From the CDC: Active Asthma and the Prevalence of Physician-Diagnosed COPD

Lung. 2014 Jun 21. [Epub ahead of print]

Active Asthma and the Prevalence of Physician-Diagnosed COPD.

Mirabelli MC1, Beavers SF, Chatterjee AB.

Author information

• 1Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop F-60, Atlanta, GA, 30341, USA, zif7@cdc.gov.

Abstract

INTRODUCTION:

Despite the considerable overlap of asthma and chronic obstructive pulmonary disease (COPD), the extent to which the two diagnoses are the manifestations of the same disease remains unresolved. We conducted these analyses to evaluate the role of active asthma in the prevalence of physician-diagnosed COPD.

METHODS:

From 2006 through 2010, 74,209 adults aged 18-99 years and with a history of asthma participated in the Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey and responded to interview-administered questionnaires via telephone. We used publicly available data from 71,639 (97%) participants to identify respondents with and without active manifestations of asthma and self-reported, physician-diagnosed COPD. We generated population-weighted estimates of physician-diagnosed COPD prevalence and conducted linear regression to estimate associations between active asthma status and the prevalence of COPD among current smokers, former smokers, and lifetime nonsmokers separately.

RESULTS:

Physician-diagnosed COPD was reported in an estimated 29% of the population with any history of asthma, including both active and inactive asthma. Age-specific prevalences of physician-diagnosed COPD were consistently higher among adults with active asthma than adults without active asthma. Compared to inactive asthma, active asthma was associated with an 8.3% [95 % confidence interval (CI) 6.1, 10.5] higher prevalence of physician-diagnosed COPD among lifetime nonsmokers, a 20.6% (95 % CI 18.0, 23.3) higher prevalence among former smokers, and a 26.7% (95 % CI 22.5, 30.9) higher prevalence among current smokers.

CONCLUSIONS:

Among adults with a history of asthma, active manifestations of asthma may play an important role in the epidemiology of COPD.

J Med Ethics. 2014 Jun 20. pii: medethics-2013-101830. doi: 10.1136/medethics-2013-101830. [Epub ahead of print]

Gamete derivation from stem cells: revisiting the concept of genetic parenthood.

Mertes H.

Abstract

Genetic parenthood is usually portrayed as a value-neutral concept that can be confirmed or rejected based on objective, scientific tests. However, on inspection, it is exposed as a very complex idea that we might need to consider as something that comes in different shapes and forms and that is open to interpretation rather than being clearly defined and fixed. Different people may therefore also desire different aspects of the general concept of genetic parenthood, which implies that some may not even be satisfied with gametes that have all the properties that their own natural gametes would have, whereas others may be satisfied with a much simpler solution. Encouraging infertility patients to gain insight into what it is exactly that they hope to gain by pursuing genetic parenthood (rather than choosing for donor conception or adoption) may lead them to recognise that the added advantage may be limited and may be acquired in other ways as well. Nevertheless, many people will find it difficult to let go of the desire for genetic parenthood as it is deeply rooted in our genes. Infertility is experienced as a grave medical condition and entails an intense grieving process for many. For that reason alone it is important that the medical and research community develop and apply methods to help people in their quest for genetic parenthood. On the other hand, it is important not to reinforce the dogma that genetic parenthood is 'the best kind of parenthood'.

Med Law. 2014 Apr;33(1):14-21.

I'm getting turned off: emerging consensus on deactivating cardiac implantable electronic devices.

Kapp MB.

Abstract

The surgical insertion of permanent heart rhythm (resynchronization) devices within individuals who have chronic cardiac deficiencies is widespread and increasing. It is predictable that some individuals who have had a permanent heart rhythm device implanted will subsequently reach a point, physically and/or emotionally, at which they (or their surrogates) indicate the desire that their own resynchronization be removed or deactivated. Despite continuing controversy, a professional international consensus has begun to emerge over the past few years, concerning the fundamental legal and ethical principles that ought to guide clinical practice regarding the deactivation of cardiac implantable electrical devices (CIEDs). The central legal and ethical principles of the emerging professional consensus in this sphere are briefly summarized in this article, along with some thoughts about the challenges of translating those principles into clinical practice for specific patients.

