Wednesday, July 10, 2013

"I am not a dyslexic person; I'm a person with dyslexia." ("a discourse linking 'being stupid' with dyslexia was pervasive")

http://www.ncbi.nlm.nih.gov/pubmed/23829518

2013 Jul 8. doi: 10.1111/jan.12199. [Epub ahead of print]

'I am not a dyslexic person I'm a person with dyslexia': identity constructions of dyslexia among students in nurse education.

Evans W.

Source

Institute of Technology Tralee, Tralee, Ireland.

Abstract

AIM:

To introduce how nursing students discursively construct their dyslexic identities.

BACKGROUND:

Identity mediates many important facets of a student's scholarly journey and the availability and use of discourses play a critical part in their ongoing construction.

DESIGN:

A discourse-based design was used to examine the language employed by students in constructing their dyslexic identities.

METHODS:

Using narrative methods, 12 student nurses with dyslexia from two higher education institutions in the Republic of Ireland were interviewed during the period February-July 2012. Discourse analysis of interviews entailed a two-stage approach: leading identity analysis followed by thematic analysis.

RESULTS:

Discourses used by students to construct their dyslexic identity correspond with positions on an 'Embracer, Passive Engager and Resister' continuum heuristic. The majority of students rejected any reference to using medical or disabled discourses and instead drew on contemporary language in constructing their dyslexic identity. Nine of the 12 students did not disclose their dyslexic identity in practice settings and drew on not being understood to support this position. In addition, a discourse linking 'being stupid' with dyslexia was pervasive in most student narratives and evolved from historical as well as more recent interactions in nurse education.

CONCLUSION:

This study indicates variation in how students discursively construct their dyslexic identities, which, in turn, has an impact on disclosure behaviours. Policy leaders must continue to be mindful of wider sociocultural and individualized understandings of dyslexic identities to enhance inclusion prerogatives.

"Students showed a superficial understanding of patient safety factors, even those who were previous health professionals"

http://www.ncbi.nlm.nih.gov/pubmed/23834567

2013 Aug;10(4):224-9. doi: 10.1111/tct.12029.

When should students learn about ethics, professionalism and patient safety?

Walton M, Jeffery H, Van Staalduinen S, Klein L, Rothnie I.

Source

Sydney School of Public Health, Sydney Medical School, University of Sydney, New South Wales, Australia Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, AustraliaOffice of Medical Education, Sydney Medical School, University of Sydney, New South Wales, Australia.

Abstract

Background Medical education curricula are required to teach ethics, professionalism and patient safety, but there is no clear evidence as to when these topics should be introduced. The Personal and Professional Development (PPD) theme incorporates these topics, and is integrated throughout our postgraduate medical programme, but we were particularly interested in knowing when and how to introduce them to year-1 students. We describe an intensive PPD programme in the context of broader issues associated with the appropriate timing of PPD curricula in a medical programme.

Methods The PPD Intensive was held over 2 days (267 students in 2008 and 299 in 2009). Attendance was mandatory. Teaching included a mixture of didactic, small group and interactive sessions. Students completed a formative case-based assessment and evaluation questionnaire.

Results In response to questions about a patient narrative, many students focused on the health provider perspective, even when asked specifically to put themselves in the patient's position when answering questions about the case. Students showed a superficial understanding of patient safety factors, even those who were previous health professionals. The Intensive was evaluated highly, but from the perspective of faculty staff there were issues relating to timing and lack of clinical context to give real meaning and purpose to the basic concepts underpinning the learning areas.

Discussion The Intensive was designed to demonstrate to students the importance of PPD. A counter position is that students lack the clinical context required for effective learning of PPD topic areas. We discuss these conflicting beliefs and the changes made to the Intensive programme in 2010. As a result of the lessons, we changed the 2010 Intensive programme to strongly emphasise professionalism; patient safety was moved to the later years.

Banning smoking in parks and on beaches: science, policy, and the politics of denormalization

http://www.ncbi.nlm.nih.gov/pubmed/23836746

2013 Jul;32(7):1291-8. doi: 10.1377/hlthaff.2012.1022.

Banning smoking in parks and on beaches: science, policy, and the politics of denormalization.

Bayer R, Bachynski KE.

