Colorado is still the least-obese state in the country. But it might not be for much longer

Colorado is still the least-obese state in the country. But it might not be for much longer.

The obesity rate jumped 10 percent in one year in Colorado

"Obesity surged 10 percent in Colorado over the past year, according to the annual America’s Health Rankings report by the United Health Foundation. That means 22.3 percent of Coloradans are now considered obese, up from 20.2 in the 2016 report. Obesity is measured by body mass index, a simple calculation involving height and weight.

Colorado was hardly alone in its increased obesity. Thirty-four U.S. states added girth between last year’s report and this year’s, but Colorado’s increase was tied with West Virginia for the second-largest. (Only Washington state’s gain was greater.) Meanwhile, the second-least-obese state — Massachusetts, which the report also named the healthiest overall state in the country — saw a decline in obesity. Massachusetts is now 1.3 percentage points behind Colorado in obesity."

"...increasing weight loss and, to a lesser extent, decreasing BMI, led to substantially worse outcomes for non-small cell lung cancer patients independent of other variables."

J Cachexia Sarcopenia Muscle. 2017 Dec 4. doi: 10.1002/jcsm.12253. [Epub ahead of print]

Post-diagnosis weight loss as a prognostic factor in non-small cell lung cancer.

Mytelka DS1, Li L1, Benoit K1.

Author information

1

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.

Abstract

BACKGROUND:

Cachexia and its most visible manifestation, weight loss, represent important poor prognostic factors for patients with non-small cell lung cancer. This work examines how severity of weight loss as an indicator of cachexia affects outcomes.

METHODS:

In a retrospective observational study of electronic medical records, patients with non-small cell lung cancer were monitored for weight loss from an initial assessment (within 2 months of index diagnosis) to a landmark at 5 months (at least 3 months after initial assessment). Patients who survived to the landmark were then followed to determine the association of baseline body mass index (BMI) and weight loss during the assessment period with outcomes. Patients were clustered to determine how BMI and weight loss related to survival as approximated by time of last appearance in the database, a strong proxy for time of death.

RESULTS:

Twelve thousand one hundred and one patients were divided into 5 cachexia risk groups based on a combination of weight loss and initial BMI. More severe groups demonstrated progressively worse outcomes, with the most severe group surviving for a median of 263 days (95% CI 254-274) from index and having a 1-year survival rate of 31%. The least severe group survived for a median of 825 days from index (95% CI 768-908) and had a 1-year survival rate of 78%. Cachexia risk group was a stronger predictor of survival than any baseline variable, including disease stage, performance status, or age.

CONCLUSIONS:

In this study, we showed that increasing weight loss and, to a lesser extent, decreasing BMI, led to substantially worse outcomes for non-small cell lung cancer patients independent of other variables. We suggest risk score groups that provide an improved approach for identifying poor prognosis patients with the greatest need.

"Overall, science understanding is associated with vaccine and genetic modification food acceptance, but not climate change acceptance."

Pers Soc Psychol Bull. 2017 Nov 1:146167217741314. doi: 10.1177/0146167217741314. [Epub ahead of print]

Not All Skepticism Is Equal: Exploring the Ideological Antecedents of Science Acceptance and Rejection.

Rutjens BT1, Sutton RM2, van der Lee R3.

Author information

1

1 University of Amsterdam, The Netherlands.

2

2 University of Kent, Canterbury, UK.

3

3 VU University Amsterdam, The Netherlands.

Abstract

Many topics that scientists investigate speak to people's ideological worldviews. We report three studies-including an analysis of large-scale survey data-in which we systematically investigate the ideological antecedents of general faith in science and willingness to support science, as well as of science skepticism of climate change, vaccination, and genetic modification (GM). The main predictors are religiosity and political orientation, morality, and science understanding. Overall, science understanding is associated with vaccine and GM food acceptance, but not climate change acceptance. Importantly, different ideological predictors are related to the acceptance of different scientific findings. Political conservatism best predicts climate change skepticism. Religiosity, alongside moral purity concerns, best predicts vaccination skepticism. GM food skepticism is not fueled by religious or political ideology. Finally, religious conservatives consistently display a low faith in science and an unwillingness to support science. Thus, science acceptance and rejection have different ideological roots, depending on the topic of investigation.

