Med J Aust. 2017 May 1;206(8):363-368.

Neurobionics and the brain-computer interface: current applications and future horizons.

Rosenfeld JV1, Wong YT2.

Author information

1

Monash Institute of Medical Engineering, Monash University, Melbourne, VIC j.rosenfeld@alfred.org.au.

2

Electrical and Computer Systems Engineering, University of Melbourne, Melbourne, VIC.

Abstract

The brain-computer interface (BCI) is an exciting advance in neuroscience and engineering. In a motor BCI, electrical recordings from the motor cortex of paralysed humans are decoded by a computer and used to drive robotic arms or to restore movement in a paralysed hand by stimulating the muscles in the forearm. Simultaneously integrating a BCI with the sensory cortex will further enhance dexterity and fine control. BCIs are also being developed to: provide ambulation for paraplegic patients through controlling robotic exoskeletons; restore vision in people with acquired blindness; detect and control epileptic seizures; and improve control of movement disorders and memory enhancement. High-fidelity connectivity with small groups of neurons requires microelectrode placement in the cerebral cortex. Electrodes placed on the cortical surface are less invasive but produce inferior fidelity. Scalp surface recording using electroencephalography is much less precise. BCI technology is still in an early phase of development and awaits further technical improvements and larger multicentre clinical trials before wider clinical application and impact on the care of people with disabilities. There are also many ethical challenges to explore as this technology evolves.

"The onus lies on medical schools and healthcare bodies endorsing international electives to ensure that individuals are appropriately prepared..."

Int J Surg. 2017 Apr 19. pii: S1743-9191(17)30331-X. doi: 10.1016/j.ijsu.2017.04.020. [Epub ahead of print]

Surgical volunteerism or voluntourism - Are we doing more harm than good?

Ahmed F1, Grade M2, Malm C3, Michelen S4, Ahmed N5.

Author information

1

NHS England, UK; London School of Hygiene and Tropical Medicine, UK. Electronic address: faheem.ahmed@doctors.org.uk.

2

Stanford Medical School, USA. Electronic address: madelinegrade@gmail.com.

3

Harvard Medical School, USA. Electronic address: carl_malm@hms.harvard.edu.

4

Harvard Medical School, USA; London School of Hygiene and Tropical Medicine, UK. Electronic address: sophia_michelen@hms.harvard.edu.

5

St George's Hospital, UK. Electronic address: naeem.ahmed@nhs.net.

Abstract

The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved. The general shortage of healthcare staff in resource-poor countries has significantly contributed to the disparities between need and provision.1 The majority of populations served by shortterm surgical volunteer trips are vulnerable communities; this raises ethical questions such as the lack of informed consent, use of unauthorised photos for marketing, and practicing new procedural techniques. 2 Whilst there exist various models that can be used to facilitate effective international health electives, there is a lack of stringent monitoring and enforcement both on the part of healthcare institutions deploying volunteers as well as recipient bodies in LMICS. Well-organised programmes prevent cases of 'poor care given to poor people' as medical students and doctors are expected to act in their patients' best interests as they would do in their home country. As clinician interest in global health projects continue to rise, too-common trainee naivety - while rooted in goodwill - must be supplanted by adequate training, ethical coherence, and cultural fluency. The onus lies on medical schools and healthcare bodies endorsing international electives to ensure that individuals are appropriately prepared and only travel through programmes that are able to demonstrate that they meet the necessary requirements and follow guidelines to avoid doing more harm than good.

Obesity - the new smoking

Obesity Tops List of Causes for Lost Years of Life, Beating Tobacco

Mary Caffey

"Obesity causes Americans to lose more years of life than any other cause, including smoking cigarettes, according to a new study from researchers at the Cleveland Clinic and the New York University School of Medicine.

The team found that obesity resulted in as much as 47% more lost life years than tobacco, while high blood pressure and tobacco took a similar number of years off the life span."




