"The law represents a significant, if long-anticipated, shift among the nation’s soda makers, who have previously fought taxes, city by city, and expended millions of dollars in the process. Soda companies say the statewide bans more efficiently protect jobs and businesses that could be hurt by local tax laws."
Saturday, June 30, 2018
California, home of the first soda tax, agrees to ban them
California, home of the first soda tax, agrees to ban them
Conflicting duties and restitution of the trusting relationship
J Med Ethics. 2018 Jun 15. pii: medethics-2017-104682. doi: 10.1136/medethics-2017-104682. [Epub ahead of print]
Conflicting duties and restitution of the trusting relationship.
Author information
- 1
- ARENA , Centre for European Studies, University of Oslo, Oslo, Norway.
- 2
- SPS, Centre for the Study of Professions, Oslo and Akershus University College, Oslo, Norway.
Abstract
It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.
From @marenwhymdmd and me: Let's Have a Tweetup: The Case for Using Twitter Professionally
Arch Pathol Lab Med. 2016 Sep;140(9):956-7. doi: 10.5858/arpa.2016-0172-SA. Epub 2016 May 19.
Let's Have a Tweetup: The Case for Using Twitter Professionally.
Author information
- 1
- From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Fuller); and the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen).
Abstract
Social media use is very common and can be an effective way for professionals to discuss information and interact with colleagues. Twitter (Twitter, Inc, San Francisco, California) is a social media network where posts, termed tweets, are limited to 140 characters. Professional use of Twitter is ideal for physicians interested in both networking and education and is optimally used to facilitate in-person networking. Live-tweeting (posting real-time reactions to events) at professional meetings is also a popular and highly successful use of Twitter. Physicians report patient privacy as the top concern preventing use of social media for professional reasons, and although generally social media use is safe, it is essential to understand how to protect patient confidentially. Other social media platforms with potential for professional use include Facebook (Facebook, Inc, Menlo Park, California), Instagram (Facebook, Inc), YouTube (YouTube, LLC, San Bruno, California), and Periscope (Twitter, Inc). With Twitter and other social media options, now is the time for pathologists to increase our visibility on social media and worldwide.
CDC: Cancers Linked To Obesity Account For 40 Percent Of All US Cancer Cases
CDC: Cancers Linked To Obesity Account For 40 Percent Of All US Cancer Cases
WASHINGTON — When it comes to obesity, studies often focus on the heart problems that can crop up as people age. New research now points to the cancer risks associated with weight: researchers discovered that of all the cancers diagnosed in the U.S. in 2014, 40 percent were related to overweight and obesity, according to a report by the Centers for Disease Control and Prevention.
Doctors and scientists know of 13 different types of cancer related to body weight and obesity. While the overall number of cancer-sufferers in America has fallen since the 1990s, increases in the proportion of those who suffer from cancers linked to an unhealthy body mass index are likely hurting those numbers.
Friday, June 29, 2018
Moving from the HIV Organ Policy Equity Act to HIV Organ Policy Equity in action: changing practice and challenging stigma
Curr Opin Organ Transplant. 2018 Apr;23(2):271-278. doi: 10.1097/MOT.0000000000000510.
Moving from the HIV Organ Policy Equity Act to HIV Organ Policy Equity in action: changing practice and challenging stigma.
Author information
- 1
- Department of Medicine.
- 2
- Department of Pathology.
- 3
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abstract
PURPOSE OF REVIEW:
The HIV Organ Policy Equity (HOPE) Act, signed in 2013, reversed the federal ban on HIV-to-HIV transplantation. In this review, we examine the progress in HOPE implementation, the current status of HIV-to-HIV transplantation, and remaining challenges.
RECENT FINDINGS:
Pursuant to the HOPE Act, the Department of Health and Human Services revised federal regulations to allow HIV-to-HIV transplants under research protocols adherent to criteria published by the National Institutes of Health. The first HIV-to-HIV kidney and liver transplants were performed at Johns Hopkins in March of 2016. Legal and practical challenges remain. Further efforts are needed to educate potential HIV+ donors and to support Organ Procurement Organizations. As of November 2017, there are 22 transplant centers approved to perform HIV-to-HIV transplants in 10 United Network for Organ Sharing regions. To date, 16 Organ Procurement Organizations in 22 states have evaluated HIV+ donors. The National Institutes of Health-funded HOPE in Action: A Multicenter Clinical Trial of HIV-to-HIV Deceased Donor (HIVDD) Kidney Transplantation Kidney Trial will launch at 19 transplant centers in December of 2017. A HOPE in Action Multicenter HIVDD Liver Trial is in development.
