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Devanshi Patel, Erica L Blouch, Linda H Rodgers-Fouché, Margaret M Emmet, Kristen M Shannon
The current practice of cancer genetic counseling is undergoing widespread change and scrutiny. While there are clinical resources for genetic counselors (GCs) regarding the delivery of cancer genetic services, there is limited literature regarding effective management of a genetic counseling clinical program. We have developed administrative tools to manage a large team of GCs at a single academic medical center over a period of increasing demand for genetics services, with the initial aim of decreasing wait time for urgent genetic counseling visits...
June 19, 2018: Journal of Genetic Counseling
Andrea Koschinsky, Luise Heinrich, Klaus Boehnke, J Christopher Cohrs, Till Markus, Maor Shani, Pradeep Singh, Karen Smith Stegen, Welf Werner
Deep-sea mining refers to the retrieval of marine mineral resources such as manganese nodules, ferromanganese crusts and seafloor massive sulfide deposits, which contain a variety of metals that serve as crucial raw materials for a range of applications, from electronic devices to renewable energy technologies to construction materials. With the intent of decreasing dependence on imports, supporting the economy and potentially even overcoming the environmental problems related to conventional terrestrial mining, a number of public and private institutions have re-discovered their interest in exploring the prospects of deep-sea mining, which had been deemed economically and technically unfeasible in the early 1980 s...
June 19, 2018: Integrated Environmental Assessment and Management
Rose McDermott, Peter K Hatemi
As new waves of populism arise and cause disruption around the globe, there is both great interest in attempting to explain the origin of this dynamic as well as a need to ameliorate its potentially destructive impact. Perhaps the greatest signal of seismic change is the global dismantling of American institutional control of the postwar world following the election of Donald Trump in the United States. In the wake of such dramatic changes, it may seem odd to turn to evolutionary psychology which looks deeply into the past to try to understand current events, but, in fact, modern technology has dramatically changed the shape of political communication in just such a way as to make politics more personal once again, increasing the need to understand and interpret modern politics through an evolutionary lens...
April 2018: Evolutionary Psychology: An International Journal of Evolutionary Approaches to Psychology and Behavior
Elizabeth A Willis
No abstract text is available yet for this article.
June 13, 2018: Medicine, Conflict, and Survival
Theodore L Steck, Yvonne Lange
The transverse asymmetry (sidedness) of phospholipids in plasma membrane bilayers is well characterized, distinctive, actively maintained and functionally important. In contrast, numerous studies using a variety of techniques have concluded that plasma membrane bilayer cholesterol is either mostly in the outer leaflet or the inner leaflet or is fairly evenly distributed. Sterols might simply partition according to their differing affinities for the asymmetrically-disposed phospholipids, but some studies have proposed that it is actively transported to the outer leaflet...
June 13, 2018: Traffic
Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh
OBJECTIVES: Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures. METHODS: This study was an applied and developmental study...
May 2018: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
Luke Y C Chen, Gary Poole
No abstract text is available yet for this article.
June 2018: Medical Education
G Walker
The opioid pain market is a lucrative one, but is experiencing significant challenges in the U.S. as the country grapples with prescription opioid addiction, overdose and fatalities. The situation has been declared a national Public Health Emergency and the Food and Drug Administration (FDA) has introduced several measures intended to reduce opioid abuse. The development of abuse-deterrent prescription opioids is one such measure, but although abuse-deterrent formulations of opioids reduce drug liking and abuse, concerns have been highlighted by an Institute of Clinical and Economic Review (ICER) report regarding the insufficiency of currently available data to determine the effects of these formulations at the population level...
April 2018: Drugs of Today
Laura D Russell
Health communication scholars grapple with complex issues, many of which probe embodied sensibilities. This essay narrates a profound, unexpected moment that gives rise to notions of trust, vulnerability, and risks involved when conducting fieldwork. The author explains how embodied interactions bring forth latent constructs pertinent to health communication research, both for investigative practices and applied purposes. Furthermore, the author questions how symbolic acts demonstrated by research participants may illuminate powerful meanings yet simultaneously pose potential dangers for researchers...
May 31, 2018: Health Communication
Mark C Henderson, Kenneth W Kizer, Richard L Kravitz
The expansion of Medicaid under the Affordable Care Act has strained the capacity of many academic health centers (AHCs) to deliver primary and specialty care to this traditionally underserved population. The authors, longtime faculty members in the University of California Davis Health (UCDH) system, discuss the challenges of UCDH's participation in Medi-Cal, the nation's largest Medicaid program, and their institution's controversial decision in 2015 to withdraw from all Medi-Cal primary care contracts, which has had untoward effects on UCDH's social and educational missions...
May 22, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Gilberto de Lima Lopes, George R Nahas
Chimeric antigen receptor (CAR) T cells represent a medical and scientific breakthrough that may represent a paradigm for the future of personalized medicine in the age of cancer immunotherapy. As with many new cancer agents, such novel and incredible results come with a high price. At the time of the writing of this article, there are two CAR T cells available, Kymriah, produced by Novrtis with a price tag of US$475,000 and Yescarta produced by Gilead Pharmaceuticals with a price tag of US$373,000, neither price including the required hospital admission in order to administer the agent in addition to potential treatment of side effects...
