Saturday, October 21, 2017

"...one of the finest science fiction novellas ever written."

John W. Campbell's Who Goes There


"In 1973, the story was voted by the Science Fiction Writers of America as one of the finest science fiction novellas ever written."

"...our children may live less healthy and shorter lives than their parents..."

Nearly 4 in 10 U.S. Adults Now Obese


Obesity is defined as a body mass index of 30 or more. A 6-foot-tall man weighing 221 pounds is considered obese, as is a 5-foot-9 woman weighing 203 pounds.
The increase in youth obesity is of particular concern because these children are at greater risk for lifelong health problems, said Dr. Seema Kumar, a childhood obesity specialist with the Mayo Clinic.
Kumar said she regularly sees children with diseases that used to be considered adult-only, including type 2 diabetes, high blood pressure, high cholesterol and fatty liver disease.
"Because rates of obesity are so high, despite all the advances we're seeing, our children may live less healthy and shorter lives than their parents," Kumar said. "We're going to have a much higher number of adults with diabetes, high blood pressure and heart disease down the line."

"The consequences of obesity in children are immediate, and future health risks include high blood pressure, high cholesterol, breathing problems, diabetes, etc."

Why is childhood obesity on the rise?

According to the World Health Organization, children are 10 times more obese than kids 40 years ago.  


"The consequences of obesity in children are immediate, and future health risks include high blood pressure, high cholesterol, breathing problems, diabetes, etc."





Diabetes boosts risk of cognitive issues after surgery, especially in seniors, study finds

Diabetes boosts risk of cognitive issues after surgery, especially in seniors, study finds


After adjusting for age, sex, surgery type, randomization, obesity and hypertension, the researchers determined diabetes was associated with an 84 percent higher risk of POCD. Patients age 65 or older were at particularly high risk.
"Our findings suggest that consideration of diabetes status may be helpful for the assessment of POCD risk among patients undergoing surgery," said Dr. Lachmann. "Further studies are warranted to examine the potential mechanisms of this association, to ultimately help in the development of potential strategies for prevention."

Michelle Mello and colleagues: Patients' Experiences With Communication-and-Resolution Programs After Medical Injury

 2017 Oct 9. doi: 10.1001/jamainternmed.2017.4002. [Epub ahead of print]

Patients' Experiences With Communication-and-Resolution Programs After Medical Injury.

Author information

1
Faculty of Law, University of New South Wales, Sydney, Australia.
2
School of Population and Global Health, University of Melbourne, Melbourne, Australia.
3
Stanford Law School, Stanford University, Stanford, California.
4
Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California.

Abstract

IMPORTANCE:

Dissatisfaction with medical malpractice litigation has stimulated interest by health care organizations in developing alternatives to meet patients' needs after medical injury. In communication-and-resolution programs (CRPs), hospitals and liability insurers communicate with patients about adverse events, use investigation findings to improve patient safety, and offer compensation when substandard care caused harm. Despite increasing interest in this approach, little is known about patients' and family members' experiences with CRPs.

OBJECTIVE:

To explore the experiences of patients and family members with medical injuries and CRPs to understand different aspects of institutional responses to injury that promoted and impeded reconciliation.

DESIGN, SETTING, AND PARTICIPANTS:

From January 6 through June 30, 2016, semistructured interviews were conducted with patients (n = 27), family members (n = 3), and staff (n = 10) at 3 US hospitals that operate CRPs. Patients and families were eligible for participation if they experienced a CRP, spoke English, and could no longer file a malpractice claim because they had accepted a settlement or the statute of limitations had expired. The CRP administrators identified hospital and insurer staff who had been involved in a CRP event and had a close relationship with the injured patient and/or family. They identified patients and families by applying the inclusion criteria to their CRP databases. Of 66 possible participants, 40 interviews (61%) were completed, including 30 of 50 invited patients and families (60%) and 10 of 16 invited staff (63%).

MAIN OUTCOMES AND MEASURES:

Patients' reported satisfaction with disclosure and reconciliation efforts made by hospitals.