 - See more at: http://www.ajmc.com/newsroom/obesity-tops-list-of-causes-for-lost-years-of-life-beating-tobacco#sthash.ahYwwtHi.dpuf

Kids With Bedtimes, Mealtimes Less Likely To Be Obese, Study Finds

"The study tracked 11,000 kids for more than a decade to pull the data from. They found that when the kids were three years old, just under half had a bedtime. Close to half had scheduled mealtimes and a fifth of them had TV and videos restricted to less than an hour a day. Of those kids, just 6% were obese by 11 years old."

Chip Roy: ObamaCare repeal: GOP leaders are missing their chance

ObamaCare repeal: GOP leaders are missing their chance

By Chip Roy

 Published April 24, 2017

"First, Congress is turning away from the free market.  Republicans talk a big game about believing in free enterprise and capitalism. But the grassroots out in real America see their actions as more cronyism than principle. Whether it’s subsidizing big corporations through the Export-Import Bank or the more recent $100 billion insurer slush fund included in the American Health Care Act, the grassroots understandably consider Congress’ actions to be political pay-offs and more of Washington picking winners and losers rather than the free market at work."

Arch Pathol Lab Med. 2017 Apr 18. doi: 10.5858/arpa.2017-0105-SA. [Epub ahead of print]

Twenty-First Century Pathologists' Advocacy.

Allen TC.

Abstract

Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are two of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years. Another current issue of far-reaching impact for pathologists is balance billing, and yet many pathologists have little or no understanding of balance billing. Pathologists at all stages of their careers, and in every professional setting, need to participate. Academic pathologists have a special obligation to, if not become directly involved in advocacy, at least have a broad and current understanding of those issues, as well as the need and responsibility of pathologists to actively engage in advocacy efforts to address them, in order to teach residents the place of advocacy, and its value, as an inseparable and indispensable component of their professional responsibilities.

DRIVERS NEEDED

How Ambulance Drivers Hemingway and Dos Passos Rerouted the Course of American Literature

The ambulance corps was one of the few ways Americans could get into WWI until the US finally entered the fray in 1917. The experience was crucial for two great authors.

JAMES MCGRATH MORRIS

04.06.17 3:31 PM ET

"If the record of war in the 20^th century is an indicator, Hemingway’s view prevailed while Dos Passos’s impassioned warning against war sadly fell on deaf ears."

"...since 2005 more than one in 10 children in Scotland had started primary school overweight or obese."

Obesity campaigners call for more salads and fewer puddings in school

"A study last year found that since 2005 more than one in 10 children in Scotland had started primary school overweight or obese.

The figures showed almost 83,000 four to five-year-olds entered P1 carrying excess weight between 2005-2006 and 2014-2015."

"Because of the complexity of cancer immunity, we still do not have a reliable biomarker to predict the response of PD-1/PD-L1–targeted therapy."

Jian Guan,Khin Sandar Lim,Tarek Mekhail,Chung-Che Chang, (2017) Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade: A Key Player Against Various Cancers. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Programmed Death Ligand-1 (PD-L1) Expression in the Programmed Death Receptor-1 (PD-1)/PD-L1 Blockade: A Key Player Against Various Cancers

Jian Guan, MD, PhD; Khin Sandar Lim, MD; Tarek Mekhail, MD; Chung-Che Chang, MD, PhD

From the Departments of Internal Medicine (Drs Guan, Lim, and Mekhail) and Pathology and Laboratory Medicine (Dr Chang), Florida Hospital, Orlando; and the Department of Pathology, University of Central Florida College of Medicine, Orlando (Dr Chang).

Reprints: Chung-Che Chang, MD, PhD, Department of Pathology and Laboratory Medicine, Florida Hospital, 601 Rollins St, Orlando, FL 32803 (email: c.jeff.chang.md@flhosp.org).

Context.— Immune checkpoint pathways, including programmed death receptor-1/programmed death ligand-1 (PD-1/PD-L1) signaling pathway, which are important in mediating self-tolerance and controlling self-damage, can sometimes be manipulated by cancer cells to evade immune surveillance. Recent clinical trials further demonstrate the efficacy of PD-1/PD-L1–targeted therapy in various cancers and reveal a new era of cancer immunotherapy.

