From U Manchester: Ethical issues in using social media for health and health care research

http://www.ncbi.nlm.nih.gov/pubmed/23477806

Health Policy. 2013 May;110(2-3):298-301. doi: 10.1016/j.healthpol.2013.02.006. Epub 2013 Mar 9.

Ethical issues in using social media for health and health care research.

McKee R.

Source

Institute for Social Change, University of Manchester, 2.11 Humanities, Bridgeford Street, Manchester M13 9PL, United Kingdom. Electronic address: r.mckee90@gmail.com.

Abstract

The dramatic growth of social media in recent years has not gone unnoticed in the health sector. Media such as Facebook and Twitter are increasingly being used to disseminate information among health professionals and patients but, more recently, are being seen as a source of data for surveillance and research, for example by tracking public concerns or capturing discourses taking place outside traditional media outlets. This raises ethical issues, in particular the extent to which postings are considered public or private and the right to anonymity of those posting on social media. These issues are not clear cut as social media, by their nature, blur the boundary between public and private. There is a need for further research on the beliefs and expectations of those using social media in relation to how their material might be used in research. In contrast, there are areas where the ethical issues are more clear cut, such as when individuals are active participants in research, where traditional considerations apply

http://www.ncbi.nlm.nih.gov/pubmed/23565944

BMC Med Educ. 2013 Apr 8;13:50. doi: 10.1186/1472-6920-13-50.

Teaching strategies for coping with stress - the perceptions of medical students.

Pereira MA, Barbosa MA.

Source

Departamento de Saúde Mental e Medicina Legal da Faculdade de Medicina da Universidade Federal de Goiás - Primeira Avenida, Goiânia, Goiás, Brazil. m_amelia_psi@hotmail.com.

Abstract

BACKGROUND:

The undergraduate medical course is a period full of stressors, which may contribute to the high prevalence of mental disorders among students and a decrease in life's quality. Research shows that interventions during an undergraduate course can reduce stress levels. The aim of this paper is to evaluate the Strategies for Coping with Professional Stress class offered to medical students of the Federal University of Goiás, at Goiânia, Goiás, in Brazil.

METHODS:

Qualitative research, developed with medical students in an elective class addressing strategies for coping with stress after a focal group (composed of nine of the 33 students taking this course) identified stress factors in the medical course and the coping strategies that these students use. Analysis of the results of the class evaluation questionnaire filled out by the students on the last day of class.

RESULTS:

Stress factors identified by students in the focus group: lack of time, excessive class content, tests, demanding too much of themselves, overload of extracurricular activities, competitiveness among students and family problems. Coping strategies mentioned in the focus group: respecting one's limits, setting priorities, avoiding comparisons, leisure activities (movies, literature, sports, meeting with friends and family). Results of the questionnaires: class content that was considered most important: quality of life, strategies for coping with stress, stress factors, assertiveness, community therapy, relaxation, cognitive restructuring, career choice, breathing, social networking, taking care of the caregiver, music therapy and narcissism. Most popular methodologies: relaxation practice, drawing words and discussion them in a group, community therapy, music therapy, simulated jury, short texts and discussion. Meaning of the class: asking questions and reinforcing already known strategies (22.6%), moment of reflection and self-assessment (19.4%), new interest and a worthwhile experience (19.4%), improvement in quality of life (16.1%), expression's opportunity (9.7%), other (6.4%).

CONCLUSION:

The stressors perceived by the medical students are intense and diverse, and the coping strategies used by them are wide-ranging. Most students felt that the class was a worthwhile learning experience, incorporated new practices for improving quality of life and recognized the importance of sharing and reflecting on one's stressors and life choices.

From Stanford: Midbrain-driven Emotion and Reward Processing in Alcoholism

http://www.ncbi.nlm.nih.gov/pubmed/23615665

Neuropsychopharmacology. 2013 Apr 24. doi: 10.1038/npp.2013.102. [Epub ahead of print]

Midbrain-driven Emotion and Reward Processing in Alcoholism.

Müller-Oehring EM, Jung YC, Sullivan EV, Hawkes WC, Pfefferbaum A, Schulte T.

Source

1] Neurosci Program, Ctr. Heallth. Sci., SRI Intl., Menlo Park, CA, USA [2] Department of Psychiatry & Beh. Sci., Stanford University, Stanford, CA, USA.

