Billions. With a B. "Though the Food and Drug Administration (FDA) says they have been unable to find asbestos in any of the talcum powder they reviewed..." #LitigationNation

Johnson & Johnson Ordered To Pay Billions In Baby Powder Lawsuit

"Politically, adverse lifestyle choices seem to forfeit the right to healthcare."

Our treatment of patients with severe obesity is unethical – but why?

Bariatric surgery is life-saving and cost-effective but due to pervasive bias, obese patients are not a healthcare priority

"Politically, adverse lifestyle choices seem to forfeit the right to healthcare. This is reminiscent of the approach taken to patients with Aids in the 1980s, where an emphasis on ethical behaviour was preferred to prioritising treatment for those who developed the disease. In the US, the American Disability Act provides some protection for obese people from discrimination at work. The European Court of Justice has ruled that it is illegal to discriminate against employees with obesity where it constitutes a disability. Article 12 of the International Covenant on Economic, Social and Cultural Rights outlines obligations of nations to respect and protect their citizens’ right to health.

So, the current denial of bariatric care not only constitutes a breach of ethical justice but also seems unwise. Patients stand to benefit from it, reliance on other strategies such as coercive public-health measures may be harmful and surgery represents good value for money.

However, because of pervasive bias and stigma, severely obese patients are not a political priority."

"Although Gulag science did not apparently possess the lethal character of Nazi medicine, neither was this work entirely benign."

Bull Hist Med. 2016;90(3):363-393.

Medical Research in Stalin's Gulag.

Alexopoulos G.

Abstract

Recently declassified Gulag archives reveal for the first time that the Stalinist leadership established medical research laboratories in the camps. The present work offers an initial reading of the medical research conducted by and on prisoners in Stalin's Gulag. Although Gulag science did not apparently possess the lethal character of Nazi medicine, neither was this work entirely benign. I argue that the highly constrained environment of the Stalinist camps distorted medical science. Scientists were forced to produce work agreeable to their Gulag administrators. Thus they remained silent regarding the context of mass starvation and forced labor, and often perpetuated Gulag myths concerning the nature of diseases and the threat of deceptive patients. Rather than aggressive treatment to save lives, they often engaged in clinical observations of dead or dying patients. At the same time, a few courageous scientists challenged the Gulag system in their research, in both subtle and overt ways.

Peter P. Luk, Christina I. Selinger, Annabelle Mahar, and Wendy A. Cooper (2018) Biomarkers for ALK and ROS1 in Lung Cancer: Immunohistochemistry and Fluorescent In Situ Hybridization. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Biomarkers for ALK and ROS1 in Lung Cancer: Immunohistochemistry and Fluorescent In Situ Hybridization

Peter P. Luk, MBBS; Christina I. Selinger, PhD; Annabelle Mahar, MBBS; Wendy A. Cooper, MBBS, PhD

From the Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia (Drs Luk, Selinger, Mahar, and Cooper); Central Clinical School, University of Sydney, Sydney, Australia (Dr Cooper); and the School of Medicine, Western Sydney University, Sydney, Australia (Dr Cooper).

The authors have no relevant financial interest in the products or companies described in this article.

The manuscript is based on an invited talk presented at the Pulmonary Pathology Society Biennial Meeting; June 14, 2017; Chicago, Illinois.

Corresponding author: Wendy A. Cooper, MBBS, PhD, Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Missenden Rd, Camperdown NSW 2050, Australia (email: Wendy.Cooper@health.nsw.gov.au).

Context.— A small proportion of non–small cell lung cancers harbor rearrangements of ALK or ROS1 genes, and these tumors are sensitive to targeted tyrosine kinase inhibitors. It is crucial for pathologists to accurately identify tumors with these genetic alterations to enable patients to access optimal treatments and avoid unnecessary side effects of less effective agents. Although a number of different techniques can be used to identify ALK- and ROS1-rearranged lung cancers, immunohistochemistry and fluorescence in situ hybridization are the mainstays.

