http://www.ncbi.nlm.nih.gov/pubmed/23532456

South Med Rev. 2012 Dec;5(2):9-19. Epub 2012 Dec 27.

Mexican Pharmacies and Antibiotic Consumption at the US-Mexico Border.

Homedes N, Ugalde A.

Source

School of Public Health, University of Texas, USA.

Abstract

OBJECTIVE:

To study antibiotic dispensing to US and Mexican residents, at Mexican pharmacies at the US-Mexico border, and the pharmacy clerks' capability to promote appropriate use.

METHODS:

The site selected was Ciudad Juarez, Chihuahua (pop. 1.2 million) separated from El Paso, Texas (pop. 800,000) by the Rio Grande River. A convenience sample of 32 pharmacies located near the international bridges, major shopping centers, and interior neighborhoods was selected. Pharmacy clients were interviewed (n=230) and 152 interactions between clients and pharmacy clerks were observed. Information was obtained about education and pharmaceutical training of 113 clerks working in 25 pharmacies. A senior pharmacy clerk in each of the 25 pharmacies was interviewed and asked for their recommendations to clients presenting two clinical scenarios and seven diagnoses.

FINDINGS:

Professionally trained pharmacists only spend a few hours a week in some pharmacies. Clerks' education levels are very low; some have only completed primary education. There is no required pharmaceutical training and their knowledge about pharmaceuticals comes mostly from representatives of the pharmaceutical industry. Clerks' knowledge of antibiotics, the most frequently sold class of medicines (65% without prescription), is very limited. Clients trust pharmacy clerks and tend to follow their advice.

CONCLUSIONS:

The findings raise concerns about dispensing of antibiotics at Mexican border pharmacies and antibiotic overuse due to lack of control. Because inappropriate antibiotic use contributes to increased resistance, pharmacy clerks should receive independent training to dispense antibiotics and promote their appropriate use.

http://www.ncbi.nlm.nih.gov/pubmed/23110633

BMC Med Ethics. 2012 Oct 30;13:28. doi: 10.1186/1472-6939-13-28.

"Snake-oil," "quack medicine," and "industrially cultured organisms:" biovalue and the commercialization of human microbiome research.

Slashinski MJ, McCurdy SA, Achenbaum LS, Whitney SN, McGuire AL.

Source

Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, USA. melody.slashinski@bcm.edu

Abstract

BACKGROUND:

Continued advances in human microbiome research and technologies raise a number of ethical, legal, and social challenges. These challenges are associated not only with the conduct of the research, but also with broader implications, such as the production and distribution of commercial products promising maintenance or restoration of good physical health and disease prevention. In this article, we document several ethical, legal, and social challenges associated with the commercialization of human microbiome research, focusing particularly on how this research is mobilized within economic markets for new public health uses.

METHODS:

We conducted in-depth, semi-structured interviews (2009-2010) with 63 scientists, researchers, and National Institutes of Health project leaders ("investigators") involved with human microbiome research. Interviews explored a range of ethical, legal, and social dimensions of human microbiome research, including investigators' perspectives on commercialization. Using thematic content analysis, we identified and analyzed emergent themes and patterns.

RESULTS:

Investigators discussed the commercialization of human microbiome research in terms of (1) commercialization, probiotics, and issues of safety, (2) public awareness of the benefits and risks of dietary supplements, and (3) regulation.

CONCLUSION:

The prevailing theme of ethical, legal, social concern focused on the need to find a balance between the marketplace, scientific research, and the public's health. The themes we identified are intended to serve as points for discussions about the relationship between scientific research and the manufacture and distribution of over-the-counter dietary supplements in the United States.

From Terhan U-Iran: Saffron, passionflower, valerian, and sage to treat symptoms of mental illness

http://www.ncbi.nlm.nih.gov/pubmed/23538079

Psychiatr Clin North Am. 2013 Mar;36(1):85-91. doi: 10.1016/j.psc.2012.12.007.

Saffron, passionflower, valerian and sage for mental health.

Modabbernia A, Akhondzadeh S.

Source

Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran 13337, Iran.

Abstract

Many cultures have developed folk herbal remedies to treat symptoms of mental illness. An evidence-based view is now being developed for some of these so-called alternative herbal treatments. This article discusses clinically relevant scientific information on medicinal extracts of 4 herbs: saffron, passionflower, valerian, and sage.

Colorectal Cancer Screening

http://www.ncbi.nlm.nih.gov/pubmed/23539676

Am J Lifestyle Med. 2012 May 1;6(3):196-203. Epub 2011 Aug 2.

