From MD Anderson: Therapeutic roles of curcumin (turmeric)

http://www.ncbi.nlm.nih.gov/pubmed/23143785

AAPS J. 2013 Jan;15(1):195-218. doi: 10.1208/s12248-012-9432-8. Epub 2012 Nov 10.

Therapeutic roles of curcumin: lessons learned from clinical trials.

Gupta SC, Patchva S, Aggarwal BB.

Source

Cytokine Research Laboratory, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1901 East Road, Unit # 1950, Houston, TX 77054, USA.

Abstract

Extensive research over the past half century has shown that curcumin (diferuloylmethane), a component of the golden spice turmeric (Curcuma longa), can modulate multiple cell signaling pathways. Extensive clinical trials over the past quarter century have addressed the pharmacokinetics, safety, and efficacy of this nutraceutical against numerous diseases in humans. Some promising effects have been observed in patients with various pro-inflammatory diseases including cancer, cardiovascular disease, arthritis, uveitis, ulcerative proctitis, Crohn's disease, ulcerative colitis, irritable bowel disease, tropical pancreatitis, peptic ulcer, gastric ulcer, idiopathic orbital inflammatory pseudotumor, oral lichen planus, gastric inflammation, vitiligo, psoriasis, acute coronary syndrome, atherosclerosis, diabetes, diabetic nephropathy, diabetic microangiopathy, lupus nephritis, renal conditions, acquired immunodeficiency syndrome, β-thalassemia, biliary dyskinesia, Dejerine-Sottas disease, cholecystitis, and chronic bacterial prostatitis. Curcumin has also shown protection against hepatic conditions, chronic arsenic exposure, and alcohol intoxication. Dose-escalating studies have indicated the safety of curcumin at doses as high as 12 g/day over 3 months. Curcumin's pleiotropic activities emanate from its ability to modulate numerous signaling molecules such as pro-inflammatory cytokines, apoptotic proteins, NF-κB, cyclooxygenase-2, 5-LOX, STAT3, C-reactive protein, prostaglandin E(2), prostate-specific antigen, adhesion molecules, phosphorylase kinase, transforming growth factor-β, triglyceride, ET-1, creatinine, HO-1, AST, and ALT in human participants. In clinical trials, curcumin has been used either alone or in combination with other agents. Various formulations of curcumin, including nanoparticles, liposomal encapsulation, emulsions, capsules, tablets, and powder, have been examined. In this review, we discuss in detail the various human diseases in which the effect of curcumin has been investigated.

Zombie allusions: They just keep on coming-performing brain surgery on cockroaches

http://www.fearnet.com/news/news-article/mad-scientist-wasp-performs-zombie-brain-surgery-cockroaches

Mad Scientist Wasp Performs Zombie Brain Surgery on Cockroaches

Gregory Burkart

Friday, August 30, 2013

- See more at: http://www.fearnet.com/news/news-article/mad-scientist-wasp-performs-zombie-brain-surgery-cockroaches#sthash.l7QbCpdl.dpuf

Mad Scientist Wasp Performs Zombie Brain Surgery on Cockroaches

Ampulex has evolved a very special kind of sting which she uses to zombify roaches by injecting a special toxin into their brains, disabling their will to escape. Sensors on the stinger give it almost surgical accuracy. The venom doesn't paralyze the roach, however, and it can still walk... so she literally steers it like a tank, grabbing hold of its antennae and driving it to a burrow she's prepared in advance... and that's where the torture porn really kicks in.

 

- See more at: http://www.fearnet.com/news/news-article/mad-scientist-wasp-performs-zombie-brain-surgery-cockroaches#sthash.l7QbCpdl.dpuf

Mad Scientist Wasp Performs Zombie Brain Surgery on Cockroaches

Gregory Burkart

Friday, August 30, 2013

- See more at: http://www.fearnet.com/news/news-article/mad-scientist-wasp-performs-zombie-brain-surgery-cockroaches#sthash.l7QbCpdl.dpuf

The Impact of Social Media on Medical Professionalism

http://www.ncbi.nlm.nih.gov/pubmed/23985172

J Med Internet Res. 2013 Aug 28;15(8):e184.

The Impact of Social Media on Medical Professionalism: A Systematic Qualitative Review of Challenges and Opportunities.

Gholami-Kordkheili F, Wild V, Strech D.

Source

Institute for History, Ethics and Philosophy of Medicine, CELLS-Centre for Ethics and Law in the Life Science, Hannover Medical School, Hannover, Germany.

Abstract

BACKGROUND:

The rising impact of social media on the private and working lives of health care professionals has made researchers and health care institutions study and rethink the concept and content of medical professionalism in the digital age. In the last decade, several specific policies, original research studies, and comments have been published on the responsible use of social media by health care professionals. However, there is no systematic literature review that analyzes the full spectrum of (1) social media-related challenges imposed on medical professionalism and (2) social media-related opportunities to both undermine and improve medical professionalism.

OBJECTIVE:

The aim of this systematic qualitative review is to present this full spectrum of social media-related challenges and opportunities.

METHODS:

We performed a systematic literature search in PubMed (restricted to English and German literature published between 2002 and 2011) for papers that address social media-related challenges and opportunities for medical professionalism. To operationalize "medical professionalism", we refer to the 10 commitments presented in the physicians' charter "Medical professionalism in the new millennium" published by the ABIM Foundation. We applied qualitative text analysis to categorize the spectrum of social media-related challenges and opportunities for medical professionalism.