Objective.— To review the role of immunohistochemistry in assessment of ALK and ROS1 rearrangements in lung cancer, focusing on practical issues in comparison with other modalities such as fluorescence in situ hybridization.

Data Sources.— This manuscript reviews the current literature on ALK and ROS1 detection using immunohistochemistry and fluorescence in situ hybridization as well as current recommendations.

Conclusions.— Although fluorescence in situ hybridization remains the gold standard for detecting ALK and ROS1rearrangement in non–small cell lung cancer, immunohistochemistry plays an important role and can be an effective screening method for detection of these genetic alterations, or a diagnostic test in the setting of ALK.

How Health Care Fails Women

Dismissed symptoms, misdiagnoses, and exclusion from clinical trials put female patients at risk. Here, the disturbing truth about gender bias in medicine—and how to get the first-rate care you deserve.

"The longtime lack of women in clinical trials continues to do damage. Over the past 2 decades, for instance, numerous drugs and medical devices have been pulled from the market because they turned out to have greater adverse effects on women than on men. One study found that 8 of the 10 treatments withdrawn between 1997 and 2000 fit that description."

#ButCommunism

“Every Day I Wake Up in a Strange Land”: Remembering the Russian Poet Naum Korzhavin

"Three years later, Korzhavin, a student at the Literary Institute in Moscow, was arrested, in the middle of the night, in his dormitory. Some said that Korzhavin was arrested for a poem critical of Stalin. Others said that he fell victim to Stalin’s anti-Semitic campaign against what Soviet papers called “cosmopolitanism.” When Korzhavin wrote about the arrest, forty years later, he described it primarily as absurd. When the secret police woke him up and demanded to see his poems, he recalled, he had nothing to show them: he kept his manuscripts with friends, not because he felt that he had anything to hide but simply because he was incapable of maintaining his own papers. Once he faced his interrogator, he wrote, he subverted the script by earnestly asking what he had done wrong. “I really wanted to know what happened—and what if I had made a mistake and this man knew what it was,” Korzhavin recalled. “Thus I won this idiocy contest. My cultivated sincere idiocy prevailed over his professional idiocy.”"

How the media covers obesity in America

• Comparing the coverage of two mainstream newspapers to two ethnic newspapers in Philadelphia, this study finds that mainstream outlets favored public policy efforts to address the obesity epidemic whereas the ethnic papers emphasized self-efficacy (e.g., individual choices like healthy eating and exercise).
• The two ethnic newspapers (which served Hispanic and African American communities) used community-based organizations as sources, direct mention of at-risk groups for obesity and common, non-jargon language — all indicators of cultural competency (the development of skills needed to communicate effectively with people from cultures other than their own). However, the African-American newspaper, The Philadelphia Tribune, discussed obesity less than expected by the researchers when compared with the overall sample.

"Only 35% of staff reported a good understanding of the Armed Forces Covenant and their responsibilities to uphold it."

Perspect Public Health. 2018 Jul 1:1757913918785650. doi: 10.1177/1757913918785650. [Epub ahead of print]

Transition from service to civvy street: the needs of armed forces veterans and their families in the UK.

Fulton E1,2, Wild D3, Hancock J3, Fernandez E2, Linnane J2.

Author information

1

Health Behaviour and Interventions Research, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.

2

Public Health Warwickshire, Warwickshire County Council, Warwick, UK.

3

Health Behaviour and Interventions Research, Faculty of Health & Life Sciences, Coventry University, Coventry, UK.

Abstract

AIMS:

Although many veterans make the transition from military to civilian life without difficulty, a small proportion struggle due to an impact on mental and physical wellbeing. Stigma and a reluctance to seek help further exacerbate this problem. The Armed Forces Covenant outlines the importance of ensuring that public services are aware of the specific needs of veterans; however, evidence suggests that knowledge among professional staff may be limited.

