Thursday, August 11, 2016

"During the invasion of Poland more than a few ordinary German soldiers objected to the massacring of enemy civilians, especially women and children. By the time of Barbarossa such objections had become rare."

Germany and the Concept of Collective Guilt

Do only psychopaths commit horrible mass crimes, or are we all more responsible than we are willing to admit? Two new histories of the Nazi war machine examine their leaders—and their soldiers.

Why take part in personalised cancer research?

 2016 Aug 10. doi: 10.1111/ecc.12563. [Epub ahead of print]

Why take part in personalised cancer research? Patients' genetic misconception, genetic responsibility and incomprehension of stratification-an empirical-ethical examination.

Author information

  • 1Department of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany.
  • 2Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.

Abstract

Therapeutic misconception is a well-known challenge for informed decision-making for cancer research participants. What is still missing, is a detailed understanding of the impact of "personalised" treatment research (e.g. biomarkers for stratification) on research participants. For this, we conducted the first longitudinal empirical-ethical study based on semi-structured interviews with colorectal cancer patients (n = 40) enrolled in a biomarker trial for (neo)adjuvant treatment, analysing the patients' understanding of and perspectives on research and treatment with qualitative methods. In addition to therapeutic misconception based on patients' confusion of research and treatment, and here triggered by misled motivation, information paternalism or incomprehension, we identified genetic misconception and genetic responsibility as new problematic issues. Patients mainly were not aware of the major research aim of future stratification into responders and non-responders nor did they fully acknowledge this as the aim for personalised cancer research. Thus, ethical and practical reflection on informed decision-making in cancer treatment and research should take into account the complexity of lay interpretations of modern personalised medicine. Instead of very formalistic, liability-oriented informed consent procedures, we suggest a more personalised communication approach to inform and motivate patients for cancer research.

Student group takes over a corner store to protest nutrition taxes and warnings

Student group takes over a corner store to protest nutrition taxes and warnings

"The project comes after documents obtained by The Canadian Press showed the federal government has weighed the possibility of a tax on soft drinks.

"We're looking to have people come by the store and get a glimpse of what it's like if the government is going to hold your hand through life, over-tax, over-regulate, over-ban everything that's bad for your health," said the group's co-ordinator, David Clement. 
"The point is to ask Canadians (whether) we need a nanny state or big government telling us how to live our lives or should adults be free to choose when it comes to what they put in their own bodies, what they eat, what they drink."
The group is the Canadian arm of an international network of libertarian students, and Clement said it comprises around 1,000 members at universities in Ontario, Quebec, Prince Edward Island and British Columbia."

"...there is a risk of lung cancer from inhalational marijuana as well as an association between inhalational marijuana and spontaneous pneumothorax, bullous emphysema, or COPD."

 2016 Aug 9. pii: respcare.04846. [Epub ahead of print]

A Systematic Review of the Respiratory Effects of Inhalational Marijuana.

Author information

  • 1University of Tampa, Department of Health Sciences and Human Performance, Tampa, Florida. MMartinasek@ut.edu.
  • 2University of Tampa, Department of Health Sciences and Human Performance, Tampa, Florida.

Abstract

This systematic review focuses on respiratory effects of inhalational marijuana. The systematic review of the literature was conducted using a comparative method between 2 researchers. Abstracts were reviewed for inclusion of respiratory effects related to inhalational marijuana. Relevant abstracts were collected, and full text articles were retrieved for review. Articles were removed if they did not contain burning marijuana; were animal studies; or were editorials, systematic reviews, commentaries, non-English language, or non-respiratory-related articles. Forty-eight articles were collected and categorized by respiratory effects. In particular, lung cancer, bullous emphysema/COPD, and other respiratory symptoms were the primary categories. Articles were noted by study population country, sample size, age distribution, and findings that were pertinent to respiratory health. The research indicates that there is a risk of lung cancer from inhalational marijuana as well as an association between inhalational marijuana and spontaneous pneumothorax, bullous emphysema, or COPD. A variety of symptoms have been reported by inhalational marijuana smokers, including wheezing, shortness of breath, altered pulmonary function tests, cough, phlegm production, bronchodilation, and other symptoms. It is important to stay current with research findings to educate patients on this smoking behavior.

"...there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care."

 2016 Jul 25. [Epub ahead of print]

A right to health care? Participatory politics, progressive policy, and the price of loose language.

Author information

  • 1Department of Philosophy, University of Tennessee, 801 McClung Tower, Knoxville, TN, 37996, USA. dreidy@utk.edu.

Abstract

This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care.

"...almost 50% of the studied children were overweight or obese and many presented alterations in the lipid and glucose levels."

