http://www.ncbi.nlm.nih.gov/pubmed/22306644
Br J Nurs. 2012 Jan 26;21(2):126-7.
Reforming the law concerning assisted dying.
McHale JV.
Source
Professor of Health Care Law, Director of Centre for Health Law, Science and Policy, University of Birmingham.
Abstract
The question of whether English law should be reformed to legalize assisted dying has been the cause of heated debate over many years. The courts have consistently rejected challenges to change the law in the area. However in 2009 Debbie Purdy achieved success in requiring the Director of Public Prosecutions to produce prosecution guidelines on assisted suicide. This paper explores the current law in the area and examines the proposals for reform of the Falconer Commission which were published in January 2012.
Tuesday, February 14, 2012
"what people are willing to pay for"
http://www.ncbi.nlm.nih.gov/pubmed/22316052
J Public Health Dent. 2012 Jan 17. doi: 10.1111/j.1752-7325.2011.00294.x. [Epub ahead of print]
Conundrums in health care reform: current experiences across the North Atlantic.
Currie RB, Pretty IA, Tickle M, Maupomé G.
Source
Faculty of Medical and Human Sciences, School of Dentistry, University of Manchester School of Dentistry, University of Manchester Preventive Dentistry, Indiana University School of Dentistry The Regenstrief Institute Inc.
Abstract
Objective:
To assist stakeholders (policy makers, dentists and patients) implementing the Patient Protection and Affordable Care Act of 2010 in the United States by providing information on conundrums arising from previous polices of the UK Labour government and emergent policies of the recently elected Coalition Government.
Methods:
The authors provide a background to the development of National Health Service dental services contrasted with US provision. Considerations are given from the different perspectives of stakeholders involved (policy makers, dentists, and patients).
Conclusions:
Policy makers must work under pressure for services to remain within boundaries of finite economic resources and what people are willing to pay for. The importance is stressed that they respond to public demands and workforce capability by clearly determining what the priorities should be, what services will be delivered, and defining responsibilities.
J Public Health Dent. 2012 Jan 17. doi: 10.1111/j.1752-7325.2011.00294.x. [Epub ahead of print]
Conundrums in health care reform: current experiences across the North Atlantic.
Currie RB, Pretty IA, Tickle M, Maupomé G.
Source
Faculty of Medical and Human Sciences, School of Dentistry, University of Manchester School of Dentistry, University of Manchester Preventive Dentistry, Indiana University School of Dentistry The Regenstrief Institute Inc.
Abstract
Objective:
To assist stakeholders (policy makers, dentists and patients) implementing the Patient Protection and Affordable Care Act of 2010 in the United States by providing information on conundrums arising from previous polices of the UK Labour government and emergent policies of the recently elected Coalition Government.
Methods:
The authors provide a background to the development of National Health Service dental services contrasted with US provision. Considerations are given from the different perspectives of stakeholders involved (policy makers, dentists, and patients).
Conclusions:
Policy makers must work under pressure for services to remain within boundaries of finite economic resources and what people are willing to pay for. The importance is stressed that they respond to public demands and workforce capability by clearly determining what the priorities should be, what services will be delivered, and defining responsibilities.
Cancer prevention health services research: an emerging field
http://www.ncbi.nlm.nih.gov/pubmed/22311693
J Cancer Educ. 2012 Feb 7. [Epub ahead of print]
Cancer Prevention Health Services Research: An Emerging Field.
Zhao H, Tektiridis JH, Zhang N, Chamberlain RM.
Source
Division of Biostatistics, School of Public Health, The University of Texas Health Science at Houston, Houston, TX, USA.
Abstract
In October 2009, The University of Texas MD Anderson Cancer Center hosted a symposium, "Future Directions in Cancer Prevention and Control: Workforce Implications for Training, Practice, and Policy." This article summarizes discussions and an Internet and literature review by the symposium's Health Services Infrastructure Working Group. We agree on the need for the recognition of Cancer Prevention Health Services Research (CP-HSR) as a unified research field. With advances in cancer screening and increased emphasis on preventive services under healthcare reform, there is a growing need for investigators with both cancer prevention and HSR expertise to consider the comparative effectiveness of cancer screening methods, the cost-effectiveness of early detection technologies, and the accessibility of preventive care for individuals at risk of cancer. Defining CP-HSR as a field will provide investigators with credibility and will serve to draw more researchers to the field. Increasing funding to train individuals in CP-HSR will be important to help meet the anticipated demand for investigators with this specialized multidisciplinary expertise.
J Cancer Educ. 2012 Feb 7. [Epub ahead of print]
Cancer Prevention Health Services Research: An Emerging Field.
Zhao H, Tektiridis JH, Zhang N, Chamberlain RM.
Source
Division of Biostatistics, School of Public Health, The University of Texas Health Science at Houston, Houston, TX, USA.
Abstract
In October 2009, The University of Texas MD Anderson Cancer Center hosted a symposium, "Future Directions in Cancer Prevention and Control: Workforce Implications for Training, Practice, and Policy." This article summarizes discussions and an Internet and literature review by the symposium's Health Services Infrastructure Working Group. We agree on the need for the recognition of Cancer Prevention Health Services Research (CP-HSR) as a unified research field. With advances in cancer screening and increased emphasis on preventive services under healthcare reform, there is a growing need for investigators with both cancer prevention and HSR expertise to consider the comparative effectiveness of cancer screening methods, the cost-effectiveness of early detection technologies, and the accessibility of preventive care for individuals at risk of cancer. Defining CP-HSR as a field will provide investigators with credibility and will serve to draw more researchers to the field. Increasing funding to train individuals in CP-HSR will be important to help meet the anticipated demand for investigators with this specialized multidisciplinary expertise.
Electronic medical records: variations in quality and consistency raise concerns
http://www.ncbi.nlm.nih.gov/pubmed/22313561
Emerg Med Australas. 2012 Feb;24(1):57-63. doi: 10.1111/j.1742-6723.2011.01486.x. Epub 2011 Sep 19.
Health reform: Is routinely collected electronic information fit for purpose?
Liaw ST, Chen HY, Maneze D, Taggart J, Dennis S, Vagholkar S, Bunker J.
Source
School of Public Health and Community Medicine Centre for Primary Health Care and Equity, University of New South Wales General Practice Unit, South West Sydney Local Health District, Sydney, New South Wales, Australia.
Abstract
Objective: Little has been reported about the completeness and accuracy of data in existing Australian clinical information systems. We examined the accuracy of the diagnoses of some chronic diseases in an ED information system (EDIS), a module of the NSW Health electronic medical record (EMR), and the consistency of the reports generated by the EMR.
Methods:
A list of ED attendees and those admitted was generated from the EDIS, using specific (e.g. angina) and possible clinical terms (e.g. chest pain) for the selected chronic diseases. This EDIS list was validated with an audit of discharge summaries, and compared with a list generated, using similar specific and possible Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT), from the underlying EMR database.
Results:
Of the 33 115 ED attendees, 2559 had diabetes mellitus (DM), cardiovascular disease or asthma/chronic obstructive pulmonary disease; of these 2559, 876 were admitted. Discharge summaries were missing for 12-15% of patients. Only three-quarters or fewer of the diagnoses were confirmed by the discharge summary audit, best for DM and worst for cardiovascular disease. Proportion of agreement between the lists generated from the EDIS and EMR was best for DM and worst for asthma/chronic obstructive pulmonary disease. Possible reasons for this discrepancy are technical, such as use of different extraction terms or system inconsistency; or clinical, such as data entry, decision-making, professional behaviour and organizational performance.
Conclusions:
Variations in information quality and consistency of the EDIS/EMR raise concerns about the 'fitness for purpose' of the information for care and planning, information sharing, research and quality assurance.
Emerg Med Australas. 2012 Feb;24(1):57-63. doi: 10.1111/j.1742-6723.2011.01486.x. Epub 2011 Sep 19.
Health reform: Is routinely collected electronic information fit for purpose?
Liaw ST, Chen HY, Maneze D, Taggart J, Dennis S, Vagholkar S, Bunker J.
Source
School of Public Health and Community Medicine Centre for Primary Health Care and Equity, University of New South Wales General Practice Unit, South West Sydney Local Health District, Sydney, New South Wales, Australia.
Abstract
Objective: Little has been reported about the completeness and accuracy of data in existing Australian clinical information systems. We examined the accuracy of the diagnoses of some chronic diseases in an ED information system (EDIS), a module of the NSW Health electronic medical record (EMR), and the consistency of the reports generated by the EMR.
Methods:
A list of ED attendees and those admitted was generated from the EDIS, using specific (e.g. angina) and possible clinical terms (e.g. chest pain) for the selected chronic diseases. This EDIS list was validated with an audit of discharge summaries, and compared with a list generated, using similar specific and possible Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT), from the underlying EMR database.
Results:
Of the 33 115 ED attendees, 2559 had diabetes mellitus (DM), cardiovascular disease or asthma/chronic obstructive pulmonary disease; of these 2559, 876 were admitted. Discharge summaries were missing for 12-15% of patients. Only three-quarters or fewer of the diagnoses were confirmed by the discharge summary audit, best for DM and worst for cardiovascular disease. Proportion of agreement between the lists generated from the EDIS and EMR was best for DM and worst for asthma/chronic obstructive pulmonary disease. Possible reasons for this discrepancy are technical, such as use of different extraction terms or system inconsistency; or clinical, such as data entry, decision-making, professional behaviour and organizational performance.
Conclusions:
Variations in information quality and consistency of the EDIS/EMR raise concerns about the 'fitness for purpose' of the information for care and planning, information sharing, research and quality assurance.
From Am J Psychiatry: Health care reform: a primer for psychiatrists
http://www.ncbi.nlm.nih.gov/pubmed/22318803
Am J Psychiatry. 2012 Feb 1;169(2):226.
Health care reform: a primer for psychiatrists.
Sharfstein SS.
Unfortunately, no abstract.
Am J Psychiatry. 2012 Feb 1;169(2):226.
Health care reform: a primer for psychiatrists.
Sharfstein SS.
Unfortunately, no abstract.
From Michigan State: Health reform ads-worth the money?
http://www.ncbi.nlm.nih.gov/pubmed/22323237
J Health Polit Policy Law. 2012 Feb 9. [Epub ahead of print]
Issue Ads and the Health Reform Debate.
Bergan D, Risner G.
Source
1 Michigan State University.
Abstract
The public debate over health care reform in 2009 was carried out partly through issue advertisements aired online and on television. Did these advertisements alter the course of the debate over health care reform? While millions of dollars are spent each year on issue ads, little is known about their effects. Results from a naturalistic online experiment on the effects of issue ads suggest that they can influence the perceived importance of an issue and perceptions of politicians associated with the featured policy while influencing support for policy only among those low in political awareness.
J Health Polit Policy Law. 2012 Feb 9. [Epub ahead of print]
Issue Ads and the Health Reform Debate.
Bergan D, Risner G.
Source
1 Michigan State University.
Abstract
The public debate over health care reform in 2009 was carried out partly through issue advertisements aired online and on television. Did these advertisements alter the course of the debate over health care reform? While millions of dollars are spent each year on issue ads, little is known about their effects. Results from a naturalistic online experiment on the effects of issue ads suggest that they can influence the perceived importance of an issue and perceptions of politicians associated with the featured policy while influencing support for policy only among those low in political awareness.
Not surprising: Tort reform and medical board complaints
http://www.ncbi.nlm.nih.gov/pubmed/22321519
J Am Coll Surg. 2012 Feb 7. [Epub ahead of print]
Tort Reform Is Associated with More Medical Board Complaints and Disciplinary Actions.
Stewart RM, Love JD, Rocheleau LA, Sirinek KR.
Source
Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX; University Hospital, San Antonio, TX.
Abstract
BACKGROUND:
Previous reports have confirmed that comprehensive tort reform in Texas (enacted in 2003) was associated with fewer lawsuits and less litigation-associated cost. We hypothesized that complaints to the Texas Medical Board (TMB) increased after tort reform.
STUDY DESIGN:
To test this hypothesis, we compared complaints, investigations, disciplinary actions, and penalties against physicians before and after comprehensive state tort reform measures were adopted. Data were obtained from the TMB for a 15-year period (1996 to 2010).
RESULTS:
When comparing the period before tort reform (1996 to 2002) with the period after tort reform (2004 to 2010), TMB complaints increased 13%; investigations opened increased 33%, disciplinary actions increased 96%, license revocations or surrenders increased 47%, and financial penalties increased 367%. All of these increases were statistically significant (p ≤ 0.01).
CONCLUSIONS:
After tort reform in Texas, the total number of complaints, investigations, disciplinary decisions, license revocations or surrenders, and financial penalties from the TMB significantly increased. In Texas, tort reform was accompanied by legislatively directed, enhanced oversight and activity of the authority (TMB) charged with regulation of the medical profession.
J Am Coll Surg. 2012 Feb 7. [Epub ahead of print]
Tort Reform Is Associated with More Medical Board Complaints and Disciplinary Actions.
Stewart RM, Love JD, Rocheleau LA, Sirinek KR.
Source
Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX; University Hospital, San Antonio, TX.
Abstract
BACKGROUND:
Previous reports have confirmed that comprehensive tort reform in Texas (enacted in 2003) was associated with fewer lawsuits and less litigation-associated cost. We hypothesized that complaints to the Texas Medical Board (TMB) increased after tort reform.
STUDY DESIGN:
To test this hypothesis, we compared complaints, investigations, disciplinary actions, and penalties against physicians before and after comprehensive state tort reform measures were adopted. Data were obtained from the TMB for a 15-year period (1996 to 2010).
RESULTS:
When comparing the period before tort reform (1996 to 2002) with the period after tort reform (2004 to 2010), TMB complaints increased 13%; investigations opened increased 33%, disciplinary actions increased 96%, license revocations or surrenders increased 47%, and financial penalties increased 367%. All of these increases were statistically significant (p ≤ 0.01).
CONCLUSIONS:
After tort reform in Texas, the total number of complaints, investigations, disciplinary decisions, license revocations or surrenders, and financial penalties from the TMB significantly increased. In Texas, tort reform was accompanied by legislatively directed, enhanced oversight and activity of the authority (TMB) charged with regulation of the medical profession.
Health care reform: the physicians' burden
http://www.ncbi.nlm.nih.gov/pubmed/22328692
Aesthet Surg J. 2012 Feb 1;32(2):230-5.
The current state of health care reform: the physicians' burden.
Horton JB, Hollier LH Jr.
Source
Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.
Abstract
Congress has passed expansive legislation to "fix" health care. US health care, however, is not "broken"; rather, it functions according to purpose. The legal standard sets health care's purpose as high-quality care, not care at a pervasive quantity or low cost. Juries focus on quality irrespective of cost, and the court's concern is not cost but whether the defendant physician has met the standard of care. As the US health system does deliver high-quality (albeit high-cost) care, it is not broken; instead, the system that defines it is broken. The legal system defines the standard of care as the care that an average physician would deliver under similar circumstances. As 91% of physicians admit to practicing defensively excessive care, the legal care standard is therefore excessive care. However, the new health care legislation passed by Congress does not address tort reform. Instead, it reduces physician remuneration and increases penalty-driven cost care control regulations. Caught between a care standard that demands high quality regardless of cost and penalty-driven federal mandates demanding low-cost care regardless of the legal care standard, physicians bear the new law's ultimate burden. US health care should not continue to focus on quality over cost and quantity; more important, the law should not continue to dictate that it do so. Rather, the system must import cost-effective care, and the law must so direct. To reduce health care costs, the legal system must first recognize a standard of care that respects cost-or tort reform that protects those physicians who do.
Aesthet Surg J. 2012 Feb 1;32(2):230-5.
The current state of health care reform: the physicians' burden.
Horton JB, Hollier LH Jr.
Source
Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.