Abstract

Campaigns to limit tobacco use started in the 1970s and have led to bans on public smoking, which have been extended to parks and beaches. A review of state and local statutes shows that during 1993-2011, smoking was banned in 843 parks and on 150 beaches across the United States. Three justifications for these restrictions have been invoked: the risk of passive smoke to nonsmokers, the pollution caused by cigarette butts, and the long-term risks to children from seeing smoking in public. Our analysis of the evidence for these claims found it far from definitive and in some cases weak. What, then, accounts for the efforts to impose such bans? We conclude that the impetus is the imperative to denormalize smoking as part of a broader public health campaign to reduce tobacco-related illness and death. Although invoking limited evidence may prove effective in the short run, it is hazardous for public health policy makers, for whom public trust is essential.

From Yale: Plagiarism as an illusional sense of authorship: the effect of predictability on source attribution of thought

http://www.ncbi.nlm.nih.gov/pubmed/23500112

2013 May;143(1):35-9. doi: 10.1016/j.actpsy.2013.01.007. Epub 2013 Mar 20.

Plagiarism as an illusional sense of authorship: the effect of predictability on source attribution of thought.

Sugimori E, Kitagami S.

Source

Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT 06520-8205, USA. sugimori@psybox.org

Erratum in

Acta Psychol (Amst). 2013 Jun;143(2):252.

Abstract

Previous studies have shown that contextually high-predictability ideas are essential for one to sense the authorship of thoughts and that having the sense that one came up with an idea of one's own, instead of through hearing of another's idea, results in the feeling that one has output the ideas. In this study, we investigated the effects of an idea's predictability on the misattribution of another's thought to oneself. The participants were asked to write down two original ideas about how to use various objects while avoiding the duplication of another's ideas that had been presented beforehand in an input-output phase. In the monitoring phase (1 week and 1 month after the input-output phase), the participants were asked whether each idea had been generated by them, by another, or not generated at all. We found that a high-predictability idea is likely to be regarded with the notion "I generated the idea." This tendency increased with time, suggesting that participants were more likely to have a sense of authorship when high-predictability ideas were presented. We also discovered that they were more likely to conclude that the source of high-predictability ideas was the "Self." We discussed the results from the viewpoint of the participant's sense of agency as well.

Tuesday, July 9, 2013

Medical students and professionalism: "unrealistic as a way of life"?

http://www.ncbi.nlm.nih.gov/pubmed/23826730

2013 Jul 5. [Epub ahead of print]

"I have the right to a private life": Medical students' views about professionalism in a digital world.

Ross S, Lai K, Walton JM, Kirwan P, White JS.

Source

University of Alberta , Canada.

Abstract

Background: Social media site use is ubiquitous, particularly Facebook. Postings on social media can have an impact on the perceivedprofessionalism of students and practitioners.

Aims: In this study, we explored the attitudes and understanding of undergraduate medical students towards professionalism, with a specific focus on online behaviour.

Methods: A volunteer sample of students (n = 236) responded to an online survey about understanding of professionalism and perceptions of professionalism in online environments. Respondents were encouraged to provide free text examples and to elaborate on their responses through free text comments. Descriptive analyzes and emergent themes analysis were carried out.

Results: Respondents were nearly unanimous on most questions of professionalism in the workplace, while 43% felt that students should act professionally at all times (including free time). Sixty-four free text comments revealed three themes: "free time is private time";" professionalism is unrealistic as a way of life"; and "professionalism should be a way of life".

Conclusions: Our findings indicate a disconnect between what students report of what they understand of professionalism, and what students feel is appropriate and inappropriate in both online and real life behaviour. Curriculum needs to target understanding of professionalism in online and real environments and communicate realistic expectations for students.

Medical students: Only "43% felt that students should act professionally at all times"

http://www.ncbi.nlm.nih.gov/pubmed/23826730

2013 Jul 5. [Epub ahead of print]

"I have the right to a private life": Medical students' views about professionalism in a digital world.

Ross S, Lai K, Walton JM, Kirwan P, White JS.

Source

University of Alberta , Canada.

Abstract

Background: Social media site use is ubiquitous, particularly Facebook. Postings on social media can have an impact on the perceivedprofessionalism of students and practitioners.

Aims: In this study, we explored the attitudes and understanding of undergraduate medical students towards professionalism, with a specific focus on online behaviour.

Harnessing Photovoice for tuberculosis advocacy in Karachi, Pakistan

http://www.ncbi.nlm.nih.gov/pubmed/23793302

2013 Jun 21. [Epub ahead of print]

Harnessing Photovoice for tuberculosis advocacy in Karachi, Pakistan.

Mohammed S, Sajun SZ, Khan FS.

