Monday, January 27, 2020

"...childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders."

 2020 Jan 1;177(1):20-36. doi: 10.1176/appi.ajp.2019.19010020. Epub 2019 Sep 20.

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders.

Author information

1
Department of Psychiatry, Institute of Early Life Adversity Research, and Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin (Lippard, Nemeroff); Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin (Lippard, Nemeroff); and Department of Psychology, University of Texas, Austin (Lippard).

Abstract

A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies demonstrating that childhood maltreatment is more prevalent and is associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the hypothalamic-pituitary-adrenal axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. The authors discuss several candidate genes and environmental factors (for example, substance use) that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies.

When Are Vaccine Mandates Appropriate?

 2020 Jan 1;22(1):E36-42. doi: 10.1001/amajethics.2020.36.

When Are Vaccine Mandates Appropriate?

Author information

1
The executive director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School in Cambridge, Massachusetts, where she is also a lecturer on law at Harvard Law School.
2
A professor of law and the James Edgar Hervey '50 Chair of Litigation at the University of California, Hastings College of the Law, in San Francisco.

Abstract

Vaccine refusal is a serious public health problem, especially in the context of diseases with potential to spark global pandemics, such as Ebola virus disease in the Democratic Republic of the Congo. This article examines whether and when compelling vaccination through mandates and criminalization, for example, are appropriate. It argues that some legal approaches are ethical when they preserve social stability, trust in government, therapeutic research opportunities, or when they diminish disease severity.

Coronavirus symptoms similar to severe flu

Coronavirus symptoms similar to severe flu


The coronavirus is a family of viruses that can cause illnesses, ranging from the common cold to pneumonia. But the strain making headlines is more virulent, says John Thyng, Medical Director for the Emergency Department at A.R. Gould Hospital.
"Unfortunately the strain that we're finding coming out of China, or they found in China, actually leads to very severe illness, with high fevers, pneumonia, can cause respiratory failure, causes kidney failure, and - and can cause death," says John Thyng.



"Tens of millions of people are reportedly in quarantine or lockdown across China as the government deals with the outbreak..." #Coronavirus

Chinese president warns of 'accelerating spread' of coronavirus and grave public health situation



"Life is of paramount importance. When an epidemic breaks out, a command is issued. It is our responsibility to prevent and control it," Xi said at a meeting of the leaders of the Communist Party of China (CPC), according to state-run media outlet Xinhua News Agency.
Tens of millions of people are reportedly in quarantine or lockdown across China as the government deals with the outbreak, which coincides with celebrations of the Lunar New Year.

"Because its incubation period is likely to be as much as a week, travelers can be harboring the infection and show no symptoms." #Coronavirus

What must be done to head off the coronavirus threat


"First, we need to better understand the nature of this bug, and its severity. The illness may be more widespread than we realize in the fog of viral war.  A key to containing the virus’s wider spread will be developing effective point-of-care diagnostics to implement more widespread screening of patients."

"But there’s little evidence to suggest that the face masks worn by members of the public prevent people from being infected by breathing in the virus..." #Coronavirus

Coronavirus FAQs: Do Masks Help? Is The Disease Really So Mysterious?



There’s a run on masks in China, with the belief that wearing one in public will protect an individual from exposure to droplets sneezed or coughed out by someone infected with the Wuhan virus.

But there’s little evidence to suggest that the face masks worn by members of the public prevent people from being infected by breathing in the virus, says William Schaffner, a professor in the division of infectious diseases at Vanderbilt University Medical Center. “There really are no good, solid, reliable data.”

According to the Centers for Disease Control and Prevention, the kind of flimsy masks that people often buy in pharmacies may not tightly fit the face, so the wearer can still breathe in air — and infected droplets.

How College Became a Commodity

How College Became a Commodity

Market-based thinking is at the heart
of how academe thinks of itself.
That’s a travesty.






"Since the 1970s, and especially since the 1990s, research universities have become major economic actors, not only in market-oriented competition for students but in the commodification of ever greater swaths of their activities, including faculty research. Tightening relationships with industry allows businesses to capture and monetize the intellectual property created by publicly funded research. These changes have been accompanied by major shifts in administrative philosophy, such as the application of metrics to scholars’ and departments’ 'performance' — a direct borrowing from corporate-management fads."












"But a writer who carries the thought police around in his head, who always feels compelled to ask: Can I say this?..."

