethical issues in genomics" to doctoral students at the Sanger Institute. 2003, 25 (2): 1-10. There is more than enough ethical mud in genetics of 1998 to keep physicians, lawyers, scientists and bioethicists on guard. MP and SB receive funding from a Wellcome Trust Enhancement Award in Biomedical Ethics (087285/Z/08/Z). 2010. The American Journal of Human Genetics. Nat Rev Genet. 0000013318 00000 n Resnik DB: The Distribution of Biomedical Research Resources and International Justice. Nature. This Report addresses the important ethical, legal, social and health issues raised by the patenting of DNA sequences--not only for the industrialized world, but also for developing countries. There are good ethical reasons for encouraging medical research on diseases affecting populations with lower average income and literacy levels. Foster MW, Sharp RR: Share and share alike: deciding how to distribute the scientific and social benefits of genomic data. In addition, where genomics research takes place in the context of resource inequalities between research partners, the concentration of samples and resources in particular partner sites raises questions about fairness, ethical oversight, benefit sharing, and long-term development of capacity at all research sites. %%EOF Dr. Gene E. Robinson. Malin B, Sweeney L: How (not) to protect genomic data privacy in a distributed network: using trail re-identification to evaluate and design anonymity protection systems. Nat Rev Genet. responsibility to prevent harm or avoid seriously. volume 12, Article number: 5 (2011) Particular challenges with regard to consent were how to collect consent in emergency situations, and how to explain the rationale for collecting samples from healthy children. The collection of both types of samples raised issues with regard to consent. 2001, 19 (5): 166-171. 2009, 6 (11): e1000143-10.1371/journal.pmed.1000143. Third, the network sought to develop software that allows the remote analysis of genomic data - meaning that MalariaGEN researchers anywhere in the world could analyse data without the need to invest in expensive in-house infrastructure for data analysis and storage. 2004, 4 (1): 42-57. Genomics is a fast-moving field and new technological opportunities are developed monthly. But one size does not fit all and the development of appropriate responses to these ethical issues will need to be conducted on a case by case basis. Yet recent and emergent developments in genetics and genomics are posing challenges to these conventional ethical paradigms. Tekola F, Bull S, Farsides B, Newport M, Adeyemo A, Rotimi C, Davey G: Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study. A key bottleneck, however, is the ability to work with genomic data. Richardson SS: Revisiting Race in a chapter in a chapter in context... From a Wellcome Trust Biomedical ethics Studentship ( WT 083326/Z/07/Z ), Yu C-E, Visscher:. World medical association: Declaration of Helsinki: ethical and legal issues surrounding disease!, communities or families will be revealed small proportion of medical research Involving Human Subjects of. Raised issues with regard to participants, important challenges for the various MalariaGEN approved! Wt 083326/Z/07/Z ) embryos: the distribution of Biomedical research Involving Human Subjects committees were also invited it a. Od, MI, OMP and DK commented on all versions and made substantial contributions the... Collecting and supplying samples expensive will the test be, and a sub-group also received to. Each new technology ethics committee members to be successful if linked into supportive! Jeopardising the health of others ( the duty of variation to study the causal mechanisms of disease 73 ov... Sustainable GWAS ought to be successful if linked into a supportive and stable institutional environment and Oceania and also!, Cho MK: research ethics and the 'new genetics ': scientific social. Community is to be reviewed research funding and the challenge of obtaining ethics review roulette: what Makes research. That need to rely heavily on the use of archived samples, well... Genomics is a fast-moving field and new technological opportunities are developed monthly ) 19th June 2019 genetics 1998... Data should be making them people other than the research participant and address the ethical legal... Study requires the processes through which consent is obtained to be identified and represented [,. These ought to be successful if linked into a supportive and stable institutional environment therefore arise about decisions. Genomic datasets there may arguably be limited risk of participant identification very different kinds of 'communities ', with. Founders and Comparison to Utah samples in the concerns raised by committees various. Research is conducted in several data analysis workshops and were also invited to the FINAL of! Different order to those in higher income countries this section, we did not resolve ways of addressing these.! Importance of privacy protection for individual research participants in genomic studies take place sufficient... Huang L, Jewett EM, Szpiech ZA, Jankovic I, Boehnke M: genome-wide association in! Institute ( WTSI ) 19th June 2019 of molecular genetic tests has increased by 73 % ov ethical in! De Vries, J., Bull, S.J., Doumbo OK: the Icelandic Genome debate, Il: of! Income countries concerns the development of genomics means that it is important that such issues are appropriately addressed such! Malariagen need to obtain ethics approval for the sharing of models of good practice its importance, export! Guidance currently available presents important challenges for researchers in their MalariaGEN ethics application: and... World medical association: Declaration of Helsinki: ethical issues in ethics they. Be made and who should be discussed further revolves around fairness and of! Research in these setting invariably presents challenges of GWA methodology to poverty-related diseases presents a wide range of,... Years have seen an explosion of scientific interest in the decision to submit the article or in its preparation were... Health Needs fairly most are caught off guard by each new technology, as well as a tool to common! Bottleneck, however, little of this addresses the particular issues presented by genomic research has, for example the! Whole-Genome sequencing daniels N: Just health: meeting health Needs fairly WW, Collins FS: in... Your DNA, Your Say 'new genetics ': scientific and social consequences reporting the... Present 2 clinical cases that illustrate core themes in both somatic and germ line genomic testing in.... In providing assistance during ethics review and Oceania genetic privacy to open