SUMMARY:
Significant progress toward full HOPE implementation has been made though barriers remain. Some challenges are unique to HIV-HIV transplantation, whereas others are amplifications of issues across the current transplant system. In addition to a public health benefit for all transplant candidates in the United States, partnership on the HOPE Act has the potential to address systemic challenges to national donation and transplantation.
Sunday, June 24, 2018
Childhood Obesity To Be Tackled By The British Government With New Stricter Measures
Childhood Obesity To Be Tackled By The British Government With New Stricter Measures
"'It is our job to empower parents to make healthier choices and make their lives easier,' added the British Health Minister."
Chocolate milk for recovery from exercise: a systematic review and meta-analysis of controlled clinical trials
Eur J Clin Nutr. 2018 Jun 19. doi: 10.1038/s41430-018-0187-x. [Epub ahead of print]
Chocolate milk for recovery from exercise: a systematic review and meta-analysis of controlled clinical trials.
Author information
- 1
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- 2
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- 3
- Food Security research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- 4
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- 5
- Faculty of Pure & Applied Science, School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada.
- 6
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada.
- 7
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. abargouei@ssu.ac.ir.
- 8
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. abargouei@ssu.ac.ir.
Abstract
BACKGROUND/OBJECTIVES:
Chocolate milk (CM) contains carbohydrates, proteins, and fat, as well as water and electrolytes, which may be ideal for post-exercise recovery. We systematically reviewed the evidence regarding the efficacy of CM compared to either water or other "sport drinks" on post-exercise recovery markers.
SUBJECTS/METHODS:
PubMed, Scopus, and Google scholar were explored up to April 2017 for controlled trials investigating the effect of CM on markers of recovery in trained athletes.
RESULTS:
Twelve studies were included in the systematic review (2, 9, and 1 with high, fair and low quality, respectively) and 11 had extractable data on at least one performance/recovery marker [7 on ratings of perceived exertion (RPE), 6 on time to exhaustion (TTE) and heart rate (HR), 4 on serum lactate, and serum creatine kinase (CK)]. The meta-analyses revealed that CM consumption had no effect on TTE, RPE, HR, serum lactate, and CK (P > 0.05) compared to placebo or other sport drinks. Subgroup analysis revealed that TTE significantly increases after consumption of CM compared to placebo [mean difference (MD) = 0.78 min, 95% confidence interval (CI): 0.27, 1.29, P = 0.003] and carbohydrate, protein, and fat-containing beverages (MD = 6.13 min, 95% CI: 0.11, 12.15, P = 0.046). Furthermore, a significant attenuation on serum lactate was observed when CM was compared with placebo (MD = -1.2 mmol/L, 95% CI: -2.06,-0.34, P = 0.006).
CONCLUSION:
CM provides either similar or superior results when compared to placebo or other recovery drinks. Overall, the evidence is limited and high-quality clinical trials with more well-controlled methodology and larger sample sizes are warranted.
Claiming agency in later life in reforming China
Ageing Soc. 2017 Nov;37(10):2074-2102. doi: 10.1017/S0144686X16000830. Epub 2016 Aug 12.
It was all planned … now what? Claiming agency in later life in reforming China.
Author information
- 1
- Department of Gerontology, University of Louisiana at Monroe, Louisiana, USA.
- 2
- Department of Sociology, Western Washington University, Bellingham, Washington, USA.