 2016 Aug 10. pii: /j/ijamh.ahead-of-print/ijamh-2016-0045/ijamh-2016-0045.xml. doi: 10.1515/ijamh-2016-0045. [Epub ahead of print]

Eating habits and presence of cardiovascular risks in children.

Abstract

INTRODUCTION:

The changes in the eating habits associated with physical inactivity are directly related to the increase in the prevalence of obesity and associated diseases such as diabetes mellitus (DM), metabolic syndrome and cardiovascular diseases.

OBJECTIVE:

The aim of this study was to investigate the relationship between the frequency of consumption of some food groups (snacks, fruits, vegetables and candies), physical exercise, nutritional classification and biochemical profile in children.

METHODS:

After the approval of the Ethics Committee, we studied 882 schoolchildren ranging between 6 and 10 years of age. Biochemical and anthropometric evaluations were performed and questionnaires were used in order to check the eating habits and physical activity.

RESULTS:

Our results showed that we may relate the consumption of snacks, fruits, vegetables or candies with modifications in the glycemia, triglycerides, total cholesterol, HDL-c, and LDL-c but we did not observe association with the nutritional classification. It is noteworthy to say that almost 50% of the studied children were overweight or obese and many presented alterations in the lipid and glucose levels.

CONCLUSION:

Our results also show that many children have abnormal levels of lipids and glycemia and a great number of them are classified as overweight or obese. In this context, we can say that urgent approaches are needed to be carried out by a multidisciplinary team in order to improve the diet and reduces the risk factors in this population of children and prevent secondary diseases in adolescence and adulthood.

Wednesday, August 10, 2016

"...breast and colon cancer survivors were the most likely to end up obese within 10 years of their diagnosis."

Breast, Colorectal Cancer Survivors Face Highest Risk Of Obesity: How Weight Gain Sets Patients Back

"The obesity epidemic continues to grow, with more than one-third of American adults considered obese. Obesity increases the risk of a number of dangerous medical conditions, including Type 2 diabetes, sleep apnea, heart disease, and stroke. It may also follow cancer survivors, a team of researchers from Columbia University’s School of Public Health have found.
Their study, published in the Journal of Clinical Oncology, reveals obesity is more prevalent among patients with a history of cancer, especially certain types. In order to uncover the link between cancer and obesity, researchers first examined 538,969 adults between the ages of 18 and 85, of which 32,447 were cancer survivors. The data overwhelmingly indicated that breast and colon cancer survivors were the most likely to end up obese within 10 years of their diagnosis."

Why Do Some Adolescents Encounter Everyday Events That Increase Their Civic Interest Whereas Others Do Not?

 2016 Aug 8. [Epub ahead of print]

Why Do Some Adolescents Encounter Everyday Events That Increase Their Civic Interest Whereas Others Do Not?

Abstract

Using a longitudinal design, we asked 2 age cohorts of adolescents (15- and 18-year-olds) whether they, during the last year, had experienced events that had increased their civic interest and about details of their experiences. Based on self-determination theory, we predicted that the adolescents who reported having experienced events of this kind had already been more interested and had had more positive feelings about politics much earlier in time, and that this original interest would have increased more over time, than that of other adolescents. Second, we proposed that the adolescents who had encountered events that triggered their civic interest would have been engaged in behaviors that reflected their needs for autonomy, relatedness, and competence, much earlier in time, and that, over time, they would have increased these behaviors more than other adolescents. These 2 predictions were largely confirmed. As for the content of the events the adolescents reported, many of them concerned national and international issues experienced as threatening, and that challenged the adolescents' beliefs and morality. Overall, a previous interest in politics and engagement in exploratory behaviors that reflect the adolescents' psychological needs seem to play crucial roles in understanding why adolescents in their everyday life encounter events that trigger their civic interest. Further, the findings show that having had everyday experiences that trigger the adolescents' civic interests are associated with a later increase in political interest more broadly.

Obesity Linked to Smaller Brain Volume ("...an estimated 10-year acceleration of brain aging.")

Obesity Linked to Smaller Brain Volume

Fran Lowry
August 10, 2016


"Results indicated that cerebral white matter volume in overweight and obese individuals was associated with a greater degree of brain atrophy, with maximal effects in middle age corresponding to an estimated 10-year acceleration of brain aging."