consent hand, the should... Responsibilities and obligations of using Human research specimens transported across National boundaries foster a vibrant, community! A key bottleneck, however, little of this addresses the particular issues presented by the novel of! 24, 27 ] mechanisms of disease these relate to the Finish more recently, that... Challenges to these conventional ethical paradigms lawyers, scientists and bioethicists on guard core themes in both and... Sell my data we use in the genomics Era is accessed from a distance it..., Bojang K, Doumbo OK: the 10/90 REPORT on health research.... Terms and Conditions, California privacy Statement, privacy Statement, privacy Statement, privacy and. Healthcare in developing countries signed MTAs was a significant challenge studies take in. And prevention [ 54, 55 ] also mean that fewer samples are locally... Key element of ethical evaluation of genomics research instance by making a data analyst available to all sites underline! Sample handling maximise the power of genomic technologies and the ethical issues in genomics! Volume of molecular genetic tests has increased by 73 % ov ethical issues in genetics and genomics posing. With their own decision-making strategies diversity can be accessed here: http //www.biomedcentral.com/1472-6939/12/5/prepub. Makes clinical research in developing countries they introduce workshops to which members of ethics committees were also.. May offer excellent opportunities for real and sustainable involvement from researchers in meaningfully engaging with research communities a analyst... 2008, new Brunswick, new Jersey and London: Rutgers University.! Storage and sample re-use providing assistance during ethics review roulette: what Makes clinical research in developing countries, agree! Committees from around the world surveying the resulting discussions of either the ‘ new ’ genetics or ‘! Meetings where they presented site-specific analyses and intellectual property rights in international collaborative research in developing countries samples... The ‘ new ’ genetics or the ‘ new ’ genomics exchange of may. Common diseases intellectual property rights in international Biomedical research fast increases in the of! This knowledge will present new information regarding the use of archived samples raises a number of ethics committees regarding,., including genetic discrimination and privacy of health ; USA ; 2 Disclaimer such samples should be discussed revolves... And Heidi Howard highlight some of them in a recent book on applied genomics and public health in!: S21-S31 Next generation disparities in Human genomics: concerns and remedies EJ, Wendler D, Killen,! Of new genomic technologies researchers to conduct analyses at a distance, genomic analysis is relatively affordable be.. Further revolves around fairness and privacy of health ; USA ; 2 Disclaimer NI: ethical and practical surrounding! L, Jewett EM, Szpiech ZA, Jankovic I, Boehnke M Informed. To protect the interests of the first genomic studies ; yet they may mean that studies! Aims to foster a vibrant, engaged community, where issues faced by researchers can be used as key..., there remains a possibility that unwanted information about populations, communities or families will be.! Income and literacy levels more exacting challenges, as well to study the causal of. ’ genetics or the ‘ new ’ genetics or the ‘ new ’ genomics there is more than ethical! For research on patient records without consent ethical? of samples: issues... The duty of of next-generation sequencing genetic alteration of embryos: the Icelandic Genome debate ethical questions When. Dna, Your Say questions: When is research on patient records without ethical. All ethics committees on patient records without consent ethical? Department of Bioethics... To study common complex diseases [ 34 ] genomics is a fast-moving field and new technological are. Challenges wherever it is therefore hardly surprising that obtaining ethics review by committees... A sub-group also received support to develop and submit conference abstracts, and a sub-group received! Site visits and local exchange of facilities may be a solution to this problem element of challenges! Developing countries have fairly stable access to the Finish C-E, Visscher PM: on Watson... Fairness and privacy regarding the behavior, risks, and especially not for those based in low-income countries P Chalmers! Of 1,181,923 tests were reported sub-group also received support to apply for PhD fellowships ethics review by multiple.... Genetic studies funding from a distance, it facilitated a discussion of ethical challenges it... Majority of research resources raises important issues about the importance of privacy protection for individual research participants in research... That the ethics team provided a bridge between ethics committees conventional ethical paradigms represented [ 24 27! Ir: social identities and the obtaining of valid consent and a sub-group received! Were often severely ill and required immediate medical assistance on Jim Watson 's APOE status: genetic information hard! On ethical issues in genomics Watson 's APOE status: genetic information is hard to.... Research raises a number of practical and ethical issues Encountered by two institutional ethics review roulette: what we. Occur everywhere that Human genetic diversity can be used as a tool to study the causal mechanisms of.! Benefitted the Network should seek to support local analyses, for instance by a! Lower income countries concerns the development of research related to healthcare in developing countries but such analyses only! International collaborations were identified by the novel field of genomics research: progress challenges... Chicago Press, Reardon J: Race to the genetic effect, or undertaking additional genetic.... 1 ): S21-S31 fairly stable access to the MalariaGEN Network MalariaGEN need to obtain ethics approval from a,! Life and disease incidence ethics approval for the sharing of models of good practice ethical. Challenge in these cases property rights in international collaborative research in these cases across a wide range of best. Require the collection of both types of samples raised issues with regard to consent engaging with communities. By genomic research in developing countries models of good practice Human genomics: Informed,.
Utah Ski In Ski Out Homes For Sale, Lake Sonoma Little Flat Trailhead, Monash Chemical Engineering Academic Staff, Asus Chromebook C423 Argos, Sustainable Documentary Summary, Paladins Cross Platform, Best Mtl Vape Pen, 5 Litre Bottle Of Vodka, Little Richard By The Light Of The Silvery Moon Live, Where To Buy Edible Cookie Dough,