Objective.— To review the mechanism of the PD-1/PD-L1 signaling pathway, the regulation of this pathway, PD-1/PD-L1 as a predictive and/or prognostic marker in various cancers, and strategies of measuring PD-L1 expression.

Data Sources.— Representative medical literature regarding PD-L1 expression in various cancers, including the preliminary results of the Blue Proposal, which compares different immunohistochemical stains for PD-L1 reported in the recent American Association of Cancer Research (AACR) Annual Meeting (April 16–20, 2016).

Conclusion.— Either PD-1/PD-L1–targeted therapy alone or in combination with other treatment modalities provides benefit for patients with advanced cancers. Because of the complexity of cancer immunity, we still do not have a reliable biomarker to predict the response of PD-1/PD-L1–targeted therapy. Future studies, including methods beyond immunohistochemical stains, are needed to develop reliable biomarker/biomarkers for pathology laboratories to aid in selecting patients who will benefit most from PD-1/PD-L1–targeted therapy.

J Nurse Pract. 2016 Jul-Aug;12(7):425-432. doi: 10.1016/j.nurpra.2016.05.013.

Obesity Stigma and Bias.

Fruh SM1, Nadglowski J2, Hall HR3, Davis SL4, Crook ED5, Zlomke K6.

Author information

1

Professor at the University of South Alabama in Mobile.

2

President/CEO of Obesity Action Coalition in Tampa, FL.

3

Professor and Associate Dean for Academic Affairs at the University of South Alabama.

4

Instructor at the Division of Nursing at Springhill College in Mobile, AL.

5

Abraham A. Mitchell Professor and Chair at the Department of Internal Medicine at the University of South Alabama.

6

Assistant Professor at the Department of Psychology at the University of South Alabama.

Abstract

Overweight and obesity are escalating in epidemic proportions in the United States. Individuals with overweight and obesity are often reluctant to seek medical help, not only for weight reduction but also for any health issue because of perceived provider discrimination. Providers who are biased against individuals with obesity can hinder our nation's effort to effectively fight the obesity epidemic. By addressing weight bias in the provider setting, individuals affected by obesity may be more likely to engage in a meaningful and productive discussion of weight. Providers need to be the go-to source for obesity-focused information on new and emerging treatments.

Stroke rates are rising in young adults

"The results showed an increase in hospitalization rates in younger adults, ages 18-44, since 1995. Increases were seen most specifically in men 35 to 44 by 42% and women of the same age group by 30%.

Even though deaths due to strokes have significantly decreased over the last 50 years, strokes were the fifth leading cause of death among all adults in 2013, according to The Washington Post."

Sci Eng Ethics. 2017 Apr 11. doi: 10.1007/s11948-017-9905-3. [Epub ahead of print]

The Ethical and Academic Implications of the Jeffrey Beall (www.scholarlyoa.com) Blog Shutdown.

Teixeira da Silva JA1.

Author information

1

, Miki-cho Post Office, 3011-2, P.O. Box 7, Ikenobe, Kagawa-ken, 761-0799, Japan. jaimetex@yahoo.com.

Abstract

A very important event took place on January 15, 2017. On that day, the Jeffrey Beall blog ( www.scholarlyoa.com ) was silently, and suddenly, shut down by Beall himself. A profoundly divisive and controversial site, the Beall blog represented an existential threat to those journals and publishers that were listed there. On the other hand, the Beall blog was a ray of hope to critics of bad publishing practices that a culture of public shaming was perhaps the only way to rout out those journals-and their editors-and publishers who did not respect basic publishing ethical principles and intrinsic academic values. While members of the former group vilified Beall and his blog, members of the latter camp tried to elevate it to the level of policy. Split by extreme polar forces, for reasons still unknown to the public, Beall deliberately shut down his blog, causing some academic chaos among global scholars, including to the open access movement.

"We’re in a culture with very few real friends, and an enormous number of unctuous sales people who will adopt the language of friendship, care and help."