Transbronchial Lung Cryobiopsy for Interstitial Lung Disease Diagnosis: A Perspective From Members of the Pulmonary Pathology Society

Kirtee Raparia , MD; Dara L. Aisner , MD; Timothy Craig Allen , MD, JD; Mary Beth Beasley , MD; Alain Borczuk , MD; Philip T. Cagle ,MD; Vera Capelozzi , MD, PhD; Sanja Dacic , MD, PhD; Lida P. Hariri , MD, PhD; Keith M. Kerr , BSc, MB, ChB, FRCPath, FRCPE;Sylvie Lantuejoul , MD, PhD; Mari Mino-Kenudson , MD; Natasha Rekhtman , MD, PhD; Anja C. Roden , MD; Sinchita Roy-Chowdhuri , MD, PhD; Lynette Sholl , MD; Maxwell L. Smith , MD; Eric Thunnissen , MD, PhD; Ming Sound Tsao , MD; Yasushi Yatabe, MD, PhD
From the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois (Dr Raparia); the Department of Pathology, University of Colorado Cancer Center, Denver (Dr Aisner); the Department of Pathology, The University of Texas Medical Branch, Galveston (Dr Allen); the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Beasley); the Department of Pathology, Weill Cornell Medical College, New York, New York (Drs Borczuk and Cagle); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Cagle); the Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil (Dr Capelozzi); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (Drs Hariri and Mino-Kenudson); the Department of Pathology, Aberdeen University Medical School and Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, United Kingdom (Dr Kerr); the Department of Biopathology, Centre Léon Bérard, Lyon, and J Fourier University–INSERM U 823-Institut A Bonniot, Grenoble, France (Dr Lantuejoul); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Rekhtman); the Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota (Dr Roden); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Roy-Chowdhuri); the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Sholl); the Department of Laboratory Medicine and Pathology, Mayo Clinic Scottsdale, Scottsdale, Arizona (Dr Smith); the Department of Pathology, VU Medical Center, Amsterdam, the Netherlands (Dr Thunnissen); the Department of Pathology, University Health Network, Princess Margaret Cancer Centre and University of Toronto, Toronto, Ontario, Canada (Dr Tsao); and the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe).
Reprints: Timothy Craig Allen, MD, JD, Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555 (email:).
Transbronchial lung cryobiopsy involves using a cryoprobe rather than forceps to obtain a bronchoscopic biopsy. Recent studies have shown that transbronchial cryobiopsy provides a larger specimen than conventional transbronchial forceps biopsy, and that the interobserver agreement in the interpretation of cryobiopsy specimens is comparable to that of a surgical lung biopsy. This is encouraging, and transbronchial lung cryobiopsy clearly has a role in the workup and diagnosis of interstitial lung diseases. However, very few patients who have been studied underwent both transbronchial lung cryobiopsy and surgical lung biopsy, and the available data suggest that the diagnostic accuracy of cryobiopsy may not be similar to that of surgical lung biopsy. Further study is needed before transbronchial lung biopsy can be recommended as a replacement for surgical lung biopsy.

Thursday, August 4, 2016

"...device reps work hard to make themselves unobtrusively indispensable in order to establish and maintain influence..."

 2016 Aug 3;11(8):e0158510. doi: 10.1371/journal.pone.0158510.

Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives.

Author information

  • 1Alpert School of Medicine, Brown University, Providence, Rhode Island, United States of America.
  • 2Retired Journalist, Takoma Park, Maryland, United States of America.
  • 3Georgetown University Medical Center, Washington, District of Columbia, United States of America.

Abstract

BACKGROUND:

Industry payments to surgeons have received public attention, but little is known about the relationships between surgeons and medical device representatives. Medical device representatives ("device reps") have become an integral part of operating room personnel. The effect of their presence on patient care deserves discussion.

STUDY DESIGN:

We conducted a qualitative, ethnographic study to explore relationships between surgeons and medical device representatives, and characterize industry involvement in the training of surgeons. We used group and individual open-ended interviews to gain insight into the beliefs, values, and perspectives of surgeons and device reps. We conducted two focus groups, one with ear, nose, and throat surgeons, and one with hospital-based attending orthopedic surgeons. We also conducted individual interviews with three former or current medical device representatives, a director of a surgical residency program at an academic medical center, and a medical assistant for a multi-physician orthopedic practice.

RESULTS:

While surgeons view themselves as indisputably in charge, device reps work hard to make themselves unobtrusively indispensable in order to establish and maintain influence, and to imbue the products they provide with personalized services that foster a surgeon's loyalty to the reps and their companies. Surgeons view industry-funded training opportunities as a necessary service. Device reps and some surgeons believe that reps benefit patient care, by increasing efficiency and mitigating deficiencies among operating room personnel (including the surgeons themselves).

CONCLUSIONS:

Our study raises ethical questions about the reliance of surgeons on device reps and device companies for education and surgical assistance and practical concerns regarding existing levels of competence among OR personnel.