The Enemies of Writing

"Fear and mistrust may be one of the greatest challenges authorities face in eliminating infectious diseases."

Coronavirus is the latest round in an age-old struggle

Mistrust and realpolitik complicate efforts to protect public health



"Today’s strategy of containment — one of the key measures deployed against endemic diseases — would be familiar to civil authorities and medical personnel as far back as the ancient world. “Quarantine” has its roots in the Venetian Republic’s 14th century efforts to keep out the plague. But the maritime power would have been hard-pressed to institute a cordon sanitaire on a Chinese scale. The ability to lock down cities the size of Wuhan, which is about as big as London, is a reflection of the power of Beijing’s ever more authoritarian rule. 

Misinformation, and disinformation, are also still prevalent. During the outbreak of Spanish flu in 1918-19, conspiracy theories of enemy bioweapons circulated. An 1853 outbreak of yellow fever in New Orleans was blamed on immigrants. On social media, wild claims are already circulating that the coronavirus was manufactured on behalf of vested interests seeking to sell vaccines. Fear and mistrust may be one of the greatest challenges authorities face in eliminating infectious diseases."

The moral residue of conservation

 2020 Jan 18. doi: 10.1111/cobi.13463. [Epub ahead of print]

The moral residue of conservation.

Author information

1
Department of Forest Ecosystems and Society, Oregon State University, 321 Richardson Hall, Corvallis, OR, 97331, USA.
2
Centre for Compassionate Conservation, School of Life Sciences, University of Technology Sydney, Ultimo, NSW, 2007, Australia.

Abstract

Should conservationists use lethal management to control introduced wildlife populations? Should they kill individual animals to protect endangered species? Are tradeoffs that prioritize some values at the expense of others morally appropriate? These sorts of ethical questions are common in conservation. In debating such questions, conservationists often seem to presume one of two possible answers: the act in question is right, or it is wrong. But morality in conservation is considerably more complex than this simple binary suggests. A robust conservation ethic requires a vocabulary that gives voice to the uncertainty and unease that arise when what seems to be the best available course of action also seems to involve a measure of wrongdoing. The philosophical literature on moral residue and moral dilemmas supplies this vocabulary. Moral dilemmas arise when one must neglect certain moral requirements to fulfill others. Under such circumstances, even the best possible decision leaves a "moral residue," which is experienced emotionally as some form of grief. In this essay we introduce the concept of moral residue, offering three philosophical accounts to explain its origins and implications, and illustrating each with a conservation example. We argue that moral residue is integral to the moral experience of conservationists today, and we suggest grief is an appropriate response to many decisions conservationists must make.

Long-term Puberty Suppression for a Nonbinary Teenager

 2020 Jan 23. pii: e20191606. doi: 10.1542/peds.2019-1606. [Epub ahead of print]

Long-term Puberty Suppression for a Nonbinary Teenager.

Author information

1
Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
2
Department of Adolescent Medicine and.
3
Departments of Paediatrics and.
4
Psychiatry.
5
Melbourne Law School, and.
6
School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
7
Children's Bioethics Centre, The Royal Children's Hospital, Melbourne, Victoria, Australia.
8
Uehiro Centre for Practical Bioethics, Oxford University, Oxford, United Kingdom.
9
The University of British Columbia, Vancouver, Canada.
10
University of Southern California, Los Angeles, California; and.
11
Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri jlantos@cmh.edu.

Abstract

Many transgender and gender-diverse people have a gender identity that does not conform to the binary categories of male or female; they have a nonbinary gender. Some nonbinary individuals are most comfortable with an androgynous gender expression. For those who have not yet fully progressed through puberty, puberty suppression with gonadotrophin-releasing hormone agonists can support an androgynous appearance. Although such treatment is shown to ameliorate the gender dysphoria and serious mental health issues commonly seen in transgender and gender-diverse young people, long-term use of puberty-suppressing medications carries physical health risks and raises various ethical dilemmas. In this Ethics Rounds, we analyze a case that raised issues about prolonged pubertal suppression for a patient with a nonbinary gender.

"I believe there are 3 major national (indeed international) challenges that pathologists will need to address soon for the profession to continue to succeed and thrive, and for residents’ and fellows’ job outlook to remain positive."

 2020 Jan 23. doi: 10.5858/arpa.2019-0680-ED. [Epub ahead of print]

Pathologists Will Prevail.

Author information

1
From the Department of Pathology, The University of Mississippi Medical School, The University of Mississippi Medical Center, Jackson.