Abstract
This study explores the social construction of agency and wellbeing among 20 Chinese urban retirees aged between 50 and 82 years old (averaging 67), with a special focus on the impact of earlier life experiences in shaping later-life pathways. Today's retirees in urban China have experienced the communist collectivist ideology during the Mao era as well as the changes to everyday life brought about by the economic transformation from centrally planned socialism to a market-orientated economy. Thereby, life in retirement for Chinese elders becomes more than just an issue of dealing with increases in discretionary time after exit from full-time work, but also one of making sense of their earlier life experiences in the midst of dramatic social changes. A grounded theory approach with semi-structured, in-depth, face-to-face interviews was used for data collection and analysis. Three interrelated themes emerged: (a) reminiscence as a mechanism of meaning-making, (b) discovery and exercise of agency in later life in contrast to a rigidly structured earlier life, and (c) varying pathways to constructing the life-stage of retirement. The findings have refuted gerontological literature and public discourse that often portray Chinese elders as passive care recipients or helpless dependants. Further, the present study has practical implications for developing policies, designing programmes and providing services to improve the quality of life for today's older Chinese people.
Religious Involvement and Marijuana Use for Medical and Recreational Purposes
J Drug Issues. 2018 Jul;48(3):421-434. doi: 10.1177/0022042618770393. Epub 2018 Apr 21.
Religious Involvement and Marijuana Use for Medical and Recreational Purposes.
Author information
- 1
- Florida State University, Tallahassee, USA.
- 2
- University of Arizona, Tucson, USA.
- 3
- Mississippi State University, Mississippi State, USA.
- 4
- University of Central Florida, Orlando, USA.
Abstract
In this article, we use data from the 2016 National Survey on Drug Use and Health (NSDUH) to examine the association between religious involvement and marijuana use for medical and recreational purposes in U.S. adults (N = 41,517). We also consider whether the association between religious involvement and marijuana use varies according to personal health status. Our results show that adults who attend religious services more frequently and hold more salient religious beliefs tend to exhibit lower rates of medical and recreational marijuana use. We also find that these "protective effects" are less pronounced for adults in poor health. Although our findings confirm previous studies of recreational marijuana use, we are the first to examine the association between religious involvement and medical marijuana use. Our moderation analyses suggest that the morality and social control functions of religious involvement may be offset under the conditions of poor health.
Rationales for expanding minority physician representation in the workforce
Med Educ. 2018 Jun 22. doi: 10.1111/medu.13618. [Epub ahead of print]
Rationales for expanding minority physician representation in the workforce: a scoping review.
Author information
- 1
- Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
- 2
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
- 3
- Division of Bioethics, Department of Paediatrics, University of Washington, Seattle, Washington, USA.
- 4
- Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA.
- 5
- Department of Health Behaviour, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA.
- 6
- College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
- 7
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.
- 8
- Department of Forensic Psychology, Walden University, Minneapolis, Minnesota, USA.
Abstract
OBJECTIVES:
The purpose of this study was to conduct a scoping review of the literature and to categorically map a 15-year trajectory of US undergraduate medical education rationales for and approaches to expanding under-represented minority (URM) physician representation in the medical workforce. Further aims were to comparatively examine related justifications and to consider international implications.
METHODS:
From 1 June to 31 July 2015, the authors searched the Cochrane Library, ERIC, PsycINFO, PubMed, Scopus, Web of Science and Google Scholar for articles published between 2000 and 2015 reporting rationales for and approaches to increasing the numbers of members of URMs in undergraduate medical school.
RESULTS:
A total of 137 articles were included in the scoping review. Of these, 114 (83%) mentioned workforce diversity and 73 (53%) mentioned concordance. The patient-physician relationship (n = 52, 38%) and service commitment (n = 52, 38%) were the most commonly cited rationales. The most frequently mentioned approaches to increasing minority representation were pipeline programmes (n = 59, 43%), changes in affirmative action laws (n = 32, 23%) and changes in admission policies (n = 29, 21%).
CONCLUSIONS:
This scoping review of the 2000-2015 literature on strategies for and approaches to expanding URM representation in medicine reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross-nationally, service commitment and patient-physician concordance benefits admittedly respond to recognised societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfil that need. The proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations. Our findings suggest that the expanding emphasis on URM service commitment and patient-physician concordance benefits warrants ongoing scrutiny and, more broadly, represent a cautionary tale of unintended consequences for medical educators globally.