"Roughly two-thirds of U.S. adults are overweight or obese, and half of these are adults have chronic conditions like diabetes or high blood pressure as a direct result."

Average American Is 15 Pounds Heavier Than 20 Years Ago

"The average American consumed 3,500 calories per day in 1990. In the year 2000, the same average American 3,804 calories per day, a huge increase. Roughly two-thirds of U.S. adults are overweight or obese, and half of these are adults have chronic conditions like diabetes or high blood pressure as a direct result. The average calories available to the average American increased 25 percent between 1970 and 2010, according to the U.S. Department of Agriculture."

Acute Lung Injury: A Clinical and Molecular Review

 2016 Apr;140(4):345-50. doi: 10.5858/arpa.2015-0519-RA.

Acute Lung Injury: A Clinical and Molecular Review.

Author information

  • 1From the Department of Pathology, The University of Texas Southwestern Medical School, Dallas (Dr Butt);
  • 2the Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler (Dr Kurdowska);
  • 3and the Departments of Pathology and Laboratory Services, The University of Texas Medical Branch, Galveston (Dr Allen).

Abstract

CONTEXT:

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are a continuum of lung changes arising from a wide variety of lung injuries, frequently resulting in significant morbidity and frequently in death. Research regarding the molecular pathophysiology of ALI/ARDS is ongoing, with the aim toward developing prognostic molecular biomarkers and molecular-based therapy.

OBJECTIVE:

To review the clinical, radiologic, and pathologic features of ALI/ARDS; and the molecular pathophysiology of ALI/ARDS, with consideration of possible predictive/prognostic molecular biomarkers and possible molecular-based therapies.

DATA SOURCES:

Examination of the English-language medical literature regarding ALI and ARDS.

CONCLUSIONS:

ARDS is primarily a clinicoradiologic diagnosis; however, lung biopsy plays an important diagnostic role in certain cases. A significant amount of progress has been made in the elucidation of ARDS pathophysiology and in predicting patient response, however, currently there is no viable predictive molecular biomarkers for predicting the severity of ARDS, or molecular-based ARDS therapies. The proinflammatory cytokines TNF-α (tumor necrosis factor α), interleukin (IL)-1β, IL-6, IL-8, and IL-18 are among the most promising as biomarkers for predicting morbidity and mortality.

Tuesday, August 2, 2016

Let's reduce the stigma of obesity

Let's reduce the stigma of obesity


"Despite all of the attention focused on the obesity epidemic, recent studies show that the overall prevalence of obesity is still increasing. With such a complex issue, it will take time for scientists to determine the best diet and exercise strategies for any given person.
In the meantime, let’s end the stigma and judgmental aspects of obesity, and let’s stop blaming people who are making a real effort to lose weight when many of the contributing factors to their obesity are beyond their control."

Meaningful Engagement of ACOs With Communities: The New Population Health Management

 2016 Jul 29. [Epub ahead of print]

Meaningful Engagement of ACOs With Communities: The New Population Health Management.

Author information

  • 1*Department of Family Medicine, College of Medicine †Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH ‡Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, NC.

Abstract

OBJECTIVES:

Population health management (PHM) activities within health care organizations have traditionally focused on coordinating services for populations who present for care in physicians' offices. With the recent proliferation of Accountable Care Organizations (ACOs), however, the reach of PHM has expanded. We aimed to study ACOs' evolving definitions of their patient populations, and how these definitions might be linked to different types of PHM activities pursued by ACOs.

METHODS:

Over a 2-year period, we conducted in-depth case studies of 4 ACOs operating in the private sector, including 149 interviews with 89 informants. Although the main study focused on the ACO implementation process, our use of both inductive and deductive qualitative methods enabled us to study emergent topics such as we report here about PHM.

RESULTS:

Interviewees across sites described their ACO populations using terms indicating both panel management and community/neighborhood involvement in the context of PHM. Further, all 4 sites reported conducting PHM activities that extended beyond traditional provider-based PHM; these ranged from wellness registries to school-based clinics. Executives at all 4 ACOs also discussed providing, or planning to provide, health care services to all community members in local settings.

CONCLUSIONS:

Administrators and physicians in private sector ACOs were proponents of ACO-led programs delivered in community settings that provided health care to all members of the community, and reported their ACOs engaged in multisector collaborations designed to improve neighborhood health. These community engagement activities point to a distinction from 90s era managed and integrated care organizations and may contribute to the sustainability of the ACO model.

Biomarker Testing in Lung Carcinoma Cytology Specimens: A Perspective From Members of the Pulmonary Pathology Society

 2016 Apr 15. [Epub ahead of print]

Biomarker Testing in Lung Carcinoma Cytology Specimens: A Perspective From Members of the Pulmonary Pathology Society.

