Friday, September 23, 2016

Saudi Gazette: Youth suffer from sitting disease

Saudi Gazette:  

Youth suffer from sitting disease

"A sedentary lifestyle predisposes people to a number of conditions, like obesity, diabetes, cardiovascular diseases, osteoporosis, and other health conditions.
“Being a physiotherapist, we are highly concerned with the effect on the bones, joints, and muscles of an individual and how these become parallel problems to the other health conditions. Most common complaints are lower back pain and neck pain, and these are serious issues we have to deal with,” Valerio said."

How science works and why it is so difficult to dispel myths in healthcare

How science works and why it is so difficult to dispel myths in healthcare


"Let me ask this. Do you really believe that the overwhelming majority of doctors are so unbelievably money hungry that they would knowingly cause untold pain and suffering? It literally goes against the very core of what makes a physician.
We have given up a large chunk of our lives in order to learn how to heal, yet somehow, do you really believe we are being taught in some secret medical school class how to abuse human beings purely for our benefit? Do you think we have a ritual where we have to strangle kittens and puppies to prove ourselves?"

"Patients will not find it persuasive, and neither should they."

 2016 Fall;27(3):227-232.

Accommodating Conscientious Objection in Medicine-Private Ideological Convictions Must Not Trump Professional Obligations.

Author information

  • 1Queen's University, Department of Philosophy, Bader Lane, Watson Hall 309, Kinston, Ontario K7L 3N6 Canada. udo.schuklenk@gmail.com.

Abstract

The opinion of the American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) on the accommodation of conscientious objectors among medical doctors aims to balance fairly patients' rights of access to care and accommodating doctors' deeply held personal beliefs. Like similar documents, it fails. Patients will not find it persuasive, and neither should they. The lines drawn aim at a reasonable compromise between positions that are not amenable to compromise. They are also largely arbitrary. This article explains why that is the case. The view that conscientious objection accommodation has no place in modern medicine is defended.

Texas Not Budging on Rule Requiring Burial or Cremation of Fetal Remains

Texas Not Budging on Rule Requiring Burial or Cremation of Fetal Remains


"Despite intense outcry from the medical community and reproductive rights advocates, Texas isn't budging on a proposed rule to require the cremation or burial of fetal remains.
Following an initial public comment period that sparked medical concerns and a legal threat, Texas health officials have re-submitted for public consideration a proposed rule change that prohibits hospitals, abortion clinics and other health care facilities from disposing of fetal remains in sanitary landfills, instead allowing only cremation or interment of all remains regardless of the period of gestation — even in instances of miscarriages."

HT:JS

Pediatric obesity guidelines

Pediatric obesity guidelines serve as toolkit for treating patients with obesity


"The Obesity Medicine Association today released guidelines on pediatric obesity care for healthcare professionals who make decisions for pediatric patients with obesity. In a project led by Dr. Suzanne Cuda, associate professor of pediatrics at Baylor College of Medicine and pediatrician at The Children’s Hospital of San Antonio, the guidelines were developed by practicing pediatricians and clinicians and provide clinicians a toolkit to guide them through diagnosis, management and treatment of infants, children and adolescents with obesity."

Friday, September 16, 2016

Social Capital is Associated With Late HIV Diagnosis

 2016 Oct 1;73(2):213-221.

Social Capital is Associated With Late HIV Diagnosis: An Ecological Analysis.

Author information

  • 1*Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA;†School of Public Health, Boston University, Boston, MA;‡Community Health Sciences, University of Nevada School, Reno, NV;§HIV Epidemiology and Field Services Program New York City, Department of Health and Mental Hygiene, Long Island City, NY; and‖Graduate School of Public Health and Health Policy, City University of New York, New York, NY.

Abstract

BACKGROUND:

Late HIV diagnosis is associated with higher medical costs, early mortality among individuals, and HIV transmission in the population. Even under optimal configurations of stable or declining HIV incidence and increase in HIV case findings, no change in proportion of late HIV diagnosis is projected after year 2019. We investigated the association among social capital, gender, and late HIV diagnosis.

METHODS:

We conduct ecological analyses (ZIP code, N = 166) using negative binomial regression of gender-specific rates of late HIV diagnoses (an AIDS defining illness or a CD4 count ≤200 cell/μL within 12 months of a new HIV diagnosis) in 2005 and 2006 obtained from the New York City HIV Surveillance Registry, and social capital indicators (civic engagement, political participation, social cohesion, and informal social control) from the New York Social Indicators Survey, 2004.