Med Law. 2014 Apr;33(1):22-39.

The historical development of health care law and bioethics in England and Wales: a symbiotic relationship?

Owusu-Dapaa E.

Abstract

The paper explores the backward and forward linkage between HCL and bioethics. Indeed, the relationship between the two is so close that it can be considered one of symbiosis. This is particularly the case when an account is taken of how HCL and bioethics positively benefitted from each other in diverse ways during their development into their present status as discrete disciplines. In the first place, the aftermath of the Second World War, such as the Nuremberg trial and unprecedented medical experiment scandals in the 1960s/70s fuelled the increasing participation of lay scholars in exploring and critiquing medical ethics which culminated in the emergence ofbioethics.2 This in turn facilitated the evolution of HCL as a discipline, since academic lawyers involved in early bioethical discourse developed interest in exploring the interface between law and bioethics at the same time that society was waking up to the ethical implications of medical advances. As HCL emerged as a discrete discipline, it consolidated the status of bioethics as a field of inquiry by projecting the relevance of the latter in adjudication of novel cases with significant slippery moral undertones. Thus, the chicken and egg paradox finds a perfect reflection in the emergence of health care law and bioethics in England and Wales.

Eur J Health Law. 2014 Apr;21(2):123-40.

Human rights and reproductive choices in the case-law of Italian and European courts.

Valongo A.

Abstract

The major issues regarding human fertilisation and embryology are addressed in a comparative perspective and in the light of relevant rulings of the European Court for Human Rights: the relationship between artificial procreation and parental responsibilities, the legal nature of the unborn child, the human right to reproduce and to have a healthy child. The article focuses on the key data of the latest Italian regulation regarding assisted conception, especially compared with British law. Particular attention is paid to the contribution given by recent European decisions to the protection of new human rights. National and international judgements ensure the right to private life and to health that are not always guaranteed by law. Converging developments in case-law panorama make the right to have children, to responsible procreation, to information about medical treatments, much less disharmonic realities than the Member States legislation suggests.

Greta Alì, Agnese Proietti, Serena Pelliccioni, Cristina Niccoli, Cristiana Lupi, Elisa Sensi, Riccardo Giannini, Nicla Borrelli, Maura Menghi, Antonio Chella, Alessandro Ribechini, Federico Cappuzzo, Franca Melfi, Marco Lucchi, Alfredo Mussi, Gabriella Fontanini, (2014) ALK Rearrangement in a Large Series of Consecutive Non–Small Cell Lung Cancers: Comparison Between a New Immunohistochemical Approach and Fluorescent In Situ Hybridization for the Screening of Patients Eligible for Crizotinib Treatment. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

ALK Rearrangement in a Large Series of Consecutive Non–Small Cell Lung Cancers: Comparison Between a New Immunohistochemical Approach and Fluorescent In Situ Hybridization for the Screening of Patients Eligible for Crizotinib Treatment

Greta Alì, MD; Agnese Proietti, MD; Serena Pelliccioni, MLT; Cristina Niccoli, MLT; Cristiana Lupi, PhD; Elisa Sensi, PhD; RiccardoGiannini, PhD; Nicla Borrelli, PhD; Maura Menghi, PhD; Antonio Chella, MD; Alessandro Ribechini, MD; Federico Cappuzzo, MD;Franca Melfi, MD; Marco Lucchi, MD; Alfredo Mussi, MD; Gabriella Fontanini, MD

From the Units of Pathological Anatomy (Drs Alì, Proietti, Lupi, and Sensi and Ms Pelliccioni), Pneumology (Dr Chella), Endoscopic Section of Pneumology (Dr Ribechini), and Thoracic Surgery (Drs Melfi and Lucchi), Azienda Ospedaliera Universitaria Pisana, Pisa, Italy; the Units of Pathological Anatomy (Ms Niccoli and Drs Giannini, Borrelli, and Fontanini) and Thoracic Surgery (Dr Mussi), Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy; Diatech Pharmacogenetics, Jesi, Italy (Dr Menghi); and the Department of Oncology, Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy (Dr Cappuzzo).