RESULTS:

The literature review retrieved 108 references, consisting of 46 original research studies and 62 commentaries, editorials, or opinion papers. All references together mentioned a spectrum of 23 broad and 12 further-specified, narrow categories for social media-related opportunities (n=10) and challenges (n=13) for medical professionalism, grouped under the 10 commitments of the physicians' charter.

CONCLUSIONS:

The accommodation of the traditional core values of medicine to the characteristics of social media presents opportunities as well as challenges for medical professionalism. As a profession that is entitled to self-regulation, health care professionals should proactively approach these challenges and seize the opportunities. There should be room to foster interprofessional and intergenerational dialogue (and eventually guidelines and policies) on both challenges and opportunities of social media in modern health care. This review builds a unique source of information that can inform further research and policy development in this regard.

From LSU: Management of a fire in the operating room

http://www.ncbi.nlm.nih.gov/pubmed/23989633

J Anesth. 2013 Aug 30. [Epub ahead of print]

Management of a fire in the operating room.

Kaye AD, Kolinsky D, Urman RD.

Source

Department of Anesthesiology, Louisiana State University Health Science Center, New Orleans, LA, USA.

Abstract

Operating room (OR) fires remain a significant source of liability for anesthesia providers and injury for patients, despite existing practice guidelines and other improvements in operating room safety. Factors contributing to OR fires are well understood and these occurrences are generally preventable. OR personnel must be familiar with the fire triad which consists of a fuel supply, an oxidizing agent, and an ignition source. Existing evidence shows that OR-related fires can result in significant patient complications and malpractice claims. Steps to reduce fires include taking appropriate safety measures before a patient is brought to the OR, taking proper preventive measures during surgery, and effectively managing fire and patient complications when they occur. Decreasing the incidence of fires should be a team effort involving the entire OR personnel, including surgeons, anesthesia providers, nurses, scrub technologists, and administrators. Communication and coordination among members of the OR team is essential to creating a culture of safety.

Charles Hill: On Decadence

http://www.the-american-interest.com/article-bd.cfm?piece=1473

“D

ecline” we Americans and Westerners mope about daily; “fall” most of us still hope to postpone. Decadence, it would seem, is the mean between the two.

- See more at: http://www.the-american-interest.com/article-bd.cfm?piece=1473#sthash.GEfFHnVZ.dpuf

From the September/October 2013 issue: On Decadence Charles Hill

“D

ecline” we Americans and Westerners mope about daily; “fall” most of us still hope to postpone. Decadence, it would seem, is the mean between the two.

- See more at: http://www.the-american-interest.com/article-bd.cfm?piece=1473#sthash.GEfFHnVZ.dpuf

On Decadence Charles Hill

On Decadence Charles Hill

On Decadence Charles Hill

From U Warwick: Poverty impedes cognitive function

http://www.ncbi.nlm.nih.gov/pubmed/23990553

Science. 2013 Aug 30;341(6149):976-80. doi: 10.1126/science.1238041.

Poverty impedes cognitive function.

Mani A, Mullainathan S, Shafir E, Zhao J.

Source

Department of Economics, University of Warwick, Coventry CV4 7AL, UK.

Abstract

The poor often behave in less capable ways, which can further perpetuate poverty. We hypothesize that poverty directly impedes cognitive function and present two studies that test this hypothesis. First, we experimentally induced thoughts about finances and found that this reduces cognitive performance among poor but not in well-off participants. Second, we examined the cognitive function of farmers over the planting cycle. We found that the same farmer shows diminished cognitive performance before harvest, when poor, as compared with after harvest, when rich. This cannot be explained by differences in time available, nutrition, or work effort. Nor can it be explained with stress: Although farmers do show more stress before harvest, that does not account for diminished cognitive performance. Instead, it appears that poverty itself reduces cognitive capacity. We suggest that this is because poverty-related concerns consume mental resources, leaving less for other tasks. These data provide a previously unexamined perspective and help explain a spectrum of behaviors among the poor. We discuss some implications for poverty policy.

Generation XL?

http://www.winnipegfreepress.com/breakingnews/healthy-living-starts-now-221898711.html

Healthy living starts now

Promoting fitness and nutrition from birth vital in battle against childhood obesity

 By: Randy Turner

"Call them Generation XL.

The numbers, like the weigh scale, don't lie. In 1978, only 15 per cent of children were overweight or obese. By 2007, Statistics Canada found 29 per cent of adolescents had unhealthy weights. By 2040, if trends continue, up to 70 per cent of adults aged 40 years will be either overweight or obese.
Smith is determined daughter Rowan won't be in that 70 per cent.

"The younger you get them involved in physical activity and away from screens...," Smith says. "I teach high school. They're glued to those things. Who knows what it's going to be like for her (Rowan) when she's older?"

Who knows, indeed."

 

 

http://www.ncbi.nlm.nih.gov/pubmed/23984261

Avicenna J Med. 2013 Jan;3(1):8-14. doi: 10.4103/2231-0770.112788.

Western and Islamic bioethics: How close is the gap?

Chamsi-Pasha H, Albar MA.

Source

Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.