Abstract

Alcohol dependence is associated with impaired control over emotionally motivated actions, possibly associated with abnormalities in the frontoparietal executive control network and midbrain nodes of the reward network associated with automatic attention. To identify differences in the neural response to alcohol-related word stimuli, 26 chronic alcoholics (ALC) and 26 healthy controls (CTL) performed an alcohol-emotion Stroop Match-to-Sample task during functional MR imaging. Stroop contrasts were modeled for color-word incongruency (eg, word RED printed in green), and for alcohol (eg, BEER), positive (eg, HAPPY), and negative emotional (eg, MAD) word content relative to congruent word conditions (eg, word RED printed in red). During color-Stroop processing, ALC and CTL showed similar left dorsolateral prefrontal activation, and CTL, but not ALC, deactivated posterior cingulate cortex/cuneus. An interaction revealed a dissociation between alcohol-word and color-word Stroop processing: ALC activated midbrain and parahippocampal regions more than CTL when processing alcohol-word relative to color-word conditions. In ALC, the midbrain region was also invoked by negative emotional Stroop words thereby showing significant overlap of this midbrain activation for alcohol-related and negative emotional processing. Enhanced midbrain activation to alcohol-related words suggests neuroadaptation of dopaminergic midbrain systems. We speculate that such tuning is normally associated with behavioral conditioning to optimize responses but here contributed to automatic bias to alcohol-related stimuli.

http://www.ncbi.nlm.nih.gov/pubmed/23616865

Appl Clin Inform. 2011 Apr 27;2(2):128-42. doi: 10.4338/ACI-2010-10-R-0060. Print 2011.

Healthy Gaming - Video Game Design to promote Health.

Brox E, Fernandez-Luque L, Tøllefsen T.

Source

Northern Research Institute , Tromsø, Norway.

Abstract

BACKGROUND:

There is an increasing interest in health games including simulation tools, games for specific conditions, persuasive games to promote a healthy life style or exergames where physical exercise is used to control the game.

OBJECTIVE:

The objective of the article is to review current literature about available health games and the impact related to game design principles as well as some educational theory aspects.

METHODS:

Literature from the big databases and known sites with games for health has been searched to find articles about games for health purposes. The focus has been on educational games, persuasive games and exergames as well as articles describing game design principles.

RESULTS:

The medical objectives can either be a part of the game theme (intrinsic) or be totally dispatched (extrinsic), and particularly persuasivegames seem to use extrinsic game design. Peer support is important, but there is only limited research on multiplayer health games. Evaluation of health games can be both medical and technical, and the focus will depend on the game purpose.

CONCLUSION:

There is still not enough evidence to conclude which design principles work for what purposes since most of the literature in health serious games does not specify design methodologies, but it seems that extrinsic methods work in persuasion. However, when designing health caregames it is important to define both the target group and main objective, and then design a game accordingly using sound game design principles, but also utilizing design elements to enhance learning and persuasion. A collaboration with health professionals from an early design stage is necessary both to ensure that the content is valid and to have the game validated from a clinical viewpoint. Patients need to be involved, especially to improve usability. More research should be done on social aspects in health games, both related to learning and persuasion.

http://www.ncbi.nlm.nih.gov/pubmed/23614794

Cyberpsychol Behav Soc Netw. 2013 Apr 24. [Epub ahead of print]

Professors' Facebook Content Affects Students' Perceptions and Expectations.

Sleigh MJ, Smith AW, Laboe J.

Source

1 Department of Psychology, Winthrop University , Rock Hill, South Carolina.

Abstract

Abstract Facebook users must make choices about level of self-disclosure, and this self-disclosure can influence perceptions of the profile's author. We examined whether the specific type of self-disclosure on a professor's profile would affect students' perceptions of the professor and expectations of his classroom. We created six Facebook profiles for a fictitious male professor, each with a specific emphasis: politically conservative, politically liberal, religious, family oriented, socially oriented, or professional. Undergraduate students randomly viewed one profile and responded to questions that assessed their perceptions and expectations. The social professor was perceived as less skilled but more popular, while his profile was perceived as inappropriate and entertaining. Students reacted more strongly and negatively to the politically focused profiles in comparison to the religious, family, and professional profiles. Students reported being most interested in professional information on a professor's Facebook profile, yet they reported being least influenced by the professional profile. In general, students expressed neutrality about their interest in finding and friending professors on Facebook. These findings suggest that students have the potential to form perceptions about the classroom environment and about their professors based on the specific details disclosed in professors' Facebook profiles.

Anointing 9/11: "the unbearable sorrow she must feel..."

http://www.ncbi.nlm.nih.gov/pubmed/23620207

J Relig Health. 2013 Apr 26. [Epub ahead of print]

Anointing 9/11.

Rorro MC.

Source

, Brick, NJ, USA, mary.rorro@va.gov.

