Yale Friday Newsletter – 01/25/13

Another Friday Newsletter from our friends at Yale.  Enjoy!

Note: The Hastings Center has just released a special report which aims to “provoke a national conversation.”  “The longstanding ethical framework for protecting human volunteers in medical research needs to be replaced because it is outdated and can impede efforts to improve health care quality.”  Seven commentaries on this issue are contained in this special report.  For further information, please check The Hastings Center website.

This Week on Campus

Wednesday, January 30

Rudd Center Seminar
Time: 12:30 PM
Location: 309 Edwards St, conf room
Speaker: Tracy A. Fox, MPH, RD, President, Food, Nutrition & Policy Consultants, LLC
Topic: Policy, Politics, and Sausage

Shulman Lecture in Science & the Humanities
Time: 5:30 PM
Location: 53 Wall St, auditorium
Speaker: Jonathan Lear, John U. Nef Distinguished Service Professor, Committee on Social Thought, Department of Philosophy, University of Chicago
Topic: Wisdom Won from Illness: Psychoanalysis, Self-Consciousness, and the Peculiarity of Human Entanglement

Off Campus Events & Conferences

Yale Environmental Law Association’s New Directions in Environmental Law Conference in March will include a workshop on “Factory Farming and the Law” (description below). Yale and New Haven community members are welcome to attend free of charge. You will need to register here: http://ndel2013.eventbrite.com. If you are not from the local area, a registration fee does apply, but if you would like to attend just the workshop, a reduction of fee might be arranged; please contact Casey Arnold at casey.arnold@yale.edu with any questions.  Animal agriculture is one of the top two or three most significant contributors to the world’s most serious environmental problems at every level, from local to global, and includes a wide range of challenges from drinking water pollution, to the rise of antibiotic-resistant bacteria, to climate change  Livestock production accounts for nearly one-fifth of all global human-induced greenhouse gas emissions (more than the share contributed by the entire transportation sector), according to a report from the Food and Agriculture Organization of the United Nations. Given that meat and dairy production is projected to double by 2060, this is an urgent challenge. In addition to environmental challenges, factory farming as it exists today is widely considered to be the most systematic and profound abuse of animals in history. This workshop’s panelists are David Wolfson and Martha Noble, two highly respected experts on animal and environmental law. They will describe the impacts of animal agriculture and factory farming as it is practiced today, the history and current state of factory farming laws, and an overview and analysis of the legal efforts begin taken to address this critical issue.

 

2013 National Undergraduate Bioethics Conference at Georgetown University: The Georgetown Undergraduate Bioethics Society is proud to be hosting this year’s conference, with the theme “Bioethics: Intersections of Global Health and Environmental Policy.” The conference is open to all undergraduate students and will be held April 5-7, 2013 at Georgetown University’s Main Campus in Washington, D.C. The conference will include the Bioethics Bowl, which begins on Friday, April 5. Students may register on our conference website, and a link to this website will be sent to you prior to the beginning of registration. Registration begins on February 1 and the deadline is March 12. For more information, please contact the Georgetown Undergraduate Bioethics Society at bioethicssociety@georgetown.edu. Thank you!

 

We hope to see you at the upcoming Global Health & Innovation Conference at Yale!  If you are interested in presenting, we are currently accepting social enterprise pitch abstracts for presentation at the conference.  We would also appreciate it if you could please forward this announcement to others who may be interested in attending or presenting.  The registration rate increases after January 31. The Global Health & Innovation Conference is the world’s largest global health conference and social entrepreneurship conference.  This must-attend, thought-leading conference annually convenes more than 2,200 leaders, changemakers, students, and professionals from all fields of global health, international development, and social entrepreneurship. Interested in presenting at the conference? Submit a social enterprise pitch abstract for consideration. Presented by Unite For Sight, 10th Annual Conference Yale University, New Haven, Connecticut, USA Saturday, April 13 – Sunday, April 14, 2013.

 

Brain Development & Learning: Making Sense of the Science Conference, July 24-28, 2013, Vancouver, BC. Hear about the latest advances in neuroscience, medicine, and developmental science from the remarkable scientists who made the discoveries. Learn about promising new, evidence-based approaches.  Come away better able to help your patients! Topics include: Trauma, Stress, & Healing; Neuroplasticity:  The Brain that Changes itself; Interrelations between Social, Emotional, & Cognitive Health and Physical Health.  CE credits are available in many fields. Save Money: Register by February 15, 2013 to get the Early Bird Discount. Conference website:  www.braindevelopmentandlearning.com.