Abstract

The relation between Islam and medicine has been described as intimate. Muslims are expected to be moderate and balanced in all matters, including health. Islamic law is based on a complete system of morality that can provide a moral context in medicine from a legal perspective. Islamic teaching is also very flexible and adaptable to many new and novel situations. Islamic Ethics also upholds "the four principles" of biomedical ethics proposed by Beauchamp and Childress. Several authors claim that the roots of these principles are clearly identifiable in Islamic teachings. However, there are some differences in the applications of these principles. This article shed light on the roots of the four principles in Islamic teachings and elaborates on the differences between Islamic and contemporary western bioethics.

http://www.ncbi.nlm.nih.gov/pubmed/23990663

J Med Philos. 2013 Aug 29. [Epub ahead of print]

Differential Diagnosis and the Suspension of Judgment.

Kennedy AG.

Abstract

In this paper I argue that ethics and evidence are intricately intertwined within the clinical practice of differential diagnosis. Too often, when a disease is difficult to diagnose, a physician will dismiss it as being "not real" or "all in the patient's head." This is both an ethical and an evidential problem. In the paper my aim is two-fold. First, via the examination of two case studies (late-stage Lyme disease and Addison's disease), I try to elucidate why this kind of dismissal takes place. Then, I propose a potential solution to the problem. I argue that instead of dismissing a patient's illness as "not real," physicians ought to exercise a compassionate suspension of judgment when a diagnosis cannot be immediately made. I argue that suspending judgment has methodological, epistemic, and ethical virtues and therefore should always be preferred to patient dismissal in the clinical setting.

From Yale and Harvard: Prescription-Drug Coupons - No Such Thing as a Free Lunch

http://www.ncbi.nlm.nih.gov/pubmed/23984672

N Engl J Med. 2013 Aug 28. [Epub ahead of print]

Prescription-Drug Coupons - No Such Thing as a Free Lunch.

Ross JS, Kesselheim AS.

Source

From the Section of General Internal Medicine and the Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, and the Center for Outcomes Research and Evaluation, Yale-New Haven Hospital - both in New Haven, CT (J.S.R.); and the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School - both in Boston (A.S.K.).

Abstract

Visit nearly any official website for a brand-name drug available in the United States and, mixed in with links to prescribing and safety information, you'll find links to drug "coupons," including copayment-assistance programs and monthly savings cards. Most offers are variations on "Why pay more? With the [drug] savings card, you can get [drug] for only $18 per prescription if eligible" or "Get a free 30-capsule trial of [drug] with your doctor's prescription and ask your doctor if [drug] is right for you." Why do manufacturers offer drug coupons? Are they good for patients in the long run? Are they . . .


See also;

Allen TC, Time to End Free Drug Samples

"...government policies should not be the most significant determinant of health for any group of people."

http://www.ncbi.nlm.nih.gov/pubmed/23986898

Int J Circumpolar Health. 2013 Aug 5;72. doi: 10.3402/ijch.v72i0.21207.

Resituating the ethical gaze: government morality and the local worlds of impoverished Indigenous women.

Tait CL.

Source

Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada.

Abstract

BACKGROUND:

Over generations, government policies have impacted upon the lives of Indigenous peoples of Canada in unique and often devastating ways. In this context, Indigenous women who struggle with poverty, mental illness, trauma and substance abuse are among the most vulnerable, as are Indigenous children involved in child welfare systems.

OBJECTIVE:

By examining the life history of Wanda, a First Nations woman, this article examines the intergenerational role that government policies play in the lives of impoverished Indigenous women and their families. Questions of moral governance and responsibility and the need for ethical policies are raised.

DESIGN:

The life narrative presented in this article is part of a larger qualitative research programme that has collected over 100 life histories of Indigenous women with addictions and who have involvement with the child welfare system, as children or adults. Wanda's life story exemplifies the impact of government policies that is characteristic of vulnerable Indigenous women and draws attention to the lack of ethical standards in government policymaking in child welfare, public health and mental health/addictions.

RESULTS:

The path to recovery for Canadian Indigenous women in need of treatment for co-occurring mental disorders and substance addiction is too frequently characterized by an inadequate and ever shifting continuum of care. For those who feel intimidated, suspicious or have simply given up on seeking supports, a profound invisibility or forgetting of their struggle exists in areas of government policy and programming provision. Living outside the scope of mental health and addiction priorities, they become visible to the human service sector only if they become pregnant, their parenting draws the attention of child and family services (CFS), they need emergency health care, or are in trouble with the law. The intergenerational cycle of substance abuse, mental illness and poverty is commonly associated with child welfare involvement, specifically practices that place the health and well-being of Indigenous children at risk. In order to break this cycle, close attention to implementation of ethically based policies and best practice interventions is required.

CONCLUSIONS:

From an ethical policy perspective, the focus of government policies and the practices they generate must be first and foremost to ensure that individuals, families and groups are not left worse off than prior to a government policy impacting upon their life. Furthermore, the impact of living a life determined by multiple government policies should not be a story of individual and family devastation, and government policies should not be the most significant determinant of health for any group of people.

From U Oklahoma: Jump Test Performance and Sarcopenia Status

http://www.ncbi.nlm.nih.gov/pubmed/23959247

J Geriatr Phys Ther. 2013 Aug 16. [Epub ahead of print]

Jump Test Performance and Sarcopenia Status in Men and Women, 55 to 75 Years of Age.