Abstract

As a psychiatrist treating veterans with post-traumatic stress disorder in the New Jersey Veterans Healthcare system and a violist, I seek to combine the two fields by playing music for veterans' events and ceremonies. I was inspired to write this poem about the 9/11 Memorial in New York City, after performing there Veterans Day weekend as part of the commemoration of the 50th Anniversary of the end of the Vietnam War. It was a cold and breezy November day, but that did not hinder countless visitors from paying homage to those who lost their lives on that fateful date. The musical selections chosen, from Amazing Grace and Nearer My God to Thee to the Largo "Going Home" theme from Dvorak's New World Symphony, sought to honor both the Vietnam veterans and the victims of 9/11. The reflecting pools at the 9/11 site, which serve as a somber reminder of the staggering loss and emptiness of that tragic day, presented me with conflicting emotions. Contemplating the finality of the deaths was overwhelming, but at the same time, I believed the flowing water symbolized the renewal of life. As I touched one of the victim's names on the side of a reflecting pool, I imagined a widow touching her husband's inscription and the unbearable sorrow she must feel knowing that she would never be able to kiss him again. Yet, there was also a chance that her grief could be transformed by a visual remembrance of his life. After the ceremony, wind blew misty drops from the reflecting pools, as though the drops were holy water sprinkled at Mass. As the water brushed my face, I was moved by the spiritual meaning of this place and of the solemn connection to those who perished and of those left behind.

Need another reason to work out? Short bouts of anaerobic exercise increase non-esterified fatty acids release in obesity

http://www.ncbi.nlm.nih.gov/pubmed/23619826

Eur J Nutr. 2013 Apr 26. [Epub ahead of print]

Short bouts of anaerobic exercise increase non-esterified fatty acids release in obesity.

Salvadori A, Fanari P, Marzullo P, Codecasa F, Tovaglieri I, Cornacchia M, Brunani A, Luzi L, Longhini E.

Source

Division of Respiratory Rehabilitation, H. San Giuseppe, Istituto Auxologico Italiano, P. O. Box N. 1, 28921, Verbania, Italy.

Abstract

PURPOSE:

It is demonstrated that aerobic exercise plays an important role in weight loss programs for obesity by increasing 24 h metabolic rate. While aerobic exercise can result in health and fitness benefits in obese subjects, also independently of weight loss, not completely clear are the effects of bouts of hard exercise on metabolic outcomes. The aim of this study was to test the hypothesis that short-term aerobic activity with anaerobic bouts might result in a greater improvement in the management of obesity than aerobic activity alone.

METHODS:

We studied 16 obese subjects (eight men) during a progressive cycloergometric test up to exhaustion, before and after 4 weeks of two different training schedules (6 days/week). Insulin and glycaemia, non-esterified fatty acids (NEFA) and lactic acid were sampled. Group A (eight subjects, four men) performed an aerobic cycle workout; Group B (eight subjects, four men) performed a 25 min aerobic workout followed by 5 min of anaerobic workout. All the subjects maintained their individual eating habits.

RESULTS:

The post-training test showed a decrease in AUCs NEFA in Group A (p < 0.05) and an increase in Group B (p < 0.05), together with an increase in lactic acid in Group A and a decrease in Group B (p < 0.01). β-cell function (HOMA2-B) revealed a reduction only in Group A (p < 0.05). Group B achieved a greatest reduction in body fat mass than Group A (p < 0.05).

CONCLUSIONS:

Aerobic plus anaerobic training seem to produce a greater response in lipid metabolism and not significant modifications in glucose indexes; then, in training prescription for obesity, we might suggest at starting weight loss program aerobic with short bouts of anaerobic training to reduce fat mass and subsequently a prolonged aerobic training alone to ameliorate the metabolic profile.

Sputum collection and disposal among pulmonary tuberculosis patients in coastal South India

http://www.ncbi.nlm.nih.gov/pubmed/23575327

Int J Tuberc Lung Dis. 2013 May;17(5):621-3. doi: 10.5588/ijtld.12.0495.

Sputum collection and disposal among pulmonary tuberculosis patients in coastal South India [Short communication].

Rekha T, Singh P, Unnikrishnan B, Prasanna Mithra P, Kumar N, Prasad KD, Raina V, Kumar Papanna M, Kulkarni V.

Source

Department of Community Medicine, Kasturba Medical College, Manipal University, Mangalore, India.

Abstract

BACKGROUND:

Safe sputum disposal practices minimise the spread of pulmonary tuberculosis (PTB).

OBJECTIVES:

To study the perceptions and practices of sputum disposal among PTB patients.

METHODOLOGY:

This study was conducted among 206 diagnosed sputum-positive TB patients registered in selected DOTS centres in Mangalore.