METHODS:

This exploratory study included three phases. Phase 1 (questionnaires) explored the needs of veterans and their families in Warwickshire (UK) regarding information about their health and wellbeing and the barriers and facilitators to accessing local public health services. Also in Phase 1, health and public services staff knowledge of veterans' needs and the Covenant is explored. In Phase 2, both samples attended a related focus group for a more in-depth exploration of the issues identified in Phase 1; in order to inform a Phase 3 workshop to co-develop an intervention.

RESULTS:

Veterans, their families and friends, wanted more information about what services do, how and when to access them and what to expect. Confusion over when to seek help for mental health 'symptoms' was highlighted. More support for families was identified, alongside a need for health and social care staff to have a better understanding of the unique experiences and needs of veterans. Only 35% of staff reported a good understanding of the Armed Forces Covenant and their responsibilities to uphold it.

CONCLUSIONS:

Public health teams within UK local authorities are well placed to ensure veterans have more knowledge about and access to public services. Interventions to address stigma and veterans' reluctance to seek help were needed. To this end, interventions for local veterans, their loved ones and staff in public services, designed in co-creation with these groups, is discussed.

Is Obesity a Disease or a Choice?

"In 2013, the American Medical Association (AMA) declared obesity a disease that requires a range of interventions to advance treatment and prevention. While some physicians at the time argued that behavior and dietary choices play a key role in weight gain, many other professional organizations, including the Obesity Society, soon followed the AMA's lead.

Five years later..."

"...sugar is scary."

So sweet but sugar is scary

"Although, there is no hard and fast rule for daily intake, one must always opt for options with less sugar," added Alaa.

"Stereotypes about many groups fall along two dimensions, one relating to agency/competence and the other morality/warmth..."

Br J Soc Psychol. 2018 Jun 29. doi: 10.1111/bjso.12262. [Epub ahead of print]

Stereotype content and morality: How competence and warmth arise from morally significant interactions.

Oldmeadow JA1.

Author information

1

Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.

Abstract

Stereotypes about many groups fall along two dimensions, one relating to agency/competence and the other morality/warmth. This paper integrates research and theory on stereotype contents and mind perception to explore how stereotypes of competence and warmth are linked to perceptions of moral agency and patiency. Competence identifies the moral agent, and warmth both identifies the moral patient and describes the moral valence of the interaction. In two experimental tests, a simple animated film showing circles and squares interacting in various ways elicited predicted competence and warmth stereotypes that tracked perceived moral valence. Integrating stereotype contents and mind perception literatures offers new ways to think about the origins, functions, and dynamics between dimensions of stereotype content.

"Once initiated, the division of theory and praxis is self-replicating, carving disciplines into ever narrower slivers and leading to the absurd situation within disciplines of different minibranches holding one another in contempt."

The ‘Two Cultures’ Fallacy

Stop pitting science and the humanities against each other

"But this tendency to downgrade 'theory' in the sciences and social sciences overlooks the importance of theoretical knowledge, as well its potential to contribute to practical advances. Thus the active/contemplative opposition not only separates disciplines from one another but also creates further division within the disciplines themselves. Once initiated, the division of theory and praxis is self-replicating, carving disciplines into ever narrower slivers and leading to the absurd situation within disciplines of different minibranches holding one another in contempt."

Patient. 2018 Jul 2. doi: 10.1007/s40271-018-0321-9. [Epub ahead of print]

Oh, the Places We'll Go: Patient-Reported Outcomes and Electronic Health Records.

Gensheimer SG1,2, Wu AW3,4, Snyder CF1,2,5; PRO-EHR Users’ Guide Steering Group; PRO-EHR Users’ Guide Working Group.

Collaborators (33)

Author information

1

Johns Hopkins School of Medicine, 624 N Broadway, Baltimore, MD, 21205, USA.

2

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

3

Johns Hopkins School of Medicine, 624 N Broadway, Baltimore, MD, 21205, USA. awu@jhu.edu.

4

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. awu@jhu.edu.

5

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.