Context.— Echinoderm microtubule associated proteinlike 4–anaplastic lymphoma receptor tyrosine kinase (EML4-ALK) translocation has been described in a subset of patients with non–small cell lung cancer (NSCLC) and has been shown to have oncogenic activity. Fluorescence in situ hybridization (FISH) is used to detect ALK-positive NSCLC, but it is expensive, time-consuming, and difficult for routine application.

Objective.— To evaluate the potential role of immunohistochemistry (IHC) as a screening tool to identify candidate cases for FISH analysis and for ALK inhibitor therapy in NSCLC.

Design.— We performed FISH and IHC for ALK and mutational analysis for epidermal growth factor receptor (EGFR) andKRAS in 523 NSCLC specimens. We conducted IHC analysis with the monoclonal antibody D5F3 (Ventana Medical Systems, Tucson, Arizona) and a highly sensitive detection system. We also performed a MassARRAY-based analysis (Sequenom, San Diego, California) in a small subset of 11 samples to detect EML4-ALK rearrangement.

Results.— Of the 523 NSCLC specimens, 20 (3.8%) were positive for ALK rearrangement by FISH analysis. EGFR andKRAS mutations were identified in 70 (13.4%) and 124 (23.7%) of the 523 tumor samples, respectively. ALK rearrangement and EGFR and KRAS mutations were mutually exclusive. Of 523 tumor samples analyzed, 18 (3.4%) were ALK⁺ by IHC, 18 samples (3.4%) had concordant IHC and FISH results, and 2 ALK⁺ cases (0.3%) by FISH failed to show ALK protein expression. In the 2 discrepant cases, we did not detect any mass peaks for the EML4-ALK variants by MassARRAY.

Conclusions.— Our results show that IHC may be a useful technique for selecting NSCLC cases to undergo ALK FISH analysis.

"Though as an economic system capitalism is ‘intrinsically faithless’, relying on the dull compulsion of the market, it is a ‘true believer’ in the value of traditional religion in the sphere of morality and social conduct."

MICHAEL FITZPATRICK

GOD IS DEAD, LONG LIVE GOD

Terry Eagleton casts a critical eye over efforts to fill that God-shaped hole.

"Though as an economic system capitalism is ‘intrinsically faithless’, relying on the dull compulsion of the market, it is a ‘true believer’ in the value of traditional religion in the sphere of morality and social conduct. The problem here is not only that the advance of market forces, science, technology and education have had a corrosive effect on popular faith. It is also the case that the distinctive ideologies of capitalism – pragmatism, materialism and utilitarianism – lack an affirmative, affective quality that might inspire the masses. Eagleton quotes the judgement of the (recently beatified) Victorian Anglo-Catholic John Henry Newman, that liberalism was ‘too cold a principle to prevail with the multitude’."

J Contin Educ Health Prof. 2014 Apr;34(2):112-22. doi: 10.1002/chp.21228.

Professionalism and maintenance of certification: using vignettes describing interpersonal dilemmas to stimulate reflection and learning.

Bernabeo EC, Reddy SG, Ginsburg S, Holmboe ES.

Abstract

INTRODUCTION:

Physicians do not always agree on "rules" governing behavior in professionally challenging situations. Little is known about contextual factors that influence physician approaches in these situations. We explored the individual-, social-, and societal-level factors that physicians consider when responding to 2 common professional dilemmas. We were particularly interested in knowing the extent to which physicians engage in self-reflection as a result of responding to the vignettes.

METHODS:

A cross-sectional Web-based survey was sent to a random sample of 396 physicians, prompting them to respond to scripted professional dilemmas.