Ann Glob Health. 2017 May - Aug;83(3-4):596-604. doi: 10.1016/j.aogh.2017.07.005. Epub 2017 Aug 15.

On Becoming a Global Citizen: Transformative Learning Through Global Health Experiences.

Litzelman DK1, Gardner A2, Einterz RM3, Owiti P4, Wambui C5, Huskins JC6, Schmitt-Wendholt KM7, Stone GS8, Ayuo PO5, Inui TS9, Umoren RA10.

Author information

1

Department of Medicine, Indiana University School of Medicine and Center for Global Health, Indianapolis, IN. Electronic address: dklitzel@iu.edu.

2

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.

3

Department of Medicine, Indiana University School of Medicine and Center for Global Health, Indianapolis, IN.

4

Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.

5

Department of Medicine, Moi University School of Medicine, Eldoret, Kenya.

6

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.

7

Regenstrief Institute, Indianapolis, IN.

8

Department of Medicine, Massachusetts General Hospital (MGH), Boston, MA; Global Medicine Program, MGH Global Health, Boston, MA.

9

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.

10

Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.

Abstract

BACKGROUND:

Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship.

OBJECTIVE:

We conducted a qualitative assessment of trainee-reported critical incidents to more deeply understand the impact of our global health experience on trainees.

METHODS:

A cross-sectional survey was administered to trainees who had participated in a 2-month elective in Kenya from January 1989 to May 2013. We report the results of a qualitative assessment of the critical incident reflections participants (n = 137) entered in response to the prompt, "Write about one of your most memorable experiences and explain why you chose to describe this particular one." Qualitative analyses were conducted using thematic analysis and crystallization immersion analytic methods based on the principles of grounded theory, employing a constructivists' research paradigm.

FINDINGS:

Four major themes emerged. These themes were Opening Oneself to a Broader World View; Impact of Suffering and Death; Life-Changing Experiences; and Commitment to Care for the Medically Underserved.

CONCLUSIONS:

Circumstances that learners encounter in the resource-scarce environment in Kenya are eye-opening and life-changing. When exposed to these frame-shifting circumstances, students elaborate on or transform existing points of view. These emotionally disruptive experiences in an international health setting allowed students to enter a transformational learning process with a global mind. Students can see the world as an interdependent society and develop the capacity to advance both their enlightened self-interest and the interest of people elsewhere in the world as they mature as global citizens. Medical schools are encouraged to foster these experiences by finding ways to integrate them into curriculum.

How do you define patient engagement? My take.

Becker's Health IT + Clinical Leadership 2018 Speaker Series: 3 questions with University of Texas Medical Branch Director of Anatomic and Surgical Pathology, Timothy Craig Allen, MD

America’s healthiest and least healthy states

"Massachusetts, Hawaii, Vermont, Utah and Connecticut rank as the five healthiest states, while West Virginia, Alabama, Arkansas, Louisiana and Mississippi rank the least healthy in America’s Health Rankings, according to the report by the United Health Foundation."

BMC Med. 2017 Dec 8;15(1):216. doi: 10.1186/s12916-017-0978-2.

The extra cost of comorbidity: multiple illnesses and the economic burden of non-communicable diseases.

Cortaredona S1,2, Ventelou B3,4.

Author information

1

Aix-Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, 19-21 boulevard Jean Moulin, 13005, Marseille, France. sebastien.cortaredona@inserm.fr.

2

ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France. sebastien.cortaredona@inserm.fr.

3

ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.

4

Aix-Marseille Univ., CNRS, EHESS, Centrale Marseille, Aix-Marseille School of Economics, Marseille, France.

Abstract

BACKGROUND:

The literature offers competing estimates of disease costs, with each study having its own data and methods. In 2007, the Dutch Center for Public Health Forecasting of the National Institute for Public Health and the Environment provided guidelines that can be used to set up cost-of-illness (COI) studies, emphasising that most COI analyses have trouble accounting for comorbidity in their cost estimations. When a patient has more than one chronic condition, the conditions may interact such that the patient's healthcare costs are greater than the sum of the costs for the individual diseases. The main objective of this work was to estimate the costs of 10 non-communicable diseases when their co-occurrence is acknowledged and properly assessed.