Source

1 Indus Hospital Research Center, Korangi Crossing, Karachi, Pakistan.

Abstract

In Pakistan, despite publically available free testing and treatment throughout the country, there were an estimated 58,000 deaths due to tuberculosis in 2010. Understanding the experiences of people affected by TB is essential in addressing barriers to effective treatment.The Indus Hospital used Photovoice to understand the experiences of people affected by TB in Karachi. Two hundred and thirty photographs and stories were collected from 55 people affected by TB. Five major themes and 12 sub-themes emerged from the data: the physical aspects of TB (weakness and the side effects of the medication), the social aspects of TB (loneliness, stigma, and the fear/guilt of infecting family members), the socio-economic aspects of TB (financial difficulties/poverty and poor living conditions), supportive factors during treatment (support from family and friends, support from welfare organizations, prayer, visiting peaceful places), and recovery (happiness about getting better). The photographs, stories, and a Call for Action were shared at a Gallery event with patients, practitioners, and policy-makers.This study provides a look at the complexities surrounding TB and emphasizes the need for holistic interventions for TB that address all aspects of the disease, including its social determinants. It also highlights the potential of Photovoice as an effective means to bring much-needed attention to this disease.

From U Murcia-Spain: From virtue bioethics to bioethics personalistic: is integration possible?

http://www.ncbi.nlm.nih.gov/pubmed/23745818

2013 Jan-Apr;24(80):49-56.

[From virtue bioethics to bioethics personalistic: is integration possible?].

[Article in Spanish]

Pastor LM.

Source

Department of Cell Biology and Histology, Medical School, IMIB, Regional Campus of International Excellence. Campus Mare Nostrum, University of Murcia, Murcia, Spain. bioetica@um.es.

Abstract

In this article we analyze how the idea of virtue as an important element of human ethical action is slowly being lost. There are proposals both in ethics and in bioethics to rehabilitate virtue and to consider it as a very important element of human morality. In particular, in the health sector the rehabilitation of virtue, would imply greater focus on the ethical character of professionals and personal improvement rather than on training for the resolution of ethical cases. Such guidance would also improve the health professional-patient relationship with an increase not only in the technical quality but also in human dimension of health sciences. However, this orientation or tendency in bioethics suffers from a deficit in reasoning due to lack of a complete theory of human action that covers the good and also norms. The second part of the article looks at the relation between of virtue and personalistic bioethics. Virtue is considered as an important element of human action and is integrated with the good and norms. After analyzing and distinguishing between what is today considered personalistic bioethics and the contributions of personalism to bioethics, the paper concludes that the integration of virtue in personalistic bioethics is not only possible but desirable to overcome the ethical minimalism that has resulted from modern day principlism driven bioethics.

Renata Adler: "Her advice to writers is: cling to your day job – wherever it happens to be – for as long as you possibly can."

http://www.guardian.co.uk/books/2013/jul/07/renata-adler-new-york-author-interview

Renata Adler: 'I've been described as shrill. Isn't that strange?'

Renata Adler talks about her life as a reporter, critic and novelist, how she was ostracised by the New Yorker for lambasting Pauline Kael and what it's like to come in from the cold as her novels are republished…

Rachel Cooke
The Observer, Saturday 6 July 2013

Her advice to writers is: cling to your day job – wherever it happens to be – for as long as you possibly can. "I've said it all along, in my even way: if you're at Condé Nast, and they're cutting your pieces to shreds, just hang on. Do your art in your own time, but don't quit because then you'll be out there, vulnerable. When I left the New Yorker, I was fair game. There is a little bit of fear when you have a connection [to a media institution], no matter how tenuous and no matter how disreputable the organisation."

Diagnostic Medical Home: A Model for Health and Well-Being

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0436-ED

Bennett W. Pafford and Cathy A. Petti (2013) Diagnostic Medical Home: A Model for Health and Well-Being. Archives of Pathology & Laboratory Medicine: July 2013, Vol. 137, No. 7, pp. 884-885.

EDITORIAL

Diagnostic Medical Home: A Model for Health and Well-Being

Bennett W. Pafford , MD, MPH; Cathy A. Petti , MD

From HealthSpring Global, Inc, Albuquerque, New Mexico.