RESULTS:

A total of 120 physicians responded, yielding a response rate of 32.6%. Physicians responded to these dilemmas in highly variable ways, negotiating a complex array of contextual factors in their decisions. Interacting factors involving individual-level physician (eg, worry, guilt), patient (eg, nature of medical condition or relationship with patient), and social/societal (eg, policy, what peers or colleagues do) were important drivers in physician responses. Qualitative analysis revealed that several interacting themes guide physician approaches to professional dilemmas: patient welfare; types of patients; political, ethical, or legal issues; guiding principles; values; rules; and habits.

DISCUSSION:

Physicians negotiate a complex set of individual-, social-, and societal-level factors in response to professional dilemmas. This finding has important implications for the promotion and assessment of professional behavior in practicing physicians. Reflecting on scenarios may be an opportunity for physicians to learn about how and why they make decisions in difficult situations.

From U Sarajevo: Plagiarism in Scientific Research and Publications and How to Prevent It

Mater Sociomed. 2014 Apr;26(2):141-146. Epub 2014 Apr 11.

Plagiarism in Scientific Research and Publications and How to Prevent It.

Masic I.

Author information

• Faculty of medicine, University of Sarajevo, Bosnia and Herzegovina.

Abstract

Quality is assessed on the basis of adequate evidence, while best results of the research are accomplished through scientific knowledge. Information contained in a scientific work must always be based on scientific evidence. Guidelines for genuine scientific research should be designed based on real results. Dynamic research and use correct methods of scientific work must originate from everyday practice and the fundamentals of the research. The original work should have the proper data sources with clearly defined research goals, methods of operation which are acceptable for questions included in the study. When selecting the methods it is necessary to obtain the consent of the patients/respondents to provide data for execution of the project or so called informed consent. Only by the own efforts can be reached true results, from which can be drawn conclusions and which finally can give a valid scholarly commentary. Text may be copied from other sources, either in whole or in part and marked as a result of the other studies. For high-quality scientific work necessary are expertise and relevant scientific literature, mostly taken from publications that are stored in biomedical databases. These are scientific, professional and review articles, case reports of disease in physician practices, but the knowledge can also be acquired on scientific and expert lectures by renowned scientists. Form of text publications must meet standards on writing a paper. If the article has already been published in a scientific journal, the same article cannot be published in any other journal with a few minor adjustments, or without specifying the parts of the first article which is used in another article. Copyright infringement occurs when the author of a new article, with or without mentioning the author, uses a substantial portion of previously published articles, including past contributions in the first article. With the permission of the publisher and the author, another journal can re-publish the article already published. In that case, that is not plagiarism, because the journal states that the article was re-published with the permission of the journal in which the article is primarily released. The original can be only one, and the copy is a copy, and plagiarism is stolen copy. The aim of combating plagiarism is to improve the quality, to achieve satisfactory results and to compare the results of their own research, rather than copying the data from the results of other people's research. Copy leads to incorrect results. Nowadays the problem of plagiarism has become huge, or widespread and present in almost all spheres of human activity, particularly in science. Scientific institutions and universities should have a center for surveillance, security, promotion and development of quality research. Establishment of rules and respect the rules of good practice are the obligations of each research institutions, universities and every individual researchers, regardless of which area of science is being investigated. There are misunderstandings and doubts about the criteria and standards for when and how to declare someone a plagiarist. European and World Association of Science Editors (EASE and WAME), and COPE - Committee on Publishing Ethics working on the precise definition of that institution or that the scientific committee may sanction when someone is proven plagiarism and familiarize the authors with the types of sanctions. The practice is to inform the editors about discovered plagiarism and articles are withdrawn from the database, while the authors are put on the so-called black list. So far this is the only way of preventing plagiarism, because there are no other sanctions.

Cancer Nurs. 2014 Jun 18. [Epub ahead of print]

Experiences of Ethical Issues When Caring for Children With Cancer.

Bartholdson C1, Lützén K, Blomgren K, Pergert P.

Author information

• 1Author Affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Abstract

BACKGROUND::

The treatment for pediatric cancer is often physically, socially, and psychologically demanding and often gives rise to ethicalissues.

