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Matthew P Smeltzer, Fedoria E Rugless, Bianca M Jackson, Courtney L Berryman, Nicholas R Faris, Meredith A Ray, Meghan Meadows, Anita A Patel, Kristina S Roark, Satish K Kedia, Margaret M DeBon, Fayre J Crossley, Georgia Oliver, Laura M McHugh, Willeen Hastings, Orion Osborne, Jackie Osborne, Toni Ill, Mark Ill, Wynett Jones, Hyo K Lee, Raymond S Signore, Roy C Fox, Jingshan Li, Edward T Robbins, Kenneth D Ward, Lisa M Klesges, Raymond U Osarogiagbon
Background: Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary vs. serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic. Methods: We used a mixed-methods approach to conduct a patient-centered, combined implementation and effectiveness study of a multidisciplinary model of lung cancer care...
February 2018: Translational Lung Cancer Research
Sang-Hyun Park, Zhen Lu, Robert S Hastings, Patricia A Campbell, Edward Ebramzadeh
BACKGROUND: In 2010, a widely used metal-on-metal hip implant design was voluntarily recalled by the manufacturer because of higher than anticipated failure rates at 5 years. Although there was a large published range of revision rates, numerous studies had reported a higher risk of revision for excessive wear and associated adverse tissue reactions when compared with other metal-on-metal total hips. The reasons for this were suggested by some to be related to cup design features. QUESTIONS/PURPOSES: From retrievals of ASR metal-on-metal implants and tissue samples obtained at revision surgery, we asked the following questions: (1) What were the common and uncommon surface features? (2) What were the common and uncommon linear and volumetric wear characteristics? (3) Were there common taper corrosion characteristics? (4) What aseptic lymphocytic vasculitis-associated lesion (ALVAL) features were present in the tissues? METHODS: Five hundred fifty-five ASRs, including 23 resurfacings, were studied at one academic research center...
February 2018: Clinical Orthopaedics and related Research
Joel Michael Reynolds
German philosopher Martin Heidegger argued that humans are defined by care. The term he used, "Sorge," picks out a wide range of caring relations, including sorrow, worry, the making of arrangements, and even fending for another. Since coming to The Hastings Center, I've been struck by the genuine care definitive of its scholars' relationship to their work. Care about newborns, the elderly, and nonhuman animals. Care about doctors, nurses, and health care institutions. Care expressed in the panoply of ways biomedical knowledge and practices inform our havings, doings, and beings in the world...
January 2018: Hastings Center Report
(no author information available yet)
The January-February 2018 issue of the Hastings Center Report includes pieces addressing patient care concerns that lie at the original core of bioethics and pieces that reflect the field's growing breadth. Among the pieces getting at the original core is an article by philosopher Daniel Brudney on the moral values underpinning surrogate decision-making. The article and the two commentaries that follow it contribute to the debate on the moral authority of surrogate decision-makers. Several items in the issue take up matters of public health and health policy...
January 2018: Hastings Center Report
James E Sabin
Although "rationing" continues to be a dirty word for the public in health policy discourse, Nir Eyal and colleagues handle the concept exactly right in their article in this issue of the Hastings Center Report. They correctly characterize rationing as an ethical requirement, not a moral abomination. They identify the key health policy question as how rationing can best be done, not whether it should be done at all. They make a cogent defense of what they call "rationing through inconvenience" as a justifiable allocational technique...
January 2018: Hastings Center Report
Hilde Lindemann
Daniel Brudney's clear-headed analysis, in this issue of the Hastings Center Report, of the difference between a patient's and a surrogate's right to make medical treatment decisions contributes to a longstanding conversation in bioethics. Brudney offers an epistemological and a moral argument for the patient's and the surrogate's right to decide. The epistemological argument is the same for both parties: the (competent) patient has a right to decide because she is presumed to know her own interests better than anyone else, and the surrogate is entitled to make decisions because she knows the patient better than anyone else...
January 2018: Hastings Center Report
Adira Hulkower, Lauren S Flicker
In this issue of the Hastings Center Report, Daniel Brudney suggests that clinicians have an overly deferential attitude toward their patients' surrogate decision-makers that is rooted in a wrongful investment of moral authority. He maintains that surrogate decision-makers have no moral right to decide for their loved ones and that their value in the decision-making process is limited to their knowledge of their loved one's preferences. If operationalized, Brudney's framework would ease the way for clinicians to remove a surrogate who cannot provide information relevant to the patient's preferences and to resort to a paternalistic model of decision-making...
January 2018: Hastings Center Report
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Hastings Center Report
Gregory E Kaebnick, Michael K Gusmano
Can we make wise policy decisions about still-emerging technologies-decisions that are grounded in facts yet anticipate unknowns and promote the public's preferences and values? There is a widespread feeling that we should try. There also seems to be widespread agreement that the central element in wise decisions is the assessment of benefits and costs, understood as a process that consists, at least in part, in measuring, tallying, and comparing how different outcomes would affect the public interest. But how benefits and costs are best weighed when making decisions about whether to move forward with an emerging technology is not clear...