"From lay press to scientific journals, changes in medical diagnostic technology have been described as revolutionary, disruptive, and transformative. And, without doubt, the era of “omics” (ie, genomic, exomic, proteomic) has forged exciting discoveries about disease, ourselves, and the world in which we live. In the near future, home- or office-based diagnostic devices will provide real-time information on disease indicators, such as cardiac status and blood glucose levels, and perform preventive screening. However, our health care system appears to be in a state of uncertainty on how to manage the data from these advanced technologies, and currently, no systematic approach has emerged. With experts claiming (with limited supporting data) that approximately 70% of medical decisions are based on diagnostic tests,¹ we need to critically examine the architecture of our health care model to ensure that we are poised to optimize the data from our diagnostic transformation."

The clinician's dilemma: Two dimensions of ethical care

http://www.ncbi.nlm.nih.gov/pubmed/23830641

2013 Jul 4. pii: S0160-2527(13)00071-X. doi: 10.1016/j.ijlp.2013.06.017. [Epub ahead of print]

The clinician's dilemma: Two dimensions of ethical care.

Gillett G, Chamberlain J.

Source

University of Otago, Bioethics Centre, New Zealand. Electronic address: grant.gillett@otago.ac.nz.

Abstract

There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care.

Ajit Pai on "entrenching incumbents (at consumers' expense)"

http://www.latimes.com/news/opinion/commentary/la-oe-pai-uber-taxi-app-20130709,0,5548791.story

L.A., let Uber's cars share the road

Too often, innovations of risk-taking entrepreneurs are hindered by entrenched industry and bureaucratic roadblocks.

By Ajit Pai

July 9, 2013

"These are just the latest chapters in an old economic story. Incumbents have long promoted regulation in the name of protecting consumers when their actual goal is to block new entrants and stifle competition. As Milton Friedman observed, "The pressure on the legislature to license an occupation rarely comes from the members of the public … the pressure invariably comes from members of the occupation itself."

Consumer protection is important. And rules to ensure safety and to deter fraud are necessary. But many regulations aren't about safeguarding consumers; they're about entrenching incumbents (at consumers' expense), and they're typically created by the very agencies that are supposed to oversee those incumbents."

Monday, July 8, 2013

"...in a world that lacks an ethics of death, as ours does..."

http://www.nytimes.com/2013/07/07/books/review/deadlines.html?nl=books&emc=edit_bk_20130705&pagewanted=all&_r=1&

Deadlines

By MEGHAN O’ROURKE

Reading today’s secular literature of death one ultimately realizes that the medical language is a scrim: on the one hand, it’s purely descriptive, a way of “recording” the strange time of the hospital. But on the other hand, its foreignness is connotative. It subconsciously serves to express the author’s fundamental alienation from the fact that this is happening to his body, his wishful hope that this remain unreal even as he experiences it as total, an immersion in what Hitchens describes as living in “another country.” The dissonance here is that dying is not really like entering “another country.” As Sontag observed accurately, it is our country from birth: “Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.” But in a world that lacks an ethics of death, as ours does, we live estranged from this deeper knowledge. Perhaps because we must.

From Yale: High-Resolution, 2- and 3-Dimensional Imaging of Uncut, Unembedded Tissue Biopsy Samples

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2013-0094-OA

Richard Torres, Sam Vesuna, Michael J. Levene, (2013) High-Resolution, 2- and 3-Dimensional Imaging of Uncut, Unembedded Tissue Biopsy Samples. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

High-Resolution, 2- and 3-Dimensional Imaging of Uncut, Unembedded Tissue Biopsy Samples

Richard Torres, MD, MS; Sam Vesuna, BS; Michael J. Levene, PhD

From the Departments of Laboratory Medicine (Dr Torres) and Neurology (Dr Levene), Yale University School of Medicine, New Haven, Connecticut; and the Department of Biomedical Engineering, Yale University School of Engineering and Applied Science, New Haven, Connecticut (Drs Torres and Levene and Mr Vesuna).

Context.—Despite continuing advances in tissue processing automation, traditional embedding, cutting, and staining methods limit our ability for rapid, comprehensive visual examination. These limitations are particularly relevant to biopsies for which immediate therapeutic decisions are most necessary, faster feedback to the patient is desired, and preservation of tissue for ancillary studies is most important. The recent development of improved tissue clearing techniques has made it possible to consider use of multiphoton microscopy (MPM) tools in clinical settings, which could address difficulties of established methods.

Objective.— To demonstrate the potential of MPM of cleared tissue for the evaluation of unembedded and uncut pathology samples.

Design.— Human prostate, liver, breast, and kidney specimens were fixed and dehydrated by using traditional histologic techniques, with or without incorporation of nucleic acid fluorescent stains into dehydration steps. A benzyl alcohol/benzyl benzoate clearing protocol was substituted for xylene. Multiphoton microscopy was performed on a home-built system.