OBJECTIVE::

The purpose of this study was to describe healthcare professionals' experiences of ethical issues and ways to deal with these when caring for children with cancer.

METHODS::

A study-specific questionnaire was given to healthcare professionals at a pediatric hospital in Sweden. Qualitative content analysis was used to analyze answers to open-ended questions. The data were sorted into 2 domains based on the objective of the study. In the next step, the data in each domain were inductively coded, generating categories and subcategories.

RESULTS::

The main ethical issues included concerns of (1) infringing on autonomy, (2) deciding on treatment levels, and (3) conflicting perspectives that constituted a challenge to collaboration. Professionals desired teamwork and reflection to deal with ethical concerns, and they needed resources for dealing with ethics.

IMPLICATIONS FOR PRACTICE::

Interprofessional consideration needs to be improved. Forums and time for ethics reflections need to be offered to deal with ethical concerns in childhood cancer care.

CONCLUSIONS::

Experiences of ethical concerns and dealing with these in caring for children with cancer evoked strong feelings and moral perplexity among nursing staff. The study raises a challenging question: How can conflicting perspectives, lack of interprofessional consideration, and obstacles related to parents' involvement be "turned around," that is, contribute to a holistic perspective of ethics in cancer care of children?

Am J Orthop (Belle Mead NJ). 2014 Jun;43(6):E117-E123.

Risk of Hepatitis C Virus Exposure in Orthopedic Surgery: Is Universal Screening Needed?

DelSole EM, Mercuri JJ, Stachel A, Phillips MS, Zuckerman JD1.

Author information

• 1NYU Hospital for Joint Diseases, New York, NY. joseph.zuckerman@nyumc.org.

Abstract

The aging baby boomer generation will soon start using tremendous orthopedic surgical resources. This group has also been identified as a group at high risk for having undiagnosed hepatitis C virus (HCV) infection. We conducted a study to assess the prevalence of HCV among orthopedic surgery patients at our institution-using their demographic data to determine whether they represent a unique cohort at high risk for having undiagnosed HCV. We estimated that we operated on as many as 233 patients with undiagnosed HCV in 2011. A cost-effective, universal preoperative HCV screening program may reduce the risk for occupational exposure in orthopedic surgery and significantly benefit public health by bringing undiagnosed patients to treatment. A robust screening program requires several ethical considerations. By offering routine screening to patients, orthopedic surgeons have an opportunity to maintain intraoperative safety and improve the health of the public.

Genet Med. 2014 Jun 19. doi: 10.1038/gim.2014.74. [Epub ahead of print]

The translational potential of research on the ethical, legal, and social implications of genomics.

Burke W1, Appelbaum P2, Dame L3, Marshall P4, Press N5, Pyeritz R6, Sharp R7, Juengst E8.

Author information

• 1University of Washington, Seattle, Washington, USA.
• 2Columbia University, New York, New York, USA.
• 3Duke University, Durham, North Carolina, USA.
• 4Case Western Reserve University, Cleveland, Ohio, USA.
• 5Oregon Health & Science University, Portland, Oregon, USA.
• 6Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
• 7Biomedical Ethics Program, Mayo Clinic, Mayo Medical School, Rochester, Minnesota, USA.
• 8University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Abstract

Federally funded research on the ethical, legal, and social implications (ELSI) of genomics includes a programmatic charge to consider policy-relevant questions and to communicate findings in venues that help inform the policy-making process. In addressing this goal, investigators must consider the range of policies that are relevant to human genetics; how foundational research in bioethics, law, and the social sciences might inform those policies; and the potential professional issues that this translational imperative raises for ELSI investigators. We review these questions in light of experiences from a consortium of federally funded Centers of Excellence in ELSI Research, and offer a set of policy recommendations for program design and evaluation of ELSI research. We conclude that it would be a mistake to require that ELSI research programs demonstrate a direct impact on science or health policy; however, ELSI researchers can take steps to increase the relevance of their work to policy makers. Similarly, funders of ELSI research who are concerned with facilitating policy development can help by building cross-disciplinary translational research capacities, and universities can take steps to make policy-relevant research more rewarding for scholars in the humanities, social sciences, and law.