METHODS:

The French Echantillon Généraliste de Bénéficiaires (EGB) database was used to assign all healthcare expenses for a representative sample of the population covered by the National Health Insurance. COIs were estimated in a bottom-up approach, through regressions on individuals' healthcare expenditure. Two-way interactions between the 10 chronic disease variables were included in the expenditure model to account for possible effect modification in the presence of comorbidity(ies).

RESULTS:

The costs of the 10 selected chronic diseases were substantially higher for individuals with comorbidity, demonstrating the pattern of super-additive costs in cases of diseases interaction. For instance, the cost associated with diabetes for people without comorbidity was estimated at 1776 €, whereas this was 2634 € for people with heart disease as a comorbidity. Overall, we detected 41 cases of super-additivity over 45 possible comorbidities. When simulating a preventive action on diabetes, our results showed that significant monetary savings could be achieved not only for diabetes itself, but also for the chronic diseases frequently associated with diabetes.

CONCLUSIONS:

When comorbidity exists and where super-additivity is involved, a given preventive policy leads to greater monetary savings than the costs associated with the single diagnosis, meaning that the returns from the action are generally underestimated.

Fat child taken into care by after their parents let them eat too much

Social workers stepped in over fears for the safety of the obese youngster in Manchester.

"Nine kids – some as young as two – were also removed from their ­families  because their parents failed to get them to brush their teeth, a freedom of information request found."

The Who. Eminence Front

The Who.  Eminence Front

Classic.

Is there really such a thing as 'fault-free obesity'? New science says maybe

Million of us have the right genes for obesity, researchers say.

"Bennett and his team can’t yet say that the presence of ankyrin-B in humans impacts weight. The next step is to research humans with the gene and compare against factors known to affect weight — like eating and exercise habits — along with family histories, metabolism, psychological traits and more."

The day of an Academic Pathologist. Finally revealed.

The day of an Academic Pathologist.  Finally revealed.

From the University of South Alabama Department of Pathology

"...because of continuing endemic prejudice in United States society and its healthcare system and the distrust this engenders..."

Camb Q Healthc Ethics. 2018 Jan;27(1):36-51. doi: 10.1017/S096318011700038X.

Compulsory Organ Retrieval: Morally, But Not Socially, Justified.

Rosoff PM.

Abstract

The number of patients with organ failure who could potentially benefit from transplantation continues to exceed the available supply of organs. Despite numerous efforts to increase the number of donors, there remains an enormous mismatch between demand and supply. Large numbers of people still die with potentially transplantable organs remaining in situ, most frequently as a result of family objections. I argue that there are no persuasive moral arguments against mandated organ retrieval from all dead individuals who meet clinical criteria. However, because of continuing endemic prejudice in United States society and its healthcare system and the distrust this engenders, I conclude that proceeding with a policy of compulsory organ retrieval, even if morally unobjectionable, would not be warranted.

"...six out of every 10 Bahamians have not one, not two, but three risk factors that can lead to a non-communicable disease such as diabetes, high blood pressure, heart disease, stroke or cancer."

Nutrition Policy To Stop People 'Dropping Like Flies'

"The latest national data shows that six out of every 10 Bahamians have not one, not two, but three risk factors that can lead to a non-communicable disease such as diabetes, high blood pressure, heart disease, stroke or cancer. NCDs account for more than 20 percent of the loss of productive life years among Bahamians."

#However, "virtually all NCDs are preventable through lifestyle changes," he added.

#ReadyPlayerOne - Playing Super Mario 64 increases hippocampal grey matter in older adults

PLoS One. 2017 Dec 6;12(12):e0187779. doi: 10.1371/journal.pone.0187779. eCollection 2017.

Playing Super Mario 64 increases hippocampal grey matter in older adults.

West GL1,2, Zendel BR2,3,4, Konishi K5, Benady-Chorney J5, Bohbot VD5, Peretz I1,2, Belleville S3.

Author information

1

Department of Psychology and Centre de Recherche en Neuropsychologie et Cognition, University of Montreal, Montreal, Quebec, Canada.

2

International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, Quebec, Canada.

3

Department of Psychology, University of Montreal and Institut universitaire de gériatrie de Montréal, QC, Canada.