Results.—Excellent morphologic detail was achievable with MPM at depths greater than 500 μm. Pseudocoloring produced images analogous to hematoxylin-eosin–stained images. Concurrent second-harmonic generation detection allowed mapping of collagen. Subsequent traditional section staining with hematoxylin-eosin did not reveal any detrimental morphologic effects. Sample immunostains on renal tissue showed preservation of normal reactivity. Complete reconstructions of 1-mm cubic samples elucidated 3-dimensional architectural organization.

Conclusions.—Multiphoton microscopy on cleared, unembedded, uncut biopsy specimens shows potential as a practical clinical tool with significant advantages over traditional histology while maintaining compatibility with gold standard techniques. Further investigation to address remaining implementation barriers is warranted.

Doctor role modelling in medical education

http://www.ncbi.nlm.nih.gov/pubmed/23826717

2013 Jul 5. [Epub ahead of print]

Doctor role modelling in medical education: BEME Guide No. 27.

Passi V, Johnson S, Peile E, Wright S, Hafferty F, Johnson N.

Source

Warwick Medical School , Coventry , UK.

Abstract

Aim: The aim of this review is to summarise the evidence currently available on role modelling by doctors in medical education.

Methods: A systematic search of electronic databases was conducted (PubMed, Psyc- Info, Embase, Education Research Complete, Web of Knowledge, ERIC and British Education Index) from January 1990 to February 2012. Data extraction was completed by two independent reviewers and included a quality assessment of each paper. A thematic analysis was conducted on all the included papers.

Results: Thirty-nine studies fulfilled the inclusion criteria for the review. Six main themes emerged from the content of high and medium quality papers: 1) the attributes of positive doctor role models; 2) the personality profiles of positive role models; 3) the influence of positive role models on students' career choice; 4) the process of positive rolemodelling; 5) the influence of negative role modelling; 6) the influence of culture, diversity and gender in the choice of role model.

Conclusions: This systematic review highlights role modelling as an important process for the professional development of learners. Excellence in role modelling involves demonstration of high standards of clinical competence, excellence in clinical teaching skills and humanistic personal qualities. Positive role models not only help to shape the professional development of our future physicians, they also influence their career choices. This review has highlighted two main challenges in doctor role modelling: the first challenge lies in our lack of understanding of the complex phenomenon of role modelling. Second, the literature draws attention to negative role modelling and this negative influence requires deeper exploration to identify ways to mitigate adverse effects. This BEME review offers a preliminary guide to future discovery and progress in the area of doctor role modelling.

Immunocompromised patients and their pets: Still best friends?

http://www.ncbi.nlm.nih.gov/pubmed/23820136

2013 Jun 29. pii: S1090-0233(13)00258-X. doi: 10.1016/j.tvjl.2013.05.042. [Epub ahead of print]

Immunocompromised patients and their pets: Still best friends?

Elad D.

Source

The Kimron Veterinary Institute, P.O. Box 12, Bet Dagan 50250, Israel. Electronic address: daniel.elad@gmail.com.

Abstract

The emergence of immunosuppressive human diseases and therapies in the last decades has raised the question of the risks and benefits for this group of patients deriving from their interaction with pets and the necessity to balance them in the best interest of the pet owner. Risks are related to the possibility of contracting zoonotic infections that are more severe and occasionally lethal in immunocompromised patients. To mitigate the risks and allow the owner to keep the pet, guidelines have been devised. The cooperation and communication between the owner, the physician and the veterinarian are fundamental for a rational approach in evaluating of the potential health risks associated with pets as sources of zoonotic diseases. The final decision should, however, be made by the owner, who alone will enjoy the benefits of the relationship but also be the one to bear the consequences.

Reframing chaos - A qualitative study of GPs managing patients with medically unexplained symptoms (what about better diagnosis?)

http://www.ncbi.nlm.nih.gov/pubmed/23826606

2013 Jul;42(7):501-2.

Reframing chaos - A qualitative study of GPs managing patients with medically unexplained symptoms.

Stone L.

Source

MBBS, BA, MPH, DipRACOG, FRACGP, FACRRM, is a PhD candidate, Centre for Values, Ethics and the Law in Medicine, University of Sydney, New South Wales.

Abstract

BACKGROUND:

Diagnosis brings order, predictability and validation to suffering. Patients with medically unexplained symptoms experience vulnerability and cultural invalidation. Doctors also struggle to manage these patients.