Psychol Sci. 2014 Jun 13. pii: 0956797614536401. [Epub ahead of print]

Can Classic Moral Stories Promote Honesty in Children?

Lee K1, Talwar V2, McCarthy A3, Ross I3, Evans A4, Arruda C2.

Author information

• 1Dr. Eric Jackman Institute of Child Study, University of Toronto kang.lee@utoronto.ca.
• 2Department of Educational and Counselling Psychology, McGill University.
• 3Dr. Eric Jackman Institute of Child Study, University of Toronto.
• 4Department of Psychology, Brock University.

Abstract

The classic moral stories have been used extensively to teach children about the consequences of lying and the virtue of honesty. Despite their widespread use, there is no evidence whether these stories actually promote honesty in children. This study compared the effectiveness of four classic moral stories in promoting honesty in 3- to 7-year-olds. Surprisingly, the stories of "Pinocchio" and "The Boy Who Cried Wolf" failed to reduce lying in children. In contrast, the apocryphal story of "George Washington and the Cherry Tree" significantly increased truth telling. Further results suggest that the reason for the difference in honesty-promoting effectiveness between the "George Washington" story and the other stories was that the former emphasizes the positive consequences of honesty, whereas the latter focus on the negative consequences of dishonesty. When the "George Washington" story was altered to focus on the negative consequences of dishonesty, it too failed to promote honesty in children.

Cancer Nurs. 2014 July/August;37(4):271-277.

Psychological Distress Between Young Adult Female Survivors of Childhood Cancer and Matched Female Cohorts Surveyed in the Adolescent Health Study.

Cantrell MA1, Posner MA.

Author information

• 1Author Affiliations: College of Nursing (Dr Cantrell) and Department of Mathematical Sciences (Dr Posner), Villanova University, Pennsylvania.

Abstract

BACKGROUND::

The psychological health of childhood cancer survivors is an essential treatment outcome. Female survivors are a subgroup of survivors with an increased risk for poor psychological outcomes.

OBJECTIVE::

This study compared psychological distress in young adult female survivors of childhood cancer with that in young adult females in the general population with no history of childhood cancer. Psychological distress was measured by assessing respondents' subjective degree ofdepressive symptoms, anxiety, and somatization.

METHODS::

The study was a secondary data analysis. The sample was drawn from the National Longitudinal Study of Adolescent Health, which used a representative, probability-based sampling technique. The sample included 66 young adult female survivors of childhood cancer and 8186 young adult females with no history of cancer. Randomized, nonparametric testing was used to construct 10 000 different age-matched female cohort samples from the general population.

RESULTS::

Young adult female survivors of childhood cancer had more depressive symptoms (P < .05) as compared with matched cohorts with 589 of the 10 000 matched samples. There were no statistically significant differences between the cancer survivors and the matched cohort groups on anxiety and somatization symptoms.

CONCLUSION::

Young adult female survivors of childhood cancer are at an increased risk of experiencing depression, which can decrease their psychological functioning and emotional well-being.

IMPLICATIONS FOR PRACTICE::

Healthcare professionals who care for these cancer survivors need to be aware that female survivors are at risk fordepression and should screen and refer accordingly.

Am J Respir Crit Care Med. 2014 Jun 17. [Epub ahead of print]

Nocturnal Asthma and the Importance of Race-ethnicity and Genetic Ancestry.

Levin AM1, Wang Y, Wells KE, Padhukasahasram B, Yang JJ, Burchard EG, Williams LK.

Author information

• 1Henry Ford Health System, Public Health Sciences , 1 Ford Place, #3E , Detroit, Michigan, United States, 48202 , 313-874-6669 , 313-874-6730 , Henry Ford Health System, Center for Bioinformatics, Detroit, Michigan, United States ; alevin1@hfhs.org.