Abstract

The growing measurement of patient-reported outcomes (PROs) and adoption of electronic health records (EHRs) presents an unprecedented opportunity to improve health care for patients and populations. The integration of PROs into EHRs can promote patient-centered care and advance quality improvement initiatives, research, and population health. Despite these potential benefits, there are few best practices to help organizations achieve integration. To integrate PROs into EHRs, organizations should evaluate the advantages and disadvantages of various approaches within three themes: Planning, Selection, and Engagement. Planning considerations for integration include what strategy will be used, how the integrated system will be governed, ethical and legal issues, and how data from multiple EHRs can be pooled across organizations. Selection considerations involve identifying which patient population to target for PRO data collection on the basis of the intended use of the data in the health care system, and then choosing specific outcomes and their measures. Engagement considerations include how, where, and with what frequency patients will respond to PRO measures, how to display PRO data in EHRs, how clinical teams will act upon PRO data, and how to train, support and incent clinical teams and patients to incorporate PRO data into care. There is no most effective model that will work in all contexts. Organizations wishing to integrate PROs and EHRs should assemble the multidisciplinary expertise needed to evaluate the advantages and disadvantages of the various approaches for their particular context. We specifically recommend that organizations think carefully about stakeholder participation; design their system with data sharing in mind; develop a framework to aid in PRO selection; create guidelines to support PRO interpretation and action for patients and clinicians; and ensure patients have access to their own PRO data.

Child obesity could be influenced by mom’s lifestyle habits: Study

"Their findings, published in the British Medical Journal, suggest that mothers who follow five specific habits may reduce the risk of obesity in their offspring."

Cadbury’s Easter Bunny Breaks Britain’s New ‘Junk Food’ Rules

“It’s censorship of children and adults in order to protect children from the images of Easter eggs, it’s pathetic,” he said.

Abandoned on Bataan #4thOfJuly #GreatestGeneration #GodBlessAmerica #LetFreedomRing

Abandoned on Bataan: One Man's Story of Survival 

"On that Christmas Day we did a brave, and perhaps foolish thing.  One of the men had an American flag that he had managed to bring in with him.  He must have come from Corregador, as the men on the march could have never brought it in.  So, foolish or brave, we displayed the American flag on Christmas Day, 1943.  We hung it up in the barracks and sang patriotic songs and carols and had a wonderfully good feeling.  Our rations had been doubled for the day and we felt less empty than usual.  It was a day to remember, the day we got to see our flag again.  Even if it was patched and faded, it was the Stars and Stripes."

Abandoned on Bataan: One Man's Story of Surival - Chapter 17

California Enacts Nation’s Strictest Data Privacy Law

"The Golden State is adopting a new online privacy law that will control how major tech businesses-like Facebook, Google, Amazon, and Uber-collect and use the personal data of their users, as reported by The Washington Post on Wednesday." 

California, home of the first soda tax, agrees to ban them

California, home of the first soda tax, agrees to ban them

"The law represents a significant, if long-anticipated, shift among the nation’s soda makers, who have previously fought taxes, city by city, and expended millions of dollars in the process. Soda companies say the statewide bans more efficiently protect jobs and businesses that could be hurt by local tax laws."

#BeforeCellPhones #DiscoLives

Earth, Wind & Fire - Boogie Wonderland

J Med Ethics. 2018 Jun 15. pii: medethics-2017-104682. doi: 10.1136/medethics-2017-104682. [Epub ahead of print]

Conflicting duties and restitution of the trusting relationship.

Eriksen A1,2.

Author information

1

ARENA , Centre for European Studies, University of Oslo, Oslo, Norway.

2

SPS, Centre for the Study of Professions, Oslo and Akershus University College, Oslo, Norway.

Abstract

It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a 'compensation view' of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The 'unity view' argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.

From @marenwhymdmd and me: Let's Have a Tweetup: The Case for Using Twitter Professionally

Arch Pathol Lab Med. 2016 Sep;140(9):956-7. doi: 10.5858/arpa.2016-0172-SA. Epub 2016 May 19.