INTERVIEW WITH MARK GREIF

"I wonder, often, whether I’m crazy.  Because I wander around and I find menus addressing me, to tell me how much they care about my dining experience. And the paper sacks that my hamburger comes in, telling me how much the gigantic company cares about the cows they’ve slaughtered for my food. And I’m constantly being offered advice on how I should dress, eat, sleep, have sex. And yet I suspect that actually, all of these sources don’t care very much about how I do these things. That’s the kind of dishonesty that I imagine. We’re in a culture with very few real friends, and an enormous number of unctuous sales people who will adopt the language of friendship, care and help."

"About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s..."

With Rise in Childhood Obesity, Corresponding Increase in Type 2 Diabetes Seen in Young Americans

"For years, health experts have bemoaned the rise of childhood obesity in the United States. About 17% of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s, according to data from the Centers for Disease Control and Prevention.

A report in this week’s edition of the New England Journal of Medicine lays out one of the consequences of all this excess weight: a corresponding increase in childhood cases of type 2 diabetes."

From Emory U: New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology

Xiaoxian Li, Gabriela M. Oprea-Ilies, and Uma Krishnamurti (2017) New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology. Archives of Pathology & Laboratory Medicine: April 2017, Vol. 141, No. 4, pp. 490-498.

SPECIAL SECTION—CONTRIBUTIONS FROM EMORY UNIVERSITY SCHOOL OF MEDICINE, PART II

New Developments in Breast Cancer and Their Impact on Daily Practice in Pathology

Xiaoxian Li, MD, PhD; Gabriela M. Oprea-Ilies, MD; Uma Krishnamurti, MD, PhD

From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Gerogia.

Reprints: Xiaoxian Li, MD, PhD, Department of Pathology and Laboratory Medicine, Emory University, 1364 Clifton Rd NE, Atlanta, GA (email: xli40@emory.edu).

The authors have no relevant financial interest in the products or companies described in this article.

Advances in research have transformed our understanding of breast cancers and have altered the daily practice of pathology. Theranostic evaluations performed by pathologists are now critical in triaging the patients into appropriate treatment groups, as are new guidelines that were recently established for the evaluation of HER2/neu gene amplification. Emerging molecular classifications of breast cancers bring novel perspectives to the assessment of individual cases, and opportunities for better treatments. Molecular studies have particularly shed light on distinct biological subsets of triple-negative breast cancers, for which new targeted therapies are being developed. The prognostic and therapeutic utility of new histopathologic parameters, such as tumor-infiltrating lymphocytes, are also being elucidated, and new protocols have been devised for the pathologic evaluation of breast specimens that have undergone neoadjuvant treatment. Novel clinical practices, such as radioactive seed localization, also affect the way breast specimens are processed and evaluated. In this brief review, we highlight the developments that are most relevant to pathology and are changing or could potentially impact our daily practice.

CV risk parameters tied to TSH concentrations in overweight, obesity

“In euthyroid overweight and (morbidly) obese children serum TSH concentrations are positively associated with markers representing increased CVD risk, such as [total cholesterol], LDL-[cholesterol], [triacylglycerol] and [monocyte chemotactic protein-1] concentrations,” the researchers wrote. “The additional observation that changes in TSH are associated with changes in [total cholesterol], LDL-[cholesterol], and [triacylglycerol] concentrations in children with successful weight loss after 1 year participating in a lifestyle intervention strengthens the earlier assumptions that serum TSH is indeed an intermediary factor in modulating lipid and lipoprotein metabolism, although causality could not be demonstrated. It is worth exploring in more depth the potential association between TSH and whole body cholesterol metabolism, including endogenous cholesterol synthesis, intestinal cholesterol absorption, and receptor mediated cholesterol clearance.”

Game changer

Philips Awarded FDA Clearance for Digital Pathology Solution for Primary Diagnostic Use

Man Dragged Off Overbooked United Airlines Flight At O’Hare Airport

CHICAGO (CBS) — A man was dragged off a United Airlines flight from Chicago to Louisville on Sunday night, after the flight was overbooked, and the passenger refused to leave voluntarily.