Abstract

Rationale: Nocturnal asthma is a common presentation and is associated with a more severe form of the disease. However, there are few epidemiologic studies of nocturnal asthma, particularly in minority populations. 

Objectives: To identify factors associated with nocturnal asthma, including the contribution of self-identified race-ethnicity and genetic ancestry. 

Methods: The analysis included individuals from the Study for Asthma Phenotypes and Pharmacogenomic Interactions by Race-ethnicity (SAPPHIRE) cohort. Nocturnal asthma symptoms were assessed by questionnaire. Genome-wide genotype data was used to estimate genetic ancestry in a subset of African American participants. Logistic regression was used evaluate the association of various factors with nocturnal asthma, such as self-identified race-ethnicity and genetic ancestry. 

Measurement and Main Results: The study comprised 3,380 African American and 1,818 European Americans individuals with asthma. After adjusting for other potential explanatory variables, including controller medication use, African Americans were more than twice as likely (odds ratio [OR] 2.56; 95% confidence interval [CI] 2.24-2.93) to report nocturnal asthma when compared with European American individuals. Among the subset of African American participants with genome-wide genotype data (n=1,040), estimated proportion of African ancestry was also associated with an increased risk of nocturnal asthma (p=0.007). Differences in lung function explained a small, but statistically significant (p=0.02), proportion of the relationship between genetic ancestry and nocturnal asthma symptoms. 

Conclusions: Both self-identified race-ethnicity and African ancestry appear to be independent predictors of nocturnal asthma.

From U Oxford: The medicalization of love

Camb Q Healthc Ethics. 2014 Jun 17:1-19. [Epub ahead of print]

The medicalization of love.

Earp BD1, Sandberg A2, Savulescu J1.

Author information

• 1Uehiro Centre for Practical Ethics,University of Oxford.
• 2Oxford Centre for Neuroethics,University of Oxford.

Abstract

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to "medicalization" of human love and heartache-for some, a source of serious concern. In this essay, we argue that the "medicalization of love" need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love's "medicalization"-should it happen to occur-more toward the "good" side than the "bad."

BMC Med Ethics. 2014 Jun 16;15(1):45. [Epub ahead of print]

Ethical issues relating to renal transplantation from prediabetic living donor.

Ferreira Hermosillo A, Valdez Martínez E, Bedolla M.

Abstract

BACKGROUND:

In Mexico, diabetes mellitus is the main cause of end - stage kidney disease, and some patients may be transplant candidates. Organ supply is limited because of cultural issues. And, there is a lack of standardized clinical guidelines regarding organ donation. These issues highlight the tension surrounding the fact that living donors are being selected despite being prediabetic. This article presents, examines and discusses using the principles of non-maleficience, autonomy, justice and the constitutionally guaranteed right to health, the ethical considerations that arise from considering a prediabetic person as a potential kidney donor.

DISCUSSION:

Diabetes is an absolute contraindication for donating a kidney. However, the transplant protocols most frequently used in Mexico do not consider prediabetes as exclusion criteria. In prediabetic persons there are well known metabolic alterations that may compromise the long - term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor's nor the recipient's long term health is usually considered.Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols.

SUMMARY:

We argue that the decision to use a kidney from a living donor known to be pre-diabetic or from those persons with family history of T2DM, obesity, hypertension, or renal failure, should be considered unethical in Mexico if the donor bases the decision to donate on socially acceptable norms rather than informed consent as understood in modern medicine.

"... the evidence points toward the conclusion that overuse of thyroid ultrasonography has the potential to do more harm than benefit."

Endocrine. 2014 Jun 13. [Epub ahead of print]

Ultrasonography, FNA, mutations, hormones and thyroid nodule obsession in the twenty-first century: a cytopathologist's plea for reason in the age of thyroid storm.

Schnadig VJ.

Author information

• Division of Cytopathology, Department of Pathology, University of Texas Medical Branch, Galveston, TX, 77555-0548, USA, vschnadi@utmb.edu.

"...learning corruption..."