Let's Have a Tweetup: The Case for Using Twitter Professionally.

Fuller MY, Allen TC1.

Author information

1

From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Fuller); and the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen).

Abstract

Social media use is very common and can be an effective way for professionals to discuss information and interact with colleagues. Twitter (Twitter, Inc, San Francisco, California) is a social media network where posts, termed tweets, are limited to 140 characters. Professional use of Twitter is ideal for physicians interested in both networking and education and is optimally used to facilitate in-person networking. Live-tweeting (posting real-time reactions to events) at professional meetings is also a popular and highly successful use of Twitter. Physicians report patient privacy as the top concern preventing use of social media for professional reasons, and although generally social media use is safe, it is essential to understand how to protect patient confidentially. Other social media platforms with potential for professional use include Facebook (Facebook, Inc, Menlo Park, California), Instagram (Facebook, Inc), YouTube (YouTube, LLC, San Bruno, California), and Periscope (Twitter, Inc). With Twitter and other social media options, now is the time for pathologists to increase our visibility on social media and worldwide.

CDC: Cancers Linked To Obesity Account For 40 Percent Of All US Cancer Cases

WASHINGTON — When it comes to obesity, studies often focus on the heart problems that can crop up as people age. New research now points to the cancer risks associated with weight: researchers discovered that of all the cancers diagnosed in the U.S. in 2014, 40 percent were related to overweight and obesity, according to a report by the Centers for Disease Control and Prevention.

Doctors and scientists know of 13 different types of cancer related to body weight and obesity. While the overall number of cancer-sufferers in America has fallen since the 1990s, increases in the proportion of those who suffer from cancers linked to an unhealthy body mass index are likely hurting those numbers.

Jamiroquai - Corner of the Earth

Curr Opin Organ Transplant. 2018 Apr;23(2):271-278. doi: 10.1097/MOT.0000000000000510.

Moving from the HIV Organ Policy Equity Act to HIV Organ Policy Equity in action: changing practice and challenging stigma.

Doby BL1, Tobian AAR2, Segev DL3, Durand CM1.

Author information

1

Department of Medicine.

2

Department of Pathology.

3

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

Abstract

PURPOSE OF REVIEW:

The HIV Organ Policy Equity (HOPE) Act, signed in 2013, reversed the federal ban on HIV-to-HIV transplantation. In this review, we examine the progress in HOPE implementation, the current status of HIV-to-HIV transplantation, and remaining challenges.

RECENT FINDINGS:

Pursuant to the HOPE Act, the Department of Health and Human Services revised federal regulations to allow HIV-to-HIV transplants under research protocols adherent to criteria published by the National Institutes of Health. The first HIV-to-HIV kidney and liver transplants were performed at Johns Hopkins in March of 2016. Legal and practical challenges remain. Further efforts are needed to educate potential HIV+ donors and to support Organ Procurement Organizations. As of November 2017, there are 22 transplant centers approved to perform HIV-to-HIV transplants in 10 United Network for Organ Sharing regions. To date, 16 Organ Procurement Organizations in 22 states have evaluated HIV+ donors. The National Institutes of Health-funded HOPE in Action: A Multicenter Clinical Trial of HIV-to-HIV Deceased Donor (HIVDD) Kidney Transplantation Kidney Trial will launch at 19 transplant centers in December of 2017. A HOPE in Action Multicenter HIVDD Liver Trial is in development.

SUMMARY:

Significant progress toward full HOPE implementation has been made though barriers remain. Some challenges are unique to HIV-HIV transplantation, whereas others are amplifications of issues across the current transplant system. In addition to a public health benefit for all transplant candidates in the United States, partnership on the HOPE Act has the potential to address systemic challenges to national donation and transplantation.

Childhood Obesity To Be Tackled By The British Government With New Stricter Measures

"'It is our job to empower parents to make healthier choices and make their lives easier,' added the British Health Minister."