RESULTS:

Overall, low to high political participation and social cohesion corresponded with significant (P < 0.0001) decreasing trends in late HIV diagnosis rates. Among men [relative risk (RR) = 0.66, 95% CI: (0.47 to 0.98)] and women [RR = 0.43, 95% CI: (0.28 to 0.67)], highest political participation was associated with lower relative odds of late HIV diagnosis, independent of income inequality. Highest informal social control [RR = 0.67, 95% CI: (0.48 to 0.93)] among men only and moderate social cohesion [RR = 0.71, 95% CI: (0.55 to 0.92)] among women only were associated with the outcome adjusting for social fragmentation, income inequality, and racial composition.

DISCUSSION:

The magnitude of association between social capital and late HIV diagnosis varies by gender and by social capital indicator.

"Despite progress in other areas, in industrialized nations, employment rates for people with disabilities keep falling."

Clocked Out for Good

Despite progress in other areas, in industrialized nations, employment rates for people with disabilities keep falling.


"The trend extends well beyond U.S. borders to other industrialized nations and to thedeveloping world, where the problem is more severe. But, despite international awareness that people with disabilities have the right to work – an entitlement enshrined in the United Nations Convention on the Rights of Persons With Disabilities – even the most advanced economies can't seem to find a way to successfully integrate them into the workplace."

Thursday, September 15, 2016

Holistic Review in Medical School Admissions and Selection: A Strategic, Mission-Driven Response to Shifting Societal Needs

 2016 Sep 13. [Epub ahead of print]

Holistic Review in Medical School Admissions and Selection: A Strategic, Mission-Driven Response to Shifting Societal Needs.

Author information

  • 1S.S. Conrad is director, Advancing Holistic Review Initiative, Association of American Medical Colleges, Washington, DC. A.N. Addams is director, Student Affairs, Strategy & Alignment, Association of American Medical Colleges, Washington, DC. G.H. Young is senior director, Student Affairs and Programs, Association of American Medical Colleges, Washington, DC.

Abstract

Medical schools and residency programs have always sought excellence in the areas of education, research, and clinical care. However, these pursuits are not accomplished within a vacuum-rather, they are continually and necessarily influenced by social, cultural, political, legal, and economic forces. Persistent demographic inequalities coupled with rapidly evolving biomedical research and a complex legal landscape heighten our collective awareness and emphasize the continued need to consider medicine's social contract when selecting, educating, and developing physicians and physician-scientists.Selection-who gains access to a medical education and to a career as a physician, researcher, and/or faculty member-is as much art as science. Quantitative assessments of applicants yield valuable information but fail to convey the full story of an applicant and the paths they have taken. Human judgment and evidence-based practice remain critical parts of implementing selection processes that yield the desired outcomes. Holistic review, in promoting the use of strategically designed, evidence-driven, mission-based, diversity-aware processes, provides a conceptual and practical framework for marrying the art with the science without sacrificing the unique value that each brings.In this Commentary, the authors situate medical student selection as both responsive to and informed by broader social context, health and health care needs, educational research and evidence, and state and federal law and policy. They propose that holistic review is a strategic, mission-driven, evidence-based process that recognizes diversity as critical to excellence, offers a flexible framework for selecting future physicians, and facilitates achieving institutional mission and addressing societal needs.

More Than 1 in 4 Adults Get No Regular Exercise, Study Shows

More Than 1 in 4 Adults Get No Regular Exercise, Study Shows


"Inactivity increased with age: among people aged 75 years or older, the prevalence was 35.3% (95% CI, 34.5 - 36.1), compared with 26.9% (95% CI, 26.3 - 27.5) among people aged 65 to 74 years and 25.4% (95% CI, 25.0 - 25.9) among those aged 50 to 64 years.
There was a marked inverse relationship between physical activity and educational level. The prevalence of inactivity was highest among people with less than a high school degree, at 44.1% (95% CI, 42.7 - 45.4); it decreased progressively for high school graduates (34.7%; 95% CI, 34.0 - 35.3) and people with some college (24.6%; 95% CI, 24.0 - 25.2), and reached a low of 14.2% (95% CI, 13.8-14.7) among those with a college degree.
Inactivity was more prevalent among Hispanics (32.7%; 95% CI, 31.0 - 34.5) and non-Hispanic blacks (33.1%; 95% CI, 31.8 - 34.3) than non-Hispanic whites (26.2%; 95% CI, 25.9 - 26.5) or people of other races or ethnicities (27.1%; 95% CI, 24.9 - 29.5). It was also higher among people who were obese, defined as having a body mass index (BMI) of at least 30 kg/m2 (35.8%; 95% CI, 35.1 - 36.4), compared with those with a BMI <25.0 kg/m2 (23.1%; 95% CI, 22.5 - 23.7).
Inactivity was also more prevalent among those with chronic illness. This was especially the case with COPD (44.4%; 95% CI, 43.3 - 45.5) vs 25.6% (95% CI, 25.2 - 25.9) among people without COPD, and stroke (42.9%; 95% CI, 41.3 - 44.5), vs 26.7% (95% CI, 26.3 - 27.0) among people with no history of stroke."