State of the Art Review: Colorectal Cancer Screening.

Diaz JA, Slomka T.

Source

Associate Professor of Medicine, Alpert Medical School of Brown University, Brown University Center for Primary Care and Prevention at Memorial Hospital of Rhode Island, 111 Brewster Street, CPCP bldg- 2 Floor, Pawtucket, RI 02860, Joseph_Diaz@Brown.edu 

Although colorectal cancer is the third leading cause of cancer-related deaths in the U.S., the burden of this disease could be dramatically reduced by increased utilization of screening. Evidence-based recommendations and guidelines from national societies recommend screening all average risk adults starting at age fifty. However, the myriad of screening options and slight differences in screening recommendations between guidelines may lead to confusion among patients and their primary care providers. This goal of this review is to briefly summarize the colorectal cancer screening guidelines issued by three major organizations, compare their recommendations, and address emerging issues in colorectal cancer screening.

From U Utah: Developing Genome and Exome Sequencing for Candidate Gene Identification in Inherited Disorders

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0107-RA

Emily M. Coonrod, Jacob D. Durtschi, Rebecca L. Margraf, and Karl V. Voelkerding (2013) Developing Genome and Exome Sequencing for Candidate Gene Identification in Inherited Disorders: An Integrated Technical and Bioinformatics Approach. Archives of Pathology & Laboratory Medicine: March 2013, Vol. 137, No. 3, pp. 415-433.

doi: http://dx.doi.org/10.5858/arpa.2012-0107-RA

REVIEW ARTICLE

Developing Genome and Exome Sequencing for Candidate Gene Identification in Inherited Disorders: An Integrated Technical and Bioinformatics Approach

Emily M. Coonrod , PhD; Jacob D. Durtschi , BS; Rebecca L. Margraf , PhD; Karl V. Voelkerding , MD

From Research and Development, ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah (Drs Coonrod, Margraf, and Voelkerding and Mr Durtschi); and the Department of Pathology, University of Utah School of Medicine, Salt Lake City (Dr Voelkerding).

Context.—Advances in sequencing technology with the commercialization of next-generation sequencing (NGS) has substantially increased the feasibility of sequencing human genomes and exomes. Next-generation sequencing has been successfully applied to the discovery of disease-causing genes in rare, inherited disorders. By necessity, the advent of NGS has fostered the concurrent development of bioinformatics approaches to expeditiously analyze the large data sets generated. Next-generation sequencing has been used for important discoveries in the research setting and is now being implemented into the clinical diagnostic arena.

Objective.—To review the current literature on technical and bioinformatics approaches for exome and genome sequencing and highlight examples of successful disease gene discovery in inherited disorders. To discuss the challenges for implementing NGS in the clinical research and diagnostic arenas.

Data Sources.—Literature review and authors' experience.

Conclusions.—Next-generation sequencing approaches are powerful and require an investment in infrastructure and personnel expertise for effective use; however, the potential for improvement of patient care through faster and more accurate molecular diagnoses is high.

From Northwestern U: Lymphoid Proliferations Associated With HIV Infection

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0095-RA

Amy Chadburn, Anmaar M. Abdul-Nabi, Bryan Scott Teruya, and Amy A. Lo (2013) Lymphoid Proliferations Associated With Human Immunodeficiency Virus Infection. Archives of Pathology & Laboratory Medicine: March 2013, Vol. 137, No. 3, pp. 360-370.

SPECIAL SECTION—CONTRIBUTIONS FROM THE ANATOMIC PATHOLOGY STAFF OF FEINBERG SCHOOL OF MEDICINE, NORTHWESTERN UNIVERSITY

Lymphoid Proliferations Associated With Human Immunodeficiency Virus Infection

Amy Chadburn , MD; Anmaar M. Abdul-Nabi , MD; Bryan Scott Teruya , MD; Amy A. Lo , MD

From the Department of Pathology, Northwestern University-Feinberg School of Medicine, Chicago, Illinois (Drs Chadburn, Abdul-Nabi, Teruya, and Lo).

Context.—Individuals who are immune deficient are at an increased risk for developing lymphoproliferative lesions and lymphomas. Human immunodeficiency virus (HIV) infection is 1 of 4 clinical settings associated with immunodeficiency recognized by the World Health Organization (WHO) in which there is an increased incidence of lymphoma and other lymphoproliferative disorders.