January 2018: Hastings Center Report
Tenzin Wangmo, Sirin Hauri, Eloise Gennet, Evelyn Anane-Sarpong, Veerle Provoost, Bernice S Elger
BACKGROUND: A review of literature published a decade ago noted a significant increase in empirical papers across nine bioethics journals. This study provides an update on the presence of empirical papers in the same nine journals. It first evaluates whether the empirical trend is continuing as noted in the previous study, and second, how it is changing, that is, what are the characteristics of the empirical works published in these nine bioethics journals. METHOD: A review of the same nine journals (Bioethics; Journal of Medical Ethics; Journal of Clinical Ethics; Nursing Ethics; Cambridge Quarterly of Healthcare Ethics; Hastings Center Report; Theoretical Medicine and Bioethics; Christian Bioethics; and Kennedy Institute of Ethics Journal) was conducted for a 12-year period from 2004 to 2015...
February 7, 2018: BMC Medical Ethics
Fatima Rodriguez, Katherine G Hastings, Jiaqi Hu, Lenny Lopez, Mark Cullen, Robert A Harrington, Latha P Palaniappan
BACKGROUND: Hispanic persons represent a heterogeneous and growing population of any race with origins in Mexico, the Caribbean, Central America, South America, or other Spanish-speaking countries. Previous studies have documented variation in cardiovascular risk and outcomes among Hispanic subgroups. Few studies have investigated whether these patterns vary by nativity status among Hispanic subgroups. METHODS AND RESULTS: We used the National Center for Health Statistics mortality file to compare deaths of Hispanic (n=1 258 229) and non-Hispanic white (n=18 149 774) adults (aged ≥25 years) from 2003 to 2012...
December 13, 2017: Journal of the American Heart Association
J P Lees, V Poireau, V Tisserand, E Grauges, A Palano, G Eigen, D N Brown, Yu G Kolomensky, M Fritsch, H Koch, T Schroeder, C Hearty, T S Mattison, J A McKenna, R Y So, V E Blinov, A R Buzykaev, V P Druzhinin, V B Golubev, E A Kravchenko, A P Onuchin, S I Serednyakov, Yu I Skovpen, E P Solodov, K Yu Todyshev, A J Lankford, J W Gary, O Long, A M Eisner, W S Lockman, W Panduro Vazquez, D S Chao, C H Cheng, B Echenard, K T Flood, D G Hitlin, J Kim, T S Miyashita, P Ongmongkolkul, F C Porter, M Röhrken, Z Huard, B T Meadows, B G Pushpawela, M D Sokoloff, J G Smith, S R Wagner, D Bernard, M Verderi, D Bettoni, C Bozzi, R Calabrese, G Cibinetto, E Fioravanti, I Garzia, E Luppi, V Santoro, A Calcaterra, R de Sangro, G Finocchiaro, S Martellotti, P Patteri, I M Peruzzi, M Piccolo, M Rotondo, A Zallo, S Passaggio, C Patrignani, H M Lacker, B Bhuyan, U Mallik, C Chen, J Cochran, S Prell, H Ahmed, A V Gritsan, N Arnaud, M Davier, F Le Diberder, A M Lutz, G Wormser, D J Lange, D M Wright, J P Coleman, E Gabathuler, D E Hutchcroft, D J Payne, C Touramanis, A J Bevan, F Di Lodovico, R Sacco, G Cowan, Sw Banerjee, D N Brown, C L Davis, A G Denig, W Gradl, K Griessinger, A Hafner, K R Schubert, R J Barlow, G D Lafferty, R Cenci, A Jawahery, D A Roberts, R Cowan, S H Robertson, B Dey, N Neri, F Palombo, R Cheaib, L Cremaldi, R Godang, D J Summers, P Taras, G De Nardo, C Sciacca, G Raven, C P Jessop, J M LoSecco, K Honscheid, R Kass, A Gaz, M Margoni, M Posocco, G Simi, F Simonetto, R Stroili, S Akar, E Ben-Haim, M Bomben, G R Bonneaud, G Calderini, J Chauveau, G Marchiori, J Ocariz, M Biasini, E Manoni, A Rossi, G Batignani, S Bettarini, M Carpinelli, G Casarosa, M Chrzaszcz, F Forti, M A Giorgi, A Lusiani, B Oberhof, E Paoloni, M Rama, G Rizzo, J J Walsh, A J S Smith, F Anulli, R Faccini, F Ferrarotto, F Ferroni, A Pilloni, G Piredda, C Bünger, S Dittrich, O Grünberg, M Heß, T Leddig, C Voß, R Waldi, T Adye, F F Wilson, S Emery, G Vasseur, D Aston, C Cartaro, M R Convery, J Dorfan, W Dunwoodie, M Ebert, R C Field, B G Fulsom, M T Graham, C Hast, W R Innes, P Kim, D W G S Leith, S Luitz, D B MacFarlane, D R Muller, H Neal, B N Ratcliff, A Roodman, M K Sullivan, J Va'vra, W J Wisniewski, M V Purohit, J R Wilson, A Randle-Conde, S J Sekula, M Bellis, P R Burchat, E M T Puccio, M S Alam, J A Ernst, R Gorodeisky, N Guttman, D R Peimer, A Soffer, S M Spanier, J L Ritchie, R F Schwitters, J M Izen, X C Lou, F Bianchi, F De Mori, A Filippi, D Gamba, L Lanceri, L Vitale, F Martinez-Vidal, A Oyanguren, J Albert, A Beaulieu, F U Bernlochner, G J King, R Kowalewski, T Lueck, I M Nugent, J M Roney, R J Sobie, N Tasneem, T J Gershon, P F Harrison, T E Latham, R Prepost, S L Wu, L Sun
We measure the mass difference, Δm_{+}, between the D^{*}(2010)^{+} and the D^{+} using the decay chain D^{*}(2010)^{+}→D^{+}π^{0} with D^{+}→K^{-}π^{+}π^{+}. The data were recorded with the BABAR detector at center-of-mass energies at and near the ϒ(4S) resonance, and correspond to an integrated luminosity of approximately 468  fb^{-1}. We measure Δm_{+}=(140 601.0±6.8[stat]±12.9[syst])  keV. We combine this result with a previous BABAR measurement of Δm_{0}≡m(D^{*}(2010)^{+})-m(D^{0}) to obtain Δm_{D}=m(D^{+})-m(D^{0})=(4824...