4

Faculty of Medicine, Division of Community Health and Humanities, Memorial University of Newfoundland, Newfoundland, Canada.

5

Douglas Hospital Research Centre, Department of Psychiatry, McGill University, Verdun, Québec, Canada.

Abstract

Maintaining grey matter within the hippocampus is important for healthy cognition. Playing 3D-platform video games has previously been shown to promote grey matter in the hippocampus in younger adults. In the current study, we tested the impact of 3D-platform video game training (i.e., Super Mario 64) on grey matter in the hippocampus, cerebellum, and the dorsolateral prefrontal cortex (DLPFC) of older adults. Older adults who were 55 to 75 years of age were randomized into three groups. The video game experimental group (VID; n = 8) engaged in a 3D-platform video game training over a period of 6 months. Additionally, an active control group took a series of self-directed, computerized music (piano) lessons (MUS; n = 12), while a no-contact control group did not engage in any intervention (CON; n = 13). After training, a within-subject increase in grey matter within the hippocampus was significant only in the VID training group, replicating results observed in younger adults. Active control MUS training did, however, lead to a within-subject increase in the DLPFC, while both the VID and MUS training produced growth in the cerebellum. In contrast, the CON group displayed significant grey matter loss in the hippocampus, cerebellum and the DLPFC.

Adv Exp Med Biol. 2017;1031:323-346. doi: 10.1007/978-3-319-67144-4_19.

Newborn Screening: Beyond the Spot.

Urv TK1, Parisi MA2.

Author information

1

Division of Clinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA. urvtiin@mail.nih.gov.

2

Intellectual and Developmental Disabilities Branch, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, National Institutes of Health, Democracy 1, Room 9108, 6701 Democracy Boulevard, Bethesda, MD, 20892-4874, USA.

Abstract

The newborn screening paradigm of testing all newborns in the United States for treatable conditions within the first few hours of birth has proven to be a remarkable success story in the realm of public health by reducing neonatal and childhood morbidity and mortality. The Newborn Screening Saves Lives Act of 2007 and its successor, the Reauthorization Act of 2014, legislated the establishment of a Department of Health and Human Services Advisory Committee to make recommendations around newborn screening and a methodology to establish and add new conditions to a Recommended Uniform Screening Panel (RUSP) which currently includes 34 core conditions. In spite of the absence of a federal mandate that requires each of the states in the U.S. to screen for the disorders on the RUSP, most state public health laboratories have adopted the conditions on this panel. Moreover, the evolution of the evidence-based review process for adding new conditions to the RUSP has led to improvements in incorporating the public health impact and feasibility and implementation considerations. The cooperation between the federal partners who support implementation and rollout of state-based screening programs, develop technical standards and proficiency materials for laboratories, review and approve new technology platforms, and promote research to develop new assays and treatments for screenable disorders, points to the success of the newborn screening enterprise nationwide. As new technologic advances are made in the realm of genomic sequencing, the potential for incorporating these technologies holds great promise for newborn screening, but the ethical ramifications must be carefully considered to avoid harming the existing trust in the program.

Is obesity going to be the new normal?

"They found that at any age, kids who are obese are more likely than their non-obese peers to be obese at age 35. They also found that older obese kids are more likely than younger obese kids to still be obese on their 35th birthday."

How about just not mixing up patient's specimens?

A Bill to 'Eliminate Prostate Cancer Misdiagnosis'

"As a remedy for these mix-ups, Dr Bucshon is sponsoring the Prostate Cancer Misdiagnosis Elimination Act of 2017, which calls for Medicare to reimburse labs $200 for DNA testing that compares and matches the patient's biopsy tissue with cells from the inside the cheek that are taken with a cotton swab to ensure both came from the same person."

U.S. Surgeon General Jerome Adams supports studying medical marijuana

"Under medical marijuana, I believe it should be like any other drug," Adams said Friday in Indianapolis. "We need to let the FDA vet it, study it, vet it. The FDA has actually approved cannabidiol oil and some derivatives of marijuana, Marijuana is not one substance. It's actually over 100 different substances, some of which benefit, some of which are harmful."