Abstract
Congress has passed expansive legislation to "fix" health care. US health care, however, is not "broken"; rather, it functions according to purpose. The legal standard sets health care's purpose as high-quality care, not care at a pervasive quantity or low cost. Juries focus on quality irrespective of cost, and the court's concern is not cost but whether the defendant physician has met the standard of care. As the US health system does deliver high-quality (albeit high-cost) care, it is not broken; instead, the system that defines it is broken. The legal system defines the standard of care as the care that an average physician would deliver under similar circumstances. As 91% of physicians admit to practicing defensively excessive care, the legal care standard is therefore excessive care. However, the new health care legislation passed by Congress does not address tort reform. Instead, it reduces physician remuneration and increases penalty-driven cost care control regulations. Caught between a care standard that demands high quality regardless of cost and penalty-driven federal mandates demanding low-cost care regardless of the legal care standard, physicians bear the new law's ultimate burden. US health care should not continue to focus on quality over cost and quantity; more important, the law should not continue to dictate that it do so. Rather, the system must import cost-effective care, and the law must so direct. To reduce health care costs, the legal system must first recognize a standard of care that respects cost-or tort reform that protects those physicians who do.
Friday, February 3, 2012
Primary pleural neoplasia: Entities other than diffuse malignant mesothelioma
http://www.ncbi.nlm.nih.gov/pubmed/18605768
Arch Pathol Lab Med. 2008 Jul;132(7):1149-70.
Primary pleural neoplasia: entities other than diffuse malignant mesothelioma.
Guinee DG, Allen TC.
Source
Department of Pathology, Virginia Mason Medical Center, Seattle, WA, USA.
Abstract
CONTEXT:
Overwhelmingly, the most common neoplasm involving the pleura is metastatic carcinoma. In contrast, diffuse malignant mesothelioma occurs relatively rarely; however, it is nonetheless the most common neoplasm primary to the pleura. Metastatic carcinoma and diffuse malignant mesothelioma each have their own prognostic and therapeutic characteristics. Other primary pleural neoplasms occur uncommonly or rarely, with their own prognostic and therapeutic characteristics.
OBJECTIVE:
To review primary pleural neoplasms other than diffuse malignant mesothelioma, to better ensure correct diagnosis and optimal assessment of prognosis and treatment.
DATA SOURCES:
Literature review and primary material from the authors' institutions.
CONCLUSIONS:
A nonexhaustive group of uncommon to rare benign and malignant primary pleural neoplasms--other than diffuse malignant mesothelioma--are presented, of which one must be aware in order to maintain an appropriate index of suspicion to include them in the differential diagnosis of a pleural tumor.
Arch Pathol Lab Med. 2008 Jul;132(7):1149-70.
Primary pleural neoplasia: entities other than diffuse malignant mesothelioma.
Guinee DG, Allen TC.
Source
Department of Pathology, Virginia Mason Medical Center, Seattle, WA, USA.
Abstract
CONTEXT:
Overwhelmingly, the most common neoplasm involving the pleura is metastatic carcinoma. In contrast, diffuse malignant mesothelioma occurs relatively rarely; however, it is nonetheless the most common neoplasm primary to the pleura. Metastatic carcinoma and diffuse malignant mesothelioma each have their own prognostic and therapeutic characteristics. Other primary pleural neoplasms occur uncommonly or rarely, with their own prognostic and therapeutic characteristics.
OBJECTIVE:
To review primary pleural neoplasms other than diffuse malignant mesothelioma, to better ensure correct diagnosis and optimal assessment of prognosis and treatment.
DATA SOURCES:
Literature review and primary material from the authors' institutions.
CONCLUSIONS:
A nonexhaustive group of uncommon to rare benign and malignant primary pleural neoplasms--other than diffuse malignant mesothelioma--are presented, of which one must be aware in order to maintain an appropriate index of suspicion to include them in the differential diagnosis of a pleural tumor.
From Respirology: Pathology of the pleura-What the pulmonologists need to know
http://www.ncbi.nlm.nih.gov/pubmed/21362105
Respirology. 2011 Apr;16(3):430-8. doi: 10.1111/j.1440-1843.2011.01957.x.
Pathology of the pleura: what the pulmonologists need to know.
Cagle PT, Allen TC.
Source
Weill Medical College of Cornell University, New York, New York, USA. pcagle@tmhs.org
Abstract
Primary and metastatic pleural neoplasms, and non-neoplastic pleural diseases, can have similar clinical, radiographic and gross features. However, treatments and prognoses of these diverse pleural conditions vary greatly. Accurate diagnosis of pleural disease is therefore extremely important, and histological interpretation of pleural biopsies is vital to rendering an accurate diagnosis. Smaller biopsies contribute to the difficulties in accurately characterizing pleural lesions, and immunostains are frequently employed in their assessment. Diffuse malignant mesothelioma, the most common primary pulmonary neoplasm, is rare; however, other less common primary pleural neoplasms, including solitary fibrous tumour, the most common benign primary pleural neoplasm, occur. These neoplasms are discussed. Also, non-neoplastic pleural diseases, including granulomatous pleuritis, eosinophilic pleuritis and fibrous and fibrinous pleuritis, among other diseases, are discussed.
Respirology. 2011 Apr;16(3):430-8. doi: 10.1111/j.1440-1843.2011.01957.x.
Pathology of the pleura: what the pulmonologists need to know.
Cagle PT, Allen TC.
Source
Weill Medical College of Cornell University, New York, New York, USA. pcagle@tmhs.org
Abstract
Primary and metastatic pleural neoplasms, and non-neoplastic pleural diseases, can have similar clinical, radiographic and gross features. However, treatments and prognoses of these diverse pleural conditions vary greatly. Accurate diagnosis of pleural disease is therefore extremely important, and histological interpretation of pleural biopsies is vital to rendering an accurate diagnosis. Smaller biopsies contribute to the difficulties in accurately characterizing pleural lesions, and immunostains are frequently employed in their assessment. Diffuse malignant mesothelioma, the most common primary pulmonary neoplasm, is rare; however, other less common primary pleural neoplasms, including solitary fibrous tumour, the most common benign primary pleural neoplasm, occur. These neoplasms are discussed. Also, non-neoplastic pleural diseases, including granulomatous pleuritis, eosinophilic pleuritis and fibrous and fibrinous pleuritis, among other diseases, are discussed.
Localized malignant mesothelioma
http://www.ncbi.nlm.nih.gov/pubmed/15958850
Am J Surg Pathol. 2005 Jul;29(7):866-73.
Localized malignant mesothelioma.
Allen TC, Cagle PT, Churg AM, Colby TV, Gibbs AR, Hammar SP, Corson JM, Grimes MM, Ordonez NG, Roggli V, Travis WD, Wick MR.
Source
Department of Pathology, Baylor College of Medicine, Houston, TX, USA.
Abstract
Localized malignant mesotheliomas are uncommon sharply circumscribed tumors of the serosal membranes with the microscopic appearance of diffuse malignant mesothelioma but without any evidence of diffuse spread. Little is known about their behavior. We report 23 new cases. The mean age at presentation was 63 years, and the sex ratio was approximately 2:1 (male/female). Twenty-one tumors were pleural and 2 were peritoneal. Sixteen tumors reproduced microscopic patterns of diffuse epithelial mesotheliomas, 6 had mixed epithelial and sarcomatous patterns, and 1 was purely sarcomatous. After surgical excision of the tumor, 10 of 21 patients with follow-up data were alive without evidence of disease from 18 months to 11 years after diagnosis. Patients who died had developed local recurrences and metastases, but none had diffuse pleural spread. Localized malignant mesotheliomas should be separated from diffuse malignant mesotheliomas because of their localized presentation, quite different biologic behavior, and far better prognosis.
Am J Surg Pathol. 2005 Jul;29(7):866-73.
Localized malignant mesothelioma.
Allen TC, Cagle PT, Churg AM, Colby TV, Gibbs AR, Hammar SP, Corson JM, Grimes MM, Ordonez NG, Roggli V, Travis WD, Wick MR.
Source
Department of Pathology, Baylor College of Medicine, Houston, TX, USA.
Abstract
Localized malignant mesotheliomas are uncommon sharply circumscribed tumors of the serosal membranes with the microscopic appearance of diffuse malignant mesothelioma but without any evidence of diffuse spread. Little is known about their behavior. We report 23 new cases. The mean age at presentation was 63 years, and the sex ratio was approximately 2:1 (male/female). Twenty-one tumors were pleural and 2 were peritoneal. Sixteen tumors reproduced microscopic patterns of diffuse epithelial mesotheliomas, 6 had mixed epithelial and sarcomatous patterns, and 1 was purely sarcomatous. After surgical excision of the tumor, 10 of 21 patients with follow-up data were alive without evidence of disease from 18 months to 11 years after diagnosis. Patients who died had developed local recurrences and metastases, but none had diffuse pleural spread. Localized malignant mesotheliomas should be separated from diffuse malignant mesotheliomas because of their localized presentation, quite different biologic behavior, and far better prognosis.
Localized malignant mesothelioma presenting as Sister Mary Joseph's nodule
http://www.ncbi.nlm.nih.gov/pubmed/21279927
Zentralbl Chir. 2011 Apr;136(2):172-4. Epub 2011 Jan 28.
Sister Mary Joseph's nodule as primary localized malignant mesothelioma. Report of a case.
Papalambros A, Sigala F, Vouza EG, Hepp W, Antonakis P.
Source
Medical School, University of Athens, First Surgical Department, Laiko Hospital, Athens, Greece. antonakispantelis@yahoo.com
Zentralbl Chir. 2011 Apr;136(2):172-4. Epub 2011 Jan 28.
Sister Mary Joseph's nodule as primary localized malignant mesothelioma. Report of a case.
Papalambros A, Sigala F, Vouza EG, Hepp W, Antonakis P.
Source
Medical School, University of Athens, First Surgical Department, Laiko Hospital, Athens, Greece. antonakispantelis@yahoo.com
Localized malignant mesothelioma with lymphohistiocytoid histology
http://www.ncbi.nlm.nih.gov/pubmed/21520787
Acta Chir Belg. 2011 Jan-Feb;111(1):38-43.
Localized malignant lymphohistiocytoid pleural mesothelioma.
Ouazzani A, Rondelet B, Sokolow Y, Ruiz Patino M, Remmelink M, Cappello M.
Source
Department of Thoracic Surgery, Erasme University Hospital, Brussels, Belgium.
Abstract
We report a case of a 42-year-old man with a right pleural mesothelioma. This neoplasm has 3 rare features. Firstly, it was a localized form: suspected by imaging, visualized by video-assisted thoracoscopy, at the time of the curative-thoracotomy and confirmed by the pathological analysis. The second characteristic is its histological type: "malignant lymphohistiocytoid mesothelioma". This rare subtype has been reported in only 4 papers. Third, after pleuro-pneumonectomy, our patient is alive after 6 years and 5 months postoperatively without any sign of recurrence. Only one case with a long follow-up has been reported but with recurrence at 5 years postoperatively.
Acta Chir Belg. 2011 Jan-Feb;111(1):38-43.
Localized malignant lymphohistiocytoid pleural mesothelioma.
Ouazzani A, Rondelet B, Sokolow Y, Ruiz Patino M, Remmelink M, Cappello M.
Source
Department of Thoracic Surgery, Erasme University Hospital, Brussels, Belgium.
Abstract
We report a case of a 42-year-old man with a right pleural mesothelioma. This neoplasm has 3 rare features. Firstly, it was a localized form: suspected by imaging, visualized by video-assisted thoracoscopy, at the time of the curative-thoracotomy and confirmed by the pathological analysis. The second characteristic is its histological type: "malignant lymphohistiocytoid mesothelioma". This rare subtype has been reported in only 4 papers. Third, after pleuro-pneumonectomy, our patient is alive after 6 years and 5 months postoperatively without any sign of recurrence. Only one case with a long follow-up has been reported but with recurrence at 5 years postoperatively.
PET-CT in the diagnosis of pleural localized malignant mesothelioma
http://www.ncbi.nlm.nih.gov/pubmed/22040794
Clin Imaging. 2011 Nov-Dec;35(6):476-7.
PET-CT in the diagnosis of localized malignant pleural mesothelioma.
Dimarakis I, Rehman S, Machaal A, Shah R.
Source
Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, UK. ioannis.dimarakis@imperial.ac.uk
Abstract
A 67-year-old man presented with right-sided chest and shoulder pain. Chest roentgenogram demonstrated a right upper zone shadow. Computed tomography (CT) revealed a pleural mass and adjacent chest wall disease. Image-guided percutaneous biopsy suggested malignant mesothelioma. We describe the use of 18-fluorodeoxyglucose-positron emission tomography (PET-CT) in the diagnosis and management of localized malignant mesothelioma.
Clin Imaging. 2011 Nov-Dec;35(6):476-7.
PET-CT in the diagnosis of localized malignant pleural mesothelioma.
Dimarakis I, Rehman S, Machaal A, Shah R.
Source
Department of Cardiothoracic Surgery, University Hospital South Manchester, Manchester, UK. ioannis.dimarakis@imperial.ac.uk
Abstract
A 67-year-old man presented with right-sided chest and shoulder pain. Chest roentgenogram demonstrated a right upper zone shadow. Computed tomography (CT) revealed a pleural mass and adjacent chest wall disease. Image-guided percutaneous biopsy suggested malignant mesothelioma. We describe the use of 18-fluorodeoxyglucose-positron emission tomography (PET-CT) in the diagnosis and management of localized malignant mesothelioma.
From U British Columbia: Ethical issues of consumer genetic testing
http://www.ncbi.nlm.nih.gov/pubmed/22290190
J Genet Couns. 2012 Jan 31. [Epub ahead of print]
Genetic Counseling and the Ethical Issues Around Direct to Consumer Genetic Testing.
Hawkins AK, Ho A.
Source
Centre for Applied Ethics, University of British Columbia, 227-6356 Agricultural Road, Vancouver, BC, V6T1Z2, Canada, alicehaw@exchange.ubc.ca.
Abstract
Over the last several years, direct to consumer (DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism, particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely, promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethical lens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately, when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions, but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic-based healthcare system.
J Genet Couns. 2012 Jan 31. [Epub ahead of print]
Genetic Counseling and the Ethical Issues Around Direct to Consumer Genetic Testing.
Hawkins AK, Ho A.
Source
Centre for Applied Ethics, University of British Columbia, 227-6356 Agricultural Road, Vancouver, BC, V6T1Z2, Canada, alicehaw@exchange.ubc.ca.
Abstract
Over the last several years, direct to consumer (DTC) genetic testing has received increasing attention in the public, healthcare and academic realms. DTC genetic testing companies face considerable criticism and scepticism, particularly from the medical and genetic counseling community. This raises the question of what specific aspects of DTC genetic testing provoke concerns, and conversely, promises, for genetic counselors. This paper addresses this question by exploring DTC genetic testing through an ethical lens. By considering the fundamental ethical approaches influencing genetic counseling (the ethic of care and principle-based ethics) we highlight the specific ethical concerns raised by DTC genetic testing companies. Ultimately, when considering the ethics of DTC testing in a genetic counseling context, we should think of it as a balancing act. We need careful and detailed consideration of the risks and troubling aspects of such testing, as well as the potentially beneficial direct and indirect impacts of the increased availability of DTC genetic testing. As a result it is essential that genetic counselors stay informed and involved in the ongoing debate about DTC genetic testing and DTC companies. Doing so will ensure that the ethical theories and principles fundamental to the profession of genetic counseling are promoted not just in traditional counseling sessions, but also on a broader level. Ultimately this will help ensure that the public enjoys the benefits of an increasingly genetic-based healthcare system.