 

Grants, Fellowships, & Jobs

Reminder: Just one week left to submit an application for the 2013 REIDS Summer Institute. If you have interest in Community Based Research and HIV/AIDS disparities, apply now for this great opportunity to receive sustained mentorship for two full years from an interdisciplinary team. All application materials must be submitted by Friday, February 1, 2013. We STRONGLY URGE you to contact Kate Stoddard (kate.stoddard@yale.edu or 203-764-8476) before you begin the application process.

Second call for Summer 2013 program applications for the NIDA funded Fordham University HIV Prevention Research Ethics Training Institute (RETI). The Fordham RETI is a competitive program offering early career investigators research ethics summer training and up to $18,000 in financial support for a mentored research project that will contribute to evidenced-based research ethics practices. Applicants must have a doctoral, medical or equivalent degree in social, behavioral, medical, nursing, public health or related fields, demonstrated scholarship in HIV prevention research, 6 years or less of post-doctoral experience, and must meet requirements to apply for NIH funding. Special attention will be given to those applicants whose proposed research ethics plan includes drug using populations. Applications must be received by March 8, 2013 and applicants will be notified of award decisions by April 12, 2013. For additional information, please visit http://www.fordham.edu/EthicsInstitute. Please do not hesitate to contact the Institute Coordinator at EthicsInst@Fordham.edu or (718) 817-0927 if you have any questions.

Calls for Papers & Nominations

Human Welfare Conference: Ideas about what makes us fare well vary within and across cultural, social and national borders, as well as among academic disciplines. These diverse understandings shape our societies and determine which outcomes matter, providing the framework within which individuals and communities work to improve human welfare.  The annual Green Templeton College Human Welfare Conference aims to engage with the specific challenges of attempting to systematically improve human welfare in both academic and professional contexts.  Fostering debate across a broad range of academic disciplines – from the sciences, medicine and business to the humanities and social sciences – is essential to this aim. Therefore, papers should typically encourage discourse and debate on what human welfare means to people across disciplines and cultures. The sixth edition of the conference invites graduate students from all disciplines to submit papers (based on their own original work) that either: Address the conceptualisation of human welfare, based on the perspectives of a specific discipline or a given cultural understanding, or contain an interesting process of defining, operationalising and/or measuring the concept of human welfare, as part of an empirical study or other piece of work. The conference is an annual event organized by students from Green Templeton College, University of Oxford, that aims to engage with the specific challenges of attempting to systematically improve human welfare in both academic and professional contexts. Please submit your abstract (500 words max) with a title to hwc@gtc.ox.ac.uk by February 15, 2013. Submissions will be reviewed anonymously and evaluated based on research excellence and relevance to the theme.If you or anyone else has any questions, please contact us at hwc@gtc.ox.ac.uk.

 

The Center to Advance Palliative Care is seeking presentations from the field for its 2013 National Seminar, “Palliative Care at the Forefront: Innovation and Opportunity,” November 7-9 in Dallas, Texas. CAPC is looking for session speakers for both brief workshop presentations and extended presentations on a variety of topics:

  • New models of outpatient palliative care
  • Integrating palliative care into primary care services
  • Palliative care team wellness and sustainability
  • System-wide palliative care programs
  • Pediatric palliative care program development
  • Small hospital programs within health systems
  • Data on non-financial benefits of palliative care
  • Implementing palliative care services to at-risk and/or disease-specific patient populations
  • Rural and community-based palliative care development
  • Effectively interfacing with hospital / facility administration
  • Projects in palliative care quality and safety

Deadline for applications is 5 PM EST February 1, 2013. Learn more about this opportunity to present your work at the CAPC National Seminar. 