"Globally, one in four adults are not active enough and more than 80% of the world’s adolescent population is insufficiently physically active."

Exercise is what the doctor ordered

"Globally, one in four adults are not active enough and more than 80% of the world’s adolescent population is insufficiently physically active."

"If we wish to accuse someone employing the word 'probable' or 'likely' of making a false probabilistic judgment, we need to be sure that they are employing the very same concept of probability that is the object of analysis in probability theory."

Invisible Manipulators of Your Mind

Tamsin Shaw 

APRIL 20, 2017 ISSUE

The Undoing Project: A Friendship That Changed Our Minds

by Michael Lewis

Norton, 362 pp., $28.95

"A further problem arises when we try to assign errors to a particular set of systematic biases, or attribute them to specific flawed heuristics. If we wish to accuse someone employing the word “probable” or “likely” of making a false probabilistic judgment, we need to be sure that they are employing the very same concept of probability that is the object of analysis in probability theory. If we wish to accuse someone of making false probabilistic judgments because they are employing a faulty heuristic, we need to be sure that the correct explanation isn’t that certain people have some complicating beliefs in the background, in luck or fate or God, for instance."

The diabetes drug that may be worth $10 bn

Ailing Novo seeks cure with diabetes drug targeting the fat

James Paton 

"The experimental treatment, called semaglutide, should go on sale next year as an injection for diabetes. But that’s only the first step of Novo’s development plan: Its scientists are working on a patient-friendly tablet version of the drug that could reach pharmacy shelves in 2020. They’re also testing the product for a form of liver disease, a market some analysts say may eventually yield $35 billion a year in sales, as well as obesity.

As a slimming medicine alone, its effect could get closer to the results delivered by bariatric surgery, Jorgensen said in an interview. The drug’s annual sales may climb to almost $10 billion over the next decade, even before taking into account its potential use as an obesity treatment, according to Nordea estimates, providing a much-needed boost for the Danish company. Only one drug in the entire pharmaceutical industry exceeded that last year."

"Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage."

Cancer. 2017 Apr 7. doi: 10.1002/cncr.30688. [Epub ahead of print]

Effect of depression before breast cancer diagnosis on mortality among postmenopausal women.

Liang X1, Margolis KL2, Hendryx M3, Reeves K4, Wassertheil-Smoller S5, Weitlauf J6,7, Danhauer SC8, Chlebowski RT9, Caan B10, Qi L11, Lane D12, Lavasani S13, Luo J14.

Author information

1

School of Social Development and Public Policy, Beijing Normal University, Beijing, China.

2

HealthPartners Institute, Minneapolis, Minnesota.

3

Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, Indiana.

4

Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts.

5

Albert Einstein College of Medicine, Bronx, New York.

6

Veterans Affairs Palo Alto Health Care System, Palo Alto, California.

7

Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.

8

Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.

9

Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California.

10

Division of Research, Kaiser Permanente, Oakland, California.

11

Department of Public Health Sciences, University of California Davis, Davis, California.

12

Department of Family, Population, and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.

13

Memorial Cancer Institute, Memorial Health Care System, Florida International University, Hollywood, Florida.

14

Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana.

Abstract

BACKGROUND:

Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer-specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer-specific mortality among older postmenopausal women.

METHODS:

A large prospective cohort, the Women's Health Initiative, was used. The study included 3095 women with incident breast cancer who had measures of depressive symptoms and antidepressant use before their diagnosis at the baseline and at year 3. Multivariate Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) between depression at the baseline, depression at year 3, and combinations of depression at these time points and all-cause mortality and breast cancer-specific mortality.

RESULTS:

Depression at year 3 before a breast cancer diagnosis was associated with higher all-cause mortality after adjustments for multiple covariates (HR, 1.35; 95% confidence interval [CI], 1.02-1.78). There was no statistically significant association of baseline depression and all-cause mortality or breast cancer-specific mortality whether or not depression was also present at year 3. In women with late-stage (regional- or distant-stage) breast cancer, newly developed depression at year 3 was significantly associated with both all-cause mortality (HR, 2.00; 95% CI, 1.13-3.56) and breast cancer-specific mortality (HR, 2.42; 95% CI, 1.24-4.70).