November 17, 2017: Physical Review Letters
Josephine Johnston, Rachel L Zacharias
In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy-they just don't talk about it...
December 2017: Hastings Center Report
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Hastings Center Report
Louise P King, Rachel L Zacharias, Josephine Johnston
Respect for autonomy is a central value in reproductive ethics, but it can be a challenge to fulfill and is sometimes an outright puzzle to understand. If a woman requests the transfer of two, three, or four embryos during fertility treatment, is that request truly autonomous, and do clinicians disrespect her if they question that decision or refuse to carry it out? Add a commitment to justice to the mix, and the challenge can become more complex still. Is it unfair for insurance policies to exclude from coverage the costs of giving fertility to those who lack it or restoring fertility in those who have lost it? What does "just reproduction" look like in the face of multifarious understandings of both justice and autonomy and in light of increasingly complex and costly reproductive technologies? In today's dialogue about reproduction, medicine, and ethics in the United States, old ethical issues-such as whether women ought to be allowed to access pregnancy termination-are more contested than they have been in decades, while new technologies-like those used to edit the genes of human embryos-suggest that our species could face unprecedented questions about who should exist...
December 2017: Hastings Center Report
Carolyn P Neuhaus
This August, I participated in the conference "Genome Editing: Biomedical and Ethical Perspectives," hosted by the Center for the Study of Bioethics at the University of Belgrade and cosponsored by the Division of Medical Ethics of NYU Langone Health and The Hastings Center. The prime minister of Serbia, Ana Brnabić, spoke of the significance of bringing together an international community of bioethicists, acknowledging that ethical, social, and legal issues surrounding gene editing technologies transcend national boundaries...
November 2017: Hastings Center Report
Michelle Oberman
The problem at the heart of "Stemming the Standard-of-Care Sprawl: Clinician Self-Interest and the Case of Electronic Fetal Monitoring," an article by Kayte Spector-Bagdady and colleagues in the November-December 2017 issue of the Hastings Center Report, is the persistence of a suboptimal standard of care long after evidence-driven approaches would dictate a change. That problem is not simply defensive medicine, or what the authors call "standard-of-care sprawl." Instead, it is that, in some cases, the standard of care lags behind best practices...
November 2017: Hastings Center Report
(no author information available yet)
In one way or another, several pieces in the November-December 2017 of the Hastings Center Report reflect an insistence on turning away from abstractions to learn how a whole community understands a problem at issue-how a community understands what's at stake in individuals' autonomous choices, how a community understands the results of a clinical trial, how a community understands, and generates and adjusts, medical standards. In the lead article, Kayte Spector-Bagdady and colleagues argue that, given extensive research showing that electronic fetal monitoring during childbirth offers very little benefit to the mother and child, a mechanism is needed to ensure that the medical standard of care is based on the right kinds of considerations...
November 2017: Hastings Center Report
Helen Haste, Howard Gardner
Presents an obituary for Jerome S. Bruner, who died in 2016. His long, and productive, life spanned much of the first century of experimental psychology and coincided with the launching of cognitive psychology, a field in which he played an indispensable and pioneering role. His innovative and provocative work constantly challenged the current "mainstream." His impact on education has been equated with that of John Dewey. He was driven throughout his life to pursue the nature of the "human" in both his conceptual and empirical work...
October 2017: American Psychologist
Richard Marlink
In this issue of the Hastings Center Report, Govind Persad and Ezekiel Emanuel argue that "[t]he provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off." I agree that we should not let the perfect get in the way of the good, but just providing cheaper, less effective treatment for utilitarian or other reasons is not a comprehensive approach to global health. In my experience as an on-the-ground global health practitioner, the choice is never that simple...
September 2017: Hastings Center Report
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