RESULTS:

Safe sputum disposal practice was followed by 50% of the subjects: it was higher among females (62%), patients of middle socio-economic status (75.5%) and those with a family history of TB (70%). Furthermore, 75% patients believed that TB was caused by several factors.

CONCLUSIONS:

High proportions of subjects were unaware about the causes of TB and did not practise safe disposal of sputum.

http://www.ncbi.nlm.nih.gov/pubmed/23618487

Glob J Health Sci. 2013 Mar 4;5(3):173-82. doi: 10.5539/gjhs.v5n3p173.

Caregivers' quality of life and quality of services for children with cancer: a review from Iran.

Sajjadi H, Vameghi M, Ghazinour M, Khodaeiardekani M.

Source

Assistant Professor in Social Determinants of Health Research Center. m_vameghi@yahoo.com.

Abstract

OBJECTIVE:

Caregivers of cancer patients are exposed to different types of psychosocial stress which influence their quality of life. The purposes of this study were to assess quality of life in caregivers of children with cancer and to investigate the relationship between the caregivers' quality of life and quality of services in the social work section.

METHOD:

125 caregivers were recruited. Quality of life was measured by the Iranian version of the WHOQOL-BREF questionnaire and data concerning service quality were obtained from the Iranian version of the SERVQUAL questionnaire.

FINDINGS:

Scores in physical health, psychological status and environmental conditions for caregivers of children with cancer were significantly lower than the general population. There was a negative correlation between the tangible domain of SERVQUAL and the psychological status and environmental conditions of quality of life. The tangible dimension was the only aspect of service quality to predict caregivers' quality of life regarding psychological status and environmental conditions.

CONCLUSION:

Caregivers of children with a disease are care consumers and, like all consumers, they expect good service. Delivering high quality services consistently is difficult but profitable for a service organization. In other words, trying to deliver more appropriate services than patients expect to receive from their social work care is one of the most reliable ways to promote caregivers' satisfaction and quality of life.

Zombie allusions: They just keep on coming-eatin' up the road

http://www.buffalonews.com/apps/pbcs.dll/article?AID=/20130424/CITYANDREGION03/130429652/1057

People’s Pharmacy: Beware of zombie drivers during allergy season

Driving drowsy may be almost as risky as driving drunk. People who would never get behind the wheel after drinking alcohol frequently drive while impaired and don’t even realize it.

According to the Centers for Disease Control and Prevention, an extraordinary number of Americans drive drowsy, and many even fall asleep: “Among nearly 150,000 adults at least 18 years or older in 19 states and the District of Columbia, 4.2 percent reported that they had fallen asleep while driving at least once in the previous 30 days.”

From Marc Ladanyi and colleagues: KRAS mutations are associated with solid growth pattern and tumor-infiltrating leukocytes in lung adenocarcinoma

http://www.ncbi.nlm.nih.gov/pubmed/23619604

Mod Pathol. 2013 Apr 26. doi: 10.1038/modpathol.2013.74. [Epub ahead of print]

KRAS mutations are associated with solid growth pattern and tumor-infiltrating leukocytes in lung adenocarcinoma.

Rekhtman N, Ang DC, Riely GJ, Ladanyi M, Moreira AL.

Source

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

Abstract

KRAS mutations define a clinically distinct subgroup of lung adenocarcinoma patients, characterized by smoking history, resistance to EGFR-targeted therapies, and adverse prognosis. Whether KRAS-mutated lung adenocarcinomas also have distinct histopathological features is not well established. We tested 180 resected lung adenocarcinomas for KRAS and EGFR mutations by high-sensitivity mass spectrometry-based genotyping (Sequenom) and PCR-based sizing assays. All tumors were assessed for the proportion of standard histological patterns (lepidic, acinar, papillary, micropapillary, solid, and mucinous), several other histological and clinical parameters, and TTF-1 expression by immunohistochemistry. Among 180 carcinomas, 63 (35%) had KRAS mutations (KRAS+), 35 (19%) had EGFR mutations (EGFR+), and 82 (46%) had neither mutation (KRAS-/EGFR-). Solid growth pattern was significantly over-represented in KRAS+ carcinomas: the mean±s.d. for the amount of solid pattern in KRAS+ carcinomas was 27±34% compared with 3±10% in EGFR+ (P<0.001) and 15±27% in KRAS-/EGFR- (P=0.033) tumors. Furthermore, at least focal (≥20%) solid component was more common in KRAS+ (28/63; 44%) compared with EGFR+ (2/35; 6%; P<0.001) and KRAS-/EGFR- (21/82; 26%; P=0.022) carcinomas. KRAS mutations were also over-represented in mucinous carcinomas and were significantly associated with the presence of tumor-infiltrating leukocytes and heavier smoking history. EGFR mutations were associated with non-mucinous non-solid patterns, particularly lepidic and papillary, lack of necrosis, lack of cytological atypia, hobnail cytology, TTF-1 expression, and never/light smoking history. In conclusion, extended molecular and clinicopathological analysis of lung adenocarcinomas reveals a novel association of KRAS mutations with solid histology and tumor-infiltrating inflammatory cells and expands on several previously recognized morphological and clinical associations of KRAS and EGFR mutations. Solid growth pattern was recently shown to be a strong predictor of aggressive behavior in lung adenocarcinomas, which may underlie the unfavorable prognosis associated with KRAS mutations in these tumors.