Objectives.—To describe the major categories of benign lymphoid proliferations, including progressive HIV-related lymphadenopathy, benign lymphoepithelial cystic lesions, and multicentric Castleman disease, as well as the different types of HIV-related lymphomas as defined by the WHO. The characteristic morphologic, immunophenotypic, and genetic features of the different entities will be discussed in addition to some of the pathogenetic mechanisms.

Data Sources.—The WHO classification of tumors of hematopoietic and lymphoid tissues (2001 and 2008), published literature from PubMed (National Library of Medicine), published textbooks, and primary material from the authors' current and previous institutions.

Conclusions.—HIV infection represents one of the clinical settings recognized by the WHO in which immunodeficiency-related lymphoproliferative disorders may arise. Although most lymphomas that arise in patients with HIV infection are diffuse, aggressive B-cell lesions, other lesions, which are “benign” lymphoid proliferations, may also be associated with significant clinical consequences. These lymphoproliferations, like many other immunodeficiency-associated lymphoproliferative disorders, are often difficult to classify. Studies of HIV-associated lymphoid proliferations will continue to increase our understanding of both the immune system and lymphomagenesis.

Brian Jackson on Prostate Cancer Screening

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0241-ED

Brian R. Jackson (2013) Prostate-Specific Antigen, Prostate Cancer Screening, and the Pathologist: What Should Be Our Role?. Archives of Pathology & Laboratory Medicine: March 2013, Vol. 137, No. 3, pp. 308-309.

EDITORIALS

Prostate-Specific Antigen, Prostate Cancer Screening, and the Pathologist: What Should Be Our Role?

Brian R. Jackson , MD, MS

From the Department of Pathology and ARUP Laboratories, University of Utah, Salt Lake City.

Most readers will be familiar with the following background: Since the introduction of the PSA test in the 1970s, it has become one of the most popular preventive care tests in the country. Yet the evidence for reduced mortality attributable to PSA screening is, at best, weak. Two recently published, large, randomized studies reported conflicting results. The European Randomized Study of Screening for Prostate Cancer¹ found a modest reduction in mortality with screening; the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial² did not.

.................................

Accordingly, guideline development organizations, notably including the American Cancer Society and the American Urologic Association, have issued expert opinions recommending that prostate cancer screening should only be entertained in men who might reasonably stand to benefit and who are in a position to make a fully informed choice that incorporates their personal risk/benefit profile with their personal values. These appear on the surface to be very reasonable recommendations, but, in fact, they reflect an almost impossible aspiration in today's health care environment.

http://factcheck.org/2013/03/bloombergs-obesity-claim/

Bloomberg’s Obesity Claim

Posted on March 29, 2013

"Public health experts have been predicting for some time that unhealthy lifestyles would surpass infectious diseases as a major killer in the developing world. An April 6, 1993, United Press International report said that the WHO estimated that 45 percent of deaths in developing countries were due to unhealthy living, but that would increase to 60 percent by 2015. Unhealthy living would account for 75 percent of deaths in industrialized countries, the WHO said.

A few years later, in 1997, the WHO again said this shift in global health was occurring: “Indeed, overweight and obesity are now so common that they are replacing the more traditional public health concerns such as undernutrition and infectious diseases as some of the most significant contributors to ill health,” it said in a report on a 1997 meeting on obesity in Geneva. In a 2004 report, the organization said that “a profound shift” had happened in the causes of death and illness in developed countries and was under way in developing nations, as noncommunicable diseases increased.

That’s the shift the Global Burden of Disease Study noted in its 2010 report. And the one Bloomberg could accurately describe as having occurred “over the past 20 years,” not “for the first time … this year,” as he has repeatedly said."

"...business leaders...complain their bottom line suffers..."

http://dfw.cbslocal.com/2013/03/30/texas-sex-offenders-in-sight-of-rare-policy-win/

Texas Sex Offenders In Sight Of Rare Policy Win

March 30, 2013 9:33 AM

AUSTIN  (AP) — Four convicted sex offenders huddled in a busy hallway at the Texas Capitol, congratulating each other for going public and testifying against a bill that would plaster their criminal past on their Facebook profiles.

............................

It’s not a change of heart swaying lawmakers but the wringing hands of frustrated business leaders — they complain their bottom line suffers when the public discovers who’s on the payroll.

The odd result: Sex offenders and Gov. Rick Perry’s favorite conservative think tank is among those left seeing eye-to-eye. The Texas Public Policy Foundation, which backs business-friendly bills, argues the current registry comes between the private relationship between employer and employee.