Author information

  • 1From the Department of Pathology, University of Texas MD Anderson Cancer Center, Houston (Dr Roy-Chowdhuri); the Department of Pathology, University of Colorado Cancer Center, Denver (Dr Aisner); the Department of Pathology, University of Texas Medical Branch, Galveston (Dr Allen); the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Beasley); the Department of Pathology, Weill Cornell Medical College, New York (Drs Borczuk and Cagle); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Dr Cagle); the Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil (Dr Capelozzi); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Dacic); the Department of Pathology, University Health Network, Princess Margaret Cancer Centre, and the University of Toronto, Toronto, Ontario, Canada (Drs da Cunha Santos and Tsao); the Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston (Drs Hariri and Mino-Kenudson); the Department of Pathology, Aberdeen University Medical School, and Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, United Kingdom (Dr Kerr); the Department of Biopathology, Centre Léon Bérard, Lyon, and J Fourier University, Institut National de la Santé et de la Recherche Médicale-Institut Albert Bonniot, Grenoble, France (Dr Lantuejoul); the Department of Pathology, New York University, New York (Dr Moreira); the Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois (Dr Raparia); the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York (Dr Rekhtman); the Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston (Drs Sholl and Vivero); the Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands (Dr Thunnissen); and the Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan (Dr Yatabe).

Abstract

The advent of targeted therapy in lung cancer has heralded a paradigm shift in the practice of cytopathology with the need for accurately subtyping lung carcinoma, as well as providing adequate material for molecular studies, to help guide clinical and therapeutic decisions. The variety and versatility of cytologic-specimen preparations offer significant advantages to molecular testing; however, they frequently remain underused. Therefore, evaluating the utility and adequacy of cytologic specimens is critical, not only from a lung cancer diagnosis standpoint but also for the myriad ancillary studies that are necessary to provide appropriate clinical management. A large fraction of lung cancers are diagnosed by aspiration or exfoliative cytology specimens, and thus, optimizing strategies to triage and best use the tissue for diagnosis and biomarker studies forms a critical component of lung cancer management. This review focuses on the opportunities and challenges of using cytologic specimens for molecular diagnosis of lung cancer and the role of cytopathology in the molecular era.

"French Muslims are caught in a dilemma..."

Why ISIS Is Targeting French Catholics


"For the Muslim community in France, the situation is even more complex. The vast majority of French Muslims are just as shocked by these attacks as their Catholic compatriots. Moreover, the sincerity of Muslim representatives like Anouar Kbibech, the president of the CFCM, cannot be gainsaid when he declared: “We are all Catholics.” But just as the optimism behind the earlier iteration of that slogan, “We are all Charlie,” has long since faded, Kbibech’s affirmation may not gain much traction. French Muslims are caught in a dilemma: by mobilizing against the attacks carried out by Islamic State loyalists, they find themselves side-by-side with those on the right and extreme right who are opposed against not just Islamism in France, but Islam itself."

"...there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care."

 2016 Jul 25. [Epub ahead of print]

A right to health care? Participatory politics, progressive policy, and the price of loose language.

Author information

  • 1Department of Philosophy, University of Tennessee, 801 McClung Tower, Knoxville, TN, 37996, USA. dreidy@utk.edu.

Abstract

This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care.

"... women have surpassed men in obesity rates..."

Why are women losing the battle of the bulge?

Rising obesity rates for women weigh on doctors' minds. 


"After a national report this summer showed that women have surpassed men in obesity rates, doctors and obesity researchers are searching for answers to why women are struggling more than men.
For the first time, more than 40 percent of U.S. women are obese, according to the latest numbers from the Centers for Disease Control and Prevention.
The nation as a whole continues to struggle with obesity, with 35 percent of men considered obese. But while men's obesity rates appear to have stabilized, women's are still rising, the CDC report shows."

"...regardless, the physician has the obligation to make sure their patient is receiving care by one means or another."

 2016 May;36(4):168-73.

The Ethical and Legal Dilemma in Terminating the Physician-Patient Relationship.

Abstract

A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.

"Certainly a strong case could and will be made for the HIV treatment. But at an estimated cost of between £10m to £20m a year..."

HIV drug row: A very modern dilemma for the NHS


"Certainly a strong case could and will be made for the HIV treatment. But at an estimated cost of between £10m to £20m a year, the fact that condoms provide a cheaper alternative to prevention will also be taken into account alongside the cases that can be made for the other treatments.
This is why if you speak to anyone involved in these sort of decisions they will say they're really tough - and as the years go by they will just get tougher."