From Bioethics: The ethics of placebo
http://www.ncbi.nlm.nih.gov/pubmed/22296589
Bioethics. 2012 Feb 2. doi: 10.1111/j.1467-8519.2011.01943.x. [Epub ahead of print]
REEXAMINATION OF THE ETHICS OF PLACEBO USE IN CLINICAL PRACTICE.
Asai A, Kadooka Y.
Source
Kumamoto University Graduate School of Medical Science.
Abstract
A placebo is a substance or intervention believed to be inactive, but is administered by the healthcare professional as if it was an active medication. Unlike standard treatments, clinical use of placebo usually involves deception and is therefore ethically problematic. Our attitudes toward the clinical use of placebo, which inevitably includes deception or withholding information, have a tremendous effect on our practice regarding truth-telling and informed consent. A casual attitude towards it weakens the current practice based on shared decision-making and mutual trust between patients and healthcare professionals. Issues concerning the clinical use of placebo are thus intimately related to patient-provider relationships, the public's trust in medicine, and medical education. A review of recent survey studies suggests that the clinical use of placebo appears to be fairly well accepted among healthcare professionals and is common in clinical settings in various countries. However, we think that an ethical discussion is urgently needed because of its controversial nature. If judged to be ethically wrong, the practice should end. In the present paper, we discuss the ethicality of the clinical use of placebo with deception and argue against it, concluding that it is unethical and should be banned. We will show that most arguments in favor of the clinical use of placebo can be refuted and are therefore incorrect or weak. These arguments will be presented and examined individually. Finally, we will briefly consider issues relevant to the clinical use of placebo without deception.
Bioethics. 2012 Feb 2. doi: 10.1111/j.1467-8519.2011.01943.x. [Epub ahead of print]
REEXAMINATION OF THE ETHICS OF PLACEBO USE IN CLINICAL PRACTICE.
Asai A, Kadooka Y.
Source
Kumamoto University Graduate School of Medical Science.
Abstract
A placebo is a substance or intervention believed to be inactive, but is administered by the healthcare professional as if it was an active medication. Unlike standard treatments, clinical use of placebo usually involves deception and is therefore ethically problematic. Our attitudes toward the clinical use of placebo, which inevitably includes deception or withholding information, have a tremendous effect on our practice regarding truth-telling and informed consent. A casual attitude towards it weakens the current practice based on shared decision-making and mutual trust between patients and healthcare professionals. Issues concerning the clinical use of placebo are thus intimately related to patient-provider relationships, the public's trust in medicine, and medical education. A review of recent survey studies suggests that the clinical use of placebo appears to be fairly well accepted among healthcare professionals and is common in clinical settings in various countries. However, we think that an ethical discussion is urgently needed because of its controversial nature. If judged to be ethically wrong, the practice should end. In the present paper, we discuss the ethicality of the clinical use of placebo with deception and argue against it, concluding that it is unethical and should be banned. We will show that most arguments in favor of the clinical use of placebo can be refuted and are therefore incorrect or weak. These arguments will be presented and examined individually. Finally, we will briefly consider issues relevant to the clinical use of placebo without deception.
From U Alabama-Birmingham: Medical ethics, doing/allowing, and physician-assisted suicide
http://www.ncbi.nlm.nih.gov/pubmed/22296611
Bioethics. 2012 Feb 2. doi: 10.1111/j.1467-8519.2011.01944.x. [Epub ahead of print]
MORAL FICTION OR MORAL FACT? THE DISTINCTION BETWEEN DOING AND ALLOWING IN MEDICAL ETHICS.
Huddle TS.
Source
University of Alabama-at-Birmingham School of Medicine and the Birimingham VA Medical Center.
Abstract
Opponents of physician-assisted suicide (PAS) maintain that physician withdrawal-of-life-sustaining-treatment cannot be morally equated to voluntary active euthanasia. PAS opponents generally distinguish these two kinds of act by positing a possible moral distinction between killing and allowing-to-die, ceteris paribus. While that distinction continues to be widely accepted in the public discourse, it has been more controversial among philosophers. Some ethicist PAS advocates are so certain that the distinction is invalid that they describe PAS opponents who hold to the distinction as in the grip of 'moral fictions'. The author contends that such a diagnosis is too hasty. The possibility of a moral distinction between active euthanasia and allowing-to-die has not been closed off by the argumentative strategies employed by these PAS advocates, including the contrasting cases strategy and the assimilation of doing and allowing to a common sense notion of causation. The philosophical debate over the doing/allowing distinction remains inconclusive, but physicians and others who rely upon that distinction in thinking about the ethics of end-of-life care need not give up on it in response to these arguments.
Bioethics. 2012 Feb 2. doi: 10.1111/j.1467-8519.2011.01944.x. [Epub ahead of print]
MORAL FICTION OR MORAL FACT? THE DISTINCTION BETWEEN DOING AND ALLOWING IN MEDICAL ETHICS.
Huddle TS.
Source
University of Alabama-at-Birmingham School of Medicine and the Birimingham VA Medical Center.
Abstract
Opponents of physician-assisted suicide (PAS) maintain that physician withdrawal-of-life-sustaining-treatment cannot be morally equated to voluntary active euthanasia. PAS opponents generally distinguish these two kinds of act by positing a possible moral distinction between killing and allowing-to-die, ceteris paribus. While that distinction continues to be widely accepted in the public discourse, it has been more controversial among philosophers. Some ethicist PAS advocates are so certain that the distinction is invalid that they describe PAS opponents who hold to the distinction as in the grip of 'moral fictions'. The author contends that such a diagnosis is too hasty. The possibility of a moral distinction between active euthanasia and allowing-to-die has not been closed off by the argumentative strategies employed by these PAS advocates, including the contrasting cases strategy and the assimilation of doing and allowing to a common sense notion of causation. The philosophical debate over the doing/allowing distinction remains inconclusive, but physicians and others who rely upon that distinction in thinking about the ethics of end-of-life care need not give up on it in response to these arguments.
LRP-1 regulates collagen 1 expression, proteolysis, and migration in human pleural mesothelial cells
http://www.ncbi.nlm.nih.gov/pubmed/22298529
Am J Respir Cell Mol Biol. 2012 Feb;46(2):196-206.
Lipoprotein receptor-related protein 1 regulates collagen 1 expression, proteolysis, and migration in human pleural mesothelial cells.
Tucker TA, Williams L, Koenig K, Kothari H, Komissarov AA, Florova G, Mazar AP, Allen TC, Bdeir K, Mohan Rao LV, Idell S.
Source
The Texas Lung Injury Institute, The University of Texas Health Science Center at Tyler, 11937 US HWY 271, Biomedical Research Building, Lab C-5, Tyler, TX 75708. torry.tucker@uthct.edu.
Abstract
The low-density lipoprotein receptor-related protein 1 (LRP-1) binds and can internalize a diverse group of ligands, including members of the fibrinolytic pathway, urokinase plasminogen activator (uPA), and its receptor, uPAR. In this study, we characterized the role of LRP-1 in uPAR processing, collagen synthesis, proteolysis, and migration in pleural mesothelial cells (PMCs). When PMCs were treated with the proinflammatory cytokines TNF-α and IL-1β, LRP-1 significantly decreased at the mRNA and protein levels (70 and 90%, respectively; P < 0.05). Consequently, uPA-mediated uPAR internalization was reduced by 80% in the presence of TNF-α or IL-1β (P < 0.05). In parallel studies, LRP-1 neutralization with receptor-associated protein (RAP) significantly reduced uPA-dependent uPAR internalization and increased uPAR stability in PMCs. LRP-1-deficient cells demonstrated increased uPAR t(1/2) versus LRP-1-expressing PMCs. uPA enzymatic activity was also increased in LRP-1-deficient and neutralized cells, and RAP potentiated uPA-dependent migration in PMCs. Collagen expression in PMCs was also induced by uPA, and the effect was potentiated in RAP-treated cells. These studies indicate that TNF-α and IL-1β regulate LRP-1 in PMCs and that LRP-1 thereby contributes to a range of pathophysiologically relevant responses of these cells.
Am J Respir Cell Mol Biol. 2012 Feb;46(2):196-206.
Lipoprotein receptor-related protein 1 regulates collagen 1 expression, proteolysis, and migration in human pleural mesothelial cells.
Tucker TA, Williams L, Koenig K, Kothari H, Komissarov AA, Florova G, Mazar AP, Allen TC, Bdeir K, Mohan Rao LV, Idell S.
Source
The Texas Lung Injury Institute, The University of Texas Health Science Center at Tyler, 11937 US HWY 271, Biomedical Research Building, Lab C-5, Tyler, TX 75708. torry.tucker@uthct.edu.
Abstract
The low-density lipoprotein receptor-related protein 1 (LRP-1) binds and can internalize a diverse group of ligands, including members of the fibrinolytic pathway, urokinase plasminogen activator (uPA), and its receptor, uPAR. In this study, we characterized the role of LRP-1 in uPAR processing, collagen synthesis, proteolysis, and migration in pleural mesothelial cells (PMCs). When PMCs were treated with the proinflammatory cytokines TNF-α and IL-1β, LRP-1 significantly decreased at the mRNA and protein levels (70 and 90%, respectively; P < 0.05). Consequently, uPA-mediated uPAR internalization was reduced by 80% in the presence of TNF-α or IL-1β (P < 0.05). In parallel studies, LRP-1 neutralization with receptor-associated protein (RAP) significantly reduced uPA-dependent uPAR internalization and increased uPAR stability in PMCs. LRP-1-deficient cells demonstrated increased uPAR t(1/2) versus LRP-1-expressing PMCs. uPA enzymatic activity was also increased in LRP-1-deficient and neutralized cells, and RAP potentiated uPA-dependent migration in PMCs. Collagen expression in PMCs was also induced by uPA, and the effect was potentiated in RAP-treated cells. These studies indicate that TNF-α and IL-1β regulate LRP-1 in PMCs and that LRP-1 thereby contributes to a range of pathophysiologically relevant responses of these cells.
From MD Anderson: Plagerism, patchwriting, and the English language
http://www.ncbi.nlm.nih.gov/pubmed/22104051
Acad Med. 2012 Jan;87(1):51-4.
Perspective: publication ethics and the emerging scientific workforce: understanding "plagiarism" in a global context.
Cameron C, Zhao H, McHugh MK.
Source
Cancer Prevention Research Training Program, Division of Cancer Prevention and Population Sciences, Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, 77230-3721, USA. ccameron@mdanderson.org
Abstract
English has long been the dominant language of scientific publication, and it is rapidly approaching near-complete hegemony. The majority of the scientists publishing in English-language journals are not native English speakers, however. This imbalance has important implications for training concerning ethics and enforcement of publication standards, particularly with respect to plagiarism. The authors suggest that lack of understanding of what constitutes plagiarism and the use of a linguistic support strategy known as "patchwriting" can lead to inadvertent misuse of source material by nonnative speakers writing in English as well as to unfounded accusations of intentional scientific misconduct on the part of these authors. They propose that a rational and well-informed dialogue about this issue is needed among editors, educators, administrators, and both native-English-speaking and nonnative-English-speaking writers. They offer recommendations for creating environments in which such dialogue and training can occur.
Acad Med. 2012 Jan;87(1):51-4.
Perspective: publication ethics and the emerging scientific workforce: understanding "plagiarism" in a global context.
Cameron C, Zhao H, McHugh MK.
Source
Cancer Prevention Research Training Program, Division of Cancer Prevention and Population Sciences, Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, 77230-3721, USA. ccameron@mdanderson.org
Abstract
English has long been the dominant language of scientific publication, and it is rapidly approaching near-complete hegemony. The majority of the scientists publishing in English-language journals are not native English speakers, however. This imbalance has important implications for training concerning ethics and enforcement of publication standards, particularly with respect to plagiarism. The authors suggest that lack of understanding of what constitutes plagiarism and the use of a linguistic support strategy known as "patchwriting" can lead to inadvertent misuse of source material by nonnative speakers writing in English as well as to unfounded accusations of intentional scientific misconduct on the part of these authors. They propose that a rational and well-informed dialogue about this issue is needed among editors, educators, administrators, and both native-English-speaking and nonnative-English-speaking writers. They offer recommendations for creating environments in which such dialogue and training can occur.
From Illinois Valley Community College: Educating students to avoid plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22157995
Nurse Educ. 2012 Jan-Feb;37(1):12-6.
Plagiarism: using a collaborative approach in an online allied health professions course.
Pence PL.
Source
Nursing, Illinois Valley Community College, Oglesby, IL 61348, USA. pat_pence@ivcc.edu
Abstract
The purpose of the study was to evaluate the effectiveness of interventions to increase the awareness and understanding of plagiarism among undergraduate students enrolled in an online allied health professions course in a community college in the Midwestern United States. The results suggested that the interventions were effective in educating students about how to avoid plagiarism.
Nurse Educ. 2012 Jan-Feb;37(1):12-6.
Plagiarism: using a collaborative approach in an online allied health professions course.
Pence PL.
Source
Nursing, Illinois Valley Community College, Oglesby, IL 61348, USA. pat_pence@ivcc.edu
Abstract
The purpose of the study was to evaluate the effectiveness of interventions to increase the awareness and understanding of plagiarism among undergraduate students enrolled in an online allied health professions course in a community college in the Midwestern United States. The results suggested that the interventions were effective in educating students about how to avoid plagiarism.
Prevalence of plagerism in recent submissions to the Croatian Medical Journal (11%!)
http://www.ncbi.nlm.nih.gov/pubmed/22207497
Sci Eng Ethics. 2011 Dec 30. [Epub ahead of print]
Prevalence of Plagiarism in Recent Submissions to the Croatian Medical Journal.
Baždarić K, Bilić-Zulle L, Brumini G, Petrovečki M.
Source
Department of Medical Informatics, Rijeka University School of Medicine, Brace Branchetta 20, 51000, Rijeka, Croatia, bksenija@medri.hr.
Abstract
To assess the prevalence of plagiarism in manuscripts submitted for publication in the Croatian Medical Journal (CMJ). All manuscripts submitted in 2009-2010 were analyzed using plagiarism detection software: eTBLAST, CrossCheck, and WCopyfind. Plagiarism was suspected in manuscripts with more than 10% of the text derived from other sources. These manuscripts were checked against the Déjà vu database and manually verified by investigators. Of 754 submitted manuscripts, 105 (14%) were identified by the software as suspicious of plagiarism. Manual verification confirmed that 85 (11%) manuscripts were plagiarized: 63 (8%) were true plagiarism and 22 (3%) were self-plagiarism. Plagiarized manuscripts were mostly submitted from China (21%), Croatia (14%), and Turkey (19%). There was no significant difference in the text similarity rate between plagiarized and self-plagiarized manuscripts (25% [95% CI 22-27%] vs. 28% [95% CI 20-33%]; U = 645.50; P = 0.634). Differences in text similarity rate were found between various sections of self-plagiarized manuscripts (H = 12.65, P = 0.013). The plagiarism rate in the Materials and Methods (61% (95% CI 41-68%) was higher than in the Results (23% [95% CI 17-36%], U = 33.50; P = 0.009) or Discussion (25.5 [95% CI 15-35%]; U = 57.50; P < 0.001) sections. Three authors were identified in the Déjà vu database. Plagiarism detection software combined with manual verification may be used to detect plagiarized manuscripts and prevent their publication. The prevalence of plagiarized manuscripts submitted to the CMJ, a journal dedicated to promoting research integrity, was 11% in the 2-year period 2009-2010.
Sci Eng Ethics. 2011 Dec 30. [Epub ahead of print]
Prevalence of Plagiarism in Recent Submissions to the Croatian Medical Journal.
Baždarić K, Bilić-Zulle L, Brumini G, Petrovečki M.
Source
Department of Medical Informatics, Rijeka University School of Medicine, Brace Branchetta 20, 51000, Rijeka, Croatia, bksenija@medri.hr.