From Nature: MD Anderson faculty express frustration with leadership

http://blogs.nature.com/news/2013/03/md-anderson-faculty-express-frustration-with-leadership.html

MD Anderson faculty express frustration with leadership

29 Mar 2013 | 19:29 GMT | Posted by Erika Check Hayden 

"The faculty who responded to the survey appear concerned with what they perceive as an unreasonably high clinical workload, departure of leaders who have nurtured the institution, concern over DePinho’s $3 billion “Moon Shots” program, focused on eight cancers, and dissatisfaction with what one faculty member called DePinho’s “dictatorial” and “imperious” style.

Particularly troubling to the faculty have been continuing conflict-of-interest issues linked to DePinho that have drawn negative publicity to the institution.

In May, the state taxpayer-funded Cancer Prevention and Research Institute of Texas (CPRIT), based in Austin, said it would review a grant that it had awarded to DePinho’s wife, Lynda Chin, who had been named to lead the Institute for Applied Cancer Science, a drug discovery center created by DePinho. The grant, worth $18 million a year, had not undergone a scientific review.

Then, in June, DePinho apologized for promoting on television the stock of a company that he co-founded,without disclosing his involvement with the company.

One faculty member writes in the survey of being 'so tired of having to answer questions from other Houstonians about why MD Anderson is going downhill/always in the [Houston] Chronicle.'"

http://www.ncbi.nlm.nih.gov/pubmed/23532959

Arch Plast Surg. 2013 Mar;40(2):123-8. doi: 10.5999/aps.2013.40.2.123. Epub 2013 Mar 11.

Risk factors of treatment failure in diabetic foot ulcer patients.

Lee KM, Kim WH, Lee JH, Choi MS.

Source

Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Abstract

BACKGROUND:

Some diabetic feet heal without complication, but others undergo amputation due to progressive wounds. This study investigates the risk factors for amputation of diabetic feet.

METHODS:

A total of 55 patients who visited our institution from 2008 to 2012 were included in the study. The patients with abnormal fasting blood sugar levels, lower leg vascularity, and poor nutrition were excluded from the study group, and the wound states were unified. The patients were categorized into a treatment success group (n=47) and a treatment failure group (n=8), and their hemoglobin A1C (HgA1C), C-reactive protein (CRP), white blood cell count (WBC), and serum creatinine levels were analyzed.

RESULTS:

The initial CRP, WBC, and serum creatinine levels in the treatment failure group were significantly higher than that of the treatment success group, and the initial HgA1C level was significantly higher in the treatment success group. The CRP and WBC levels of both groups changed significantly as time passed, but their serum creatinine levels did not.

CONCLUSIONS:

The initial CRP, WBC, and serum creatinine levels were considered to be risk factors for amputation. Among them, the serum creatinine level was found to be the most important predictive risk factor. Because serum creatinine represents the renal function, thorough care is needed for the feet of diabetic patients with renal impairment.

http://www.ncbi.nlm.nih.gov/pubmed/23539520

Int J Offender Ther Comp Criminol. 2013 Mar 27. [Epub ahead of print]

Managing Risk and Marginalizing Identities: On the Society-of-Captives Thesis and the Harm of Social Dis-Ease.

Arrigo BA.

Abstract

This article develops the constitutive features of the society-of-captives thesis as suggested by Arrigo and Milovanovic, and Arrigo, Bersot, and Sellers. The relevance of this thesis is briefly explored in relation to the institutional and community-based treatment philosophies that currently inform the mental health and criminal justice systems. This exploration specifies how risk (being human and doing humanness differently) is managed symbolically, linguistically, materially, and culturally. The management of this risk extends to the kept as well as to their keepers, regulators, and watchers (i.e., the society of captives). This article calls for a new clinical praxis (being/doing a critical mindfulness) designed to overcome the totalizing madness (the harm of social dis-ease) that follows from managing risk fearfully and marginalizing identities desperately as reified recursively through society's captivity. The ethical underpinnings of this clinical praxis represent an emergent direction for undertaking correctional policy reform.

From NEJM: Salt in health and disease--a delicate balance

http://www.ncbi.nlm.nih.gov/pubmed/23534562

N Engl J Med. 2013 Mar 28;368(13):1229-37. doi: 10.1056/NEJMra1212606.

Salt in health and disease--a delicate balance.

Kotchen TA, Cowley AW Jr, Frohlich ED.