Singh H, Kim D, Kim E, Bemben MG, Anderson M, Seo DI, Bemben DA.

Source

1Department of Health and Exercise Science, University of Oklahoma, Norman. 2University of Oklahoma Health Sciences Center, Oklahoma City.

Abstract

BACKGROUND AND PURPOSE::

Jumping mechanography uses maximal countermovement jumps to test obtain such as jump power (JPow). Recently, it has been shown to be a safe method for assessing muscle function in older adults; however, little is known about the relationships between JPow, muscle strength, and sarcopenia status. The purpose of this study was to examine jump performance, muscle strength, and sarcopenia status in older adults.

METHODS::

This was a cross-sectional study that included men (n = 27) and women (n = 33) (55-75 years) recruited from the general community. Participants completed health status and physical activity questionnaires. Body composition, including appendicular skeletal muscle mass (ASM), bone free lean body mass, and relative skeletal muscle mass index, were assessed by total body dual-energy x-ray absorptiometry scans. The criteria for sarcopenia were relative skeletal muscle mass index values less than 7.26 kg/m for men and less than 5.45 kg/m for women. Three vertical jumps on a jump mat were performed to assess JPow, jump velocity (JVel), and jump height (JHt). Muscle strength was measured by 1RM testing for leg press (LP) and right and left hip abduction isotonic resistance exercises.

RESULTS::

Sarcopenia was found in 20% (12/60) of the participants. Jump power was significantly lower (P= .001) in the sarcopenia group than in the normal group, 651.1 (41.7) W versus 851.0 (27.4) W, respectively. Jump power and JHt were significantly (P< .01) positively correlated (r= 0.54-0.77) with ASM and bone free lean body mass. Significant (P< .01) positive correlations (r= 0.43-0.70) were also reported between jump test variables (JPow, JVel, JHt) and muscle strength (LP, right and left hip abduction).

DISCUSSION::

The jump test protocol was conducted safely with no injuries or balance issues. Our finding of lower JPow in sarcopenic individuals adds new information to the existing literature on age-related declines in muscle power.

CONCLUSION::

Community-dwelling individuals classified as sarcopenic had significantly lower JPow but not muscle strength compared with their counterparts with normal amounts of muscle mass. Jump test variables were positively correlated with lean tissue and lower body muscle strength. Based on our findings, JPow may be useful for sarcopenia screening in the middle-aged and older adults; however, more research is needed to determine the utility of this method in clinical populations.

"Wagons full of gleeful surgeons and appetite drug hucksters are heading towards the bonanza that this resolution has created."

http://www.huffingtonpost.com/walter-m-bortz-ii-md/dare-to-be-100-obesity-is_b_3838804.html

Dare to Be 100: Obesity Is Not a Disease 

Walter M. Bortz II, M.D.

 

"Thirty years ago I was a member of the House of Delegates of the AMA. I am certain, in retrospect, that we passed some resolutions that were wrong. But nothing like the one that they passed in June. All newspapers headlined, "AMA declares obesity a disease." Translated, that means about 100 million Americans are officially diseased.

Just plain awful! -- was my reaction. Are nail biting, compulsive gambling, and homosexuality next on their list of "pathologies"?

The stampede has already begun. Wagons full of gleeful surgeons and appetite drug hucksters are heading towards the bonanza that this resolution has created."

"The tumour board has outlived its intended function..."

http://www.ncbi.nlm.nih.gov/pubmed/23982525

Nat Rev Clin Oncol. 2013 Aug 27. doi: 10.1038/nrclinonc.2013.159. [Epub ahead of print]

Innovation: Tumour board-introducing real time to oncology management.

Allen TC, Liang BA.

Source

Department of Pathology, The University of Texas Health Science Center at Tyler, 11937 US Highway 271, Tyler, TX 75708-3154, USA.


"The tumour board has outlived its intended function—it delays care, provides minimal patient benefit, is costly, does not account for patient psychosocial issues, is not evidence-based and has numerous potential legal issues. Instead, multidisciplinary oncology teams using real-time social media and networking that integrates patient input is a better approach."

From Michael Torres and colleagues: TBK1 directly engages Akt/PKB survival signaling to support oncogenic transformation

http://www.ncbi.nlm.nih.gov/pubmed/?term=tbk1+directly+engages

Mol Cell. 2011 Feb 18;41(4):458-70. doi: 10.1016/j.molcel.2011.01.019.

TBK1 directly engages Akt/PKB survival signaling to support oncogenic transformation.

Ou YH, Torres M, Ram R, Formstecher E, Roland C, Cheng T, Brekken R, Wurz R, Tasker A, Polverino T, Tan SL, White MA.

Source

Department of Cell Biology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.