Rev Clin Esp. 2014 May 2. pii: S0014-2565(14)00126-X. doi: 10.1016/j.rce.2014.03.007. [Epub ahead of print]

Fraud and plagiarisim in school and career.

[Article in English, Spanish]

Agud JL.

Author information

• Servicio de Medicina Interna, Hospital Severo Ochoa, Facultad de Medicina, Universidad Alfonso X, Madrid, España. Electronic address: joseluisagudaparicio@yahoo.es.

Abstract

Between 0% and 94% of university students acknowledge having committed academic fraud. Its forms are varied: cheating on examinations, submitting someone else's work, plagiarism, false citations, false reporting on experiments, tests or findings in the medical history and physical examination, unfair behavior toward fellow students, and many others. The consequences of academic fraud include learning corruption, useless efforts by students and faculty, incorrect performance evaluations and unfair selection for jobs. Since this can be a prelude to future fraud as doctors or researches, the prevalence, risk factors, motivations, clinical appearances, detection and prevention of the disease of academic fraud are here reviewed.

"71% of male versus 84% of female respondents believe that cheating is wrong..."

BMC Med Ethics. 2014 May 29;15(1):43. [Epub ahead of print]

Self-reported attitudes and behaviours of medical students in Pakistan regarding academic misconduct: a cross-sectional study.

Ghias K, Lakho GR, Asim H, Azam IS, Saeed SA.

Abstract

BACKGROUND:

Honesty and integrity are key attributes of an ethically competent physician. However, academic misconduct, which includes but is not limited to plagiarism, cheating, and falsifying documentation, is common in medical colleges across the world. The purpose of this study is to describe differences in the self-reported attitudes and behaviours of medical students regarding academic misconduct depending on gender, year of study and type of medical institution in Pakistan.

METHODS:

A cross sectional study was conducted with medical students from one private and one public sector medical college. A pre-coded questionnaire about attitudes and behaviours regarding plagiarism, lying, cheating and falsifying documentation was completed anonymously by the students.

RESULTS:

A total of 465 medical students filled the questionnaire. 53% of private medical college students reported that they recognize copying an assignment verbatim and listing sources as references as wrong compared to 35% of public medical college students. 26% of private medical college students self-report this behaviour as compared to 42% of public medical college students. 22% of private versus 15% of public medical college students and 21% of students in clinical years compared to 17% in basic science years admit to submitting a fake medical certificate to justify an absence. 87% of students at a private medical college believe that cheating in an examination is wrong as compared to 66% of public medical college students and 24% self-report this behaviour in the former group as compared to 41% in the latter. 63% of clinical year students identify cheating as wrong compared to 89% of their junior colleagues. 71% of male versus 84% of female respondents believe that cheating is wrong and 42% of males compared to 23% of females admit to cheating.

CONCLUSIONS:

There are significant differences in medical students' attitudes and behaviours towards plagiarism, lying, cheating and stealing by gender, seniority status and type of institution. The ability to identify acts of academic misconduct does not deter students from engaging in the behaviour themselves, as evidenced by self-reporting.

"...acts of bullying are a root cause of new nurses leaving their units or the profession entirely..."

AORN J. 2014 May;99(5):587-93. doi: 10.1016/j.aorn.2013.10.023.

Bullying, mentoring, and patient care.

Frederick D.

Abstract

The literature suggests that acts of bullying are a root cause of new nurses leaving their units or the profession entirely and have the potential to worsen the nursing shortage. As an effective way to address bullying in the perioperative setting, mentoring benefits the nursing profession. Mentoring can have a direct influence on nurses' longevity in a health care organization, thereby strengthening the nursing workforce. Magnet-designated hospitals support the importance of mentor-mentee relationships for positive employee retention and positive recruitment outcomes. One of the most important tasks that a mentor should undertake is that of a role model. Establishing a culture of mentoring requires authentic leadership, genuine caring and respect for employees, and open communication. The entire nursing profession benefits from a culture of mentoring, as do the patients and families who receive care.