From Harvard: Speaking the same language? International variations in the safety information accompanying top-selling prescription drugs

http://www.ncbi.nlm.nih.gov/pubmed/23620531

BMJ Qual Saf. 2013 Apr 25. [Epub ahead of print]

Speaking the same language? International variations in the safety information accompanying top-selling prescription drugs.

Kesselheim AS, Franklin JM, Avorn J, Duke JD.

Source

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, , Boston, Massachusetts, USA.

Abstract

BACKGROUND:

The official prescribing information document distributed with a prescription drug is a key source of safety information, but it may include excessive or insufficient details.

OBJECTIVES:

To compare prescribing information approved by the US Food and Drug Administration with the UK, Canada and Australia to identify content differences in safety warnings.

METHODS:

For 20 top-selling prescription drugs, we used an automated natural language processing tool to calculate the number and severity of reported adverse drug reactions (ADRs). We fit hierarchical Poisson models and included fixed effects for other prescribing information characteristics. Separately, we analysed the appearance and content of 'black box' warnings.

RESULTS:

There was substantial variation in safety content of approved prescribing information. Canada had the highest median ADRs per drug (138 (IQR 86-234)) and the UK had the lowest (84 (IQR 51-111)). The number of ADRs reported was on average 50% higher in Canada compared with the USA (ratio of ADRs/document: 1.5, 95% CI 1.4 to 1.6, p<0.001). By contrast, there were on average 15% fewer ADRs listed in the UK compared with the USA (ratio of ADRs/document 0.85 (95% CI 0.78 to 0.93, p<0.001), and 21% fewer ADRs listed in Australia compared with the USS (ratio of ADRs/document 0.79, 95% CI 0.74 to 0.85, p<0.001). There were no variations in ADR severity. The presence and qualitative content of boxed warnings also showed substantial diversity.

CONCLUSIONS:

International variations exist in the presentation of safety data in drug prescribing information, which may have important implications for patient safety. Better international coordination is necessary to enhance use of this information for patient decision-making.

Intensely troubling: "A majority of [4th year medical] students reported that they would not speak up when witnessing a possible adverse event..."

http://www.ncbi.nlm.nih.gov/pubmed/23619067

Acad Med. 2013 Apr 24. [Epub ahead of print]

Enculturation of Unsafe Attitudes and Behaviors: Student Perceptions of Safety Culture.

Bowman C, Neeman N, Sehgal NL.

Source

Dr. Bowman is internal medicine resident, University of California, San Francisco, San Francisco, California. Ms. Neeman is administrative director, Quality and Safety Program, Department of Medicine, University of California, San Francisco, San Francisco, California. Dr. Sehgal is associate professor of medicine and associate chair, Quality and Safety, Department of Medicine, University of California, San Francisco, San Francisco, California.

Abstract

PURPOSE:

Safety culture may exert an important influence on the adoption and learning of patient safety practices by learners at clinical training sites. This study assessed students' perceptions of safety culture and identified curricular gaps in patient safety training.

METHOD:

A total of 170 fourth-year medical students at the University of California, San Francisco, were asked to complete a modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture in 2011. Students responded on the basis of either their third-year internal medicine or surgery clerkship experience. Responses were recorded on a five-point Likert scale. Percent positive responses were compared between the groups using a chi-square test.

RESULTS:

One hundred twenty-one students (71% response rate) rated "teamwork within units" and "organizational learning" highest among the survey domains; "communication openness" and "nonpunitive response to error" were rated lowest. A majority of students reported that they would not speak up when witnessing a possible adverse event (56%) and were afraid to ask questions if things did not seem right (55%). In addition, 48% of students reported feeling that mistakes were held against them. Overall, students reported a desire for additional patient safety training to enhance their educational experience.

CONCLUSIONS:

Assessing student perceptions of safety culture highlighted important observations from their clinical experiences and helped identify areas for curricular development to enhance patient safety. This assessment may also be a useful tool for both clerkship directors and clinical service chiefs in their respective efforts to promote safe care.