Abstract
To assess the prevalence of plagiarism in manuscripts submitted for publication in the Croatian Medical Journal (CMJ). All manuscripts submitted in 2009-2010 were analyzed using plagiarism detection software: eTBLAST, CrossCheck, and WCopyfind. Plagiarism was suspected in manuscripts with more than 10% of the text derived from other sources. These manuscripts were checked against the Déjà vu database and manually verified by investigators. Of 754 submitted manuscripts, 105 (14%) were identified by the software as suspicious of plagiarism. Manual verification confirmed that 85 (11%) manuscripts were plagiarized: 63 (8%) were true plagiarism and 22 (3%) were self-plagiarism. Plagiarized manuscripts were mostly submitted from China (21%), Croatia (14%), and Turkey (19%). There was no significant difference in the text similarity rate between plagiarized and self-plagiarized manuscripts (25% [95% CI 22-27%] vs. 28% [95% CI 20-33%]; U = 645.50; P = 0.634). Differences in text similarity rate were found between various sections of self-plagiarized manuscripts (H = 12.65, P = 0.013). The plagiarism rate in the Materials and Methods (61% (95% CI 41-68%) was higher than in the Results (23% [95% CI 17-36%], U = 33.50; P = 0.009) or Discussion (25.5 [95% CI 15-35%]; U = 57.50; P < 0.001) sections. Three authors were identified in the Déjà vu database. Plagiarism detection software combined with manual verification may be used to detect plagiarized manuscripts and prevent their publication. The prevalence of plagiarized manuscripts submitted to the CMJ, a journal dedicated to promoting research integrity, was 11% in the 2-year period 2009-2010.
From Yale: Children's responses to plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22213911
Dev Sci. 2011 Mar;14(2):431-9.
‘No fair, copycat!’: what children’s response to plagiarism tells us about their understanding of ideas.
Olson KR, Shaw A.
Source
Department of Psychology, Yale University, New Haven, CT 06520, USA. kristina.olson@yale.edu
Abstract
Adults believe that plagiarizing ideas is wrong, which requires an understanding that others can have ideas and that it is wrong to copy them. In order to test when this understanding emerges, we investigated when children begin to think plagiarism is wrong. In Study 1, children aged 7, 9 and 11 years old, as well as adults, disliked someone who plagiarized compared to someone who drew an original drawing or someone who drew an identical picture by chance. Study 2 investigated the same question with younger children, focusing on children aged 3–6 years old. Children aged 5–6 years old evaluated plagiarizers negatively relative to unique drawers, but 3–4-year-olds did not. Study 3 replicated the findings from Study 2 and found that children justify their negative evaluations of plagiarizers by mentioning concerns over copying. These experiments provide evidence that, by age 5 years old, children understand that others have ideas and dislike the copying of these ideas.
Dev Sci. 2011 Mar;14(2):431-9.
‘No fair, copycat!’: what children’s response to plagiarism tells us about their understanding of ideas.
Olson KR, Shaw A.
Source
Department of Psychology, Yale University, New Haven, CT 06520, USA. kristina.olson@yale.edu
Abstract
Adults believe that plagiarizing ideas is wrong, which requires an understanding that others can have ideas and that it is wrong to copy them. In order to test when this understanding emerges, we investigated when children begin to think plagiarism is wrong. In Study 1, children aged 7, 9 and 11 years old, as well as adults, disliked someone who plagiarized compared to someone who drew an original drawing or someone who drew an identical picture by chance. Study 2 investigated the same question with younger children, focusing on children aged 3–6 years old. Children aged 5–6 years old evaluated plagiarizers negatively relative to unique drawers, but 3–4-year-olds did not. Study 3 replicated the findings from Study 2 and found that children justify their negative evaluations of plagiarizers by mentioning concerns over copying. These experiments provide evidence that, by age 5 years old, children understand that others have ideas and dislike the copying of these ideas.
From U Hong Kong: Copying and plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22212356
Sci Eng Ethics. 2012 Jan 3. [Epub ahead of print]
Text-Based Plagiarism in Scientific Writing: What Chinese Supervisors Think About Copying and How to Reduce it in Students' Writing.
Li Y.
Source
Faculty of Education, University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong, yongyan@hku.hk.
Abstract
Text-based plagiarism, or textual copying, typically in the form of replicating or patchwriting sentences in a row from sources, seems to be an issue of growing concern among scientific journal editors. Editors have emphasized that senior authors (typically supervisors of science students) should take the responsibility for educating novices against text-based plagiarism. To address a research gap in the literature as to how scientist supervisors perceive the issue of textual copying and what they do in educating their students, this paper reports an interview study with 14 supervisors at a research-oriented Chinese university. The study throws light on the potentiality of senior authors mentoring novices in English as an Additional Language (EAL) contexts and has implications for the efforts that can be made in the wider scientific community to support scientists in writing against text-based plagiarism.
Sci Eng Ethics. 2012 Jan 3. [Epub ahead of print]
Text-Based Plagiarism in Scientific Writing: What Chinese Supervisors Think About Copying and How to Reduce it in Students' Writing.
Li Y.
Source
Faculty of Education, University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong, yongyan@hku.hk.
Abstract
Text-based plagiarism, or textual copying, typically in the form of replicating or patchwriting sentences in a row from sources, seems to be an issue of growing concern among scientific journal editors. Editors have emphasized that senior authors (typically supervisors of science students) should take the responsibility for educating novices against text-based plagiarism. To address a research gap in the literature as to how scientist supervisors perceive the issue of textual copying and what they do in educating their students, this paper reports an interview study with 14 supervisors at a research-oriented Chinese university. The study throws light on the potentiality of senior authors mentoring novices in English as an Additional Language (EAL) contexts and has implications for the efforts that can be made in the wider scientific community to support scientists in writing against text-based plagiarism.
Copying, conflicts of interest, and plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22287538
Biomed Mater. 2012 Jan 27;7(1):010201. [Epub ahead of print]
Coping with copying and conflicts (of interest).
Lee IS, Spector M.
Abstract
As we reflect on the past year, we applaud the efforts of the contributing authors and of the editorial staff, Editorial Board, and referees of Biomedical Materials (BMM), which have resulted in an increase in the journal's Impact Factor to 2.467. The importance of the papers published this past year is demonstrated in part by the increase in the number of downloads, from an average of 126 downloads per article in 2010 to 226 in 2011. And as we look ahead to 2012, highlights include focus issues on 'Injectable Hydrogels for Tissue/Organ Repair', guest edited by J A Burdick, and 'Biomaterials in Translational Regenerative Medicine', guest edited by A Atala and S J Lee. Moreover, Institute of Physics Publishing (IOPP) will be implementing the publication of future articles in BMM in an enhanced HTML format as an additional convenience for readers. BMM remains ever attentive to maintaining the highest standards in publishing work principally focused on biomaterials for use in tissue engineering and regenerative medicine, including assurance that the papers represent unpublished and unbiased work. To ensure that this is the case, IOPP has taken all steps possible including the use of the newest text screening software. But even with these safeguards in place, and the attendant vigilance of referees, it continues to be you, the reader, who is the final arbiter of the veracity of a published scientific paper. Fortunately, plagiarism, particularly involving unauthorized and non-credited use of previously reported data from investigators other than those taking credit for the work, is exceedingly rare. But there is another form of copying/duplication that is much more prevalent. It is when authors copy text from the introduction, materials and methods, and/or discussion sections from one of their papers for use in another. This practice may seem particularly innocuous when the text is that which describes experimental methods. And there are times when a sentence or two or three from the introduction or discussion of a paper have been so well crafted to capture the subject, that it seems a shame not to use the text in a subsequent manuscript on a similar topic. But, of course, while seemingly innocuous, unless quotation marks are inserted around the passage and a reference citation is included, this is not an acceptable practice. In accepting the conditions for publication of their work in BMM or most other journals, authors sign a Transfer of Copyright agreement that assigns exclusively to the publisher the worldwide copyright to, i.e. ownership of, all text as well as all other content of the paper. And now, with software widely available to check the similarity of text of a new paper with that of all prior publications, copied text can be readily detected, placing the reputations of the authors in jeopardy. One such software package is eTBLAST (http://etest.vbi.vt.edu/etblast3/), which is a free web-based service of The Innovation Laboratory at the Virginia Bioinformatics Institute, Blacksburg, VA, USA. eTBLAST compares text submitted by the user to the full text of previously published papers in several databases, including PubMed. Another text comparison software package with a similar purpose is iThenticate (http://www.ithenticate.com/). IOPP is a member of CrossCheck (http://www.crossref.org/crosscheck/), a plagiarism detection service that employs iThenticate to compare text in a submitted manuscript with published manuscripts from more than 50 publishers. When the BMM editorial staff are alerted to the similarity in whole passages (i.e. several sentences in a row or full paragraphs) of a submitted paper with the text of a prior publication, the paper is immediately returned, without review, to the authors with a notification of the duplication. An important service is thus being rendered to the authors, because if the duplication had gone undetected by the BMM staff, a consequence is that it would likely have been detected eventually by certain surveillance groups [1], who are examining publications worldwide for duplicated material and then publishing their results in a freely accessible database, 'Deja vu: a Database of Highly Similar Citations' (http://spore.vbi.vt.edu/dejavu/). Deja vu lists the authors and their works which display duplication. This is one list that I do not think that any of us want to be on. So the cautionary note for us, as authors, is to avoid copying text from one of our papers into another of our papers, even though that text may simply be a description of methods. Another area requiring the attention of authors, and readers, is the bias that comes with 'conflict of interest'. As with most other publishers, IOPP requests that authors disclose potential conflicts of interest in their manuscripts and that referees, too, report potential conflicts to the editorial office. Understandably the principal criterion for establishing whether a conflict exists relates to financial involvement of the authors, or referees, in the work being reported. But recognizing that financial interests alone do not capture the spirit of assurance that the work is free of bias, IOPP, in their Ethical Policy, asks authors to consider two practical guidelines: (1) 'to declare any competing interests that could embarrass you were they to become publicly known after your work was published; and (2) to declare any information which, when revealed later, would make a reasonable reader feel misled or deceived.' And for referees, the IOPP Ethical Policy requests that individuals act within the spirit of the Nolan Principles of Public Life (http://www.archive.official-documents.co.uk/document/parlment/nolan/seven.htm). In fact, the most prevalent conflict is likely unrelated to financial interests. It comes in the form of a bias that authors may bring with them to a work, based on their prior studies of a subject and their professional stake in a certain biomaterial or process or concept. Many of us are vested in a certain material system or treatment or point of view and, thus, even with an absence of any financial involvement, may overstate the promise of experimental findings. The methods and data are valid and clearly stated in black and white, but the interpretation of the findings may be just a bit colored. There is no editorial disclosure form that is likely to be able to screen for this type of bias. And while it is up to the referees to determine the appropriateness of the conclusions drawn from the experimental results, in the end it is the reader who will be the judge of the meaningfulness of the reported findings. Readers of BMM can remain assured that IOPP, and the editorial staff, Editorial Board, and referees will continue to do their best to have papers published in the journal meet the highest standards for publication. But as always, it will be you, the reader, who will be the final judge of the meaningfulness of the papers published in BMM. Reference [1] Couzin-Frankel J and Grom J 2009 Scientific publishing. Plagiarism sleuths Science 324 1004-7.
Biomed Mater. 2012 Jan 27;7(1):010201. [Epub ahead of print]
Coping with copying and conflicts (of interest).
Lee IS, Spector M.
Abstract
As we reflect on the past year, we applaud the efforts of the contributing authors and of the editorial staff, Editorial Board, and referees of Biomedical Materials (BMM), which have resulted in an increase in the journal's Impact Factor to 2.467. The importance of the papers published this past year is demonstrated in part by the increase in the number of downloads, from an average of 126 downloads per article in 2010 to 226 in 2011. And as we look ahead to 2012, highlights include focus issues on 'Injectable Hydrogels for Tissue/Organ Repair', guest edited by J A Burdick, and 'Biomaterials in Translational Regenerative Medicine', guest edited by A Atala and S J Lee. Moreover, Institute of Physics Publishing (IOPP) will be implementing the publication of future articles in BMM in an enhanced HTML format as an additional convenience for readers. BMM remains ever attentive to maintaining the highest standards in publishing work principally focused on biomaterials for use in tissue engineering and regenerative medicine, including assurance that the papers represent unpublished and unbiased work. To ensure that this is the case, IOPP has taken all steps possible including the use of the newest text screening software. But even with these safeguards in place, and the attendant vigilance of referees, it continues to be you, the reader, who is the final arbiter of the veracity of a published scientific paper. Fortunately, plagiarism, particularly involving unauthorized and non-credited use of previously reported data from investigators other than those taking credit for the work, is exceedingly rare. But there is another form of copying/duplication that is much more prevalent. It is when authors copy text from the introduction, materials and methods, and/or discussion sections from one of their papers for use in another. This practice may seem particularly innocuous when the text is that which describes experimental methods. And there are times when a sentence or two or three from the introduction or discussion of a paper have been so well crafted to capture the subject, that it seems a shame not to use the text in a subsequent manuscript on a similar topic. But, of course, while seemingly innocuous, unless quotation marks are inserted around the passage and a reference citation is included, this is not an acceptable practice. In accepting the conditions for publication of their work in BMM or most other journals, authors sign a Transfer of Copyright agreement that assigns exclusively to the publisher the worldwide copyright to, i.e. ownership of, all text as well as all other content of the paper. And now, with software widely available to check the similarity of text of a new paper with that of all prior publications, copied text can be readily detected, placing the reputations of the authors in jeopardy. One such software package is eTBLAST (http://etest.vbi.vt.edu/etblast3/), which is a free web-based service of The Innovation Laboratory at the Virginia Bioinformatics Institute, Blacksburg, VA, USA. eTBLAST compares text submitted by the user to the full text of previously published papers in several databases, including PubMed. Another text comparison software package with a similar purpose is iThenticate (http://www.ithenticate.com/). IOPP is a member of CrossCheck (http://www.crossref.org/crosscheck/), a plagiarism detection service that employs iThenticate to compare text in a submitted manuscript with published manuscripts from more than 50 publishers. When the BMM editorial staff are alerted to the similarity in whole passages (i.e. several sentences in a row or full paragraphs) of a submitted paper with the text of a prior publication, the paper is immediately returned, without review, to the authors with a notification of the duplication. An important service is thus being rendered to the authors, because if the duplication had gone undetected by the BMM staff, a consequence is that it would likely have been detected eventually by certain surveillance groups [1], who are examining publications worldwide for duplicated material and then publishing their results in a freely accessible database, 'Deja vu: a Database of Highly Similar Citations' (http://spore.vbi.vt.edu/dejavu/). Deja vu lists the authors and their works which display duplication. This is one list that I do not think that any of us want to be on. So the cautionary note for us, as authors, is to avoid copying text from one of our papers into another of our papers, even though that text may simply be a description of methods. Another area requiring the attention of authors, and readers, is the bias that comes with 'conflict of interest'. As with most other publishers, IOPP requests that authors disclose potential conflicts of interest in their manuscripts and that referees, too, report potential conflicts to the editorial office. Understandably the principal criterion for establishing whether a conflict exists relates to financial involvement of the authors, or referees, in the work being reported. But recognizing that financial interests alone do not capture the spirit of assurance that the work is free of bias, IOPP, in their Ethical Policy, asks authors to consider two practical guidelines: (1) 'to declare any competing interests that could embarrass you were they to become publicly known after your work was published; and (2) to declare any information which, when revealed later, would make a reasonable reader feel misled or deceived.' And for referees, the IOPP Ethical Policy requests that individuals act within the spirit of the Nolan Principles of Public Life (http://www.archive.official-documents.co.uk/document/parlment/nolan/seven.htm). In fact, the most prevalent conflict is likely unrelated to financial interests. It comes in the form of a bias that authors may bring with them to a work, based on their prior studies of a subject and their professional stake in a certain biomaterial or process or concept. Many of us are vested in a certain material system or treatment or point of view and, thus, even with an absence of any financial involvement, may overstate the promise of experimental findings. The methods and data are valid and clearly stated in black and white, but the interpretation of the findings may be just a bit colored. There is no editorial disclosure form that is likely to be able to screen for this type of bias. And while it is up to the referees to determine the appropriateness of the conclusions drawn from the experimental results, in the end it is the reader who will be the judge of the meaningfulness of the reported findings. Readers of BMM can remain assured that IOPP, and the editorial staff, Editorial Board, and referees will continue to do their best to have papers published in the journal meet the highest standards for publication. But as always, it will be you, the reader, who will be the final judge of the meaningfulness of the papers published in BMM. Reference [1] Couzin-Frankel J and Grom J 2009 Scientific publishing. Plagiarism sleuths Science 324 1004-7.