The Tragedy of Liberalism

Patrick J. Deneen

The ship of liberalism is in dangerous waters not because it hasn’t yet realized its potential but because it overwhelmingly has. Our political battles are likely to continue to be shaped by the dominant narrative to which we have all become accustomed—conservative against progressive, right against left. And all the while, the logic of liberalism will inexorably continue to unfold, impelling the ship toward the inevitable iceberg while its passengers bicker not over the arrangement of the deck chairs but over which end of the ship will stay above water when the iceberg strikes.

What is needed today is not better theory, but better practice. When Tocqueville visited America in the early 1830s, he marveled at Americans’ political do-it-yourself spirit. Unlike his French compatriots, who for centuries had acquiesced in a centralized aristocratic order, Americans would readily gather in local settings to solve problems. In the process, they learned the “arts of association.” They were largely indifferent to the distant central government, which then exercised relatively few powers. Local township government, Tocqueville wrote, was the “schoolhouse of democracy,” and he praised the commitment of citizens to securing the goods of common life not only for the ends they achieved but for the habits and practices they fostered and the beneficial changes they wrought on citizens themselves. The greatest benefit of civic participation, he argued, was not its effects in the world, but those on the relations among people engaged in civic life: “When the members of a community are forced to attend to public affairs, they are necessarily drawn from the circle of their own interests and snatched at times from self-observation. As soon as a man begins to treat of public affairs in public, he begins to perceive that he is not so independent of his fellow men as he had at first imagined, and that in order to obtain their support he must often lend them his cooperation.”9

"Researchers at Harvard say that if current trends in child obesity continue, nearly six out of 10 of today’s children will have obesity when they are 35."

Nearly 6 out of 10 of today’s children will be obese at 35, researchers say

"Researchers at Harvard say that if current trends in child obesity continue, nearly six out of 10 of today’s children will have obesity when they are 35.

Escess weight in childhood is predictive of adult obesity and only children who are at a healthy weight have a less than 50 percent chance of having obesity as adults, the researchers also found."

Thom Lambert: Pai’s Right on Net Neutrality and Title II

Pai’s Right on Net Neutrality and Title II

As I explain in my new book, How to Regulate, sound regulation requires thinking like a doctor.  When addressing some “disease” that reduces social welfare, policymakers should catalog the available “remedies” for the problem, consider the implementation difficulties and “side effects” of each, and select the remedy that offers the greatest net benefit.

If we followed that approach in deciding what to do about the way Internet Service Providers (ISPs) manage traffic on their networks, we would conclude that FCC Chairman Ajit Pai is exactly right:  The FCC should reverse its order classifying ISPs as common carriers (Title II classification) and leave matters of non-neutral network management to antitrust, the residual regulator of practices that may injure competition.

HT:MN

J Med Ethics. 2017 Aug 20. pii: medethics-2016-103778. doi: 10.1136/medethics-2016-103778. [Epub ahead of print]

Direct to consumer genetic testing and the libertarian right to test.

Bonython WE1, Arnold BB1.

Author information

1

School of Law and Justice , Faculty of Business Government and Law, University of Canberra, Australian Capital Territory, Australia.

Abstract

Loi recently proposed a libertarian right to direct to consumer genetic testing (DTCGT)- independent of autonomy or utility-reflecting Cohen's work on self-ownership and Hohfeld's model of jural relations. Cohen's model of libertarianism dealt principally with self-ownership of the physical body. Although Loi adequately accounts for the physical properties of DNA, DNA is also an informational substrate, highly conserved within families. Information about the genome of relatives of the person undergoing testing may be extrapolated without requiring directengagement with their personal physical copy of the genome, triggering rights and interests of relatives that may differ from the rights and interests of others, that is, individual consumers, testing providers and regulators. Loi argued that regulatory interference with exercise of the right required justification, whereas prima facie exercise of the right did not. Justification of regulatory interference could include 'conflict with other people's rights', 'aggressive' use of the genome and 'harming others'. Harms potentially experienced by relatives as a result of the individual's exercise of a right to test include breach of genetic privacy, violation of their right to determine when, and if, they undertake genetic testing and discrimination. Such harms may justify regulatory intervention, in the event they are recognised; motives driving 'aggressive' use of the genome may also be relevant. Each of the above criteria requires clarification, as potential redundancies and tensions exist between them, with different implications affecting different groups of rights holders.

"Domestication, it turns out, was a decidedly mixed blessing for humans."