"We all want there to be a continuing positive job market outlook for pathology trainees in the future. I believe there are 3 major national (indeed international) challenges that pathologists will need to address soon for the profession to continue to succeed and thrive, and for residents’ and fellows’ job outlook to remain positive. These are (1) scope of practice creep, (2) consolidation and centralization of hospitals, and (3) artificial intelligence (AI) and digitalization. For pathologists’ ultimate success, these all must be considered and addressed."

Monday, January 20, 2020

Pulmonary Pathology Society Perspective on the 2018 American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society (ATS/ERS/JRS/ALAT) Idiopathic Pulmonary Fibrosis Clinical Practice Guidelines

 2020 Jan 16. doi: 10.1513/AnnalsATS.201910-801PS. [Epub ahead of print]

 2020 Jan 16. doi: 10.1513/AnnalsATS.201910-801PS. [Epub ahead of print]

Pulmonary Pathology Society Perspective on the 2018 American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society (ATS/ERS/JRS/ALAT) Idiopathic Pulmonary Fibrosis Clinical Practice Guidelines.

Author information

1
Massachusetts General Hospital, Pathology, Boston, Massachusetts, United States; LHARIRI@mgh.harvard.edu.
2
Mayo Clinic Scottsdale, 384840, Department of Laboratory Medicine and Pathology, Scottsdale, Arizona, United States.
3
Massachusetts General Hospital, Pathology, Boston, Massachusetts, United States.
4
University of Mississippi Medical Center, 21693, Pathology, Jackson, Mississippi, United States.
5
Cardiff University, 2112, Department of Pathology, Cardiff, South Glamorgan, United Kingdom of Great Britain and Northern Ireland.
6
Weill Cornell Medicine, Pathology and Laboratory Medicine , New York, New York, United States.
7
Cork University Hospital, Department of Histopathology, Cork, Ireland.
8
University of São Paulo Institute of Biomedical Sciences, 54544, Sao Paulo, SP, Brazil.
9
University of Pittsburgh Medical Center, 6595, Department of Pathology, Pittsburgh, Pennsylvania, United States.
10
Virginia Mason Medical Center, 7289, Pathology, Seattle, Washington, United States.
11
Kaiser Permanente, 6152, Oakland, California, United States.
12
Mayo Clinic College of Medicine, Anatomic Pathology and Laboratory Medicine, Rochester, Minnesota, United States.
13
University of Texas MD Anderson Cancer Center, 4002, Houston, Texas, United States.
14
Brigham and Women's Hospital, Boston, Massachusetts, United States.
15
Mount Sinai Medical Center, 5944, Department of Pathology, New York, New York, United States.
16
University of British Columbia, Department of Pathology, Vancouver, British Columbia, Canada.

Author information

1
Massachusetts General Hospital, Pathology, Boston, Massachusetts, United States; LHARIRI@mgh.harvard.edu.
2
Mayo Clinic Scottsdale, 384840, Department of Laboratory Medicine and Pathology, Scottsdale, Arizona, United States.
3
Massachusetts General Hospital, Pathology, Boston, Massachusetts, United States.
4
University of Mississippi Medical Center, 21693, Pathology, Jackson, Mississippi, United States.
5
Cardiff University, 2112, Department of Pathology, Cardiff, South Glamorgan, United Kingdom of Great Britain and Northern Ireland.
6
Weill Cornell Medicine, Pathology and Laboratory Medicine , New York, New York, United States.
7
Cork University Hospital, Department of Histopathology, Cork, Ireland.
8
University of São Paulo Institute of Biomedical Sciences, 54544, Sao Paulo, SP, Brazil.
9
University of Pittsburgh Medical Center, 6595, Department of Pathology, Pittsburgh, Pennsylvania, United States.
10
Virginia Mason Medical Center, 7289, Pathology, Seattle, Washington, United States.
11
Kaiser Permanente, 6152, Oakland, California, United States.
12
Mayo Clinic College of Medicine, Anatomic Pathology and Laboratory Medicine, Rochester, Minnesota, United States.
13
University of Texas MD Anderson Cancer Center, 4002, Houston, Texas, United States.
14
Brigham and Women's Hospital, Boston, Massachusetts, United States.
15
Mount Sinai Medical Center, 5944, Department of Pathology, New York, New York, United States.
16
University of British Columbia, Department of Pathology, Vancouver, British Columbia, Canada.