From Nature: How to stop plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22222735
Nature. 2012 Jan 4;481(7379):21-3. doi: 10.1038/481021a.
Science publishing: How to stop plagiarism.
[No authors listed]
Nature. 2012 Jan 4;481(7379):21-3. doi: 10.1038/481021a.
Science publishing: How to stop plagiarism.
[No authors listed]
From U Queensland-Brisbane: Academic integrity and plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22251343
Eur J Dent Educ. 2012 Feb;16(1):e180-6. doi: 10.1111/j.1600-0579.2011.00695.x. Epub 2011 Jun 3.
Academic integrity and plagiarism: perceptions and experience of staff and students in a school of dentistry: A situational analysis of staff and student perspectives.
Ford PJ, Hughes C.
Source
The University of Queensland, School of Dentistry, Brisbane, Queensland, Australia The University of Queensland, Teaching and Educational Development Institute, Brisbane, Queensland, Australia.
Abstract
Introduction: This project has investigated student and staff perceptions and experience of plagiarism in a large Australian dental school to develop a response to an external audit report.
Methods: Workshops designed to enhance participants' understanding of plagiarism and to assist with practical ways to promote academic integrity within the school were provided to all students and staff. Anonymous surveys were used to investigate perceptions and experience of plagiarism and to assess the usefulness of the workshops.
Results: Most participants felt that plagiarism was not a problem in the school, but a significant number were undecided. The majority of participants reported that the guidelines for dealing with plagiarism were inadequate and most supported the mandatory use of text-matching software in all courses. High proportions of participants indicated that the workshops were useful and that they would consider improving their practice as a result.
Conclusions: The study provided data that enhanced understanding of aspects of plagiarism highlighted in the report at the school level and identified areas in need of attention, such as refining and raising awareness of the guidelines and incorporation of text-matching software into courses, as well as cautions to be considered (how text-matching software is used) in planning responsive action.
Eur J Dent Educ. 2012 Feb;16(1):e180-6. doi: 10.1111/j.1600-0579.2011.00695.x. Epub 2011 Jun 3.
Academic integrity and plagiarism: perceptions and experience of staff and students in a school of dentistry: A situational analysis of staff and student perspectives.
Ford PJ, Hughes C.
Source
The University of Queensland, School of Dentistry, Brisbane, Queensland, Australia The University of Queensland, Teaching and Educational Development Institute, Brisbane, Queensland, Australia.
Abstract
Introduction: This project has investigated student and staff perceptions and experience of plagiarism in a large Australian dental school to develop a response to an external audit report.
Methods: Workshops designed to enhance participants' understanding of plagiarism and to assist with practical ways to promote academic integrity within the school were provided to all students and staff. Anonymous surveys were used to investigate perceptions and experience of plagiarism and to assess the usefulness of the workshops.
Results: Most participants felt that plagiarism was not a problem in the school, but a significant number were undecided. The majority of participants reported that the guidelines for dealing with plagiarism were inadequate and most supported the mandatory use of text-matching software in all courses. High proportions of participants indicated that the workshops were useful and that they would consider improving their practice as a result.
Conclusions: The study provided data that enhanced understanding of aspects of plagiarism highlighted in the report at the school level and identified areas in need of attention, such as refining and raising awareness of the guidelines and incorporation of text-matching software into courses, as well as cautions to be considered (how text-matching software is used) in planning responsive action.
From Am J Roentgenol: Plagerism
http://www.ncbi.nlm.nih.gov/pubmed/22292180
AJR Am J Roentgenol. 2012 Jan;198(1):1.
Plagiarism: I didn't mean to do it.
Berquist TH.
AJR Am J Roentgenol. 2012 Jan;198(1):1.
Plagiarism: I didn't mean to do it.
Berquist TH.
From Ohio U: Research ethics III
http://www.ncbi.nlm.nih.gov/pubmed/21081675
J Speech Lang Hear Res. 2011 Feb;54(1):S346-62. Epub 2010 Nov 16.
Research ethics III: Publication practices and authorship, conflicts of interest, and research misconduct.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity.
METHOD:
In Research Ethics III, they review the RCR domains of publication practices and authorship, conflicts of interest, and research misconduct. Whereas the legal definition of research misconduct under federal law pertains mainly to intentional falsification, fabrication, and plagiarism, they discuss a host of research practices that raise ethical concerns.
CONCLUSIONS:
The integrity of the scientific record--its accuracy, completeness, and value--ultimately impacts the health and well-being of society. For this reason, scientists are both entrusted and obligated to use the highest standards possible when proposing, performing, reviewing, and reporting research or when educating and mentoring new investigators.
J Speech Lang Hear Res. 2011 Feb;54(1):S346-62. Epub 2010 Nov 16.
Research ethics III: Publication practices and authorship, conflicts of interest, and research misconduct.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity.
METHOD:
In Research Ethics III, they review the RCR domains of publication practices and authorship, conflicts of interest, and research misconduct. Whereas the legal definition of research misconduct under federal law pertains mainly to intentional falsification, fabrication, and plagiarism, they discuss a host of research practices that raise ethical concerns.
CONCLUSIONS:
The integrity of the scientific record--its accuracy, completeness, and value--ultimately impacts the health and well-being of society. For this reason, scientists are both entrusted and obligated to use the highest standards possible when proposing, performing, reviewing, and reporting research or when educating and mentoring new investigators.
From Ohio U: Research ethics II
http://www.ncbi.nlm.nih.gov/pubmed/21081679
J Speech Lang Hear Res. 2011 Feb;54(1):S330-45. Epub 2010 Nov 16.
Research ethics II: Mentoring, collaboration, peer review, and data management and ownership.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity. In Research Ethics II, the authors review the RCR domains of mentoring, collaboration, peer review, and data management and ownership.
METHOD:
They relied on authoritative documents, both historical and contemporary, insightful commentary, and empirical research in order to identify current issues and controversies of potential interest to both faculty and students.
CONCLUSIONS:
The authors close by urging readers to stay abreast of the manifold ethics issues facing today's community of scientists, policymakers, and research institutions, and to adhere to best practices as they evolve.
J Speech Lang Hear Res. 2011 Feb;54(1):S330-45. Epub 2010 Nov 16.
Research ethics II: Mentoring, collaboration, peer review, and data management and ownership.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity. In Research Ethics II, the authors review the RCR domains of mentoring, collaboration, peer review, and data management and ownership.
METHOD:
They relied on authoritative documents, both historical and contemporary, insightful commentary, and empirical research in order to identify current issues and controversies of potential interest to both faculty and students.
CONCLUSIONS:
The authors close by urging readers to stay abreast of the manifold ethics issues facing today's community of scientists, policymakers, and research institutions, and to adhere to best practices as they evolve.
From Ohio U: Research ethics I
http://www.ncbi.nlm.nih.gov/pubmed/21081677
J Speech Lang Hear Res. 2011 Feb;54(1):S303-29. Epub 2010 Nov 16.
Research ethics I: Responsible conduct of research (RCR)--historical and contemporary issues pertaining to human and animal experimentation.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity. In Research Ethics I, they present a historical overview of the evolution of RCR in the United States then examine the evolution of human and animal experimentation from the birth of scientific medicine through World War II to the present day.
METHOD:
They relied on authoritative documents, both historical and contemporary, insightful commentary, and empirical research in order to identify current issues and controversies of potential interest to both faculty and students.
CONCLUSIONS:
The authors have written this article from a historical perspective because they think all readers interested in RCR should appreciate how the history of science and all the good--and harm--it has produced can inform how researchers practice responsible research in the 21st century and beyond.
J Speech Lang Hear Res. 2011 Feb;54(1):S303-29. Epub 2010 Nov 16.
Research ethics I: Responsible conduct of research (RCR)--historical and contemporary issues pertaining to human and animal experimentation.
Horner J, Minifie FD.
Source
College of Health Sciences and Professions, Ohio University, W380 Grover Center, Athens, OH 45701, USA. hornerj@ohio.edu
Abstract
PURPOSE:
In this series of articles--Research Ethics I, Research Ethics II, and Research Ethics III--the authors provide a comprehensive review of the 9 core domains for the responsible conduct of research (RCR) as articulated by the Office of Research Integrity. In Research Ethics I, they present a historical overview of the evolution of RCR in the United States then examine the evolution of human and animal experimentation from the birth of scientific medicine through World War II to the present day.
METHOD:
They relied on authoritative documents, both historical and contemporary, insightful commentary, and empirical research in order to identify current issues and controversies of potential interest to both faculty and students.
CONCLUSIONS:
The authors have written this article from a historical perspective because they think all readers interested in RCR should appreciate how the history of science and all the good--and harm--it has produced can inform how researchers practice responsible research in the 21st century and beyond.
From U Alberta: Responsible conduct of bioethics research
http://www.ncbi.nlm.nih.gov/pubmed/21390874
Account Res. 2011 Mar;18(2):102-19.
The responsible conduct of bioethics research.
Master Z.
Source
Health Law Institute, Law Centre, University of Alberta, Edmonton, Alberta, Canada. zubin@zubsplace.com
Abstract
The responsible conduct of research in the biomedical and behavioral sciences has received significant attention since the late 1980s. However, very little has been written about the responsible conduct of bioethics research. Bioethics is an interdisciplinary field and brings together divergent ethical standards and practices which may be the source of tension or conflict. This article argues that bioethicists should reflect more on ethical issues in the responsible conduct of bioethics research through examination of authorship practices and peer review. I also outline three possible approaches to promote research integrity in bioethics.
Account Res. 2011 Mar;18(2):102-19.
The responsible conduct of bioethics research.
Master Z.
Source
Health Law Institute, Law Centre, University of Alberta, Edmonton, Alberta, Canada. zubin@zubsplace.com
Abstract
The responsible conduct of research in the biomedical and behavioral sciences has received significant attention since the late 1980s. However, very little has been written about the responsible conduct of bioethics research. Bioethics is an interdisciplinary field and brings together divergent ethical standards and practices which may be the source of tension or conflict. This article argues that bioethicists should reflect more on ethical issues in the responsible conduct of bioethics research through examination of authorship practices and peer review. I also outline three possible approaches to promote research integrity in bioethics.
Appropriately handling research misconduct cases
http://www.ncbi.nlm.nih.gov/pubmed/21647595
Sci Eng Ethics. 2011 Jun 7. [Epub ahead of print]
Assessing the Preparedness of Research Integrity Officers (RIOs) to Appropriately Handle Possible Research Misconduct Cases.
Bonito AJ, Titus SL, Wright DE.
Source
RTI, International, 3040 Cornwallis Road, Box 12194, Research Triangle Park, NC, 27709, USA, ajb@rti.org.
Abstract
Institutions receiving federal funding for research from the U.S.Public Health Service need to have policies and procedures to both prevent research misconduct and to adjudicate it when it occurs. The person who is designated to handle research misconduct is typically referred to as the research integrity officer (RIO). In this interview study we report on 79 RIOs who describe how they would handle allegations of research misconduct. Their responses were compared to two expert RIOs. The responses to the allegations in the scenarios demonstrated that RIOs are not uniformly well prepared to handle activities associated with reported allegations of research misconduct. We recommend greater preparation through directed training, use of check lists of possible behaviors necessary to consider when situations arise, being involved in a network of RIOs so one can discuss options, and the possible need to certify RIOs.
Sci Eng Ethics. 2011 Jun 7. [Epub ahead of print]
Assessing the Preparedness of Research Integrity Officers (RIOs) to Appropriately Handle Possible Research Misconduct Cases.
Bonito AJ, Titus SL, Wright DE.
Source
RTI, International, 3040 Cornwallis Road, Box 12194, Research Triangle Park, NC, 27709, USA, ajb@rti.org.
Abstract
Institutions receiving federal funding for research from the U.S.Public Health Service need to have policies and procedures to both prevent research misconduct and to adjudicate it when it occurs. The person who is designated to handle research misconduct is typically referred to as the research integrity officer (RIO). In this interview study we report on 79 RIOs who describe how they would handle allegations of research misconduct. Their responses were compared to two expert RIOs. The responses to the allegations in the scenarios demonstrated that RIOs are not uniformly well prepared to handle activities associated with reported allegations of research misconduct. We recommend greater preparation through directed training, use of check lists of possible behaviors necessary to consider when situations arise, being involved in a network of RIOs so one can discuss options, and the possible need to certify RIOs.
From Philadelphia Veterans Affairs Medical Center: Research integrity and community-based research
http://www.ncbi.nlm.nih.gov/pubmed/21680972
J Empir Res Hum Res Ethics. 2011 Jun;6(2):3-12.
Misbehaviors of front-line research personnel and the integrity of community-based research.
True G, Alexander LB, Richman KA.
Source
Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA. Jennifer.True2@va.gov
Abstract
There has been little empirical research into misconduct and misbehavior among community research workers who recruit and collect data in vulnerable and marginalized health populations and are also members of those same communities. We conducted qualitative interviews with community research workers and traditional research assistants to understand the context and consequences of misbehaviors that pose a threat to research ethics and data integrity. In our sample, more community research workers acknowledged engaging in research wrongdoing than did traditional research assistants. These behaviors were most prevalent among community research workers who were not well-integrated into the research team. We suggest best practices for investigators to promote an environment that supports research integrity in research projects that employ community research workers.
J Empir Res Hum Res Ethics. 2011 Jun;6(2):3-12.
Misbehaviors of front-line research personnel and the integrity of community-based research.
True G, Alexander LB, Richman KA.
Source
Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA. Jennifer.True2@va.gov
Abstract
There has been little empirical research into misconduct and misbehavior among community research workers who recruit and collect data in vulnerable and marginalized health populations and are also members of those same communities. We conducted qualitative interviews with community research workers and traditional research assistants to understand the context and consequences of misbehaviors that pose a threat to research ethics and data integrity. In our sample, more community research workers acknowledged engaging in research wrongdoing than did traditional research assistants. These behaviors were most prevalent among community research workers who were not well-integrated into the research team. We suggest best practices for investigators to promote an environment that supports research integrity in research projects that employ community research workers.
From Jefferson Medical College-Philadelphia: Research integrity and transparency
http://www.ncbi.nlm.nih.gov/pubmed/21925440
Heart Fail Clin. 2011 Oct;7(4):561-7.
Reporting of clinical trials: publication, authorship, and trial registration.
Bonita RE, Adams S, Whellan DJ.
Source
Division of Cardiology, Jefferson Medical College, Jefferson Heart Institute, 925 Chestnut Street, Philadelphia, PA 19107, USA. Raphael.Bonita@jefferson.edu
Abstract
Transparency is the foundation on which all of research integrity rests. The public trust from patients, providers, and policy makers depends on fidelity to the mandates of accountability and access. Two important foundational practices for maintaining transparency in research and the reporting of clinical trials discussed in this review concern manuscript authorship and clinical trial registry, recognizing recent controversies regarding honorary and ghost authorship in the publication of industry-sponsored studies.