"We redefine the illicit drug focused cryptomarket as a place of exchange, mediation[,] and reciprocity."
Int J Drug Policy. 2018 Jun 2;58:78-84. doi: 10.1016/j.drugpo.2018.05.008. [Epub ahead of print]
'Nice people doing shady things': Drugs and the morality of exchange in the darknet cryptomarkets.
Abstract
BACKGROUND:
An ethnographic analysis of drug-centred cryptomarket community and exchange, this article explores the embedded values around drug distribution and consumption within this setting. Drawing on our interviews with cryptomarket users, we analyze the ways in which users claim the cryptomarket as a space of morality, empathy, trust, reciprocity, knowledge transfer, harm reduction and self-limitation. The anthropological concept of the morality of exchange is central to our theoretical approach.
METHODS:
Between December 2014 and July 2017, nine interviews were undertaken with users of drug cryptomarkets. These were conducted in person, using Skype video calling, and using the encrypted 'self-erasing' chat app Wickr. The researchers also used overt non-participant observation (NPO) within the cryptomarket forum. This two-pronged approach - interviews and spending time within the community via NPO - enabled a thick description style of ethnographic analysis.
RESULTS:
Our research reveals online drug markets less as perfect markets (working to rules of supply and demand) and more as constructive communities of interest that perform and negotiate drug use and supply. We found that participation within these interest communities had practical impact such as changing the type of drug that users consume and the ways in which they participate in street drug supply. Significantly, these values and actions mediate the interface between online action and 'meatspace' (the offline world) and reinforce that the motivations and processes of internet activity are just as 'real' as offline action.
CONCLUSION:
We redefine the illicit drug focused cryptomarket as a place of exchange, mediation and reciprocity. Real-time knowledge transfer with the aim of harm reduction is one example of the impact of cryptomarket interaction. We caution that this is not a space of kinship and affinity: it is not without its scams, hackers and threats. It is, however, much more than a 'drug marketplace' and to understand how users themselves conceptualise this space is fruitful for any understanding of cryptomarkets. Cryptomarket exchange is a form of social action that is not restricted to its economic value for participants.
"Scientists called the 7 bad habits that undermine heart health."
The main habit that kill heart health
Constant stress in the long run literally drained the heart.
"Scientists called the 7 bad habits that undermine heart health. Some of them well known to the people of our country."
"Scientists called the 7 bad habits that undermine heart health. Some of them well known to the people of our country."
Saturday, June 23, 2018
Obesity - "...it was not the methods that were decisive, but rather the ability to maintain a lower caloric intake over a period of time."
Lonely and prolonged struggle for people with severe obesity
The majority of people with severe obesity have a lonely and prolonged struggle with their weight. In one study spanning more than 10 years, 83 percent report that they constantly strive to lose weight or prevent weight gain.
"None of these methods was better or worse than the others in terms of weight loss. Those who had reduced their weight by more than 10 percent over a 10-year period had used the same methods as those who had gained an equal amount of weight.
Consequently, it was not the methods that were decisive, but rather the ability to maintain a lower caloric intake over a period of time. The degree of success varied greatly. Some in the group gained a lot of weight in 10 years; other lost a great deal."
H. Tristram Engelhardt, Jr. RIP
H. Tristram Engelhardt, Jr. RIP
A gentleman, a philosopher, a physician, a proud "Texian," a brilliant raconteur, and a clear-eyed defender of liberty has died.
"Engelhardt argued that any effort to construct a morality that can be shared by "moral strangers," that is, people living and believing in different moral communities, must have two cardinal characteristics: First, a recognition that there is no canonical warrant for a particular morality. One cannot in principle determine which moral intuitions should trump. This means that one cannot with sound argument, using discursive reason, reach secular agreement. Second, such a modest morality must recognize the fact of the actual plurality of moralities.
His correct conclusion is that the only way forward for humanity is the peaceable moral community in which people with differing moral views agree to disagree."
"It was not a necessary gesture. I didn’t expect it and he was in no way obliged to write it, but write it he did."