Abstract

The innate immune-signaling kinase, TBK1, couples pathogen surveillance to induction of host defense mechanisms. Pathological activation of TBK1 in cancer can overcome programmed cell death cues, enabling cells to survive oncogenic stress. The mechanistic basis of TBK1 prosurvival signaling, however, has been enigmatic. Here, we show that TBK1 directly activates AKT by phosphorylation of the canonical activation loop and hydrophobic motif sites independently of PDK1 and mTORC2. Upon mitogen stimulation, triggering of the innate immune response, re-exposure to glucose, or oncogene activation, TBK1 is recruited to the exocyst, where it activates AKT. In cells lacking TBK1, insulin activates AKT normally, but AKT activation by exocyst-dependent mechanisms is impaired. Discovery and characterization of a 6-aminopyrazolopyrimidine derivative, as a selective low-nanomolar TBK1 inhibitor, indicates that this regulatory arm can be pharmacologically perturbed independently of canonical PI3K/PDK1 signaling. Thus, AKT is a direct TBK1 substrate that connects TBK1 to prosurvival signaling.

From Thomas Frank: Academy Fight Song

http://thebaffler.com/past/academy_fight_song

Academy Fight Song

Thomas Frank

 

 

"The coming of “academic capitalism” has been anticipated and praised for years; today it is here. Colleges and universities clamor greedily these days for pharmaceutical patents and ownership chunks of high-tech startups; they boast of being “entrepreneurial”; they have rationalized and outsourced countless aspects of their operations in the search for cash; they fight their workers nearly as ferociously as a nineteenth-century railroad baron; and the richest among them have turned their endowments into in-house hedge funds.

Now, consider the seventeen-year-old customer against whom this predatory institution squares off. He comes loping to the bargaining table armed with about the same amount of guile that, a few years earlier, he brought to Santa’s lap in the happy holiday shopping center. You can be sure that he knows all about the imperative of achieving his dreams, and the status that will surely flow from the beloved institution. Either he goes to college like the rest of his friends, or he goes to work."

Zombie allusions: They just keep on coming-What higher education bubble?

http://www.buffalo.edu/ubreporter/featured-stories.host.html/content/shared/university/news/ub-reporter-articles/stories/2013/zombies-to-invade-ub-classroom-this-semester.detail.html

Campus News

Zombies to invade UB classroom this semester

By MARCENE ROBINSON

Published August 29, 2013


"The zombie outbreak that has infected American popular culture will spread to UB this fall.

John Edgar Browning, an English adjunct professor, vampire expert and author of 12 books on the undead, will teach “A Cultural History of the Walking Dead,” a seminar exploring the history and cultural impact of zombies."

 

 

 

Prozac nation: Millions use sleeping pills to get rest

http://www.timesrecordnews.com/news/2013/aug/29/9-million-use-sleeping-pills-get-more-zzzs/

Millions use sleeping pills to get rest

• MIKE STOBBE, AP Medical Writer
• Posted August 29, 2013
• 
  
  ATLANTA — Can't get enough shuteye? Nearly 9 million U.S. adults resort to prescription sleeping pills — and most are white, female, educated or 50 or older, according to the first government study of its kind.
  
  But that's only part of the picture. Experts believe there are millions more who try options like over-the-counter medicines or chamomile tea, or simply suffer through sleepless nights.
  
  
  
  

From Mass General/Harvard: The evolving landscape in the therapy of acute myeloid leukemia

http://www.ncbi.nlm.nih.gov/pubmed/23982740

Protein Cell. 2013 Aug 27. [Epub ahead of print]

The evolving landscape in the therapy of acute myeloid leukemia.

Peloquin GL, Chen YB, Fathi AT.

Source

Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, 02114, USA.

Abstract

Acute myeloid leukemia (AML) is a heterogeneous clonal disorder of myeloid precursors arrested in their maturation, creating a diverse disease entity with a wide range of responses to historically standard treatment approaches. While significant progress has been made in characterizing and individualizing the disease at diagnosis to optimally inform those affected, progress in treatment to reduce relapse and induce remission has been limited thus far. In addition to a brief summary of the factors that shape prognostication at diagnosis, this review attempts to expand on the current therapies under investigation that have shown promise in treating AML, including hypomethylating agents, gemtuzumab ozogamicin, FLT3 tyrosine kinase inhibitors, antisense oligonucleotides, and other novel therapies, including aurora kinases, mTOR and PI3 kinase inhibitors, PIM kinase inhibitors, HDAC inhibitors, and IDH targeted therapies. With these, and undoubtedly many others in the future, it is the hope that by combining more accurate prognostication with more effective therapies, patients will begin to have a different, and more complete, outlook on their disease that allows for safer and more successful treatment strategies.

From Bryan Liang and me: Tumour board-introducing real time to oncology management

http://www.ncbi.nlm.nih.gov/pubmed/23982525

Nat Rev Clin Oncol. 2013 Aug 27. doi: 10.1038/nrclinonc.2013.159. [Epub ahead of print]

Innovation: Tumour board-introducing real time to oncology management.

Allen TC, Liang BA.

Source

Department of Pathology, The University of Texas Health Science Center at Tyler, 11937 US Highway 271, Tyler, TX 75708-3154, USA.

 The tumour board has outlived its intended function—it delays care, provides minimal patient benefit, is costly, does not account for patient psychosocial issues, is not evidence-based and has numerous potential legal issues. Instead, multidisciplinary oncology teams using real-time social media and networking that integrates patient input is a better approach.

http://www.ncbi.nlm.nih.gov/pubmed/23971060

Aust Fam Physician. 2013 Aug;42(8):532-41.

Obesity - Recommendations for management in general practice and beyond.

Grima M, Dixon JB.