Heart Fail Clin. 2011 Oct;7(4):561-7.
Reporting of clinical trials: publication, authorship, and trial registration.
Bonita RE, Adams S, Whellan DJ.
Source
Division of Cardiology, Jefferson Medical College, Jefferson Heart Institute, 925 Chestnut Street, Philadelphia, PA 19107, USA. Raphael.Bonita@jefferson.edu
Abstract
Transparency is the foundation on which all of research integrity rests. The public trust from patients, providers, and policy makers depends on fidelity to the mandates of accountability and access. Two important foundational practices for maintaining transparency in research and the reporting of clinical trials discussed in this review concern manuscript authorship and clinical trial registry, recognizing recent controversies regarding honorary and ghost authorship in the publication of industry-sponsored studies.
From Baylor Research Institute-Dallas: Preserving research integrity
http://www.ncbi.nlm.nih.gov/pubmed/21738296
Proc (Bayl Univ Med Cent). 2011 Jul;24(3):224-6.
Unraveling the conflicts to preserve research integrity.
Chapman BJ.
Source
Baylor Research Institute, Dallas, Texas.
"For decades, constructive collaborations between investigators and industry have benefited patients and the public. Recently, high-profile lawsuits (1), public interest groups, and politicians (2) have raised concerns that financial and other interests may unduly influence professional judgment and threaten the integrity of scientific research.
As a result of the attention regarding payments to physicians, a sense of urgency has arisen to better detect and deal with conflicts. Multiple efforts have emerged to mitigate the conflicts and promote objectivity in research. Individual states (3), professional organizations (4), and even industry (5) promote more rigorous reporting and restrictions. In addition to the Food and Drug Administration (FDA) regulations (6), the Public Health Service (PHS) National Institutes of Health (NIH) proposed new, more stringent guidelines in May 2010 aimed at preventing financial conflict of interests among researchers who receive federal research funding (7)."
Proc (Bayl Univ Med Cent). 2011 Jul;24(3):224-6.
Unraveling the conflicts to preserve research integrity.
Chapman BJ.
Source
Baylor Research Institute, Dallas, Texas.
"For decades, constructive collaborations between investigators and industry have benefited patients and the public. Recently, high-profile lawsuits (1), public interest groups, and politicians (2) have raised concerns that financial and other interests may unduly influence professional judgment and threaten the integrity of scientific research.
As a result of the attention regarding payments to physicians, a sense of urgency has arisen to better detect and deal with conflicts. Multiple efforts have emerged to mitigate the conflicts and promote objectivity in research. Individual states (3), professional organizations (4), and even industry (5) promote more rigorous reporting and restrictions. In addition to the Food and Drug Administration (FDA) regulations (6), the Public Health Service (PHS) National Institutes of Health (NIH) proposed new, more stringent guidelines in May 2010 aimed at preventing financial conflict of interests among researchers who receive federal research funding (7)."
From U Alberta: Promoting research integrity
http://www.ncbi.nlm.nih.gov/pubmed/22268504
Account Res. 2012 Jan;19(1):47-52.
Promoting research on research integrity in Canada.
Master Z, McDonald M, Williams-Jones B.
Source
a Health Law and Science Policy Group, Law Centre , University of Alberta , Edmonton , Alberta , Canada.
Abstract
Research on research integrity is an important element in building a strong national research integrity framework. There is a lack of empirical evidence and conceptual research on research integrity in Canada. To further strengthen and develop our system of research integrity, we believe that greater support is needed to promote research on research integrity. Research on research integrity is imperative in order to gain a richer understanding of the diversity of responsible conduct of research norms, practices, education and policies from a Canadian perspective. The knowledge gained would help in the development of an evidenced-based and responsive Canadian system of research integrity.
Account Res. 2012 Jan;19(1):47-52.
Promoting research on research integrity in Canada.
Master Z, McDonald M, Williams-Jones B.
Source
a Health Law and Science Policy Group, Law Centre , University of Alberta , Edmonton , Alberta , Canada.
Abstract
Research on research integrity is an important element in building a strong national research integrity framework. There is a lack of empirical evidence and conceptual research on research integrity in Canada. To further strengthen and develop our system of research integrity, we believe that greater support is needed to promote research on research integrity. Research on research integrity is imperative in order to gain a richer understanding of the diversity of responsible conduct of research norms, practices, education and policies from a Canadian perspective. The knowledge gained would help in the development of an evidenced-based and responsive Canadian system of research integrity.
From J Law Med Ethics: Research integrity
http://www.ncbi.nlm.nih.gov/pubmed/21871046
J Law Med Ethics. 2011 Fall;39(3):513-28. doi: 10.1111/j.1748-720X.2011.00618.x.
Views and experiences of IRBs concerning research integrity.
Klitzman R.
Source
Bioethics Program at Columbia University, USA.
Abstract
Institutional Review Boards (IRBs) can play vital roles in observing, monitoring, and responding to research integrity (RI) issues among researchers, yet many questions remain concerning whether, when, and in what ways these boards adopt these roles. I contacted 60 IRBs (every fourth one in the list of the top 240 institutions by NIH funding), and interviewed leaders from 34 (response rate=55%), and an additional 12 members and administrators. IRBs become involved in a variety of RI problems, broadly defined, and face challenges in deciding how and when to do so. IRBs vary in how they define, discover, and respond to RI problems, and interact with other institutional offices concerning these issues; and what types of RI violations they encountered. While many institutions establish separate Compliance Offices, the boundaries and relationships between these entities and IRBs vary; and many IRBs discover and monitor RI violations, and struggle with how to respond. Larger questions arise of how IRBs decide whether to trust vs. closely monitor individual PIs. IRBs' roles are often indirect, and not fully systematic, raising questions of whether these functions should be enhanced, and if so, to what degree, and how. These areas require heightened investigation and discussion.
J Law Med Ethics. 2011 Fall;39(3):513-28. doi: 10.1111/j.1748-720X.2011.00618.x.
Views and experiences of IRBs concerning research integrity.
Klitzman R.
Source
Bioethics Program at Columbia University, USA.
Abstract
Institutional Review Boards (IRBs) can play vital roles in observing, monitoring, and responding to research integrity (RI) issues among researchers, yet many questions remain concerning whether, when, and in what ways these boards adopt these roles. I contacted 60 IRBs (every fourth one in the list of the top 240 institutions by NIH funding), and interviewed leaders from 34 (response rate=55%), and an additional 12 members and administrators. IRBs become involved in a variety of RI problems, broadly defined, and face challenges in deciding how and when to do so. IRBs vary in how they define, discover, and respond to RI problems, and interact with other institutional offices concerning these issues; and what types of RI violations they encountered. While many institutions establish separate Compliance Offices, the boundaries and relationships between these entities and IRBs vary; and many IRBs discover and monitor RI violations, and struggle with how to respond. Larger questions arise of how IRBs decide whether to trust vs. closely monitor individual PIs. IRBs' roles are often indirect, and not fully systematic, raising questions of whether these functions should be enhanced, and if so, to what degree, and how. These areas require heightened investigation and discussion.
Thursday, February 2, 2012
From U Guelph-Ontario: Protein-carbohydrate ratio and obesity
http://www.ncbi.nlm.nih.gov/pubmed/22243943
Br J Nutr. 2012 Jan 16:1-14. [Epub ahead of print]
Effect of the protein:carbohydrate ratio in hypoenergetic diets on metabolic syndrome risk factors in exercising overweight and obese women.
Campbell DD, Meckling KA.
Source
Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada N1G 2W1.
Abstract
Overweight and obesity are growing problems both in Canada and around the world. Obesity is associated with a number of chronic diseases including type 2 diabetes and CVD, which puts a tremendous burden on the health care systems in place. The present study sought to investigate whether there were differences in the effectiveness of three low-fat, hypo- and isoenergetic diets differing in protein:carbohydrate ratio, low protein (LP, 1 g protein:4 g carbohydrate), normal protein (NP, 1 g protein:2 g carbohydrate) or high protein (HP, 1 g protein:1 g carbohydrate), on weight loss and markers of the metabolic syndrome (MetS) in overweight women. Subjects were randomly assigned to receive one of three intervention diets, all of which included a 60 min exercise programme three times/week for 12 weeks. Of the total subjects, fifty-four overweight and obese local women with MetS risk factors completed the study. All groups had similar improvements in body weight, insulin sensitivity, lipid profile, blood pressure and fitness. Subjects reported that the NP diet was easier to comply with and achieved better improvements in body fat, waist circumference and waist:hip ratio, and preservation of lean mass compared with the other two diets. In conclusion, energy restriction and exercise both facilitate weight loss in overweight and obese subjects and reduce symptoms of the MetS. A diet with a 1:2 protein:carbohydrate ratio promoted better improvements than either the LP or HP diets, and may be superior in reducing long-term chronic disease risk in this population.
Br J Nutr. 2012 Jan 16:1-14. [Epub ahead of print]
Effect of the protein:carbohydrate ratio in hypoenergetic diets on metabolic syndrome risk factors in exercising overweight and obese women.
Campbell DD, Meckling KA.
Source
Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada N1G 2W1.
Abstract
Overweight and obesity are growing problems both in Canada and around the world. Obesity is associated with a number of chronic diseases including type 2 diabetes and CVD, which puts a tremendous burden on the health care systems in place. The present study sought to investigate whether there were differences in the effectiveness of three low-fat, hypo- and isoenergetic diets differing in protein:carbohydrate ratio, low protein (LP, 1 g protein:4 g carbohydrate), normal protein (NP, 1 g protein:2 g carbohydrate) or high protein (HP, 1 g protein:1 g carbohydrate), on weight loss and markers of the metabolic syndrome (MetS) in overweight women. Subjects were randomly assigned to receive one of three intervention diets, all of which included a 60 min exercise programme three times/week for 12 weeks. Of the total subjects, fifty-four overweight and obese local women with MetS risk factors completed the study. All groups had similar improvements in body weight, insulin sensitivity, lipid profile, blood pressure and fitness. Subjects reported that the NP diet was easier to comply with and achieved better improvements in body fat, waist circumference and waist:hip ratio, and preservation of lean mass compared with the other two diets. In conclusion, energy restriction and exercise both facilitate weight loss in overweight and obese subjects and reduce symptoms of the MetS. A diet with a 1:2 protein:carbohydrate ratio promoted better improvements than either the LP or HP diets, and may be superior in reducing long-term chronic disease risk in this population.
From Brazil: Physical fitness and quality of life
http://www.ncbi.nlm.nih.gov/pubmed/22249758
Rev Saude Publica. 2012 Feb;46(1):166-179.
Association between physical activity and quality of life in adults.
[Article in English, Portuguese]
Pucci GC, Rech CR, Fermino RC, Reis RS.
Source
Centro de Ciências Biológicas e da Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
Abstract
OBJECTIVE:
To summarize and analyze evidences of the association between physical activity and quality of life.
METHODS:
Systematic literature review in three electronic databases -PubMed, Lilacs and SciELO- using the following descriptors: "physical activity," "motor activity," "exercise," "walking," "running," "physical fitness," "sport," "life style," "quality of life," "WHOQOL" and "SF." There were selected 38 studies published between 1980 and 2010 that used any instrument to measure physical activity and any version of the Medical Outcomes Study 36-Item Short-Form Health Survey or the World Health Organization Quality of Life to assess quality of life.
RESULTS:
Most studies reviewed were cross-sectional (68%), 18% experimental, 8% prospective follow-up cohort and 5% mixed-design (cross-sectional and longitudinal). The most widely used questionnaire to assess quality of life was SF-36 (71%), and physical activity was self-reported in 82% of the studies reviewed. Higher level of physical activity was associated with better perception of quality of life in the elderly, apparently healthy adults and individuals with different clinical conditions.
CONCLUSIONS:
There is a positive association between physical activity and quality of life that varies according to the domain analyzed.
Rev Saude Publica. 2012 Feb;46(1):166-179.
Association between physical activity and quality of life in adults.
[Article in English, Portuguese]
Pucci GC, Rech CR, Fermino RC, Reis RS.
Source
Centro de Ciências Biológicas e da Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brasil.
Abstract
OBJECTIVE:
To summarize and analyze evidences of the association between physical activity and quality of life.
METHODS:
Systematic literature review in three electronic databases -PubMed, Lilacs and SciELO- using the following descriptors: "physical activity," "motor activity," "exercise," "walking," "running," "physical fitness," "sport," "life style," "quality of life," "WHOQOL" and "SF." There were selected 38 studies published between 1980 and 2010 that used any instrument to measure physical activity and any version of the Medical Outcomes Study 36-Item Short-Form Health Survey or the World Health Organization Quality of Life to assess quality of life.
RESULTS:
Most studies reviewed were cross-sectional (68%), 18% experimental, 8% prospective follow-up cohort and 5% mixed-design (cross-sectional and longitudinal). The most widely used questionnaire to assess quality of life was SF-36 (71%), and physical activity was self-reported in 82% of the studies reviewed. Higher level of physical activity was associated with better perception of quality of life in the elderly, apparently healthy adults and individuals with different clinical conditions.
CONCLUSIONS:
There is a positive association between physical activity and quality of life that varies according to the domain analyzed.
Sports drinks vs. coconut water for exercise performance and hydration
http://www.ncbi.nlm.nih.gov/pubmed/22257640
J Int Soc Sports Nutr. 2012 Jan 18;9(1):1. [Epub ahead of print]
Comparison of coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men.
Kalman DS, Feldman S, Krieger DR, Bloomer RJ.
Abstract
ABSTRACT:
BACKGROUND:
Sport drinks are ubiquitous within the recreational and competitive fitness and sporting world. Most are manufactured and artificially flavored carbohydrate-electrolyte beverages. Recently, attention has been given to coconut water, a natural alternative to manufactured sport drinks, with initial evidence indicating efficacy with regard to maintaining hydration. We compared coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men.
Methods: Following a 60- minute bout of dehydrating treadmill exercise, 12 exercise-trained men (26.6+/-5.7 yrs) received bottled water (BW), pure coconut water (VitaCoco(R): CW), coconut water from concentrate (CWC), or a carbohydrate-electrolyte sport drink (SD) [a fluid amount based on body mass loss during the dehydrating exercise] on four occasions (separated by at least 5 days) in a random order, single blind (subject and not investigators), cross-over design. Hydration status (body mass, fluid retention, plasma osmolality, urine specific gravity) and performance (treadmill time to exhaustion; assessed after rehydration) were determined during the recovery period. Subjective measures of thirst, bloatedness, refreshed, stomach upset, and tiredness were also determined using a 5-point visual analog scale.
Results: Subjects lost approximately 1.7 kg (~2% of body mass) during the dehydrating exercise and regained this amount in a relatively similar manner following consumption of all conditions. No differences were noted between coconut water (CW or CWC) and SD for any measures of fluid retention (p>0.05). Regarding exercise performance, no significant difference (p>0.05) was noted between BW (11.9+/-5.9 min), CW (12.3+/-5.8 min), CWC (11.9+/-6.0 min), and SD (12.8+/-4.9 min). In general, subjects reported feeling more bloated and experienced greater stomach upset with the CW and CWC conditions.
Conclusion: All beverages are capable of promoting rehydration. Little difference is noted 3 between the four tested conditions with regard to markers of hydration or exercise performance in a sample of young, healthy men. Additional study inclusive of a more demanding dehydration protocol, as well as a time trial test as the measure of exercise performance, may more specifically determine the efficacy of these beverages on enhancing hydration and performance following dehydrating exercise.
J Int Soc Sports Nutr. 2012 Jan 18;9(1):1. [Epub ahead of print]
Comparison of coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men.
Kalman DS, Feldman S, Krieger DR, Bloomer RJ.