OBJECTIVE:

To explore the strategies general practitioners use to manage patients with mixed emotional and physical symptoms and no diagnosis.

METHODS:

Thematic analysis utilising semi-structured interviews of 24 Australian GPs.

RESULTS:

Validation of the patient as a person involved building a helpful therapeutic alliance. Commitment to the patient, which the GPs described as 'ownership', involved advocacy and support. Holding uncertainty involved managing the need for a disease name. This included harm minimisation, including uncertainty management. Shift to coping involved the challenges of managing ongoing symptoms that had no name, no cure and no predictable outcome.

DISCUSSION:

Managing patients with medically unexplained symptoms involves professional and personal challenges. However, many of the GPs in this study found managing these patients rewarding in the long term.

From U Chicago: Impact of the lung allocation score

http://www.ncbi.nlm.nih.gov/pubmed/23821502

2013 Jun;34(3):275-80. doi: 10.1055/s-0033-1348461. Epub 2013 Jul 2.

Impact of the lung allocation score.

McShane PJ, Garrity ER Jr.

Source

Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

Abstract

The number of donors falls short of the number of patients on the wait list for lung transplantation making it necessary to ration the available donor organs. The ideal allocation system is guided by ethical principles and scientifically accurate at identifying patients who will gain the greatest degree of benefit from receiving the organ, in terms of both pre- and posttransplantation survival. The lung allocation score (LAS) was developed in 2005 to reduce mortality on the wait list, prioritize candidates based on urgency, minimize the role of geography, and maximize transplant benefit. The LAS has not made much of an impact on the geographic disparity of listing patients for lung transplantation, but it did achieve the goal of reducing wait-list mortality and prioritizing patients based on urgency. In prioritizing patients with the most urgent status, a new controversy has come into the forefront: whether or not the increased number of critically ill recipients maximizes transplant benefit. Despite the controversy, the LAS system is an improvement compared with the traditional first-come, first-served system, and it has even been adopted by Eurotransplant. In the future, as modifications are made to improve the LAS, the issue of critically ill patients and maximizing posttransplant benefit will be the focus.

Overriding parents' medical decisions for their children: a systematic review of normative literature

http://www.ncbi.nlm.nih.gov/pubmed/23824967

2013 Jul 3. [Epub ahead of print]

Overriding parents' medical decisions for their children: a systematic review of normative literature.

McDougall RJ, Notini L.

Source

Centre for Health and Society, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

Abstract

This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question 'when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents' wishes?' We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality.

Friday, July 5, 2013

Reconstruction of the boundary between climate science and politics: The IPCC in the Japanese mass media, 1988-2007

http://www.ncbi.nlm.nih.gov/pubmed/23825249

2012 Aug 3. [Epub ahead of print]

Reconstruction of the boundary between climate science and politics: The IPCC in the Japanese mass media, 1988-2007.

Asayama S, Ishii A.

Source

Tohoku University, Japan.

Abstract

The Intergovernmental Panel on Climate Change (IPCC) plays a significant role in bridging the boundary between climate science and politics. Media coverage is crucial for understanding how climate science is communicated and embedded in society. This study analyzes the discursive construction of the IPCC in three Japanese newspapers from 1988 to 2007 in terms of the science-politics boundary. The results show media discourses engaged in boundary-work which rhetorically separated science and politics, and constructed the iconic image of the IPCC as a pure scientific authority. In the linkages between the global and national arenas of climate change, the media "domesticate" the issue, translating the global nature of climate change into a discourse that suits the national context. We argue that the Japanese media's boundary-work is part of the media domestication that reconstructed the boundary between climate science and politics reflecting the Japanese context.

Zombie allusions: They just keep on coming-bringing Israelis and Palestinians together

http://www.jewishtimes-sj.com/news/2013-07-05/National_%7C_World_Briefs/What_World_War_Z_Says_About_Israel.html

What ‘World War Z’ Says About Israel

ARTS & CULTURE

By Jana Banin

"But that's all the blogosphere needed to start buzzing for weeks about the deeper meaning of the Israel-related plot line and the message that it sends about Israel and its policies.

Some see the cinematic version as a pro-Israel statement, justifying the existence of a wall in the real-life, non-zombieridden West Bank – the wall is extreme, but it keeps people safe.

Interestingly, in the film the wall actually brings Israelis and Palestinians together. In apocalyptic Jerusalem, background is irrelevant. As long as you’re not a monster with an appetite for humans, you’re cool."