April 2018: Chinese Clinical Oncology
Timothy P Daaleman
For several months I have been trying to tag a greyness that has shaded my doctoring. I was not burned out but uncovered the desert experience of mind and soul known as acedia, which is called the noonday demon because it vexes those in the mid-stages of life. Grappling with the noonday demon has upended all of my assumptions about the workings of hope in the practice of medicine. For me, hope is no longer the anticipation of a positive outcome, or the warm feeling associated with the validation of a correct diagnosis, or the conclusion of successful treatment...
May 2018: Annals of Family Medicine
M Elizabeth Sublette
No abstract text is available yet for this article.
May 9, 2018: Mayo Clinic Proceedings
Pamela Jagger, Joseph Pedit, Ashley Bittner, Laura Hamrick, Tione Phwandapwhanda, Charles Jumbe
National governments and other key stakeholders in developing countries are grappling with how to reduce household air pollution (HAP) resulting from cooking with solid fuels using traditional cooking technologies. Recent studies have shown that improved cookstoves may offer reductions in fuel use and harmful emissions of carbon monoxide (CO) and fine particulate matter (PM2.5 ), yet there is little quantitative evidence collected in a "real-world" setting showing how improved stoves perform directly compared to traditional cooking technologies...
December 2017: Energy for Sustainable Development: the Journal of the International Energy Initiative
James H Lubowitz, Jefferson C Brand, Michael J Rossi
Our journal has grown in pages including more articles plus commentary. On the one hand, we see this as a subscriber benefit, but we also recognize that more is not always better. We risk information overload resulting in fatigue and the inability to read every word of every article. The challenge of information overload has expanded since the explosion of the internet and electronic communications. We could increase our already high rejection rates, but at the risk of rejecting high-quality research, which we do not prefer...
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Gisèle Bourgeois-Law, Pim W Teunissen, Glenn Regehr
Suboptimal performance in practicing physicians is a decades-old problem. The lack of a universally accepted definition of remediation, the paucity of research on best remediation practices, and the ongoing controversy regarding the institutional responsibility for enacting and overseeing this activity suggests that the remediation of physicians is not merely a difficult problem to solve, but a problem that the community does not grapple with meaningfully. Undoubtedly, logistical and political considerations contribute to this state of affairs; however, other underlying conceptual issues may also play a role in the medical profession's difficulties in engaging with the challenges around remediation...
April 24, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Leilani M Abaya, Tracy N Wiegner, Steven L Colbert, James P Beets, Kaile'a M Carlson, K Lindsey Kramer, Rebecca Most, Courtney S Couch
Sewage pollution is contributing to the global decline of coral reefs. Identifying locations where it is entering waters near reefs is therefore a management priority. Our study documented shoreline sewage pollution hotspots in a coastal community with a fringing coral reef (Puakō, Hawai'i) using dye tracer studies, sewage indicator measurements, and a pollution scoring tool. Sewage reached shoreline waters within 9 h to 3 d. Fecal indicator bacteria concentrations were high and variable, and δ15 N macroalgal values were indicative of sewage at many stations...
April 2018: Marine Pollution Bulletin
Ryoko Hamaguchi
Incorporating classmates' unique one-word reflections on human anatomy and the experience of engaging with the bodies of our anatomical donors, this series captures a diverse spectrum of human emotions surrounding anatomical dissection. Grappling with the humanity of our varied reactions, we related ourselves-ethically and clinically, individually and collectively-to our first "patients" and their critical role in our education and growth as physicians.
April 1, 2018: AMA Journal of Ethics
Benjamin Chin-Yee, Atara Messinger, L Trevor Young
Medicine in the twenty-first century faces an 'identity crisis,' as it grapples with the emergence of various 'ways of knowing,' from evidence-based and translational medicine, to narrative-based and personalized medicine. While each of these approaches has uniquely contributed to the advancement of patient care, this pluralism is not without tension. Evidence-based medicine is not necessary individualized; personalized medicine may be individualized but is not necessarily person-centered. As novel technologies and big data continue to proliferate today, the focus of medical practice is shifting away from the dialogic encounter between doctor and patient, threatening the loss of humanism that many view as integral to medicine's identity...
April 16, 2018: Advances in Health Sciences Education: Theory and Practice
Sarah L Barber, Ankit Kumar, Tomas Roubal, Francesca Colombo, Luca Lorenzoni
Governments frequently draw upon the private health care sector to promote sustainability, optimal use of resources, and increased choice. In doing so, policy-makers face the challenge of harnessing resources while grappling with the market failures and equity concerns associated with private financing of health care. The growth of the private health sector in South Africa has fundamentally changed the structure of health care delivery. A mutually reinforcing ecosystem of private health insurers, private hospitals and specialists has grown to account for almost half of the country's spending on health care, despite only serving 16% of the population with the capacity to pay...
May 2018: Health Policy
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