Great Scott

George Scialabba

Against the Grain: A Deep History of the Earliest States
by James Scott
Yale University Press, 312 pp., USD$26.

Domestication, it turns out, was a decidedly mixed blessing for humans. Judging from fossils, cereal-based diets were associated with shorter stature, bone distress, iron-deficiency anemia, and other deficits. The domus—the module including house and outbuildings, livestock yards, gardens, etc.—attracted hordes of commensals: not only dogs, pigs, and other mammals but also rodents, sparrows, insects, and weeds, as well as all their associated parasites and disease organisms, for which the domus was an ideal environment. A loss of alertness and emotional reactivity—the invariable result of animal domestication—may have similarly occurred among human domus-dwellers. And so labor-intensive was life in the domus that, Scott writes, “if we squint at the matter from a slightly different angle, one could argue that it is we who have been domesticated.”⁴

China's Obesity Problem Linked To Single Child Policy

"What they found was that only-sons had significantly greater BMI and were at greater risk (23 percent) of overweight and obesity than sibling-sons. Overall, the only-sons reported less time spent in watching TV and using the internet than sibling-sons. Further, the weight trend was accentuated in only-sons from urban areas — they were 36 percent more likely to be overweight and 43 percent more likely to be obese than were urban sibling-sons.

Analysis of girls’ data indicated that only-daughters had a higher risk of obesity (43 percent) than sibling-daughters, but this difference wasn’t statistically significant — even when urban and rural girls were examined separately."

Why Ajit Pai is right

PRO-NEUTRALITY, ANTI-TITLE II

"Any regulatory decision — indeed, any decision period — is about tradeoffs. To choose one course of action is to gain certain benefits and incur certain costs, and it is to forgo the benefits (and costs!) of alternative courses of action. What makes evaluating regulations so difficult is that the benefits are usually readily apparent — the bad behavior or outcome is, hopefully, eliminated — but the costs are much more difficult to quantify. Short-term implementation costs may be relatively straightforward, but future innovations and market entries that don’t happen by virtue of the regulation being in place are far more difficult to calculate. Equally difficult to measure is the inevitable rent-seeking that accompanies regulation, as incumbents find it easier to lobby regulators to foreclose competition instead of winning customers in an open market.

A classic example of this phenomenon is restaurants: who could possibly be against food safety? Then you read about how San Francisco requires 14 permits that take 9 months to issue (plus a separate alcohol permit) and you wonder why anyone opens a restaurant at all (compounded by the fact that already-permitted restaurants have a vested interest in making the process more onerous over time). Multiply that burden by all of the restaurants that never get created and the cost is very large indeed."

HT:MK

Psychol Res. 2017 Nov 7. doi: 10.1007/s00426-017-0937-8. [Epub ahead of print]

Morality and soap in engineers and social scientists: the Macbeth effect interacts with professions.

Schaefer M1.

Author information

1

Medical School Berlin, Calandrellistr. 1-9, 12247, Berlin, Germany. michael.schaefer@medicalschool-berlin.de.

Abstract

Several studies demonstrate that physical cleansing is actually efficacious to cope with threatened morality, thus demonstrating that physical and moral purity are psychologically interwoven. This so-called Macbeth effect has been explained, for example, by the conceptual metaphor theory that suggests an embodiment of the moral purity metaphor. Recent research draws attention to individual differences when using conceptual metaphors. The present study shows that the moral purity link interacts with different professions. Engineering and social science students were asked to hand copy a text in which the protagonist behaved in an immoral way (or in a moral way, control condition). Subsequently, they had to rate cleansing and other products. Both groups of participants showed higher ratings for cleansing products when hand copying the unethical story, but this Macbeth effect was significantly stronger for the group of engineering students. The results demonstrate that the Macbeth effect interacts with individual differences of the chosen profession. The outcome is discussed in terms of recent theories on individual differences in disgust sensitivity.

PTPR-γ

Liver Link between Obesity and Diabetes Highlights New Therapeutic Target

"In summary, our results indicate that the increased hepatic PTPR-γ level observed in obesity is sufficient to cause insulin resistance and hence unveil PTPR-γ as a new target for anti-T2DM therapy,” the authors continue. “Our data suggest that means aimed at decreasing hepatic PTPR-γ expression/activity should improve T2DM. This goal could be achieved by development of specific PTPR-γ inhibitors."