From Johns Hopkins: Willingness of the United States general public to participate in kidney paired donation

http://www.ncbi.nlm.nih.gov/pubmed/22404601

Clin Transplant. 2012 Sep-Oct;26(5):714-21. doi: 10.1111/j.1399-0012.2012.01596.x. Epub 2012 Mar 8.

Willingness of the United States general public to participate in kidney paired donation.

Segev DL, Powe NR, Troll MU, Wang NY, Montgomery RA, Boulware LE.

Source

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

BACKGROUND:

Availability of kidney paired donation (KPD) is increasing in the United States, and a national system through UNOS is forthcoming. However, little is known about attitudes toward KPD among the general public, from which donors (particularly non-directed) are drawn.

METHODS:

In a national study, we assessed the public's attitudes regarding participation in KPD.

RESULTS:

Among 845 randomly selected participants, 85.2% of respondents were either "extremely willing" or "very willing" to participate in KPD. Experiences with the medical or organ transplant systems, such as undergoing surgery, having a primary medical provider, a living will, a friend who donated or received an organ, and considering donation after death, were associated with increased willingness. However, increased age, male sex, African American race, Hispanic ethnicity, distrust of the medical system, and not understanding organ allocation were associated with less willingness.

CONCLUSIONS:

We identify strong support for KPD but some important potential barriers to participation which should be considered as KPD programs are implemented.

http://www.ncbi.nlm.nih.gov/pubmed/23618020

Can J Public Health. 2012 Nov 6;103(6):e420-4.

False-positive Screening Mammograms and Biopsies Among Women Participating in a Canadian Provincial Breast Screening Program.

Coldman AJ, Phillips N.

Source

BC Cancer Agency. acoldman@bccancer.bc.ca.

Abstract

BACKGROUND:

Mammography screening results in false positives that cause anxiety and utilize scarce medical resources for their resolution. Determination of screening recommendations requires knowledge of the population risk of false positives.

METHODS:

Data were extracted from the Screening Mammography Program of British Columbia and analyzed to determine the influence of personal factors including age, ethnic group and screening history, and the centre where screening was performed, on the likelihood a new screen would result in a false positive and whether a biopsy was required. The resulting probabilities were combined to provide values for lifetime screening algorithms.

RESULTS:

Age, screen sequence number, history of previous abnormal screens and centre where screening was performed were significantly related to the likelihood a new screen would be a false positive. British Columbia women screened biennially between the ages of 50 and 69 have a projected 41% chance of a false-positive screen and a 5.6% risk of a related biopsy, with the best performing centres having rates of 26% and 3%, respectively.

INTERPRETATION:

Model projections for BC overall are comparable to other North American estimates. Estimates varied depending upon screeningcentre attended.

http://www.ncbi.nlm.nih.gov/pubmed/23619732

Chest. 2013 Apr 25. doi: 10.1378/chest.13-0809. [Epub ahead of print]

Chronic Obstructive Pulmonary Disease Surveillance-United States, 1999-2011.

Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH.

Abstract

BACKGROUND:

This report updates surveillance results for chronic obstructive pulmonary disease (COPD) in the United States.

METHODS:

For 1999 to 2011, data from national data systems for adults aged ≥25 years were analyzed.

RESULTS:

In 2011, 6.5% of adults (∼13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-adjusted prevalence of having been diagnosed with COPD declined (p=0.019). In 2010, there were 10.3 million (494.8 per 10,000) physician office visits, 1.5 million (72.0 per 10,000) emergency room visits, and 699,000 (32.2 per 10,000) hospital discharges for COPD. From 1999-2010, no significant overall trends were noted for physician office visits and emergency room visits; however, the age-adjusted hospital discharge rate for COPD declined significantly (p=0.001). In 2010 there were 312,654 (11.2 per 1000) Medicare hospital discharge claims submitted for COPD. Medicare claims (1999-2010) declined overall (p=0.045), among men (p=0.022), and among enrollees aged 65-74 years (p=0.033). There were 133,575 deaths (63.1 per 100,000) from COPD in 2010. The overall age-adjusted death rate for COPD did not change during 1999-2010 (p=0.163). Death rates (1999-2010) increased among adults aged 45-54 years (p&lt;0.001) and among American Indian/Alaska Natives (p=0.008) but declined among those aged 55-64 years (p=0.002) and 65-74 years (p&lt;0.001), Hispanics (p=0.038), Asian/Pacific Islanders (p&lt;0.001), and men (p=0.001). Geographic clustering of prevalence, Medicare hospitalizations, and deaths was observed.