Source

Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA. tkotchen@mcw.edu

This review provides an overview of our current understanding of the relation of salt consumption to hypertension and cardiovascular disease.

http://www.ncbi.nlm.nih.gov/pubmed/23523785

Biochem Biophys Res Commun. 2013 Mar 21. pii: S0006-291X(13)00447-6. doi: 10.1016/j.bbrc.2013.03.032. [Epub ahead of print]

Ceramide mediates lung fibrosis in cystic fibrosis.

Ziobro R, Henry B, Edwards MJ, Lentsch AB, Gulbins E.

Source

Dept. of Molecular Biology, University Hospital, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany; Department of Surgery, University of Cincinnati, Cincinnati, OH 45267, USA.

Abstract

Fibrosis of the lung is one of the major clinical problems of cystic fibrosis and chronic obstructive pulmonary disease. However, the molecular mechanisms leading to pulmonary fibrosis are poorly characterized and require definition. Here, we demonstrate that chronic accumulation of ceramide in the lung contributes to the development of fibrosis in aged cystic fibrosis mice. Genetic or pharmacological normalization of ceramide incystic fibrosis mice, which was achieved by heterozygosity of acid sphingomyelinase or chronic (6.5 month long) treatment of mice with pharmacological inhibitors of acid sphingomyelinase significantly decreased the development of lung fibrosis. Moreover, our studies demonstrate that long-term treatment of cystic fibrosis mice with pharmacological inhibitors of acid sphingomyelinase or genetic heterozygosity of the enzyme also minimizes pulmonary inflammatory cytokines in cystic fibrosis mice. This data identifies ceramide as a key molecule associated with pulmonaryfibrosis in cystic fibrosis mice and demonstrate for the first time that prolonged inhibition of acid sphingomyelinase is able to attenuate fibrosis and inflammation in this animal model.

http://www.ncbi.nlm.nih.gov/pubmed/23230938

Med J Aust. 2012 Dec 10;197(11):652-4.

Tay Sachs disease in Australia: reduced disease incidence despite stable carrier frequency in Australian Jews.

Lew RM, Proos AL, Burnett L, Delatycki M, Bankier A, Fietz MJ.

Source

Department of Obstetrics, Gynaecology and Neonatology, University of Sydney, and Pacific Laboratory Medicine Services, Pathology North, NSW Health Pathology, Royal North Shore Hospital, Sydney, NSW, Australia. rlew2064@uni.sydney.edu.au

Abstract

OBJECTIVES:

To evaluate the outcomes of preconception screening of Jewish Australians for Tay Sachs disease (TSD) carrier status on Jewish TSD-affected births.

DESIGN, PARTICIPANTS AND SETTING:

Epidemiological observational study involving a complete retrospective audit of infantile and intermediate TSD cases diagnosed in Sydney and Melbourne between 1 January 1995 and 31 December 2011 (Royal Children's Hospital Melbourne; Pacific Laboratory Medicine Services, Pathology North, NSW Health Pathology, Sydney; Victorian Clinical Genetics Services, Melbourne; and SA Pathology, Adelaide), and carrier frequency among Jewish high school students attending schools participating in TSD screening programs over the same period.

MAIN OUTCOME MEASURES:

Jewish TSD carrier frequency; and expected versus observed Jewish TSD-affected births.

RESULTS:

The 2006 Census indicated that most of the total 88,826 Jewish Australians live in Melbourne (46%) and Sydney (40%). The 7,756 Jewish high school students screened for TSD in Sydney and Melbourne during the study period had a carrier frequency of one in 31 (3.26%; 95% CI, 2.89%-3.68%).The estimated expected number of TSD-affected births in Melbourne and Sydney in 1995-2011 was 4.1 for Jewish births and 7.4 for other births (a ratio of Jewish to non-Jewish births of 1:2). The actual number was 12 (four in Sydney and eight in Melbourne), of which two were Jewish (a ratio of Jewish to non-Jewish births of 1:5). This finding of fewer than expected Jewish TSD cases coincided with a period during which screening programs were operating. There have been no Jewish TSD-affected children born to parents who were screened previously.

CONCLUSION:

Community education, appreciation of autosomal recessive inheritance and genetic carrier screening before pregnancy are the likely factors in our finding of fewer than expected Jewish babies with TSD. Ongoing outcome monitoring must continue.

http://www.ncbi.nlm.nih.gov/pubmed/23522494

J Am Med Dir Assoc. 2013 Mar 19. pii: S1525-8610(13)00082-0. doi: 10.1016/j.jamda.2013.02.004. [Epub ahead of print]

Body Weight, Anorexia, and Undernutrition in Older People.