Eur J Clin Nutr. 2018 Jun 19. doi: 10.1038/s41430-018-0187-x. [Epub ahead of print]

Chocolate milk for recovery from exercise: a systematic review and meta-analysis of controlled clinical trials.

Amiri M1,2, Ghiasvand R3,4, Kaviani M5, Forbes SC6, Salehi-Abargouei A7,8.

Author information

1

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

3

Food Security research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

4

Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

5

Faculty of Pure & Applied Science, School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada.

6

Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada.

7

Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. abargouei@ssu.ac.ir.

8

Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. abargouei@ssu.ac.ir.

Abstract

BACKGROUND/OBJECTIVES:

Chocolate milk (CM) contains carbohydrates, proteins, and fat, as well as water and electrolytes, which may be ideal for post-exercise recovery. We systematically reviewed the evidence regarding the efficacy of CM compared to either water or other "sport drinks" on post-exercise recovery markers.

SUBJECTS/METHODS:

PubMed, Scopus, and Google scholar were explored up to April 2017 for controlled trials investigating the effect of CM on markers of recovery in trained athletes.

RESULTS:

Twelve studies were included in the systematic review (2, 9, and 1 with high, fair and low quality, respectively) and 11 had extractable data on at least one performance/recovery marker [7 on ratings of perceived exertion (RPE), 6 on time to exhaustion (TTE) and heart rate (HR), 4 on serum lactate, and serum creatine kinase (CK)]. The meta-analyses revealed that CM consumption had no effect on TTE, RPE, HR, serum lactate, and CK (P > 0.05) compared to placebo or other sport drinks. Subgroup analysis revealed that TTE significantly increases after consumption of CM compared to placebo [mean difference (MD) = 0.78 min, 95% confidence interval (CI): 0.27, 1.29, P = 0.003] and carbohydrate, protein, and fat-containing beverages (MD = 6.13 min, 95% CI: 0.11, 12.15, P = 0.046). Furthermore, a significant attenuation on serum lactate was observed when CM was compared with placebo (MD = -1.2 mmol/L, 95% CI: -2.06,-0.34, P = 0.006).

CONCLUSION:

CM provides either similar or superior results when compared to placebo or other recovery drinks. Overall, the evidence is limited and high-quality clinical trials with more well-controlled methodology and larger sample sizes are warranted.

Claiming agency in later life in reforming China

Ageing Soc. 2017 Nov;37(10):2074-2102. doi: 10.1017/S0144686X16000830. Epub 2016 Aug 12.

It was all planned … now what? Claiming agency in later life in reforming China.

Liang J1, Luo B2.

Author information

1

Department of Gerontology, University of Louisiana at Monroe, Louisiana, USA.

2

Department of Sociology, Western Washington University, Bellingham, Washington, USA.

Abstract

This study explores the social construction of agency and wellbeing among 20 Chinese urban retirees aged between 50 and 82 years old (averaging 67), with a special focus on the impact of earlier life experiences in shaping later-life pathways. Today's retirees in urban China have experienced the communist collectivist ideology during the Mao era as well as the changes to everyday life brought about by the economic transformation from centrally planned socialism to a market-orientated economy. Thereby, life in retirement for Chinese elders becomes more than just an issue of dealing with increases in discretionary time after exit from full-time work, but also one of making sense of their earlier life experiences in the midst of dramatic social changes. A grounded theory approach with semi-structured, in-depth, face-to-face interviews was used for data collection and analysis. Three interrelated themes emerged: (a) reminiscence as a mechanism of meaning-making, (b) discovery and exercise of agency in later life in contrast to a rigidly structured earlier life, and (c) varying pathways to constructing the life-stage of retirement. The findings have refuted gerontological literature and public discourse that often portray Chinese elders as passive care recipients or helpless dependants. Further, the present study has practical implications for developing policies, designing programmes and providing services to improve the quality of life for today's older Chinese people.