Tuesday, September 13, 2016

If you build it, they will come: unintended future uses of organised health data collections

 2016 Sep 6;17(1):54. doi: 10.1186/s12910-016-0137-x.

If you build it, they will come: unintended future uses of organised health data collections.

Author information

  • 1Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada. kieran.odoherty@uoguelph.ca.
  • 2Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada.
  • 3Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway.
  • 4Norwegian Research Center for Computers and Law, Faculty of Law, University of Oslo, Oslo, Norway.
  • 5Norwegian Cancer Genomics Consortium, Oslo, Norway.
  • 6Department of Bioethics & Humanities, University of Washington, Seattle, USA.
  • 7Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • 8UCSF Bioethics, Institute for Health & Aging, University of California, San Francisco, USA.
  • 9Institute of Health Policy Management and Evaluation | Joint Centre for Bioethics, University of Toronto, Toronto, Canada.
  • 10Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Canada.

Abstract

BACKGROUND:

Health research increasingly relies on organized collections of health data and biological samples. There are many types of sample and data collections that are used for health research, though these are collected for many purposes, not all of which are health-related. These collections exist under different jurisdictional and regulatory arrangements and include: 1) Population biobanks, cohort studies, and genome databases 2) Clinical and public health data 3) Direct-to-consumer genetic testing 4) Social media 5) Fitness trackers, health apps, and biometric data sensors Ethical, legal, and social challenges of such collections are well recognized, but there has been limited attention to the broader societal implications of the existence of these collections.

DISCUSSION:

Although health research conducted using these collections is broadly recognized as beneficent, secondary uses of these data and samples may be controversial. We examine both documented and hypothetical scenarios of secondary uses of health data and samples. In particular, we focus on the use of health data for purposes of: Forensic investigations Civil lawsuits Identification of victims of mass casualty events Denial of entry for border security and immigration Making health resource rationing decisions Facilitating human rights abuses in autocratic regimes

CONCLUSIONS:

Current safeguards relating to the use of health data and samples include research ethics oversight and privacy laws. These safeguards have a strong focus on informed consent and anonymization, which are aimed at the protection of the individual research subject. They are not intended to address broader societal implications of health data and sample collections. As such, existing arrangements are insufficient to protect against subversion of health databases for non-sanctioned secondary uses, or to provide guidance for reasonable but controversial secondary uses. We are concerned that existing debate in the scholarly literature and beyond has not sufficiently recognized the secondary data uses we outline in this paper. Our main purpose, therefore, is to raise awareness of the potential for unforeseen and unintended consequences, in particular negative consequences, of the increased availability and development of health data collections for research, by providing a comprehensive review of documented and hypothetical non-health research uses of such data.

On Not Reading

On Not Reading


By Amy Hungerford 


"Here is why refusal is so important. Sometimes scholars will need not just to silently make their choices without acknowledging the choices forgone, but to refuse, in a reasoned and deliberate way, to read what the literary press and the literary marketplace put forward as worthy of attention. This requires a distinctly nonscholarly form of reasoning: One must decide, without reading a work, whether it is worth the time to read it or not. And a decision not to read must be defended, and received, on the basis of this different standard of evidence.
Why admit to this unscholarly approach, which seems to run against all our intellectual values — the commitment to open-minded reading and exploration, the commitment to gathering a credible body of evidence before making an argument or a judgment? We need to tolerate this shortfall in method because a scarce resource is at stake: the reader’s time, and, by extension, the attention that could be paid to any number of other books among the throngs that will always remain unread."

"Individually, they all came to realize that wellness programs alienated employees and wasted money."

Workplace wellness programs are a total sham


"Individually, they all came to realize that wellness programs alienated employees and wasted money. After Khanna accepted a job running a wellness program for a nonprofit health system, he says, "I had a light bulb moment when I realized that these people who want these wellness programs and are running them really, literally have no idea what they're doing."
Their criticisms of the industry start with two of the most common tools in the wellness program's toolbox: the health risk assessment and the biometric screening. HRAs typically offer advice that any moderately educated adult has already heard hundreds of times: Eat lots of fruits and vegetables. Exercise. Don't smoke. Get enough sleep."