 

Articles of Interest

In the News

Abortion

Lohr, Kathy. States Become Battlegrounds for Nation’s Deep Abortion Divide. NPR. 22 January 2013.
Tuesday marks the 40th anniversary of Roe v. Wade, the U.S. Supreme Court decision that legalized abortion. Thousands of activists on both sides of the issue are holding rallies marking the day at state capitals across the country. In the decades since the decision, abortion has been one of the most debated and legislated issues in the nation. And state legislatures, which are increasingly passing laws restricting abortion, have become the debate’s key battlegrounds. Continue reading…

Health Care

Andrews, Michelle. Restrictive policies in hospices may discourage patients from enrolling. Washington Post. 23 January 2013.
Many people who are terminally ill delay entering hospice care until just a few days or weeks before they die, in part because they or their families don’t want to admit that there’s no hope for a cure. “It’s a hard decision to say yes to,” says Jeanne Dennis, senior vice president at the Visiting Nurse Service of New York, which provides hospice care to 900 patients daily, among other services. “Everybody knows it means you’re not going to get better.” Continue reading…

Pittman, Genvera. Virtual Visits to Doctor May Be Cheaper Than and as Effective as In-Person Visits. Washington Post. 21 January 2013.
A new study suggests that “e-visits” to health-care providers for sinus infections and urinary tract infections (UTIs) may be cheaper than in-person office visits and similarly effective. For e-visits, patients fill out online forms about their symptoms and a doctor or nurse gets back to them within a few hours with treatment advice. Continue reading…

Brody, Jane E. A Check on Physicals. New York Times. 21 January 2013.
“Go Beyond Your Father’s Annual Physical. Live Longer, Feel Better.” This sales pitch for the Princeton Longevity Center’s “comprehensive exam” promises, for $5,300, to take “your health beyond the annual physical.” But it is far from certain whether this all-day checkup, and others less inclusive, make a meaningful difference to health or merely provide reassurance to the worried well. Continue reading…

Medical Ethics

Struck, Kathleen. New HIPPAA Rules Fortify Patient Privacy. MedPage. 21 January 2013.
Addressing 15 years of digital advances in health record information, the Department of Health and Human Services released stronger rules and protections governing patient privacy last week. Continue reading…

Public Health

Parker-Pope, Tara. Facing Cancer, a Stark Choice. New York Times. 21 January 2013.
In the 1970s, women’s health advocates were highly suspicious of mastectomies. They argued that surgeons — in those days, pretty much an all-male club — were far too quick to remove a breast after a diagnosis of cancer, with disfiguring results. But today, the pendulum has swung the other way. A new generation of women want doctors to take a more aggressive approach, and more and more are asking that even healthy breasts be removed to ward off cancer before it can strike. Continue reading…

Seaman, Andrew M. Segregation Tied to More Lunch Cancer Deaths: Study. Reuters Health. 17 January 2013.
Black lung cancer patients seem more likely to die of the disease than white cancer patients in the U.S., especially those living in segregated counties, according to a new study. Researchers, who published their findings in JAMA Surgery on Wednesday, found blacks patients living in segregated counties had a lung cancer mortality rate about 10 percentage points higher than those living in diverse neighborhoods during the mid-2000s. Continue reading…

Galewitz, Phil. Health Insurers Crack Down on Preterm Deliveries that are Not Medically Necessary. Washington Post. 21 January 2013.
Jenn McCorkle still regrets giving birth early. McCorkle was 37 weeks pregnant when her obstetrician scheduled her for a Caesarean section the following week, saying there was no reason to wait. But when her son, Maverick, was born in August 2008, his lungs were not fully developed; within hours, one of them collapsed. The infant spent the next 13 days in a neonatal intensive care unit (NICU), most of them hooked up to a ventilator. Continue reading…

Research Ethics

Gorman, James. Agency Moves to Retire Most Research Chimps. New York Times. 22 January 2013. Almost all of the 451 chimpanzees owned or supported by the National Institutes of Health that are now at research facilities should be permanently retired from research and moved to sanctuaries, with planning for the move to start immediately, a report from an N.I.H. council unanimously recommended Tuesday. Continue reading…

Men More Likeley Than Women to Commit Scientific Fraud. Science Daily. 22 January 2013.
Male scientists are far more likely to commit fraud than females and the fraud occurs across the career spectrum, from trainees to senior faculty. The analysis of professional misconduct was co-led by a researcher at Albert Einstein College of Medicine of Yeshiva University and was published January 22 in the online journal mBio. Continue reading…

Prentice, David and Samuel B. Casey. Flouting the law barring embryo research. Washington Times. 17 January 2013.
Last week, the U.S. Supreme Court declined to consider the question of whether federal taxpayer dollars can be used lawfully to destroy human embryos in order to harvest their stem cells. The case challenged regulations of the National Institutes of Health (NIH) that allow the destruction of living human embryos originally created for in vitro fertilization to harvest their stem cells for laboratory research. Continue reading…