RESULTS:

A total of 40 participants completed interviews (15 men and 25 women; mean [range] age, 46 [18-67] years). Among the 30 patients and family members interviewed, 27 patients experienced injuries attributed to error and received compensation. The CRP experience was positive overall for 18 of the 30 patients and family members, and 18 patients continued to receive care at the hospital. Satisfaction was highest when communications were empathetic and nonadversarial, including compensation negotiations. Patients and families expressed a strong need to be heard and expected the attending physician to listen without interrupting during conversations about the event. Thirty-five of the 40 respondents believed that including plaintiffs' attorneys in these discussions was helpful. Sixteen of the 30 patients and family members deemed their compensation to be adequate but 17 reported that the offer was not sufficiently proactive. Patients and families strongly desired to know what the hospital did to prevent recurrences of the event, but 24 of 30 reported receiving no information about safety improvement efforts.

CONCLUSIONS AND RELEVANCE:

As hospitals strive to provide more patient-centered care, opportunities exist to improve institutional responses to injuries and promote reconciliation.

A Decade of War: Prospective Trajectories of Post-Traumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure

 2017 Sep 27. doi: 10.1093/aje/kwx318. [Epub ahead of print]

A Decade of War: Prospective Trajectories of Post-Traumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure.

Abstract

Post-traumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies across individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members participating in the Millennium Cohort Study from 2001-2011. Using latent class growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample and in individuals with and without combat exposure. Four trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate-stable. Across all trajectories combat deployed service members diverged from non-combat deployed service members after a single deployment, and generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat and 80% of those with combat exposure remained resilient over the 10-year period. Findings demonstrate the clinical course of PTSD symptoms have heterogeneous patterns of development, but that combat exposure is uniformly associated with poorer mental health.

Weight loss medications in Canada - a new frontier or a repeat of past mistakes?

 2017 Oct 4;10:413-417. doi: 10.2147/DMSO.S141571. eCollection 2017.

Weight loss medications in Canada - a new frontier or a repeat of past mistakes?

Author information

1
The Wharton Medical Clinic, Hamilton, ON, Canada.
2
School of Kinesiology and Health Science, York University, Toronto, ON, Canada.

Abstract

Current methods for the treatment of excess weight can involve healthy behavior changes, pharmacotherapy, and surgical interventions. Many individuals are able to lose some degree of weight through behavioral changes; however, they are often unable to maintain their weight loss long-term. This is in part due to physiological processes that cannot be addressed through behavioral changes alone. Bariatric surgery, which is the most successful treatment for excess weight to date, does result in physiological changes that can help with weight loss and weight maintenance. However, many patients either do not qualify or elect to not have this procedure. Fortunately, research has recently identified changes in neurochemicals (i.e., orexigens and anorexigens) that occur during weight loss and contribute to weight regain. The neurochemicals and hormones may be able to be targeted by medications to achieve greater and more sustained weight loss. Two medications are approved in adjunction to lifestyle management for weight loss in Canada: orlistat and liraglutide. Both medications are able to target physiological processes to help patients lose weight and maintain a greater amount of weight loss than with just behavioral modifications alone. Two other weight management medications, which also target specific physiological processes to aid in weight loss and its maintenance, a bupropion/naltrexone combination and lorcaserin, are currently pending approval in Canada. Nonetheless, there remain significant barriers for health care professionals to prescribe medications for weight loss, such as a lack of training and knowledge in the area of obesity. Until this has been addressed, and we begin treating obesity as we do other diseases, we are unlikely to combat the increasing trend of obesity in Canada and worldwide.

A Big Test of Police Body Cameras Defies Expectations (HT:DC)

A Big Test of Police Body Cameras Defies Expectations


"Usually, we behave better when we know we’re being watched. According to decades of research, the presence of other people, cameras or even just a picture of eyes seems to nudge us toward civility: We become more likely to give to charity, for example, and less likely to speed, steal or take more than our fair share of candy.
But what happens when the cameras are on the chests of police officers? The results of the largest, most rigorous study of police body cameras in the United States came out Friday morning, and they are surprising both police officers and researchers."


HT:DC

"...the authors estimate a lower bound of over 32,000 papers that have worked on the wrong cells, compared to what they report."

Bad Cells. So Many Bad Cells.