"If it can be shown that some people with serious mental illness can be rational with regard to suicide..."

Int J Law Psychiatry. 2013 Sep-Dec;36(5-6):358-65. doi: 10.1016/j.ijlp.2013.06.006. Epub 2013 Jul 7.

Why are people with mental illness excluded from the rational suicide debate?

Hewitt J1.

Author information

1

Centre for Philosophy, History and Law in Healthcare, College of Human and Health Science, Swansea University, UK. Electronic address: j.l.hewitt@swan.ac.uk.

Abstract

The topic of rational suicide is often approached with some trepidation by mental health professionals. Suicide prevention strategies are more likely to be seen as the domain of psychiatry and a wealth of psychiatric literature is devoted to identifying and managing suicide risk. Whether or not suicide can be deemed permissible is ostensibly linked to discussions of autonomy and mental capacity, and UK legislation directs that a patient's wishes must be respected with regard to treatment refusal where decisional capacity is intact. In the context of the care and treatment of those with physical disorders, extreme and untreatable physical suffering is likely to be accepted as rational grounds for suicide, where the person possesses cognitive coherence and an ability to realistically appreciate the consequences of his or her actions. In the case of those with serious mental disorder, the grounds for accepting that suicide is rational are however less clear-cut. Serious mental illness is typically conceived of as a coercive pressure which prevents rational deliberation and as such, the suicides of those with serious mental illness are considered to be substantially non-voluntary acts arising from constitutive irrationality. Therefore, where an appropriate clinician judges that a person with serious mental disorder is non-autonomous, suicide prevention is likely to be thought legally and morally justified. There are arguably, two questionable assumptions in the position that psychiatry adopts: Firstly, that psychogenic pain is in some way less real than physical pain and secondly, that mental illness invariably means that a desire to die is irrational and inauthentic. If it can be shown that some people with serious mental illness can be rational with regard to suicide and that psychological pain is of equal significance as physical suffering, then it may be possible to conclude that some persons with serious mental illness should not by definition be excluded from the class of those for whom rational suicide may be a coherent choice.

"People bereaved by suicide are especially vulnerable to developing complicated grief."

PLoS One. 2017 Jun 23;12(6):e0179496. doi: 10.1371/journal.pone.0179496. eCollection 2017.

Grief interventions for people bereaved by suicide: A systematic review.

Linde K1, Treml J1, Steinig J1, Nagl M1, Kersting A1.

Author information

1

Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.

Abstract

BACKGROUND:

Adaption to the loss of a loved one due to suicide can be complicated by feelings of guilt, shame, responsibility, rejection, and stigmatization. Therefore people bereaved by suicide have an increased risk for developing complicated grief which is related to negative physical and mental disorders and an increased risk for suicidal behavior. Grief interventions are needed for this vulnerable population. The aim of this systematic review was to provide an overview of the current state of evidence concerning the effectiveness of interventions that focus on grief for people bereaved by suicide.

METHODS:

We conducted a systematic literature search using PubMed, Web of Science, and PsycINFO for articles published up until November 2016. Relevant papers were identified and methodological quality was assessed by independent raters. A narrative synthesis was conducted.

RESULTS:

Seven intervention studies met the inclusion criteria. Two interventions were based on cognitive-behavioral approaches, four consisted of bereavement groups, and one utilized writing therapy. As five of the seven interventions were effective in reducing grief intensity on at least one outcome measure, there is some evidence that they are beneficial. Bereavement groups tend to be effective in lowering the intensity of uncomplicated grief, as are writing interventions in lowering suicide-specific aspects of grief. Cognitive-behavioral programs were helpful for a subpopulation of people who had high levels of suicidal ideation.

LIMITATION:

On average, methodological quality was low so the evidence for benefits is not robust. The stability of treatment effects could not be determined as follow-up assessments are rare. Generalizability is limited due to homogeneous enrollments of mainly female, white, middle-aged individuals.

CONCLUSIONS:

People bereaved by suicide are especially vulnerable to developing complicated grief. Therefore, grief therapies should be adapted to and evaluated in this population. Prevention of complicated grief may be successful in populations of high risk individuals.