Technology

Whitney, Eric. Growing Pains as Doctors’ Offices Adopt Electronic Records. NPR. 22 January 2013.
Information technology has transformed much of the American economy, but its use in health care still lags, especially when it comes to electronic medical records. Here’s an example: The state of Colorado runs a computerized registry where any provider who gives a child a vaccine can report that information. The system should help kids stay current with their immunizations. But the state’s computer system isn’t compatible with most of the ones doctors use, so many practices don’t. Continue reading…

 

In the Journals

Borgelt, Emilt L. Neuroimaging in mental health care: Voices in Translation. Frontiers in Human Neuroscience. 2012.
Images of brain function, popularly called “neuroimages,” have become a mainstay of contemporary communication about neuroscience and mental health. Paralleling media coverage of neuroimaging research and the high visibility of clinics selling scans is pressure from sponsors to move basic research about brain function along the translational pathway. Indeed, neuroimaging may offer benefits to mental health care: early or tailored intervention, opportunities for education and planning, and access to resources afforded by objectification of disorder. However, risks of premature technology transfer, such as misinterpretation, misrepresentation, and increased stigmatization, could compromise patient care. The insights of stakeholder groups about neuroimaging for mental health care are a largely untapped resource of information and guidance for translational efforts. We argue that the insights of key stakeholders—including researchers, healthcare providers, patients, and families—have an essential role to play upstream in professional, critical, and ethical discourse surrounding neuroimaging in mental health. Here we integrate previously orthogonal lines of inquiry involving stakeholder research to describe the translational landscape as well as challenges on its horizon. Continue reading…

Gabbard, Glen O. A psychoanalytic perspective on ethics, self-deception and the corrupt physician. British Journal of Psychotherapy. May 2012.
In this paper the authors use a psychoanalytic perspective to understand observations about the modes of self-deception that operate in physicians who have been dishonest or have engaged in other transgressions of ethics guidelines. They emphasize that it is inaccurate to categorize physicians as simply honest or dishonest, ethical or unethical. Physicians who have been ethical practitioners may rationalize sexual relations with patients, stealing from professional treasuries, lying, or other transgressions while convincing themselves that they have acted in an honourable manner. The authors share their experience of evaluating these phenomena in over 300 physicians who were referred to a specialized treatment centre by licensing boards, hospitals, physician health organizations or ethics committees. They note the high prevalence of defensive compartmentalization, temporal splitting and projective disavowal as means of tolerating behaviours they would generally regard as unethical. They also examine the implications of these modes of self-deception for psychotherapy. Continue reading…

Levin, Jeff. Jewish Ethical Themes That Should Inform the National Healthcare Discussion: A Prolegomenon. Journal of Religion and Health. September 2012.
Despite the passage of H.R. 3590 in the 111th Congress, the national healthcare debate in the United States continues, with repeal or modification of the Patient Protection and Affordable Care Act under ongoing consideration. Reference is often made to morality or ethics, but typically in general terms only. This paper elucidates themes from one system of moral theology, namely Jewish healthcare ethics, that would valuably inform this debate. Themes include “covenant,” “holiness,” “justice,” “mercy,” “for the sake of peace,” “to save a life,” “peoplehood,” “repair of the world,” “repentance,” and “jubilee.” Policy-related, economic, political, and moral challenges to acting on these principles are discussed. Continue reading…

Mello, Michelle. Ethical considerations in studying drug safety: The Institute of Medicine Report. The New England Journal of Medicine. 2012.
The tumult arising from revelations of serious safety risks associated with widely prescribed drugs, including rosiglitazone (Avandia, GlaxoSmithKline), rofecoxib (Vioxx, Merck), and celecoxib (Celebrex, Pfizer), has led to widespread recognition that improvement is needed in our national system of ensuring drug safety. The experience with rosiglitazone and the TIDE trial offers a lesson in how our current approach to the oversight of drug-safety and postmarketing research can fail both the public and the research participants. Reactive policymaking is tempting but problematic. The history of regulation of human subjects research suggests that rules that are “born in scandal and reared in protectionism” often fall short of providing meaningful protections to research participants and that, once adopted, regulations can ossify and become difficult to dislodge. Continue reading…

 