"Here’s a new paper in PLoS ONE that tries to get a handle on the problem. The real kicker is that some of these cell lines became contaminated along the way, so that earlier papers and later ones in the field are actually referring to different cells. And others became contaminated (or mis-identified) so early that basically all of the literature on them is mistaken. Warnings have taken place about this stuff again and again, and the current literature is surely cleaner than the older papers. But how bad is it in the published record?
By correlating the literature with a list of known contaminated cell lines (many of them invaded by HeLa cells), the authors estimate a lower bound of over 32,000 papers that have worked on the wrong cells, compared to what they report. In turn, these papers are cited by at least 500,000 more articles, and that total excludes self-citations. And as the authors note, they were quite conservative with their name strings in the searches, so although there are also still a few false positives in those numbers, they are surely tiny compared to the false negatives – the mistaken papers that haven’t been flagged yet." 

"...children from the most deprived areas more than twice as likely to be obese..."

Obesity in schools continuing to rise

The report also found that obesity prevalence for children living in the most deprived areas was more than double that of those living in the least deprived areas for both reception and year six.
Obesity also varied by local authority. For reception this ranged from 4.8% in Kingston-upon-Thames to 13.5% in Wolverhampton.
“The latest data also shows that inequalities are widening, with children from the most deprived areas more than twice as likely to be obese as those from the least deprived,” said Buck.

Friday, October 20, 2017

"Art must be dangerous. Once it has ceased to be dangerous it is no use."

In the loop


This is the edited text of a speech given in June at the annual dinner of the Royal Academy of Arts in London.
"Anthony Burgess wrote 'There can be no art till craft has been mastered. Art must be dangerous. Once it has ceased to be dangerous it is no use'. Burgess was born a century ago, 1917 – the year that Marcel Duchamp changed forever the face of urinals. His tiresome schoolboy jest has spawned numberless hackneyed imitations which are far from dangerous. And no use."

Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing

 2017 Oct 16. doi: 10.1001/jamainternmed.2017.5152. [Epub ahead of print]

Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing.

Author information

1
Department of Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
2
Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
3
Division of General Internal Medicine, Department of Medicine, Sinai Health System, Toronto, Ontario, Canada.
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
5
Division of General Internal Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
6
The Michigan Medicine/Institute for Healthcare Policy and Innovation for Program on Value Enhancement, Ann Arbor.
7
Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
8
Division of Hospital Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
9
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
10
Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, Maryland.
11
Section of Hospital Medicine, Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville.

Abstract

Routine daily laboratory testing of hospitalized patients reflects a wasteful clinical practice that threatens the value of health care. Choosing Wisely initiatives from numerous professional societies have identified repetitive laboratory testing in the face of clinical stability as low value care. Although laboratory expenditure often represents less than 5% of most hospital budgets, the impact is far-reaching given that laboratory tests influence nearly 60% to 70% of all medical decisions. Excessive phlebotomy can lead to hospital-acquired anemia, increased costs, and unnecessary downstream testing and procedures. Efforts to reduce the frequency of laboratory orders can improve patient satisfaction and reduce cost without negatively affecting patient outcomes. To date, numerous interventions have been deployed across multiple institutions without a standardized approach. Health care professionals and administrative leaders should carefully strategize and optimize efforts to reduce daily laboratory testing. This review presents an evidence-based implementation blueprint to guide teams aimed at improving appropriate routine laboratory testing among hospitalized patients.

#ProzacNation

Entitled Nation


"One, the U.S. government owes more than $20 trillion to foreign and domestic investors. Two, the national debt is well beyond 100 percent of the total annual output of the American economy—a defensible state of affairs during a cataclysm on the order of the Second World War but sheer idiocy in peacetime. Three, the federal government’s yearly expenditures outstrip revenues by half a trillion dollars or more—our current budget deficit is $693 billion and climbing. Four, by far the largest contributors to our debt and deficits are the big three 'entitlement' programs, Medicaid, Medicare, and Social Security. And five, there is currently no plan to do anything about any of it."


In the 80s, this was called warming up.

Walking only 17 minutes a day could extend your life, experts say

"Walking did the best job at preventing death from respiratory disease; six hours a week of walking led to a 35 percent lower risk of death compared to those who did not do any physical activity.
Another benefit? Walking improves mental health, reduces depression and improves cognitive function. Psychology Today called the results “a landmark study,” pointing out that another study released this month showed that one hour of exercise a week — at any intensity — helps prevent future depression."