CONCLUSION:

Declines in the age-adjusted prevalence, death rate in men, and hospitalizations for COPD since 1999 suggest progress in the prevention of COPD in the United States.

From U Toronto: Reducing Blood Pressure With Internet-Based Interventions

http://www.ncbi.nlm.nih.gov/pubmed/23618507

Can J Cardiol. 2013 May;29(5):613-21. doi: 10.1016/j.cjca.2013.02.007.

Reducing Blood Pressure With Internet-Based Interventions: A Meta-analysis.

Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, Nolan RP.

Source

Behavioural Cardiology Research Unit, University Health Network, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Elevated blood pressure is a leading risk factor for cardiovascular disease and mortality. Internet-based interventions (e-counselling) have the potential to deliver a wide range of preventive counselling services. The purpose of this review was to (1) assess the efficacy of e-counselling in reducing blood pressure and (2) identify key components of successful trials in order to highlight factors that may contribute significantly to blood pressure control.

METHODS:

MEDLINE, PubMed, EMBASE, PsycINFO, and the Cochrane Library were searched up to June 2012 with the following key words: Web-based, Internet-based, e-counselling, mobile health, blood pressure, and hypertension. Trials were selected in which blood pressure was reported as a primary or secondary outcome and whose participants had baseline systolic and diastolic blood pressure within the prehypertensive (120-139/80-89 mm Hg) or hypertensive (≥ 140/90 mm Hg) range.

RESULTS:

The search strategy identified 13 trials, and the mean reduction of systolic and diastolic blood pressure was -3.8 mm Hg (95% confidence interval [Cl], -5.63 to -2.06 mm Hg; P < 0.01) and -2.1 mm Hg (95% CI, -3.51 to -0.65 mm Hg; P < 0.05), respectively. The greatest magnitude of blood pressure reduction was found for interventions that lasted 6 months or longer, used 5 or more behavior change techniques, or delivered health messages proactively.

CONCLUSION:

Research on preventive e-counselling for blood pressure reduction is at an early stage of development. This review provides preliminary evidence of blood pressure reduction with Internet-based interventions. Future studies need to evaluate the contribution of specific intervention components in order to establish a best practice e-counselling protocol that is efficacious in reducing blood pressure.

From the Irish Times: Why Priests? A Failed Tradition by Garry Wills

http://www.irishtimes.com/culture/books/why-priests-a-failed-tradition-by-garry-wills-1.1362151?page=1

Why Priests? A Failed Tradition by Garry Wills

It has no biblical justification, says a Pulitzer-winning author, and it is time the Roman Catholic Church moved back towards egalitarianism

Linda Hogan

Wills is clear in this that his target is not the 400,000 individual priests, many of whom, he acknowledges, make a significant contribution to the lives of countless millions worldwide. Rather, his focus is on the institution, which, he argues, has a flimsy biblical heritage and a dubious theological justification and is an impediment to the development of a more egalitarian Christianity.

Graduated responsibility for pathology residents

http://www.ncbi.nlm.nih.gov/pubmed/23544934

Arch Pathol Lab Med. 2013 Apr;137(4):457-61. doi: 10.5858/arpa.2012-0161-ED.

Graduated responsibility for pathology residents: no time for half measures.

Allen TC.

Source

From the Department of Pathology, University of Texas Health Science Center, Tyler.

For more than half a decade the pathology community has been discussing initiating robust, graduated resident responsibilities.1,11–13 As Talbert and colleagues12 said 3 years ago: ‘‘The time to act is now.’’ ‘‘Didactic lectures, teaching conferences (intradepartmental and interdepartmental), and teaching aids. . . do not substitute for real-time experience in [anatomic pathology].’’12 Graduated responsibility will be an important measure in eliminating disparities, and although transitioning to genuine graduated resident responsibility ‘‘will be a major adjustment for residents, fellows, and supervising faculty. . .,’’13 it annot be achieved with half measures. ‘‘The risks of maintaining the status quo are very high, not the east of which is loss of traditional pathology duties to other specialties.’’12 Current training practices for athology residents are unsustainable, and as Paul Campos, JD, Above the Law’s 2011 Lawyer of the ear, said, ‘‘[W]hen you have an unsustainable business model you have to change or die.’’25

From Jackson State U: Scholarship and diversity in higher education

http://www.ncbi.nlm.nih.gov/pubmed/23614174

J Cult Divers. 2013 Spring;20(1):3-6.

Scholarship and diversity in higher education.

Akombo DO.