Source

BSc (Nutr), MDiet, is an Accredited Practising Dietitian and research assistant, Human Neurotransmitters & Clinical Obesity Research Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria.

Abstract

BACKGROUND:

It is well recognised that Australia has one of the highest prevalences of overweight and obesity in the developed world, and that this is the greatest contributing factor, along with ageing, to the chronic disease burden in our society. Predictions are confronting; close to 80% of Australian adults are predicted by be obese by the year 2025. The determinants of obesity are multifactorial and are influenced by early life environments as well as genetics. Prevention is failing due to many factors including a poor understanding of these determinants as well as reluctance to act at a government/community level.

OBJECTIVE:

This article aims to provide a practical approach to weight management in general practice with a focus on some of the more intensive interventions beyond the first line lifestyle modification advice.

DISCUSSION:

General practitioners are often well placed to identify overweight and obesity. Patient engagement in management is critical, as for any chronic disease. Treatment needs to be evidence based and focused on a broad range of health outcomes, not simply on weight. Intensive interventions to potentiate weight loss may involve use of very low energy diets, pharmacotherapy and bariatric surgery. Referral to specialist weight assessment and management clinics, where available may be appropriate, particularly for complex cases with more severe comorbidity.

From Yonsei U-Seoul: Therapeutic Strategies for Well-differentiated Papillary Mesothelioma of the Peritoneum

http://www.ncbi.nlm.nih.gov/pubmed/23964112

Jpn J Clin Oncol. 2013 Aug 20. [Epub ahead of print]

Therapeutic Strategies for Well-differentiated Papillary Mesothelioma of the Peritoneum.

Lee YK, Jun HJ, Nahm JH, Lim TS, Park JS, Ahn JB, Rha SY, Chung HC, Oh HE, Song JS, Yang WI, Kim HS.

Source

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul.

Abstract

OBJECTIVE:

Well-differentiated papillary mesothelioma is an uncommon subtype of mesothelioma with a frequently indolent course, although it occasionally manifests in a more aggressive form. To establish a treatment strategy for this rare disease, we report the clinical characteristics and outcomes of 15 patients with well-differentiated papillary mesothelioma.

METHODS:

All pathologically diagnosed well-differentiated papillary mesothelioma cases were reviewed between 1998 and 2012.

RESULTS:

Of the 15 cases, 8 and 7 presented with single and multiple lesions, respectively. All cases with single lesions were asymptomatic, while 4 out of the 7 cases with multiple lesions were symptomatic. After tumor excision, none of the eight single-lesion cases experienced tumor recurrence. Among the other seven cases with multiple lesions, only one patient with disseminated lesions died due to disease burden. Five patients with multiple lesions received cisplatin-based intravenous or intraperitoneal chemotherapy, with a mix of complete (n= 2) and partial (n= 2) responses observed. Of particular note, one patient receiving cisplatin and pemetrexed combination chemotherapy experienced complete tumor resolution without any serious toxicity.

CONCLUSIONS:

We recommend different treatment strategies based on the disease status. If the tumor is completely resectable, an excisional biopsy seems to be sufficient. If complete resection is unavailable for the asymptomatic patient with a localized tumor extent, close follow-up is an appropriate option. When the tumor is extensive or accompanied by symptoms, chemotherapy should be strongly considered.

http://www.ncbi.nlm.nih.gov/pubmed/23858390

J Pathol Inform. 2013 Jun 29;4:15. doi: 10.4103/2153-3539.114206. Print 2013.

Going fully digital: Perspective of a Dutch academic pathology lab.

Stathonikos N, Veta M, Huisman A, van Diest PJ.

Source

Department of Pathology, University Medical Center, Utrecht, The Netherlands.

Abstract

During the last years, whole slide imaging has become more affordable and widely accepted in pathology labs. Digital slides are increasingly being used for digital archiving of routinely produced clinical slides, remote consultation and tumor boards, and quantitative image analysis for research purposes and in education. However, the implementation of a fully digital Pathology Department requires an in depth look into the suitability of digital slides for routine clinical use (the image quality of the produced digital slides and the factors that affect it) and the required infrastructure to support such use (the storage requirements and integration with lab management and hospital information systems). Optimization of digital pathology workflow requires communication between several systems, which can be facilitated by the use of open standards for digital slide storage and scanner management. Consideration of these aspects along with appropriate validation of the use of digital slides for routine pathology can pave the way for pathology departments to go "fully digital." In this paper, we summarize our experiences so far in the process of implementing a fully digital workflow at our Pathology Department and the steps that are needed to complete this process.

http://www.ncbi.nlm.nih.gov/pubmed/23931731

Telemed J E Health. 2013 Aug 9. [Epub ahead of print]

Testing a Top-Down Strategy for Establishing a Sustainable Telemedicine Program in a Developing Country: The Arizona Telemedicine Program-U.S. Army-Republic of Panama Initiative.

Vega S, Marciscano I, Holcomb M, Erps KA, Major J, Lopez AM, Barker GP, Weinstein RS.