J Drug Issues. 2018 Jul;48(3):421-434. doi: 10.1177/0022042618770393. Epub 2018 Apr 21.

Religious Involvement and Marijuana Use for Medical and Recreational Purposes.

Burdette AM1, Webb NS1, Hill TD2, Haynes SH3, Ford JA4.

Author information

1

Florida State University, Tallahassee, USA.

2

University of Arizona, Tucson, USA.

3

Mississippi State University, Mississippi State, USA.

4

University of Central Florida, Orlando, USA.

Abstract

In this article, we use data from the 2016 National Survey on Drug Use and Health (NSDUH) to examine the association between religious involvement and marijuana use for medical and recreational purposes in U.S. adults (N = 41,517). We also consider whether the association between religious involvement and marijuana use varies according to personal health status. Our results show that adults who attend religious services more frequently and hold more salient religious beliefs tend to exhibit lower rates of medical and recreational marijuana use. We also find that these "protective effects" are less pronounced for adults in poor health. Although our findings confirm previous studies of recreational marijuana use, we are the first to examine the association between religious involvement and medical marijuana use. Our moderation analyses suggest that the morality and social control functions of religious involvement may be offset under the conditions of poor health.

Rationales for expanding minority physician representation in the workforce

Med Educ. 2018 Jun 22. doi: 10.1111/medu.13618. [Epub ahead of print]

Rationales for expanding minority physician representation in the workforce: a scoping review.

Kelly-Blake K1,2, Garrison NA3,4, Fletcher FE5, Ajegba B6, Smith N7, Brafford M8, Bogdan-Lovis E1.

Author information

1

Center for Ethics and Humanities in the Life Sciences, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.

2

Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.

3

Division of Bioethics, Department of Paediatrics, University of Washington, Seattle, Washington, USA.

4

Treuman Katz Center for Pediatric Bioethics, Seattle Children's Hospital and Research Institute, Seattle, Washington, USA.

5

Department of Health Behaviour, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA.

6

College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.

7

Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA.

8

Department of Forensic Psychology, Walden University, Minneapolis, Minnesota, USA.

Abstract

OBJECTIVES:

The purpose of this study was to conduct a scoping review of the literature and to categorically map a 15-year trajectory of US undergraduate medical education rationales for and approaches to expanding under-represented minority (URM) physician representation in the medical workforce. Further aims were to comparatively examine related justifications and to consider international implications.

METHODS:

From 1 June to 31 July 2015, the authors searched the Cochrane Library, ERIC, PsycINFO, PubMed, Scopus, Web of Science and Google Scholar for articles published between 2000 and 2015 reporting rationales for and approaches to increasing the numbers of members of URMs in undergraduate medical school.

RESULTS:

A total of 137 articles were included in the scoping review. Of these, 114 (83%) mentioned workforce diversity and 73 (53%) mentioned concordance. The patient-physician relationship (n = 52, 38%) and service commitment (n = 52, 38%) were the most commonly cited rationales. The most frequently mentioned approaches to increasing minority representation were pipeline programmes (n = 59, 43%), changes in affirmative action laws (n = 32, 23%) and changes in admission policies (n = 29, 21%).

CONCLUSIONS:

This scoping review of the 2000-2015 literature on strategies for and approaches to expanding URM representation in medicine reveals a repetitive, amplifying message of URM physician service commitment to vulnerable populations in medically underserved communities. Such message repetition reinforces policies and practices that might limit the full scope of URM practice, research and leadership opportunities in medicine. Cross-nationally, service commitment and patient-physician concordance benefits admittedly respond to recognised societal need, yet there is an associated risk for instrumentally singling out members of URMs to fulfil that need. The proceedings of a 2001 US Institute of Medicine symposium warned against creating a deterministic expectation that URM physicians provide care to minority populations. Our findings suggest that the expanding emphasis on URM service commitment and patient-physician concordance benefits warrants ongoing scrutiny and, more broadly, represent a cautionary tale of unintended consequences for medical educators globally.