Monday, September 12, 2016

"If the left’s predicament comes down to a single fault, it is this. It is very good at demanding change, but pretty hopeless at understanding it."

Does the left have a future?

All over the west, the left is in crisis. It cannot find answers to three urgent problems: the disruptive force of globalisation, the rise of populist nationalism, and the decline of traditional work
"If the left’s predicament comes down to a single fault, it is this. It is very good at demanding change, but pretty hopeless at understanding it. Supposedly radical elements too often regard deep technological shifts as the work of greedy capitalists and rightwing politicians, and demand that they are rolled back. Meanwhile, the self-styled moderates tend to advocate large-scale surrender, instead of recognising that technological and economic changes can create new openings for left ideas. A growing estrangement from the left’s traditional supporters makes these problems worse, and one side tends to cancel out the other. The result: as people experience dramatic change in their everyday lives, they form the impression that half of politics has precious little to say to them."

Obesity In The US Military Spiked In Past 15 Years

Obesity In The US Military Spiked In Past 15 Years

Ethical erosion in newly qualified doctors

 2016 Sep 6;7:286-92. doi: 10.5116/ijme.57b8.48e4.

Ethical erosion in newly qualified doctors: perceptions of empathy decline.

Author information

  • 1John Radcliffe Hospital, Oxford, UK.
  • 2The University of Manchester, UK.
  • 3Health Education England (North West Office), UK.

Abstract

OBJECTIVES:

This study sought to understand whether UK Foundation doctors perceived the phenomena of ethical erosion and empathy decline during their initial period of clinical practice, and if so, why this occurred.

METHODS:

This qualitative study used semi-structured interviews with nine doctors in their first year of clinical practice at Royal Bolton Hospital, UK. Participants were invited to discuss the definition of empathy, how individuals acquire and maintain empathic ability, perceptions of ethical erosion in the self and others, and how clinical experiences have influenced their empathic ability. The interviews were transcribed, and analysed to identify emergent themes.

RESULTS:

Each participant reported a conscious acknowledgement of empathy decline in their own and their colleagues' early clinical experiences as doctors. Stressful working environments, the prioritisation of patients' physical rather than psychological well-being, and the attitudes of senior colleagues were all suggested as possible causes. Some doctors believed that specialties with reduced patient contact had a culture which precluded empathy, and influenced their own practice. In addition, some described how their value judgements of patients had affected their ability to empathise. However, all doctors perceived that empathy skills were desirable in senior clinicians, and some believed that educational interventions may be useful in arresting ethical erosion.

CONCLUSIONS:

Newly qualified doctors are aware of ethical erosion in themselves and their colleagues as they begin clinical practice. This has serious implications for patient care. Improving working conditions may reverse this trend. Empathy skills training within undergraduate and postgraduate curricula may be a useful intervention.

Wednesday, September 7, 2016

Why the University of Chicago Law School is the best

A Fix for the Culture Wars


SEP 7, 2016 11:40 AM EDT
By



Monday, September 5, 2016

Biomarker Testing in Lung Carcinoma Cytology Specimens: A Perspective From Members of the Pulmonary Pathology Society

 2016 Apr 15. [Epub ahead of print]

Biomarker Testing in Lung Carcinoma Cytology Specimens: A Perspective From Members of the Pulmonary Pathology Society.

Author information

  • 1From the Department of Pathology, University of Texas MD Anderson Cancer Center, Houston (Dr Roy-Chowdhuri); the Department of Pathology, University of Colorado Cancer Center, Denver (Dr Aisner); the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen); the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Beasley); the Department of Pathology, Weill Cornell Medical College, New York (Drs Borczuk and Cagle); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Cagle); the Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil (Dr Capelozzi); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, University Health Network, Princess Margaret Cancer Centre, and the University of Toronto, Toronto, Ontario, Canada (Drs da Cunha Santos and Tsao); the Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston (Drs Hariri and Mino-Kenudson); the Department of Pathology, Aberdeen University Medical School, and Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, United Kingdom (Dr Kerr); the Department of Biopathology, Centre Léon Bérard, Lyon, and J Fourier University, Institut National de la Santé et de la Recherche Médicale-Institut Albert Bonniot, Grenoble, France (Dr Lantuejoul); the Department of Pathology, New York University, New York (Dr Moreira); the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois (Dr Raparia); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York (Dr Rekhtman); the Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston (Drs Sholl and Vivero); the Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands (Dr Thunnissen); and the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe).