CONCLUSIONS:

Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage.

"The Internet and social media offer promising ways to improve the reach, efficiency, and effectiveness of recruitment efforts at a reasonable cost, but raise unique ethical dilemmas."

J Med Internet Res. 2017 Apr 6;19(4):e104. doi: 10.2196/jmir.7029.

Ethics and Privacy Implications of Using the Internet and Social Media to Recruit Participants for Health Research: A Privacy-by-Design Framework for Online Recruitment.

Bender JL1,2, Cyr AB3, Arbuckle L4, Ferris LE2.

Author information

1

Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research (ELLICSR) Health, Wellness, and Cancer Survivorship Centre, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

2

Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

3

Cancer Education, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

4

Electronic Health Information Lab, Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada.

Abstract

BACKGROUND:

The Internet and social media offer promising ways to improve the reach, efficiency, and effectiveness of recruitment efforts at a reasonable cost, but raise unique ethical dilemmas. We describe how we used social media to recruit cancer patients and family caregivers for a research study, the ethical issues we encountered, and the strategies we developed to address them.

OBJECTIVE:

Drawing on the principles of Privacy by Design (PbD), a globally recognized standard for privacy protection, we aimed to develop a PbD framework for online health research recruitment.

METHODS:

We proposed a focus group study on the dietary behaviors of cancer patients and their families, and the role of Web-based dietary self-management tools. Using an established blog on our hospital website, we proposed publishing a recruitment post and sharing the link on our Twitter and Facebook pages. The Research Ethics Board (REB) raised concern about the privacy risks associated with our recruitment strategy; by clicking on a recruitment post, an individual could inadvertently disclose personal health information to third-party companies engaged in tracking online behavior. The REB asked us to revise our social media recruitment strategy with the following questions in mind: (1) How will you inform users about the potential for privacy breaches and their implications? and (2) How will you protect users from privacy breaches or inadvertently sharing potentially identifying information about themselves?

RESULTS:

Ethical guidelines recommend a proportionate approach to ethics assessment, which advocates for risk mitigation strategies that are proportional to the magnitude and probability of risks. We revised our social media recruitment strategy to inform users about privacy risks and to protect their privacy, while at the same time meeting our recruitment objectives. We provide a critical reflection of the perceived privacy risks associated with our social media recruitment strategy and the appropriateness of the risk mitigation strategies that we employed by assessing their alignment with PbD and by discussing the following: (1) What are the potential risks and who is at risk? (2) Is cancer considered "sensitive" personal information? (3) What is the probability of online disclosure of a cancer diagnosis in everyday life? and (4) What are the public's expectations for privacy online and their views about online tracking, profiling, and targeting? We conclude with a PbD framework for online health research recruitment.

CONCLUSIONS:

Researchers, REBs, ethicists, students, and potential study participants are often unaware of the privacy risks of social media research recruitment and there is no official guidance. Our PbD framework for online health research recruitment is a resource for these wide audiences.

Disco lives

S.O.S. Band - Take Your Time | performs at SoulTrain (1980)

"According to the New York Times, in 1990 only 6 percent of colorectal cancers were discovered in people under 50. But in 2013, just 23 years later, that figure had risen to 11 percent."

Why are Colorectal Cancer Rates Increasing in Young Adults?

"According to the New York Times, in 1990 only 6 percent of colorectal cancers were discovered in people under 50. But in 2013, just 23 years later, that figure had risen to 11 percent. That doesn’t mean that colon and rectal cancers are becoming young people’s diseases — the majority of cases are still found in adults over 50. But the sharp increase of cases in younger adults has doctors worried."

"Against a rising tide of taxpayer-subsidized pathology, there is only so much that investments in even the best health-care system in the world can do."

Teaching Obesity, Selling Sickness

We are subsidizing our own disease burden.