Source

1 School of Medicine, Latin American University of Science and Technology , Panama City, Panama .

Abstract

Abstract Objective: Many developing countries have shown interest in embracing telemedicine and incorporating it into their healthcare systems. In 2000, the U.S. Army Yuma Proving Ground (YPG) initiated a program to assist the Republic of Panama in establishing a demonstration Panamanian rural telemedicine program. YPG engaged the Arizona Telemedicine Program (ATP) to participate in the development and implementation of the program.
Materials and Methods: The ATP recommended adoption of a "top-down" strategy for creating the program. Early buy-in of the Panamanian Ministry of Health and academic leaders was regarded as critical to the achievement of long-term success.
Results: High-level meetings with the Minister of Health and the Rectors (i.e., Presidents) of the national universities gained early program support. A telemedicine demonstration project was established on a mountainous Indian reservation 230 miles west of Panama City. Today, three rural telemedicine clinics are linked to a regional Ministry of Health hospital for teleconsultations. Real-time bidirectional videoconferencing utilizes videophones connected over Internet protocol networks at a data rate of 768 kilobits per second to the San Felix Hospital. Telepediatrics, tele-obstetrics, telepulmonology, teledermatology, and tele-emergency medicine services became available. Telemedicine services were provided to the three sites for a total of 1,013 cases, with numbers of cases increasing each year. These three demonstration sites remained in operation after discontinuation of the U.S. involvement in September 2009 and serve as a model program for other telemedicine initiatives in Panama.
Conclusions: Access to the assets of a partner-nation was invaluable in the establishment of the first model telemedicine demonstration program in Panama. After 3 years, the Panamanian Telemedicine and Telehealth Program (PTTP) became self-sufficient. The successful achievement of sustainability of the PTTP after disengagement by the United States fits the Latifi-Weinstein model for establishing telemedicine programs in developing countries.

From U Chicago: Violence as a source of pleasure or displeasure is associated with specific functional connectivity with the nucleus accumbens

http://www.ncbi.nlm.nih.gov/pubmed/23964226

Front Hum Neurosci. 2013 Aug 13;7:447. doi: 10.3389/fnhum.2013.00447. eCollection 2013.

Violence as a source of pleasure or displeasure is associated with specific functional connectivity with the nucleus accumbens.

Porges EC, Decety J.

Source

Department of Psychology, The University of Chicago Chicago, IL, USA.

Abstract

The appraisal of violent stimuli is dependent on the social context and the perceiver's individual characteristics. To identify the specific neural circuits involved in the perception of violent videos, forty-nine male participants were scanned with functional MRI while watching video-clips depicting Mixed Martial Arts (MMA) and Capoeira as a baseline. Prior to scanning, a self-report measure of pleasure or displeasure when watching MMA was collected. Watching MMA was associated with activation of the anterior insula (AI), brainstem, ventral tegmental area (VTA), striatum, medial, and lateral prefrontal cortex, orbitofrontal cortex, somatosensory cortex, and supramarginal gyrus. While this pattern of brain activation was not related to participants' reported experience of pleasure or displeasure, pleasurable ratings of MMA predicted increased functional connectivity (FC) seeded in the nucleus accumbens (NAcc) (a structure known to be responsive to anticipating both positive and negative outcomes) with the subgenual anterior cingulate cortex (ACC) and anterior insular cortex (AIC) (regions involved in positive feelings and visceral somatic representations). Displeasure ratings of MMA were related to increased FC with regions of the prefrontal cortex and superior parietal lobule, structures implicated in cognitive control and executive attention. These data suggest that functional connectivity is an effective approach to investigate the relationship between subjective feelings of pleasure and pain of neural structures known to respond to both the anticipation of positive and negative outcomes.

http://www.ncbi.nlm.nih.gov/pubmed/23918482

Health Aff (Millwood). 2013 Aug;32(8):1383-91. doi: 10.1377/hlthaff.2013.0233.

High physician concern about malpractice risk predicts more aggressive diagnostic testing in office-based practice.

Carrier ER, Reschovsky JD, Katz DA, Mello MM.

Abstract

Despite widespread agreement that physicians who practice defensive medicine drive up health care costs, the extent to which defensive medicine increases costs is unclear. The differences in findings to date stem in part from the use of two distinct approaches for assessing physicians' perceived malpractice risk. In this study we used an alternative strategy: We linked physicians' responses regarding their levels of malpracticeconcern as reported in the 2008 Health Tracking Physician Survey to Medicare Parts A and B claims for the patients they treated during the study period, 2007-09. We found that physicians who reported a high level of malpractice concern were most likely to engage in practices that would be considered defensive when diagnosing patients who visited their offices with new complaints of chest pain, headache, or lower back pain. No consistent relationship was seen, however, when state-level indicators of malpractice risk replaced self-rated concern. Reducing defensive medicine may require approaches focused on physicians' perceptions of legal risk and the underlying factors driving those perceptions.

http://www.ncbi.nlm.nih.gov/pubmed/23960159

Psychosom Med. 2013 Aug 19. [Epub ahead of print]

The Association of Depressive Symptoms and Pulmonary Function in Healthy Adults.

Ochs-Balcom HM, Lainhart W, Mnatsakanova A, Charles LE, Violanti JM, Andrew ME, Freudenheim JL, Muti P, Trevisan M, Burchfiel CM, Schünemann HJ.