Charles Krauthammer, 1950-2018
Anyway, Charles liked the Standard, and he like the work we did, and when I left editing there, he wrote me the nicest letter I have ever received. It was not a necessary gesture. I didn’t expect it and he was in no way obliged to write it, but write it he did. It was the first act of pure kindness he had ever shown me, and it began a friendship—a very distant friendship, but a friendship nonetheless—that would last two decades. Over time he would share bits and pieces of the way he was compelled to live. He told me that the year Ford came out with the van he was able to drive was the greatest liberation of his life. He did love driving that van—and drove it with frightening flourish.
Study finds the body positive movement is probably contributing to the obesity crisis
Study finds the body positive movement is probably contributing to the obesity crisis
The past few years have seen a rise in a movement called body positivity, which seeks to end fat shaming, increase self-esteem, and generally make people feel good in their own skin. Models like Ashley Graham and Iskra Lawrence have been in the forefront of this movement, which saw Graham launch a best selling size-inclusive swimwear line.
However, this movement seems to have had a negative impact on our collective health.
“Seeing the huge potential of the fuller-sized fashion market, retailers may have contributed to the normalization of being overweight and obese,” said Dr Muttarak in a release. “While this type of body positive movement helps reduce stigmatization of larger-sized bodies, it can potentially undermine the recognition of being overweight and its health consequences.”
"If behavioral unresponsiveness does not equate to unconsciousness, then the philosophical underpinning of the definition based on loss of capacity for consciousness as well as the criteria, and tests in brain death determination are incongruent with empirical evidence."
J Relig Health. 2018 Jun 21. doi: 10.1007/s10943-018-0654-7. [Epub ahead of print]
Neuroscience and Brain Death Controversies: The Elephant in the Room.
Author information
- 1
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA.
- 2
- Department of Critical Care Medicine, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA. rady.mohamed@mayo.edu.
- 3
- Department of Philosophy and Religion, Methodist University, 5400 Ramsey Street, Fayetteville, NC, 28311-1498, USA.
Abstract
The conception and the determination of brain death continue to raise scientific, legal, philosophical, and religious controversies. While both the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in 1981 and the President's Council on Bioethics in 2008 committed to a biological definition of death as the basis for the whole-brain death criteria, contemporary neuroscientific findings augment the concerns about the validity of this biological definition. Neuroscientific evidentiary findings, however, have not yet permeated discussions about brain death. These findings have critical relevance (scientifically, medically, legally, morally, and religiously) because they indicate that some core assumptions about brain death are demonstrably incorrect, while others lack sufficient evidential support. If behavioral unresponsiveness does not equate to unconsciousness, then the philosophical underpinning of the definition based on loss of capacity for consciousness as well as the criteria, and tests in brain death determination are incongruent with empirical evidence. Thus, the primary claim that brain death equates to biological death has then been de facto falsified. This conclusion has profound philosophical, religious, and legal implications that should compel respective authorities to (1) reassess the philosophical rationale for the definition of death, (2) initiate a critical reappraisal of the presumed alignment of brain death with the theological definition of death in Abrahamic faith traditions, and (3) enact new legislation ratifying religious exemption to death determination by neurologic criteria.
Philosophy is dead
Philosophy is dead
JONATHAN RÉE
There are two different ways of responding to this predicament. Geuss sketches one of them in a scintillating chapter on Theodor Adorno, the twentieth-century aesthete who sought to combine classical Marxism with disdain for the stupidity of the masses. Adorno, you might say, showed signs of intellectual mysophobia, or Platonistic revulsion from impurity, and Geuss – who regards Plato as an “intellectual bully” – is uneasy about Adorno’s “relentless negativism”. He finds an amiable alternative in Michel de Montaigne who, having no desire to correct the follies of humanity, was “free of all these pathologies”.
Conflicting duties and restitution of the trusting relationship
J Med Ethics. 2018 Jun 15. pii: medethics-2017-104682. doi: 10.1136/medethics-2017-104682. [Epub ahead of print]
Conflicting duties and restitution of the trusting relationship.
Author information
- 1
- ARENA , Centre for European Studies, University of Oslo, Oslo, Norway.
- 2
- SPS, Centre for the Study of Professions, Oslo and Akershus University College, Oslo, Norway.
Abstract
It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.
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