By ADDISON DEL MASTRO • April 6, 2017

"Against a rising tide of taxpayer-subsidized pathology, there is only so much that investments in even the best health-care system in the world can do. Dismantling the agricultural-industrial complex might pay more health dividends."

C. Eric Freitag, Michael A. Arnold, Jerad M. Gardner, and Christina A. Arnold (2017) If You Are Not on Social Media, Here's What You're Missing! #DoTheThing. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

If You Are Not on Social Media, Here's What You're Missing! #DoTheThing

C. Eric Freitag, MD; Michael A. Arnold, MD, PhD; Jerad M. Gardner, MD; Christina A. Arnold, MD

From the Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus (Drs Freitag, M. A. Arnold, and C. A. Arnold); the Department of Pathology, Nationwide Children's Hospital, Columbus, Ohio (Dr M. A. Arnold); and the Departments of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock (Dr Gardner).

Camb Q Healthc Ethics. 2017 Apr;26(2):337-341. doi: 10.1017/S0963180116000931.

Safeguarding Confidentiality in Electronic Health Records.

Shenoy A, Appel JM.

Abstract

Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health. Features of one institutional model are described that may illustrate the efforts to both ensure adequate transparency and ensure patient confidentiality. Trust and the therapeutic alliance are critical to the provider-patient relationship and quality healthcare services. All of the benefits of an EHR are only possible if patients retain confidence in the security and accuracy of their medical records.

How to eat healthy without spending more

When you have limited money for food, it is natural to gravitate towards foods that will provide the most calories per dollar and fill you up. This may help explain why the highest rates of obesity are found in lower income groups.

Suzanne M. Dintzis, Emily K. Clennon, Carolyn D. Prouty, Lisa M. Reich, Joann G. Elmore, and Thomas H. Gallagher (2017) Pathologists' Perspectives on Disclosing Harmful Pathology Error. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Pathologists' Perspectives on Disclosing Harmful Pathology Error

Suzanne M. Dintzis, MD, PhD; Emily K. Clennon, BA; Carolyn D. Prouty, DVM; Lisa M. Reich, PhD; Joann G. Elmore, MD, MPH; Thomas H. Gallagher, MD

From the Departments of Pathology (Dr Dintzis), Medicine (Ms Clennon and Drs Prouty, Reich, Elmore, and Gallagher), and Epidemiology (Dr Elmore), University of Washington, Seattle.

Reprints: Suzanne M. Dintzis, MD, PhD, Department of Pathology, University of Washington Medical Center, 325 Ninth Ave, Box 359791, Seattle, WA 98104 (email: dintzis@u.washington.edu).

Context.— Medical errors are unfortunately common. The US Institute of Medicine proposed guidelines for mitigating and disclosing errors. Implementing these recommendations in pathology will require a better understanding of how errors occur in pathology, the relationship between pathologists and treating clinicians in reducing error, and pathologists' experiences with and attitudes toward disclosure of medical error.

Objective.— To understand pathologists' attitudes toward disclosing pathology error to treating clinicians and patients.

Design.— We conducted 5 structured focus groups in Washington State and Missouri with 45 pathologists in academic and community practice. Participants were questioned about pathology errors, how clinicians respond to pathology errors, and what roles pathologists should play in error disclosure to patients.

Results.— These pathologists believe that neither treating physicians nor patients understand the subtleties and limitations of pathologic diagnoses, which complicates discussions about pathology errors. Pathologists' lack of confidence in communication skills and fear of being misrepresented or misunderstood are major barriers to their participation in disclosure discussions. Pathologists see potential for their future involvement in disclosing error to patients, but at present advocate reliance on treating clinicians to disclose pathology errors to patients. Most group members believed that going forward pathologists should offer to participate more actively in error disclosure to patients.

Conclusions.— Pathologists lack confidence in error disclosure communication skills with both treating physicians and patients. Improved communication between pathologists and treating physicians could enhance transparency and promote disclosure of pathology errors. Consensus guidelines for best practices in pathology error disclosure may be useful.