#PumpIron

Physical inactivity and restless sleep exacerbate genetic risk of obesity


"They found the strongest evidence to date of a modest gene-activity interaction. For example, for a person of average height with 10 genetic variants associated with obesity, that genetic risk accounted for a 3.6 kilogram increase in weight among those who were less physically active but just 2.8 kilograms among those who were more active. Results were similar in analyses of sleep patterns; among participants with some genetic risk of obesity, those who woke up frequently or slept more restlessly had higher BMIs than those who slept more efficiently.
The researchers are currently examining whether this interaction between genetics and  differs between men and women. They are also studying the effects of patterns of activity - for example, whether a consistent level of moderate activity has different effects from overall low levels punctuated by periods of vigorous ."

"Job Lock" Among Long-term Survivors of Childhood Cancer

 2017 Oct 19. doi: 10.1001/jamaoncol.2017.3372. [Epub ahead of print]

"Job Lock" Among Long-term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study.

Author information

1
Huntsman Cancer Institute, University of Utah, Salt Lake City.
2
Department of Pediatrics, University of Utah, Salt Lake City.
3
Department of Medicine, Massachusetts General Hospital Cancer Center, Boston.
4
Harvard Medical School, Boston.
5
Department of Pediatrics, Massachusetts General Hospital, Boston.
6
Department of Pediatrics, Harvard Medical School, Boston.
7
Clinical Research Division and Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
8
Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston.
9
Massachusetts General Hospital Cancer Survivorship Program, Massachusetts General Hospital Cancer Center, Boston.
10
Department of Medicine, Duke University Medical Center, Durham, North Carolina.
11
Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
12
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
13
Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee.

Abstract

IMPORTANCE:

Childhood cancer survivors may be reluctant to make changes in their employment because of access to health insurance.

OBJECTIVE:

To examine the prevalence of "job lock" (staying at a job to keep work-related health insurance) in a sample drawn from an established, multi-institutional cohort of full-time employed childhood cancer survivors compared with a random sample of siblings and to explore factors associated with job lock among cancer survivors.

DESIGN, SETTING, AND PARTICIPANTS:

Cross-sectional survey of full-time employed adult survivors of childhood cancer and a random sample of siblings derived from a cohort of 25 US pediatric oncology centers.

EXPOSURES:

Data collection included sociodemographic factors, insurance coverage, chronic medical conditions, and treatment.

MAIN OUTCOMES AND MEASURES:

Self-report of job lock and factors associated with job lock.

RESULTS:

Among the 522 participants, 394 were cancer survivors (54.5% male) and 128 were siblings (51.5% male). Job lock was reported by 23.2% (95% CI, 18.9%-28.1%) of survivors, compared with 16.9% (95% CI, 11.1%-25.0%) of siblings (P = .16). Job lock was more common among survivors reporting previous health insurance denial (relative risk [RR], 1.60; 95% CI, 1.03-2.52) and problems paying medical bills (RR, 2.43; 95% CI, 1.56-3.80). Among survivors, being female (RR, 1.70; 95% CI, 1.11-2.59; P = .01) and having a severe, disabling, or life-threatening health condition (RR, 1.72; 95% CI, 1.09-2.69; P = .02) were associated with job lock.

CONCLUSIONS AND RELEVANCE:

Job lock is common among long-term childhood cancer survivors who are employed full-time. A survivor's decision to remain employed at a job in order to maintain health insurance coverage may affect career trajectory, diminish potential earning power, and ultimately impact quality of life.

Obesity as malnourishment

Obesity as malnourishment



"Obesity is often blamed on overeating and lack of willpower.
Overweight people might think that something is inherently wrong with them because they cannot control their calorie intake.
I want to shatter this myth once and for all.
The seeming lack of control is the body’s way of letting us know it needs something that it is not getting.
If we eat low nutrient foods (no matter what the calorie count is), the cravings never end and we keep eating in a desperate but futile attempt to nourish ourselves.
Obesity is one way the body indicates to us that it is not receiving the nutrients it needs to function in the easy and elegant manner that it was designed for."

Thursday, October 19, 2017

Economics. Round One and Round Two

Economics.  Round One and Round Two

Country and regional variations in purchase prices for essential cancer medications

 2017 Aug 24;17(1):566. doi: 10.1186/s12885-017-3553-5.

Country and regional variations in purchase prices for essential cancer medications.

Cuomo RE1,2,3Seidman RL4Mackey TK5,6,7.