Source

Jackson State University, Jackson, MS 39217, USA. david.o.akombo@jsums.edu

Abstract

Colleges and universities which are less diverse in their communities are often characterized by values, behavior patterns, and linguistic traits impinging on the institutions' milieu. These traits differ in significant ways from those within the dominant society for which the institution is established. The diverse students, and faculty alike, find these policies to be quasi-exclusive and limited to the geographical and demo- graphical environments in which the institutions are located. This paper examines some of these traits that affect the experience in higher education for both students and faculty from minority groups.

http://www.kaiserhealthnews.org/Daily-Reports/2013/April/26/medicaid-expansion.aspx

Medicaid Expansion Challenges: Which States Are Facing Roadblocks, Running Out Of Time?

APR 26, 2013

News outlets report on recent events in Florida, Ohio, Texas, Arizona and South Carolina.

From U Freiburg-Germany: "Obese Equals Lazy?" Analysis of the Association between Weight Status and Physical Activity in Children

http://www.ncbi.nlm.nih.gov/pubmed/23533723

J Obes. 2013;2013:437017. doi: 10.1155/2013/437017. Epub 2013 Feb 28.

"Obese Equals Lazy?" Analysis of the Association between Weight Status and Physical Activity in Children.

Kreuser F, Kromeyer-Hauschild K, Gollhofer A, Korsten-Reck U, Röttger K.

Source

Department of Rehabilitative and Preventive Sports Medicine, University Medical Center, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany ; Institute of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117 Freiburg, Germany.

Abstract

Introduction. Literature provides evidence that overweight children are more sedentary. To verify this generalized statement behavior patterns of overweight and nonoverweight children needs to be understood. Therefore, we investigated the distribution of sedentary and activity levels in a quantitative and qualitative way. Methods. Data was collected from 37 randomly selected nonoverweight and 55 overweight children. They were 8 to 11 years of age. Height and weight were measured and weight status was characterized by BMI (BMI-percentile, BMI-SDS). Daily PA (physical activity) was measured by direct accelerometry. Spare time and screen time entertainment were obtained by questionnaires. Results. The amount of time spent "passive" was significantly higher in overweight children, while nonoverweight children were more "active." The multiple regression model shows a significant association between weight status (BMI-SDS) and activity parameters. Additionally, screen time entertainment was significantly related to BMI-SDS. Conclusion. The results support the statement that overweight children are less active than nonoverweight children. The high amount of PA seems to be an important factor to prevent overweight in children given that PA shows the highest correlation to weight status. Quantitative and qualitative measurements are needed for further analysis.

http://nationalinterest.org/article/the-many-faces-neo-marxism-8387

The Many Faces of Neo-Marxism

Walter Laqueur 

| 

May 1, 2013

"And, while some of the conferences and festivals lauding the anticapitalist crusader seem to be motivated by genuine neo-Marxist sentiments, others appear to be using the man as a kind of bandwagon for separate trendy causes and impulses. Consider the agenda at a recent such meeting at the University of Washington. One has to doubt whether these followers of Marx are on the right track when the papers under discussion contain titles such as “Reconsidering Impossible Totalities: Marxist Deployments of the Sublime,” “A Few Thoughts on the Academic Poet as Hobo-Tourist,” “Reading Hip-Hop at the Intersection of Culture and Capitalism,” “Annals of Sexual States” and “The Political Economy of Stranger Intimacy.”

One wonders what Marx’s reaction would be if he sat at his desk in the British Museum’s Reading Room and contemplated such discussions at a gathering dedicated to rethinking his ideas. Would he be impressed, amused or speechless? Perhaps it would remind him of the carnival celebrations each February in his native Trier: wine, funny masks and customs, and pranks—all followed by a hangover of five or six days."

http://www.ncbi.nlm.nih.gov/pubmed/23586687

Nephrology (Carlton). 2013 Apr 16. doi: 10.1111/nep.12065. [Epub ahead of print]

The often difficult decision of which patients will benefit from dialysis.

Brown MA, Crail SM.

Source

Depts Renal Medicine and Medicine, St George Hospital and University of NSW, Sydney, NSW.

Abstract

Nephrologists seek to provide dialysis to those who will benefit most while being honest and direct with those who are unlikely to benefit or even be harmed by dialysis; these can be difficult decisions A 'conservative' or 'not for dialysis' pathway is an important option for the management of ESKD patients who are elderly, have significant co-morbidity, poor functional status, malnutrition or who reside in a nursing home. Such a pathway is best underpinned by a specific Renal supportive Care program in each Unit. Nephrologists need to lead realistic discussions about likely survival with patients and their families before dialysis is instituted. Key ethics principles are a good aid in this decision making process A 'non-dialysis' renal supportive care program is a very positive way of offering holistic care for patients and their families; many of these patients live much longer without dialysis than might have been expected.