Abstract
ABSTRACT:
BACKGROUND:
Sport drinks are ubiquitous within the recreational and competitive fitness and sporting world. Most are manufactured and artificially flavored carbohydrate-electrolyte beverages. Recently, attention has been given to coconut water, a natural alternative to manufactured sport drinks, with initial evidence indicating efficacy with regard to maintaining hydration. We compared coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men.
Methods: Following a 60- minute bout of dehydrating treadmill exercise, 12 exercise-trained men (26.6+/-5.7 yrs) received bottled water (BW), pure coconut water (VitaCoco(R): CW), coconut water from concentrate (CWC), or a carbohydrate-electrolyte sport drink (SD) [a fluid amount based on body mass loss during the dehydrating exercise] on four occasions (separated by at least 5 days) in a random order, single blind (subject and not investigators), cross-over design. Hydration status (body mass, fluid retention, plasma osmolality, urine specific gravity) and performance (treadmill time to exhaustion; assessed after rehydration) were determined during the recovery period. Subjective measures of thirst, bloatedness, refreshed, stomach upset, and tiredness were also determined using a 5-point visual analog scale.
Results: Subjects lost approximately 1.7 kg (~2% of body mass) during the dehydrating exercise and regained this amount in a relatively similar manner following consumption of all conditions. No differences were noted between coconut water (CW or CWC) and SD for any measures of fluid retention (p>0.05). Regarding exercise performance, no significant difference (p>0.05) was noted between BW (11.9+/-5.9 min), CW (12.3+/-5.8 min), CWC (11.9+/-6.0 min), and SD (12.8+/-4.9 min). In general, subjects reported feeling more bloated and experienced greater stomach upset with the CW and CWC conditions.
Conclusion: All beverages are capable of promoting rehydration. Little difference is noted 3 between the four tested conditions with regard to markers of hydration or exercise performance in a sample of young, healthy men. Additional study inclusive of a more demanding dehydration protocol, as well as a time trial test as the measure of exercise performance, may more specifically determine the efficacy of these beverages on enhancing hydration and performance following dehydrating exercise.
Running as add-on therapy for depression in adults
http://www.ncbi.nlm.nih.gov/pubmed/22260713
BMC Public Health. 2012 Jan 19;12(1):50. [Epub ahead of print]
Effect of running therapy on depression (EFFORT-D). Design of a randomised controlled trial in adult patients [ ISRCTN 1894].
Kruisdijk FR, Hendriksen IJ, Tak EC, Beekman AT, Hopman-Rock M.
Abstract
BACKGROUND:
The societal and personal burden of depressive illness is considerable. Despite the developments in treatment strategies, the effectiveness of both medication and psychotherapy is not ideal. Physical activity, including exercise, is a relatively cheap and non-harmful lifestyle intervention which lacks the side-effects of medication and does not require the introspective ability necessary for most psychotherapies. Several cohort studies and randomised controlled trials (RCTs) have been performed to establish the effect of physical activity on prevention and remission of depressive illness. However, recent meta-analysis's of all RCTs in this area showed conflicting results. The objective of the present article is to describe the design of a RCT examining the effect of exercise on depressive patients.
METHODS:
The EFFect Of Running Therapy on Depression in adults (EFFORT-D) is a RCT, studying the effectiveness of exercise therapy (running therapy (RT) or Nordic walking (NW)) on depression in adults, in addition to usual care. The study population consists of patients with depressive disorder, Hamilton Rating Scale for Depression (HRSD) [greater than or equal to] 14, recruited from specialised mental health care. The experimental group receives the exercise intervention besides treatment as usual, the control group receives treatment as usual. The intervention program is a group-based, 1 h session, two times a week for 6 months and of increasing intensity. The control group only performs low intensive non-aerobic exercises. Measurements are performed at inclusion and at 3,6 and 12 months. Primary outcome measure is reduction in depressive symptoms measured by the HRSD. Cardio-respiratory fitness is measured using a sub maximal cycling test, biometric information is gathered and blood samples are collected for metabolic parameters. Also, co-morbidity with pain, anxiety and personality traits is studied, as well as quality of life and cost-effectiveness.
DISCUSSION:
Exercise in depression can be used as a standalone or as an add-on intervention. In specialised mental health care, chronic forms of depression, co-morbid anxiety or physical complaints and treatment resistance are common. An add-on strategy therefore seems the best choice. This is the first high quality large trial into the effectiveness of exercise as an add-on treatment for depression in adult patients in specialised mental health care. Dutch Trial Register trial ID:NTR1894, acronym: EFFORT-D.
BMC Public Health. 2012 Jan 19;12(1):50. [Epub ahead of print]
Effect of running therapy on depression (EFFORT-D). Design of a randomised controlled trial in adult patients [ ISRCTN 1894].
Kruisdijk FR, Hendriksen IJ, Tak EC, Beekman AT, Hopman-Rock M.
Abstract
BACKGROUND:
The societal and personal burden of depressive illness is considerable. Despite the developments in treatment strategies, the effectiveness of both medication and psychotherapy is not ideal. Physical activity, including exercise, is a relatively cheap and non-harmful lifestyle intervention which lacks the side-effects of medication and does not require the introspective ability necessary for most psychotherapies. Several cohort studies and randomised controlled trials (RCTs) have been performed to establish the effect of physical activity on prevention and remission of depressive illness. However, recent meta-analysis's of all RCTs in this area showed conflicting results. The objective of the present article is to describe the design of a RCT examining the effect of exercise on depressive patients.
METHODS:
The EFFect Of Running Therapy on Depression in adults (EFFORT-D) is a RCT, studying the effectiveness of exercise therapy (running therapy (RT) or Nordic walking (NW)) on depression in adults, in addition to usual care. The study population consists of patients with depressive disorder, Hamilton Rating Scale for Depression (HRSD) [greater than or equal to] 14, recruited from specialised mental health care. The experimental group receives the exercise intervention besides treatment as usual, the control group receives treatment as usual. The intervention program is a group-based, 1 h session, two times a week for 6 months and of increasing intensity. The control group only performs low intensive non-aerobic exercises. Measurements are performed at inclusion and at 3,6 and 12 months. Primary outcome measure is reduction in depressive symptoms measured by the HRSD. Cardio-respiratory fitness is measured using a sub maximal cycling test, biometric information is gathered and blood samples are collected for metabolic parameters. Also, co-morbidity with pain, anxiety and personality traits is studied, as well as quality of life and cost-effectiveness.
DISCUSSION:
Exercise in depression can be used as a standalone or as an add-on intervention. In specialised mental health care, chronic forms of depression, co-morbid anxiety or physical complaints and treatment resistance are common. An add-on strategy therefore seems the best choice. This is the first high quality large trial into the effectiveness of exercise as an add-on treatment for depression in adult patients in specialised mental health care. Dutch Trial Register trial ID:NTR1894, acronym: EFFORT-D.
Exergaming like cybercycling may be better for older people than traditional exercise
http://www.ncbi.nlm.nih.gov/pubmed/22261206
Am J Prev Med. 2012 Feb;42(2):109-19.
Exergaming and older adult cognition a cluster randomized clinical trial.
Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA.
Source
Healthy Aging and Neuropsychology Lab, Department of Psychology, Union College, Schenectady, New York; Health and Exercise Sciences Department, Skidmore College, Saratoga Springs, New York.
Abstract
BACKGROUND:
Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation.
PURPOSE:
To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase.
DESIGN:
Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011.
SETTING/PARTICIPANTS:
102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed.
INTERVENTIONS:
A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle.
MAIN OUTCOME MEASURES:
Executive function (Color Trails Difference, Stroop C, Digits Backward); clinical status (mild cognitive impairment; MCI); exercise effort/fitness; and plasma BDNF.
RESULTS:
Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function (p=0.002). Cybercycling yielded a medium effect over traditional exercise (d=0.50). Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant group X time interaction for BDNF (p=0.05) indicated enhanced neuroplasticity among cybercyclists.
CONCLUSIONS:
Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline.
TRIAL REGISTRATION:
This study is registered at Clinicaltrials.govNCT01167400.
Am J Prev Med. 2012 Feb;42(2):109-19.
Exergaming and older adult cognition a cluster randomized clinical trial.
Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA.
Source
Healthy Aging and Neuropsychology Lab, Department of Psychology, Union College, Schenectady, New York; Health and Exercise Sciences Department, Skidmore College, Saratoga Springs, New York.
Abstract
BACKGROUND:
Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation.
PURPOSE:
To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase.
DESIGN:
Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function in older adults. Data were collected in 2008-2010; analyses were conducted in 2010-2011.
SETTING/PARTICIPANTS:
102 older adults from eight retirement communities enrolled; 79 were randomized and 63 completed.
INTERVENTIONS:
A recumbent stationary ergometer was utilized; virtual reality tours and competitors were enabled on the cybercycle.
MAIN OUTCOME MEASURES:
Executive function (Color Trails Difference, Stroop C, Digits Backward); clinical status (mild cognitive impairment; MCI); exercise effort/fitness; and plasma BDNF.
RESULTS:
Intent-to-treat analyses, controlling for age, education, and cluster randomization, revealed a significant group X time interaction for composite executive function (p=0.002). Cybercycling yielded a medium effect over traditional exercise (d=0.50). Cybercyclists had a 23% relative risk reduction in clinical progression to MCI. Exercise effort and fitness were comparable, suggesting another underlying mechanism. A significant group X time interaction for BDNF (p=0.05) indicated enhanced neuroplasticity among cybercyclists.
CONCLUSIONS:
Cybercycling older adults achieved better cognitive function than traditional exercisers, for the same effort, suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline.
TRIAL REGISTRATION:
This study is registered at Clinicaltrials.govNCT01167400.
Need another reason to work out? I SAID, NEED ANOTHER REASON TO WORK OUT?
http://www.ncbi.nlm.nih.gov/pubmed/22271908
Am J Audiol. 2012 Jan 23. [Epub ahead of print]
Association Between Cardiorespiratory Fitness and Hearing Sensitivity.
Loprinzi PD, Cardinal BJ, Gilham B.
Source
Assistant Professor, Bellarmine University, Department of Exercise Science, Donna & Allan Lansing School of Nursing & Health Sciences, Louisville, KY.
Abstract
PURPOSE:
As a follow up to previous smaller-scale studies, the purpose of the present study was to examine the link between cardiorespiratory fitness (VO(2max;) maximum oxygen uptake) using a nationally representative U.S. sample of adults.
METHOD:
Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used in the analyses. After exclusions, the final sample included 1,082 NHANES participants (20-49 years). VO(2max) was obtained from an established non-exercise prediction equation and through heart rate extrapolation during a treadmill-based submaximal test. Audiometry data was objectively-measured to obtain estimates of low (LPTA) and high (HPTA) pure tone frequency average.
RESULTS:
VO(2max) was not associated with hearing sensitivity when using the heart rate extrapolation method, but was significantly associated with hearing sensitivity (for women) when applying the non-exercise prediction equation for both LPTA and HPTA (p < 0.01). Women with higher predicted aerobic fitness were 6% more likely to have good hearing compared to worse hearing (RR: 1.06 [95% CI: 1.00, 1.13]; p = 0.05).
CONCLUSIONS:
Cardiorespiratory fitness was associated with hearing sensitivity using the non-exercise prediction equation. Further studies are needed to confirm these findings that suggest a potentially auditory-protective effect of cardiorespiratory fitness.
Am J Audiol. 2012 Jan 23. [Epub ahead of print]
Association Between Cardiorespiratory Fitness and Hearing Sensitivity.
Loprinzi PD, Cardinal BJ, Gilham B.
Source
Assistant Professor, Bellarmine University, Department of Exercise Science, Donna & Allan Lansing School of Nursing & Health Sciences, Louisville, KY.
Abstract
PURPOSE:
As a follow up to previous smaller-scale studies, the purpose of the present study was to examine the link between cardiorespiratory fitness (VO(2max;) maximum oxygen uptake) using a nationally representative U.S. sample of adults.
METHOD:
Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used in the analyses. After exclusions, the final sample included 1,082 NHANES participants (20-49 years). VO(2max) was obtained from an established non-exercise prediction equation and through heart rate extrapolation during a treadmill-based submaximal test. Audiometry data was objectively-measured to obtain estimates of low (LPTA) and high (HPTA) pure tone frequency average.
RESULTS:
VO(2max) was not associated with hearing sensitivity when using the heart rate extrapolation method, but was significantly associated with hearing sensitivity (for women) when applying the non-exercise prediction equation for both LPTA and HPTA (p < 0.01). Women with higher predicted aerobic fitness were 6% more likely to have good hearing compared to worse hearing (RR: 1.06 [95% CI: 1.00, 1.13]; p = 0.05).
CONCLUSIONS:
Cardiorespiratory fitness was associated with hearing sensitivity using the non-exercise prediction equation. Further studies are needed to confirm these findings that suggest a potentially auditory-protective effect of cardiorespiratory fitness.
Diabetes prevention by exercise and diet
http://www.ncbi.nlm.nih.gov/pubmed/22270225
Diabetologia. 2012 Jan 21. [Epub ahead of print]
What's new since Hippocrates? Preventing type 2 diabetes by physical exercise and diet.
Hawley JA, Gibala MJ.
Source
Exercise Metabolism Group, Health Innovations Research Institute, School of Medical Sciences, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia, john.hawley@rmit.edu.au.
Abstract
Since the work of Eriksson and Lindgärde, published over two decades ago (Diabetologia 1991;34:891-898), we have known that type 2 diabetes can be prevented or delayed by supervised lifestyle interventions (physical exercise and diet modification) in persons at risk of the disease. Here we discuss a novel, time-efficient approach to physical exercise prescription, low-volume, high-intensity interval training (LVHIT), and its efficacy for inducing a range of health benefits in a variety of populations at risk of inactivity-related diseases. We look to the future and suggest that current guidelines for exercise may need to be revised to include different training techniques to deliver the optimum exercise prescription. Indeed, we predict that subsequent exercise guidelines will include LVHIT as part of a comprehensive 'fitness menu' that allows individuals to select the exercise regimen that best fulfils their medical needs, is suited to their lifestyle and daily time restraints, and meets their personal goals.
Diabetologia. 2012 Jan 21. [Epub ahead of print]
What's new since Hippocrates? Preventing type 2 diabetes by physical exercise and diet.
Hawley JA, Gibala MJ.
Source
Exercise Metabolism Group, Health Innovations Research Institute, School of Medical Sciences, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia, john.hawley@rmit.edu.au.
Abstract
Since the work of Eriksson and Lindgärde, published over two decades ago (Diabetologia 1991;34:891-898), we have known that type 2 diabetes can be prevented or delayed by supervised lifestyle interventions (physical exercise and diet modification) in persons at risk of the disease. Here we discuss a novel, time-efficient approach to physical exercise prescription, low-volume, high-intensity interval training (LVHIT), and its efficacy for inducing a range of health benefits in a variety of populations at risk of inactivity-related diseases. We look to the future and suggest that current guidelines for exercise may need to be revised to include different training techniques to deliver the optimum exercise prescription. Indeed, we predict that subsequent exercise guidelines will include LVHIT as part of a comprehensive 'fitness menu' that allows individuals to select the exercise regimen that best fulfils their medical needs, is suited to their lifestyle and daily time restraints, and meets their personal goals.
Fitness characteristics of a SWAT team
http://www.ncbi.nlm.nih.gov/pubmed/22289693
J Strength Cond Res. 2012 Jan 26. [Epub ahead of print]
Fitness Characteristics of a Suburban Special Weapons and Tactics Team.
Pryor RR, Colburn D, Crill MT, Hostler DP, Suyama J.
Source
1Department of Emergency Medicine, Emergency Responder Human, Performance Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania; 2Center for Rehab Services, Pittsburgh, Pennsylvania; and 3Ohio Health, Work Health, Columbus, Ohio.