Soenen S, Chapman IM.

Source

Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Abstract

Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people.

"the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness"

http://www.ncbi.nlm.nih.gov/pubmed/23517498

Nurs Inq. 2013 Mar 21. doi: 10.1111/nin.12026. [Epub ahead of print]

The politics of knowledge: implications for understanding and addressing mental health and illness.

Jenkins EK.

Source

School of Nursing, University of British Columbia, Vancouver, BC, Canada.

Abstract

While knowledge represents a valuable commodity, not all forms of knowledge are afforded equal status. The politics of knowledge, which entails the privileging of particular ways of knowing through linkages between the producers of knowledge and other bearers of authority or influence, represents a powerful force driving knowledge development. Within the health research and practice community, biomedical knowledge (i.e. knowledge pertaining to the biological factors influencing health) has been afforded a privileged position, shaping the health research and practice community's view of health, illness and appropriate intervention. The aim of this study is to spark critical reflection and dialogue surrounding the ways in which the politics of knowledge have constrained progress in addressing mental health and illness, one of today's leading public health issues. I argue that the hegemony of biological knowledge represents an ethical issue as it limits the breadth of knowledge available to support practitioners to 'do good' in terms of addressing mental illness. Given the power and influence inherent within the nursing community, I propose that nurses ought to engage in critical reflection and action in an effort to better situate the health research and practice community to effectively address the mental health of populations.

http://www.ncbi.nlm.nih.gov/pubmed/23394419

Med Ref Serv Q. 2013;32(1):42-51. doi: 10.1080/02763869.2013.749115.

Are medical school students ready for e-readers?

Atlas MC.

Source

Kornhauser Health Sciences Library, University of Louisville, Louisville, Kentucky 40292, USA. michel.atlas@louisville.edu

Abstract

College textbook publishers are planning to make college and professional education textbooks available online to be downloaded to personal communication devices (e.g., smartphones), digital audio players (e.g., iPods), and digital readers (e.g., Kindles). The current literature on the attitudes of current students to this technological change, especially as it relates to medical school students is reviewed. A short survey attempted to determine how ready the first-year medical students at the University of Louisville are to accept this change in their study habits.

Chairs Cause Obesity

http://www.lewrockwell.com/blog/lewrw/archives/134719.html

March 29, 2013

Chairs Cause Obesity

Posted by Karen De Coster on March 29, 2013 07:11 PM

The Coca-Cola anti-obesity campaign has been a laughingstock, especially in the ancestral health and traditional food communities. The initial ad launch by Coca-Cola was mocked in this spot with a custom voiceover. Now Coca-Cola Spain has produced an ad titled, 'What if we stand up?" In this ad, the chairs are in control, and if we humans can only release ourselves from this bondage, we can break free from our Chair Oppressors and obesity. The ad is supposed to convey bizarre humor, but still, the message at the end affirms Coca-Cola's "commitment to fight an overweight and sedentary lifestyle," so it's no joke. Certainly, the 81 grams of sugar in one 24 oz. bottle of Coke is the breakfast of healthy champions who are fighting obesity.

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0086-RA

Kristina A. Matkowskyj, Zongming E. Chen, M. Sambasiva Rao, and Guang-Yu Yang (2013) Dysplastic Lesions in Inflammatory Bowel Disease: Molecular Pathogenesis to Morphology. Archives of Pathology & Laboratory Medicine: March 2013, Vol. 137, No. 3, pp. 338-350.

SPECIAL SECTION—CONTRIBUTIONS FROM THE ANATOMIC PATHOLOGY STAFF OF FEINBERG SCHOOL OF MEDICINE, NORTHWESTERN UNIVERSITY

Dysplastic Lesions in Inflammatory Bowel Disease: Molecular Pathogenesis to Morphology

Kristina A. Matkowskyj , MD, PhD; Zongming E. Chen , MD, PhD; M. Sambasiva Rao , MD; Guang-Yu Yang , MD, PhD

From the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Context.—Inflammatory bowel disease (IBD) is a long-standing chronic active inflammatory process in the bowel with increased risk for the development of colorectal carcinoma. Several molecular events involved in chronic active inflammatory processes contribute to multistage progression of human cancer development, including reactive oxygen and nitrogen species, aberrant arachidonic acid metabolites and cytokines/growth factors, and immune dysfunction. These molecular events in IBD lead to genetic abnormality and promote aberrant cell proliferation, which further lead to epithelial changes encompassing a broad spectrum from inflammation-induced hyperplasia to dysplasia.