Abstract

The advent of targeted therapy in lung cancer has heralded a paradigm shift in the practice of cytopathology with the need for accurately subtyping lung carcinoma, as well as providing adequate material for molecular studies, to help guide clinical and therapeutic decisions. The variety and versatility of cytologic-specimen preparations offer significant advantages to molecular testing; however, they frequently remain underused. Therefore, evaluating the utility and adequacy of cytologic specimens is critical, not only from a lung cancer diagnosis standpoint but also for the myriad ancillary studies that are necessary to provide appropriate clinical management. A large fraction of lung cancers are diagnosed by aspiration or exfoliative cytology specimens, and thus, optimizing strategies to triage and best use the tissue for diagnosis and biomarker studies forms a critical component of lung cancer management. This review focuses on the opportunities and challenges of using cytologic specimens for molecular diagnosis of lung cancer and the role of cytopathology in the molecular era.

"...mounting evidence linking loneliness to physical illness and to functional and cognitive decline."

The Health Effects of Growing Old, and Lonely

Sunday, September 4, 2016

"But the fact that the Rolling Stones can still sell out stadiums 52 years after the release of their first album does not mean that their music has passed the test of posterity."

Is It Here to Stay?

Rock’n’roll considered
 


"But the fact that the Rolling Stones can still sell out stadiums 52 years after the release of their first album does not mean that their music has passed the test of posterity. Was baby-boom rock as musically significant as golden-age American popular music long ago proved itself to be? Or might it be that its popularity was an epiphenomenon of the turmoil of the ’60s and ’70s, and that its latter-day appeal is nothing more than a manifestation of the longing of the boomers for their lost youth?"

Obesity Rates Fall in Minnesota, Montana, New York and Ohio

Obesity Rates Fall in Four States


"There's some good news about obesity in the U.S. for a change. Rates of obesity fell in four states last year: Minnesota, Montana, New York and Ohio, according to a report released Thursday."

The convergent and divergent evolution of social-behavioral economics

 2016 Jan;39:e96. doi: 10.1017/S0140525X15001028.

The convergent and divergent evolution of social-behavioral economics.

Author information

  • 1Department of Biological Sciences,Simon Fraser University,Burnaby,BC V5A 1S6,Canada.Crespi@sfu.cahttp://www.sfu.ca/biology/faculty/crespi/

Abstract

Human hunter-gatherers share a suite of traits with social insects, which demonstrates convergent social evolution of these taxa prior to agriculture. Humans differ from social insects in that their divisions of labor are more competitive than cooperative. Resulting higher within-group competition in humans has been alleviated by religion and culturally imposed monogamy, both of which also find parallels among social insects.

"...overweight patients and smokers waiting up to a year for elective surgery"


Plans to deny surgery to obese patients and smokers put on hold

Vale of York NHS group to review policy that would mean overweight patients and smokers waiting up to a year for elective surgery

"The report by the CCG said obese patients may secure a referral in less than a year if they shed 10% of their weight. Similarly, if smokers refuse to quit they faced having procedures delayed for up to six months, which can be accelerated if they quit their habit for eight weeks.
News of the proposed rationing sparked criticism from the former health minister Norman Lamb, who said it was “outrageous”.
NHS Providers, which represents NHS leaders, said similar proposals were likely to follow in future."

Thursday, September 1, 2016

The Archives of Pathology & Laboratory Medicine: The Most Widely Read Pathology Journal Today

Timothy Craig Allen MD, JD
From the Departments of Pathology and Laboratory Services, The University of Texas Medical Branch, Galveston.

The author has no relevant financial interest in the products or companies described in this article.
Reprints: Timothy Craig Allen, MD, JD, Departments of Pathology and Laboratory Services, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555 (email: ).
The Archives of Pathology & Laboratory Medicine was first published in 1926 as a subspecialty journal of the American Medical Association. It became the official journal of the College of American Pathologists in 1995. Under the dynamic leadership of its most recent editor-in-chief, Philip T. Cagle, MD, and his vibrant editorial board, the Archives has nearly doubled its impact factor and become the most widely read general pathology journal today. Dr Cagle has consistently added leading pathologists to the editorial board, and the collective expertise of these individuals is clearly evident in new, cutting-edge journal masthead sections. The Archives has featured innovative content in the field of digital pathology, including articles on the utilization of smart phones in pathology and incorporation of whole-slide images and videos into the content of articles. Special sections have characterized the Archives during the current editorial board's tenure and have proven immensely popular with the journal's readership. As the Archives celebrates its 90th anniversary, its editorial board remains committed to providing insightful and relevant medical knowledge. The journal's open access Web site (www.archivesofpathology.org) allows the dissemination of this knowledge to every corner of the globe at no expense to those who wish to be educated or improve their medical practice.