Abstract
Pryor, RR, Colburn, D, Crill, MT, Hostler, DP, and Suyama, J. Fitness characteristics of a suburban special weapons and tactics team. J Strength Cond Res 26(X): 000-000, 2012-Special Weapons and Tactics (SWAT) operators are specialized law enforcement officers who traditionally perform their duties with higher anticipated workloads because of additional body armor, weapons, and equipment used for enhanced operations and protection. This elevated workload increases the need for SWAT operators to improve or maintain their physical fitness to consistently perform routine operations. Typical tasks require trunk rotation, overhead upper extremity use, upper and lower body strength use, and long waiting periods followed by explosive movements while wearing additional equipment. Eleven male SWAT operators from 1 SWAT team performed flexibility, strength, power, and aerobic capacity tests and a variety of job-related tasks. Data were compared with age- and gender-based normative data. Fitness testing revealed that officers ranked high on tests of muscular strength (leg strength, 90th percentile; bench press, 85th percentile); however, body composition (55th percentile), core body strength, and flexibility ranked lower. Furthermore, aerobic capacity and muscular power had a wide range of scores and were also not ideal to support maximal performance during routine operations. These data can assist exercise specialists choose fitness programs specifically for job-related tasks of SWAT operators when creating fitness programs. Fitness programming for law enforcement should focus on improving aerobic fitness, flexibility, core strength, and muscular power while maintaining muscular strength to meet the needs of these specialized officers.
J Strength Cond Res. 2012 Jan 26. [Epub ahead of print]
Fitness Characteristics of a Suburban Special Weapons and Tactics Team.
Pryor RR, Colburn D, Crill MT, Hostler DP, Suyama J.
Source
1Department of Emergency Medicine, Emergency Responder Human, Performance Laboratory, University of Pittsburgh, Pittsburgh, Pennsylvania; 2Center for Rehab Services, Pittsburgh, Pennsylvania; and 3Ohio Health, Work Health, Columbus, Ohio.
Abstract
Pryor, RR, Colburn, D, Crill, MT, Hostler, DP, and Suyama, J. Fitness characteristics of a suburban special weapons and tactics team. J Strength Cond Res 26(X): 000-000, 2012-Special Weapons and Tactics (SWAT) operators are specialized law enforcement officers who traditionally perform their duties with higher anticipated workloads because of additional body armor, weapons, and equipment used for enhanced operations and protection. This elevated workload increases the need for SWAT operators to improve or maintain their physical fitness to consistently perform routine operations. Typical tasks require trunk rotation, overhead upper extremity use, upper and lower body strength use, and long waiting periods followed by explosive movements while wearing additional equipment. Eleven male SWAT operators from 1 SWAT team performed flexibility, strength, power, and aerobic capacity tests and a variety of job-related tasks. Data were compared with age- and gender-based normative data. Fitness testing revealed that officers ranked high on tests of muscular strength (leg strength, 90th percentile; bench press, 85th percentile); however, body composition (55th percentile), core body strength, and flexibility ranked lower. Furthermore, aerobic capacity and muscular power had a wide range of scores and were also not ideal to support maximal performance during routine operations. These data can assist exercise specialists choose fitness programs specifically for job-related tasks of SWAT operators when creating fitness programs. Fitness programming for law enforcement should focus on improving aerobic fitness, flexibility, core strength, and muscular power while maintaining muscular strength to meet the needs of these specialized officers.
From Bryan Liang and colleague: Vaccine shortages and suspect online pharmacy sellers
http://www.ncbi.nlm.nih.gov/pubmed/22094281
Vaccine. 2012 Jan 5;30(2):105-8. Epub 2011 Nov 15.
Vaccine shortages and suspect online pharmacy sellers.
Liang BA, Mackey TK.
Source
Institute of Health Law Studies, California Western School of Law, 350 Cedar Street, San Diego, CA 92101, USA. baliang@alum.mit.edu
Abstract
Vaccines represent half the products on the FDA Biologics Product Shortages list. As a result, providers and patients may purchase them online, a process rife with patient safety risks. We examined vaccine online availability by assessing up to 5 identified online sellers. We determined if sites were accredited by the National Association of Boards of Pharmacy (NABP) VIPPS program, listed as US or international, employed social media linking to suspect online pharmacies, and if they were on the NABP Not Recommended list. All vaccines were advertised by online pharmacies and through data aggregation and social media sites, none were VIPPS-accredited, and most were on the NABP Not Recommended list. We found some online sellers advertising vaccines as over-the-counter. We extended our analysis to WHO Essential Medicines List vaccines and found all are also available online from suspect, non-VIPPS accredited sellers. Stakeholders should be aware of these online patient safety dangers.
Vaccine. 2012 Jan 5;30(2):105-8. Epub 2011 Nov 15.
Vaccine shortages and suspect online pharmacy sellers.
Liang BA, Mackey TK.
Source
Institute of Health Law Studies, California Western School of Law, 350 Cedar Street, San Diego, CA 92101, USA. baliang@alum.mit.edu
Abstract
Vaccines represent half the products on the FDA Biologics Product Shortages list. As a result, providers and patients may purchase them online, a process rife with patient safety risks. We examined vaccine online availability by assessing up to 5 identified online sellers. We determined if sites were accredited by the National Association of Boards of Pharmacy (NABP) VIPPS program, listed as US or international, employed social media linking to suspect online pharmacies, and if they were on the NABP Not Recommended list. All vaccines were advertised by online pharmacies and through data aggregation and social media sites, none were VIPPS-accredited, and most were on the NABP Not Recommended list. We found some online sellers advertising vaccines as over-the-counter. We extended our analysis to WHO Essential Medicines List vaccines and found all are also available online from suspect, non-VIPPS accredited sellers. Stakeholders should be aware of these online patient safety dangers.
From Keith Kerr and colleagues: Personalized cancer medicine
http://www.ncbi.nlm.nih.gov/pubmed/22143935
Virchows Arch. 2012 Jan;460(1):3-8. Epub 2011 Dec 6.
Personalized cancer medicine and the future of pathology.
Moch H, Blank PR, Dietel M, Elmberger G, Kerr KM, Palacios J, Penault-Llorca F, Rossi G, Szucs TD.
Source
Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland, holger.moch@usz.ch.
Abstract
In February 2011, a group of pathologists from different departments in Europe met in Zurich, Switzerland, to discuss opportunities and challenges for pathology in the era of personalized medicine. The major topics of the meeting were assessment of the role of pathology in personalized medicine, its future profile among other biomedical disciplines with an interest in personalized medicine as well as the evolution of companion diagnostics. The relevance of novel technologies for genome analysis in clinical practice was discussed. The participants recognize that there should be more initiatives taken by the pathology community in companion diagnostics and in the emerging field of next-generation sequencing and whole genome analysis. The common view of the participants was that the pathology community has to be mobilized for stronger engagement in the future of personalized medicine. Pathologists should be aware of the challenges and the analytical opportunities of the new technologies. Challenges of clinical trial design as well as insurance and reimbursement questions were addressed. The pathology community has the responsibility to lead medical colleagues into embracing this new area of genomic medicine. Without this effort, the discipline of pathology risks losing its key position in molecular tissue diagnostics.
Virchows Arch. 2012 Jan;460(1):3-8. Epub 2011 Dec 6.
Personalized cancer medicine and the future of pathology.
Moch H, Blank PR, Dietel M, Elmberger G, Kerr KM, Palacios J, Penault-Llorca F, Rossi G, Szucs TD.
Source
Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, CH-8091, Zurich, Switzerland, holger.moch@usz.ch.
Abstract
In February 2011, a group of pathologists from different departments in Europe met in Zurich, Switzerland, to discuss opportunities and challenges for pathology in the era of personalized medicine. The major topics of the meeting were assessment of the role of pathology in personalized medicine, its future profile among other biomedical disciplines with an interest in personalized medicine as well as the evolution of companion diagnostics. The relevance of novel technologies for genome analysis in clinical practice was discussed. The participants recognize that there should be more initiatives taken by the pathology community in companion diagnostics and in the emerging field of next-generation sequencing and whole genome analysis. The common view of the participants was that the pathology community has to be mobilized for stronger engagement in the future of personalized medicine. Pathologists should be aware of the challenges and the analytical opportunities of the new technologies. Challenges of clinical trial design as well as insurance and reimbursement questions were addressed. The pathology community has the responsibility to lead medical colleagues into embracing this new area of genomic medicine. Without this effort, the discipline of pathology risks losing its key position in molecular tissue diagnostics.
From Johns Hopkins: Post-treatment Lyme disease syndrome?
Qual Life Res. 2012 Feb 1. [Epub ahead of print]
Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?
Aucott JN, Rebman AW, Crowder LA, Kortte KB.
Source
Department of Medicine, Johns Hopkins University School of Medicine, 10755 Falls Road, Suite 200, Lutherville, MD, 21093, USA, jaucott2@jhmi.edu.
Abstract
PURPOSE:
A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.
METHODS:
Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months.
RESULTS:
Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than "minimal" depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months.
CONCLUSIONS:
Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.
Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?
Aucott JN, Rebman AW, Crowder LA, Kortte KB.
Source
Department of Medicine, Johns Hopkins University School of Medicine, 10755 Falls Road, Suite 200, Lutherville, MD, 21093, USA, jaucott2@jhmi.edu.
Abstract
PURPOSE:
A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.
METHODS:
Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months.
RESULTS:
Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than "minimal" depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months.
CONCLUSIONS:
Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.
Excellent commentary by Schiff and Leape regarding diagnostic errors
http://www.ncbi.nlm.nih.gov/pubmed/22273611
Acad Med. 2012 Feb;87(2):135-8.
Commentary.
Schiff GD, Leape LL.
Source
Dr. Schiff is associate director, Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, and associate professor of medicine, Harvard Medical School, Boston, Massachusetts. Dr. Leape is adjunct professor of health policy, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts.
Abstract
Diagnostic errors are common and are a leading cause of patient dissatisfaction and malpractice suits. Because of its traditional heavy reliance on memory and lack of standardization, the diagnostic process is particularly error prone. A study by Zwaan and colleagues on diagnostic failures in treating dyspneic patients makes several important contributions: examining the process behind the diagnosis, seeking insights as to the reasons for the process failures by interviewing the treating physicians, and using the Delphi process with experts to map the optimal diagnostic process.There is considerable confusion about definitions in the field of diagnostic errors. The authors of this commentary use a Venn diagram to clarify distinctions and relationships between diagnosis processes errors, delayed diagnosis and misdiagnosis, and adverse outcomes. A key question is whether a much more rigorous process should be employed for diagnosis, specifically the routine use of algorithms or guidelines, and whether barriers to achieving it can be overcome.The authors propose an alternate simpler approach: six-part checklists for the top 20 or 30 clinical symptoms or problems. The elements of these checklists for minimizing diagnostic errors include essential data elements, don't-miss diagnoses, red-flag symptoms, potential drug causes, required referral(s), and follow-up instructions.These checklists could-and should-be developed by collaborative efforts of the main users, primary care physicians, and emergency physicians, working with specialist physicians on specific symptoms and diagnoses. Absent such professional commitment, progress in diagnostic accuracy is likely to be slow.
Acad Med. 2012 Feb;87(2):135-8.
Commentary.
Schiff GD, Leape LL.
Source
Dr. Schiff is associate director, Center for Patient Safety Research and Practice, Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, and associate professor of medicine, Harvard Medical School, Boston, Massachusetts. Dr. Leape is adjunct professor of health policy, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts.
Abstract
Diagnostic errors are common and are a leading cause of patient dissatisfaction and malpractice suits. Because of its traditional heavy reliance on memory and lack of standardization, the diagnostic process is particularly error prone. A study by Zwaan and colleagues on diagnostic failures in treating dyspneic patients makes several important contributions: examining the process behind the diagnosis, seeking insights as to the reasons for the process failures by interviewing the treating physicians, and using the Delphi process with experts to map the optimal diagnostic process.There is considerable confusion about definitions in the field of diagnostic errors. The authors of this commentary use a Venn diagram to clarify distinctions and relationships between diagnosis processes errors, delayed diagnosis and misdiagnosis, and adverse outcomes. A key question is whether a much more rigorous process should be employed for diagnosis, specifically the routine use of algorithms or guidelines, and whether barriers to achieving it can be overcome.The authors propose an alternate simpler approach: six-part checklists for the top 20 or 30 clinical symptoms or problems. The elements of these checklists for minimizing diagnostic errors include essential data elements, don't-miss diagnoses, red-flag symptoms, potential drug causes, required referral(s), and follow-up instructions.These checklists could-and should-be developed by collaborative efforts of the main users, primary care physicians, and emergency physicians, working with specialist physicians on specific symptoms and diagnoses. Absent such professional commitment, progress in diagnostic accuracy is likely to be slow.
From Tehran U: Medical error disclosure
http://www.ncbi.nlm.nih.gov/pubmed/22282741
Postgrad Med J. 2012 Jan 25. [Epub ahead of print]
Medical error disclosure: the gap between attitude and practice.
Ghalandarpoorattar SM, Kaviani A, Asghari F.
Source
Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
Background
This study aims to evaluate the attending surgeons' and residents' attitudes towards error disclosure and factors that can potentially affect these tendencies in major academic hospitals affiliated with Tehran University of Medical Sciences (TUMS).
Methods and materials
In a cross-sectional study, self-administered questionnaires were delivered to all attending surgeons and second to fourth year surgical residents of TUMS during October and November 2009. The questionnaire contained two clinical scenarios and questions regarding physicians' attitudes towards disclosing medical error and their actual practice in the case of their last error. Of the 63 distributed questionnaires, 53 (84.1%) were completed and returned.
Results
Participants were less likely to disclose minor (39.6%; 21/53) than major (49.1%; 29/53) medical errors. Participants believed that their most important concerns for not disclosing errors were fear of a malpractice lawsuit (71.7%, n=38), losing patients' trust (62.3%, n=33), and emotional reactions of the patients and their relatives (56.6%, n=30). Although most physicians indicated they would disclose errors in minor and major scenarios, only 16.7% (n=8) had disclosed their last medical errors to their patients, two of which had resulted in patients taking legal action.
Conclusion
There was an obvious gap between surgeons' intentions and actual practices concerning disclosure of medical error. Education in medical error management to professionally support error disclosure might help reduce the gap.
Postgrad Med J. 2012 Jan 25. [Epub ahead of print]
Medical error disclosure: the gap between attitude and practice.
Ghalandarpoorattar SM, Kaviani A, Asghari F.
Source
Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
Background
This study aims to evaluate the attending surgeons' and residents' attitudes towards error disclosure and factors that can potentially affect these tendencies in major academic hospitals affiliated with Tehran University of Medical Sciences (TUMS).
Methods and materials
In a cross-sectional study, self-administered questionnaires were delivered to all attending surgeons and second to fourth year surgical residents of TUMS during October and November 2009. The questionnaire contained two clinical scenarios and questions regarding physicians' attitudes towards disclosing medical error and their actual practice in the case of their last error. Of the 63 distributed questionnaires, 53 (84.1%) were completed and returned.
Results
Participants were less likely to disclose minor (39.6%; 21/53) than major (49.1%; 29/53) medical errors. Participants believed that their most important concerns for not disclosing errors were fear of a malpractice lawsuit (71.7%, n=38), losing patients' trust (62.3%, n=33), and emotional reactions of the patients and their relatives (56.6%, n=30). Although most physicians indicated they would disclose errors in minor and major scenarios, only 16.7% (n=8) had disclosed their last medical errors to their patients, two of which had resulted in patients taking legal action.
Conclusion
There was an obvious gap between surgeons' intentions and actual practices concerning disclosure of medical error. Education in medical error management to professionally support error disclosure might help reduce the gap.
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