Objective.—To review the (1) epidemiologic and molecular pathogenesis of the risk for colorectal cancer in IBD, (2) morphologic characterization, biomarker(s), and classification of dysplastic lesions, and (3) clinical management of dysplastic lesions arising in IBD.

Data Sources.—The different IBD-related dysplastic lesions are illustrated by using morphology in conjunction with molecular pathways, and the “field cancerization” theory and its potential significance are discussed with a review of the literature.

Conclusions.—Patients with IBD are at increased risk of developing colorectal cancer. The risk of developing carcinoma is related to the extent/duration/activity of the patient's disease. There is no consensus regarding the extent of carcinoma risk associated with IBD; however, all would agree that patients with IBD represent a group at significant risk for developing carcinoma and as such, warrant adequate surveillance and prevention. With better screening modalities and detection/characterization of dysplastic lesions, IBD-associated serrated lesions, and “field cancerization,” we will improve our understanding of and approach to risk stratification.

From Kirtee Raparia and colleagues: Lymphoproliferative Neoplasms of the Lung

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0202-RA

Josette William, Daina Variakojis, Anjana Yeldandi, and Kirtee Raparia (2013) Lymphoproliferative Neoplasms of the Lung: A Review. Archives of Pathology & Laboratory Medicine: March 2013, Vol. 137, No. 3, pp. 382-391.

SPECIAL SECTION—CONTRIBUTIONS FROM THE ANATOMIC PATHOLOGY STAFF OF FEINBERG SCHOOL OF MEDICINE, NORTHWESTERN UNIVERSITY

Lymphoproliferative Neoplasms of the Lung: A Review

Josette William , MD, PhD; Daina Variakojis , MD; Anjana Yeldandi , MD; Kirtee Raparia , MD

From the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Context.—Diagnosis and classification of lymphomas are based on the morphologic, immunologic, and genetic features that the lesional cells share with their normal B and T lymphocyte counterparts. Primary pulmonary lymphomas account for 0.3% of primary lung neoplasms and less than 0.5% of all lymphomas.

Objective.—To describe and summarize the clinical and histopathologic features of the primary pulmonary lymphoma and secondary involvement of the lung by lymphoma.

Data Sources.—Peer-reviewed published literature and personal experience.

Conclusions.—Diagnosis of clonal lymphoid proliferations in the lung has evolved owing to the greater utility of molecular and flow cytometric analysis of tissue. Further studies are needed to best define the clinical and prognostic features, as well as search for targeted therapy for these patients with rare neoplasms.

Zombie allusions: They just keep on coming-shuffling around the statehouse halls

http://www.cnn.com/2013/03/29/opinion/obeidallah-disgraced-politicians/

Zombie politicians find new life after disgrace

By Dean Obeidallah, Special to CNN

updated 1:56 PM EDT, Fri March 29, 2013

"Disgraced politicians never die. They're like Jason from the "Friday the 13th" movies -- you just can't kill them. They keep coming at you like the political version of zombies."

http://www.ncbi.nlm.nih.gov/pubmed/23499565

Vaccine. 2013 Apr 12;31(16):2011-23. doi: 10.1016/j.vaccine.2013.02.026. Epub 2013 Feb 26.

What the World's religions teach, applied to vaccines and immune globulins.

Grabenstein JD.

Source

Merck Vaccines, 770 Sumneytown Pike, WP97-B364, West Point, PA 19426, USA. Electronic address: john_grabenstein@merck.com.

Abstract

For millennia, humans have sought and found purpose, solace, values, understanding, and fellowship in religious practices. Buddhist nuns performed variolation against smallpox over 1000 years ago. Since Jenner developed vaccination against smallpox in 1796, some people have objected to and declined vaccination, citing various religious reasons. This paper reviews the scriptural, canonical basis for such interpretations, as well as passages that support immunization. Populous faith traditions are considered, including Hinduism, Buddhism, Jainism, Judaism, Christianity, and Islam. Subjects of concern such as blood components, pharmaceutical excipients of porcine or bovine origin, rubella strain RA 27/3, and cell-culture media with remote fetal origins are evaluated against the religious concerns identified. The review identified more than 60 reports or evaluations of vaccine-preventable infectious-disease outbreaks that occurred within religious communities or that spread from them to broader communities. In multiple cases, ostensibly religious reasons to decline immunization actually reflected concerns about vaccine safety or personal beliefs among a social network of people organized around a faith community, rather than theologically based objections per se. Themes favoring vaccine acceptance included transformation of vaccine excipients from their starting material, extensive dilution of components of concern, the medicinal purpose of immunization (in contrast to diet), and lack of alternatives. Other important features included imperatives to preserve health and duty to community (e.g., parent to child, among neighbors). Concern that 'the body is a temple not to be defiled' is contrasted with other teaching and quality-control requirements in manufacturing vaccines and immune globulins. Health professionals who counsel hesitant patients or parents can ask about the basis for concern and how the individual applies religious understanding to decision-making about medical products, explain facts about content and processes, and suggest further dialog with informed religious leaders. Key considerations for observant believers for each populous religion are described.