Author information

1
Joint Doctoral Program in Global Public Health, University of California, San Diego - San Diego State University, San Diego, CA, USA.
2
Global Health Policy Institute, San Diego, CA, USA.
3
Department of Anesthesiology, University of California, San Diego - School of Medicine, San Diego, CA, USA.
4
Division of Health Management and Policy, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
5
Global Health Policy Institute, San Diego, CA, USA. tmackey@ucsd.edu.
6
Department of Anesthesiology, University of California, San Diego - School of Medicine, San Diego, CA, USA. tmackey@ucsd.edu.
7
Division of Global Public Health, University of California, San Diego - School of Medicine, San Diego, CA, USA. tmackey@ucsd.edu.

Abstract

BACKGROUND:

Accessibility to essential cancer medications in low- and middle-income countries is threatened by insufficient availability and affordability. The objective of this study is to characterize variation in transactional prices for essential cancer medications across geographies, medication type, and time.

METHODS:

Drug purchase prices for 19 national and international buyers (representing 29 total countries) between 2010 and 2014 were obtained from Management Sciences for Health. Median values for drug pricing were computed, to address outliers in the data. For comparing purchase prices across geographic units, medications, and over time; Mann-Whitney U tests were used to compare two groups, Kruskal Wallis H tests were used to compare more than two groups, and linear regression was used to compare across continuous independent variables.

RESULTS:

During the five-year data period examined, the median price paid for a package of essential cancer medication was $12.63. No significant differences in prices were found based on country-level wealth, country-level disease burden, drug formulation, or year when medication was purchased. Statistical tests found significant differences in prices paid across countries, regions, individual medications, and medication categories. Specifically, countries in the Africa region appeared to pay more for a package of essential cancer medication than countries in the Latin America region, and cancer medications tended to be more expensive than anti-infective medications and cardiovascular medications.

CONCLUSIONS:

Though preliminary, our study found evidence of variation in prices paid by health systems to acquire essential cancer medications. Primarily, variations in pricing based on geographic location and cancer medication type (including when comparing to essential medicines that treat cardiovascular and infectious diseases) indicate that these factors may impact availability, affordability and access to essential cancer drugs. These factors should be taken into consideration when countries assess formulary decisions, negotiate drug procurement terms, and when formulating health and cancer policy.

Obesity can have a negative effect on sperm quality



Obesity can have a negative effect on sperm quality


"There are indications that fatty acids may be part of the explanation for the link between obesity and poor sperm quality," says Andersen.

'The beneficial fatty acids are basically not able to enter the sperm cells and this can contribute to poor sperm quality, particularly in relation to the sperm’s shape and motility. It may be both diet and the circumstances surrounding the obesity that lead to lower levels of DHA fatty acids in sperm.'
'Overweight is unfavourable both for sperm quality in itself and for the fatty acid composition in sperm cells, which is an important factor in sperm quality,' says Andersen."

Guidelines for Pathologic Diagnosis of Malignant Mesothelioma: 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group

 2017 Jul 7. doi: 10.5858/arpa.2017-0124-RA. [Epub ahead of print]

Guidelines for Pathologic Diagnosis of Malignant Mesothelioma: 2017 Update of the Consensus Statement From the International Mesothelioma Interest Group.

Abstract

CONTEXT:

- Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose.

OBJECTIVE:

- To provide updated, practical guidelines for the pathologic diagnosis of MM.

DATA SOURCES:

- Pathologists involved in the International Mesothelioma Interest Group and others with an interest and expertise in the field contributed to this update. Reference material included up-to-date, peer-reviewed publications and textbooks.

CONCLUSIONS:

- There was discussion and consensus opinion regarding guidelines for (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) recognition of the key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas, and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid MM, (7) use of molecular markers in the diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels employed is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Depending on the morphology, immunohistochemical panels should contain both positive and negative markers for mesothelial differentiation and for lesions considered in the differential diagnosis. Immunohistochemical markers should have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (>10% is suggested for cytoplasmic and membranous markers). Selected molecular markers are now being used to distinguish benign from malignant mesothelial proliferations. These guidelines are meant to be a practical diagnostic reference for the pathologist; however, some new pathologic predictors of prognosis and response to therapy are also included.

"Soldiers are trained to survive conditions of violence and extremity far better than the rest of us, but they can still be devastated by those experiences."

What Is Moral Injury?