Opinion

Ars Technica

Pegoraro, Rob. Neil deGrasse Tyson: Science funding can guarantee your economic future. January 24, 2013.
Neil deGrasse Tyson came to Washington on Wednesday to deliver the science-specific version of President Barack Obama’s second inaugural address. Where Obama emphasized the utility and necessity of government doing what citizens cannot do individually across the breadth of society, Twitter’s favorite astrophysicist focused on the case for government having a unique capacity to fund basic research. Continue reading…

Boston Globe

Editorial. All Americans are at risk. January 25, 2013.
Statistics that show the United States ranking below other rich countries on health measures are often broadly attributed to the lack of public health resources and dangerous environments confronting Americans who are poor or members of minority groups. But while unequal access to health care remains a problem, a new report by the National Institutes of Health has a sobering message: Unhealthy and unsafe practices are leaving even well-off Americans with lower life-expectancies than their peers in other countries. Continue reading…

Los Angeles Times

Editorial. Restricting Vicodin is the wrong Rx. January 2, 2013.
More than 1 million Americans visit an emergency room each year because of prescription drug abuse, and the toll has been rising steadily since 2004. The U.S. Drug Enforcement Administration thinks it has an idea that will help: Reclassify the pain reliever Vicodin and other medications containing hydrocodone as Schedule II drugs, the most restrictive category for pharmaceuticals with accepted medical uses. Continue reading…

Editorial. Healthcare reform’s fail-safe. January 20, 2013.
Although Republicans are eager to repeal the entire 2010 healthcare reform law, they started the new session of Congress last week by taking aim at one provision in particular: the Independent Payment Advisory Board, a yet-to-be-named group of 15 presidential appointees from various healthcare disciplines that could play a key role in limiting the growth of Medicare spending. Critics argue that it’s a bad idea and even un-American to put so much power in the hands of unelected bureaucrats. But with lawmakers seemingly unable to resist the pressure from the healthcare industry to spend freely on Medicare, enlisting the help of independent experts may be the only way to hold down costs. Continue reading…

Miami Herald

Edgerton, Anna. Bioethics commission meets at UM to consider testing anthrax vaccine on children. January 22, 2013.
In “Dark Zephyr,” fictional terrorists released a cloud of anthrax on San Francisco. Adults were successfully vaccinated, but doctors didn’t know the safe dosage to give children. Fortunately this was just a practice exercise in emergency response in 2011. But the realization that modern medicine had no protocol to protect children from a deadly bacterial pathogen prompted U.S. Secretary of Health Kathleen Sebelius to ask the Presidential Commission for the Study of Bioethical Issues to consider the ethics of using healthy children in anthrax vaccine research. Continue reading…

New York Times

Editorial. Evidence of rape ignored. January 20, 2013.
In the final hours of the last Congress, the Senate approved action against an intolerable failure of criminal justice — the backlog of scores of thousands of rape test kits allowed to sit untested for years in police custody. Victims are denied justice while the perpetrators remain free to rape again. Continue reading…

Editorial. Stem cell research gets a reprieve. January 20, 2013.
The Supreme Court has wisely ended a bizarre and destructive lawsuit to prevent the federal government from financing embryonic stem cell research. By refusing to hear the case, the court put a halt to more than three years of turmoil that drove some scientists away from such research because of uncertainty about its legality and questions about continued federal funding. Continue reading…

News Medical

Editorial. Bioethics leader proposes bold and controversial approach to fight obesity epidemic. January 24, 2013.
Arguing that obesity “may be the most difficult and elusive public health problem the United States has ever encountered” and that anti-obesity efforts having made little discernible difference, Daniel Callahan, co-founder and President Emeritus of The Hastings Center, proposes a bold and controversial approach to fighting the epidemic. Continue reading…

Washington Post

Editorial. A bumper crop of subsidies. January 19, 2013.
The drought that struck the United States in 2012 affected about 80 percent of agricultural land, making it the most extensive such weather event since the 1950s, according to the Agriculture Department (USDA). Consumers will feel the impact of last year’s smaller harvests in the form of higher grocery prices this year. Yet the increases will be relatively modest — a half-percentage-point increase in food price inflation, according to USDA economic projections. Continue reading…

Editorial. The second-term climate. January 20, 2013.
President Obama hardly mentioned climate change during long stretches of his first term. As he rebuilds his administration and refines his second-term agenda, he should give this challenge the priority it deserves. Continue reading…

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