Source

Department of Social and Preventive Medicine (H.M.O-B., W.L., J.M.V., J.J.F., P.M., M.T., H.J.S.), School of Public Health and Health Professions, University at Buffalo, Buffalo, New York; Biostatistics and Epidemiology Branch (A.M., L.E.C., M.E.A., C.M.B.), Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia; Departments of Oncology (P.M.) and Clinical Epidemiology & Biostatistics and Medicine (H.J.S.), McMaster University, Hamilton, Ontario, Canada; Department of Community Health and Social Medicine (M.T.), School of Biomedical Education, The City College of New York, New York, New York.

Abstract

ObjectiveChronic lung disease is exacerbated by comorbid psychiatric issues and treatment of depression may improve disease symptoms. We sought to add to the literature as to whether depression is associated with pulmonary function in healthy adults.MethodsIn 2551 healthy adults from New York State, we studied the association of depression via the Center for Epidemiologic Studies Depression scale (CES-D) scale score and forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) using general linear models and a cross-sectional design.ResultsWe identified statistically significant inverse trends in FEV₁, FVC, FEV₁%, and FVC% by CES-D category, especially in ever-smokers and men. When adjusted for covariates, the difference in FEV₁ and FEV₁% for smokers with more than 18.5 lifetime pack-years from CES-D scores 0 to 3 to 16 or more (depressed) is approximately 0.25 l and 5.0% (adjusted p values for trend are <.001 and .019, respectively). In men, we also observed statistically significant inverse trends in pulmonary function with increasing CES-D.ConclusionsWe identified an inverse association of depressive symptoms and pulmonary function in healthy adults, especially in men and individuals with a heavy smoking history. Further studies of these associations are essential for the development and tailoring of interventions for the prevention and treatment of chronic lung disease.

Helicopter parenting "negatively associated with parental autonomy granting and school engagement"

http://www.ncbi.nlm.nih.gov/pubmed/22503075

J Adolesc. 2012 Oct;35(5):1177-90. doi: 10.1016/j.adolescence.2012.03.007. Epub 2012 Apr 13.

Black Hawk down? Establishing helicopter parenting as a distinct construct from other forms of parental control during emerging adulthood.

Padilla-Walker LM, Nelson LJ.

Source

School of Family Life, Brigham Young University, Provo, UT 84602, USA. laura_walker@byu.edu

Abstract

The purpose of the current study was to establish a measure of helicopter parenting that was distinct from other forms of parental control, and to examine parental and behavioral correlates of helicopter parenting. Participants included 438 undergraduate students from four universities in the United States (M(age) = 19.65, SD = 2.00, range = 18-29; 320 women, 118 men), and at least one of their parents. Analyses revealed that helicopterparenting loaded on a separate factor from both behavioral and psychological control, and that helicopter parenting was positively associated with behavioral and psychological control, but not at levels suggesting complete overlap. Results also revealed that helicopter parenting was positively associated with parental involvement and with other positive aspects of the parent-child relationship; but negatively associated with parental autonomy granting and school engagement. Discussion focuses on the implications of helicopter parenting for healthy development during emerging adulthood.

From GWU: The Role of Community Health Centers in Providing Behavioral Health Care

http://www.ncbi.nlm.nih.gov/pubmed/23963817

J Behav Health Serv Res. 2013 Aug 21. [Epub ahead of print]

The Role of Community Health Centers in Providing Behavioral Health Care.

Shin P, Msc JS, Mauery DR.

Source

Department of Health Policy, George Washington University, 2021 K Street NW, Suite 800, Washington, DC, 20006, USA, pshin@gwu.edu.

Abstract

The prevalence of behavioral health problems is higher for low-income individuals, yet this population is less likely to receive behavioral health treatment. Community health centers have their advantages as behavioral health-care providers because they serve a majority low-income population and are located in medically underserved areas. Their role in providing behavioral health care is expected to expand under health reform as they are expected to double their patient capacity, and due to increased insurance coverage for individuals with behavioral health problems. However, the ability of community health centers to provide behavioral health care is compromised by provider shortages and funding shortfalls.

http://www.ncbi.nlm.nih.gov/pubmed/23955289

J Med Ethics. 2013 Aug 16. doi: 10.1136/medethics-2013-101420. [Epub ahead of print]

Reasons for academic honesty and dishonesty with solutions: a study of pharmacy and medical students in New Zealand.

Henning MA, Ram S, Malpas P, Sisley R, Thompson A, Hawken SJ.

Source

Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, University of Auckland, , Auckland, New Zealand.

Abstract

This paper presents students' views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours? (2) What reasons would students articulate in reference to maintaining high levels of integrity? (3) What strategies would students suggest to decrease engagement in dishonest behaviours and/or promote honest behaviours? The design of the study incorporated an initial descriptive analysis to interpret students' responses to an 18-item questionnaire about justifications for dishonest action. This was followed by a qualitative analysis of students' commentaries in reference to why students would engage in either honest or dishonest action. Finally a qualitative analysis was conducted on students' views regarding solutions to dishonest action. The quantitative results showed that students were more likely to use time management and seriousness justifications for dishonest actions. The qualitative findings found that students' actions (honest or dishonest) were guided by family and friends, the need to do well, issues of morality and institutional guidelines. Students suggested that dishonest action could be ameliorated by external agencies and polarised views between punitive and rewards-based mechanisms were offered. These results suggest that these students engaged in dishonest action for various reasons and solutions addressing dishonest action need to consider diverse mechanisms that likely extend beyond the educational institution.