Soldiers are trained to survive conditions of violence and extremity far better than the rest of us, but they can still be devastated by those experiences. As Brock puts it:
The reason [veterans] have so much trouble unpacking what happened to them in relation to moral injury is that they are conditioned by ritual training in military behaviors and adaptations, including repressing vulnerability and harm, and not just consciously. It is deeply engrained in the body system in training … if you think, you’re too slow and you’re dead.

"The interpretive problems that computers solve are not the ones that have long stumped critics. On the contrary, the technology demands that it be asked only what it can answer..."

The Digital-Humanities Bust

After a decade of investment and hype, what has the field accomplished? Not much.
OCTOBER 15, 2017 

"The digital humanities ignores a nagging theoretical dilemma: The interpretive problems that computers solve are not the ones that have long stumped critics. On the contrary, the technology demands that it be asked only what it can answer, changing the questions to conform to its own limitations. These turn out to be not very interesting. As often happens in computational schemes, DH researchers shrink their inquiries to make them manageable. For example, to build a baseline standard of what constitutes quality, So and Piper posit that "literary excellence" be equated with being reviewed in The New York Times. Such an arbitrary standard would not withstand scrutiny in a non-DH essay. The disturbing possibility is not only that this "cheat" is given a pass (the aura of digital exactness foils the reproaches of laymen), but also that DH methods — operating across incompatible registers of quality and quantity — demand empty signifiers of this sort to set the machine in motion."

"...Americans associate greater satisfaction with acting autonomously than with acting to fulfill social expectations, whereas Indians associate high levels of satisfaction with both types of cases."

 2017 Sep;12(5):867-875. doi: 10.1177/1745691617706099.

A Cultural Psychology of Agency: Morality, Motivation, and Reciprocity.

Author information

1
The New School for Social Research.

Abstract

We highlight the need to culturally broaden psychological theories of social development in providing an overview of our programs of cross-cultural research on interpersonal morality, motivation, and reciprocity. Our research demonstrates that whereas Americans tend to treat interpersonal morality as a matter of personal choice, Indians tend to treat it as a role-related duty. Furthermore, Americans associate greater satisfaction with acting autonomously than with acting to fulfill social expectations, whereas Indians associate high levels of satisfaction with both types of cases. We also demonstrate that cultural variation exists in reliance on communal norms versus reciprocal exchange norms in everyday social support interactions among American, Indian, and Japanese populations, with these norms providing a background for contrasting experiences of agency. In conclusion, we highlight the contributions of cultural research to basic psychological theory. Although cultural research provides greater awareness of diversity in psychological functioning, its fundamental value is to contribute new insights into the theoretical formulations and methodological stances adopted in the discipline more generally.

Obesity Reaches Highest Level Ever (by Chuck Norris. So it got to be true.)

Obesity Reaches Highest Level Ever



"...an epidemic driven by powerful influences from industry, to federal policies (or the lack thereof) and social norms, has made it virtually impossible to reverse habits destructive to our health."

Ethical considerations in prenatal testing: Genomic testing and medical uncertainty

 2017 Oct 12. pii: S1744-165X(17)30111-7. doi: 10.1016/j.siny.2017.10.001. [Epub ahead of print]

Ethical considerations in prenatal testing: Genomic testing and medical uncertainty.

Author information

1
Lucile Packard Children's Hospital Stanford, Fetal and Pregnancy Health Program, Palo Alto, CA, USA.
2
Stanford University School of Medicine, Department of Genetics and Stanford Center for Biomedical Ethics, Stanford, CA, USA. Electronic address: k-ormond@stanford.edu.

Abstract

Prenatal diagnostic testing has recently progressed from karyotype to routinely available chromosomal microarray, and the potential for fetal whole exome sequencing, both through invasive diagnostic testing and, in some cases, non-invasive prenatal testing. These tests bring beneficence through providing a higher diagnostic yield, often with lower risks of miscarriage than previously available testing, but also raise the question of harms related to an increase in uncertain and unknown results. Some parents-to-be report a desire to learn as much information as possible prenatally, and there may be beneficence in providing them with this information. However, the potential uncertainty these tests may create may raise anxiety and may complicate pregnancy decision-making for both patients and providers. This article reviews current prenatal technologies and the growing research on the clinical and ethical aspects of uncertainty as it relates to expanding prenatal testing options.