From Dana-Farber and Harvard: United States Acculturation and Cancer Patients' End-of-Life Care

http://www.ncbi.nlm.nih.gov/pubmed/23536809

PLoS One. 2013;8(3):e58663. Epub 2013 Mar 11.

United States Acculturation and Cancer Patients' End-of-Life Care.

Wright AA, Stieglitz H, Kupersztoch YM, Paulk ME, Kim Y, Katz IT, Munoz F, Jimenez RB, Mutchler J, Rivera L, Back AL, Prigerson HG.

Source

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America ; Center for Psychosocial Epidemiology and Outcomes Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America ; Harvard Medical School, Boston, Massachusetts, United States of America ; Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America.

Abstract

BACKGROUND:

Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients' end-of-life treatment preferences and medical care.

METHODS AND FINDINGS:

In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19-item scale developed to assess the degree of "Americanization" in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers' USAS scores predicted patients' communication, treatment preferences, and end-of-life medical care in multivariable models that corrected for significant confounding influences (e.g. education, country of origin, English proficiency). The USAS measure was internally consistent (Cronbach α = 0.98); and significantly associated with US birthplace (r = 0.66, P<0.0001). USAS scores were predictive of patients' preferences for prognostic information (AOR = 1.31, 95% CI:1.00-1.72), but not comfort asking physicians' questions about care (AOR 1.23, 95% CI:0.87-1.73). They predicted patients' preferences for feeding tubes (AOR = 0.68, 95% CI:0.49-0.99) and wish to avoid dying in an intensive care unit (AOR = 1.36, 95% CI:1.05-1.76). Scores indicating greater acculturation were also associated with increased odds of patient participation in clinical trials (AOR = 2.20, 95% CI:1.28-3.78), compared with lower USAS scores, and greater odds of patients receiving chemotherapy (AOR = 1.59, 95% CI:1.20-2.12).

CONCLUSION:

The USAS is a reliable and valid measure of "Americanization" associated with advanced cancer patients' end-of-life preferences and care. USAS scores indicating greater caregiver acculturation were associated with increased odds of patient participation in cancer treatment (chemotherapy, clinical trials) compared with lower scores. Future studies should examine the effects of acculturation on end-of-life care to identify patient and provider factors that explain these effects and targets for future interventions to improve care (e.g., by designing more culturally-competent health education materials).

http://www.ncbi.nlm.nih.gov/pubmed/23482979

BMJ. 2013 Mar 12;346:f1543. doi: 10.1136/bmj.f1543.

Is the cap on social care in England the perfect storm for a lawyer?

Dudley N.

Source

St James's University Hospital, Leeds LS9 7TF, UK.

The secretary of state for health, Jeremy Hunt, considers it a scandal that 30 000-40 000 people have to sell their home each year to pay for their care costs.1 2 The real scandal is that many of those people paying for “social” means tested care should be receiving free care paid for …

Second that. From U Alberta: Harm, hype and evidence: ELSI research and policy guidance

http://www.ncbi.nlm.nih.gov/pubmed/23534337

Genome Med. 2013 Mar 26;5(3):21. [Epub ahead of print]

Harm, hype and evidence: ELSI research and policy guidance.

Caulfield T, Chandrasekharan S, Joly Y, Cook-Deegan R.

Source

Health Law and Science Policy Group, University of Alberta, Edmonton, Alberta Canada, T6G 2H5. tcaulfld@law.ualberta.ca.

Abstract

There has been much investment in research on the ethical, legal and social issues (ELSI) associated with genetic and genomic research. This research should inform the development of the relevant policy. So far, much of the relevant policy - such as in the areas of patents, genetic testing and genetic discrimination - seems to be informed more by speculation of harm and anecdote than by available evidence. Although a quest for evidence cannot always be allowed to delay policy choice, it seems axiomatic to us that policy options are improved by the incorporation of evidence.