Yale Friday Newsletter – 02/08/13

 Enjoy today’s Yale Friday Newsletter, with greetings from snowy New Haven!

Item of Interest:

*The Conversation Project: This organization gets people to write down what they’d like in the way of end-of-life care.  The different approaches (especially by age) give an insight into the needs/desires from many different angles.  If you are interested,  click here.

This Week on Campus

Monday, February 11

Lowering Spending in Health Care Debate
Time: 6:30 PM
Location: 333 Cedar St, Mary S. Harkness Memorial Auditorium
Moderator: Prof. jack Hughes
Topic: Be It Resolved That: Markets with Limited Government Intervention are the Best Way to Control Spending Growth In Health Care

Wednesday, February 13

Schell Center Lecture
Time: 6:10 PM
Location: 127 Wall St, Room 122
Speaker: Jorge Contesse, LLM ’05, Professor, Universidad Diego Portales, Chile, and Schell Center Visiting Human Rights Fellow
Topic: Sexual Orientation in the Inter-American Human Rights System: The Atala Case

Thursday, February 14

Genocide Studies Seminar
Time: 1:30 PM
Location: 77 Prospect St, room B012
Speaker: Prof. Paul Bartrop, Director, Center for Judaic, Holocaust, and Genocide Studies, Florida Gulf Coast University
Topic: When Good Breaks Out during Genocide: Case Studies of Heroic Acts in the Face of Evil

Friday, February 15

Zigler Center Lecture
Time: 11:30 AM
Location: 100 Wall St, room 116
Speaker: Laura Stout Sosinsky, PhD, Assistant Professor, Psychology, Fordham University
Topic: Early Care and Education: Parental Decision-Making in a Patchwork System

 

Conferences & Off Campus Events 

Children’s Environmental Health and Disease Prevention Research Centers will hold a webinar on Wednesday February 13, 2013. The webinar will include five presentations from five of the Centers about engaging community partners in developing outreach strategies; understanding the role of networks; educating and engaging children; identifying the role of health professionals; and identifying the role of environmentally sustainable hospitals. We urge you to let your colleagues know about these webinars – there is no limit to the number of people that can participate in the webinar.  This webinar will be on Wednesday, February 13, 2013 from 1:00 PM – 2:30 PM EST. To register go to:
http://www.epa.gov/ncer/events/#febcehc-webinar   

Speakers:
Amy Kyle, Associate Adjunct Professor, Center for Integrative Research on Childhood Leukemia and the Environment (CIRCLE) – UC Berkeley
Topic: Aligning the Planets: Working with Networks to Achieve Structural Change

Alyssa Creighton, Community Outreach and Translation Program Coordinator, Columbia Center for Children’s Environmental Health
Topic: Engaging Community Partners for Effective Development of Outreach Strategies

Daniel Madrigal, Community Outreach Coordinator, Center for Environmental Research and Children’s Health, University of California, Berkeley
Topic: Engaging Children and Adolescents in Environmental Health Research

Patrice Sutton, Research Scientist, Program on Reproductive Health and the Environment, Children’s Environmental Health and Disease Prevention Research Center: Formative
Center, University of California, San Francisco
Topic: The Role of Health Professionals in Prevention

Phil Brown, University Distinguished Professor of Sociology and Health Sciences Director
Social Science Environmental Health Research Institute, Northeastern University
Topic: Hospitals for a Healthy Environment

 

iV: The Ivy League Vegan Conference
On February 15-17, 2013 Yale University will host the second Ivy League conference dedicated to exploring the academic basis for plant-based diets and building a cohesive community of activists and advocates. The conference aims to embolden and empower vegan activists in their work throughout the Ivy League, build a lasting and powerful network of colleagues, and expand and modernize the concept of veganism for the 21st century academic. We expect an attendance of approximately 100 students, alumni, and researchers from across the Ivy League. Learn more about the conference.

 

The Health Care Ethics Consortium of Georgia and Emory University Center for Ethics 2013 Annual Conference
The Politics of Caring:  Ethical Issues of Distributive Justice in an Era of Scarce Resources March 21 & 22, 2013 Emory Conference Center Hotel Atlanta, Georgia
Click here for more information.

 

Grants, Fellowships, & Jobs

Postdoctoral Fellowship in Social Studies of Clinical Trials at UNC Center for Bioethics
Applications are now being accepted to fill a postdoctoral fellowship as part of an NIH-funded study investigating the participation of healthy volunteers in pharmaceutical Phase I clinical trials. The position is part of a new five-year longitudinal study to investigate healthy volunteers’ patterns of participation in clinical trials. The research will focus on the relationship over time between healthy volunteers’ perceptions of the risks and benefits of trial participation and their behaviors and decision-making surrounding enrollment in those studies. The principal investigator on the project is Jill Fisher. This will be a one-year position beginning no later than July 1, 2013, with the possibility of annual renewal for four additional years. This fellowship is made possible through a grant from the National Institute of General Medical Sciences, one of the U.S. National Institutes of Health.

Requirements:    Applicants must possess a Ph.D. in a relevant social science field (e.g., sociology, science and technology studies, anthropology, or communication). Applicants must have advanced methodological expertise in interviewing and qualitative data analysis, excellent writing skills, and motivation to take initiative to ensure the success of the project. Preference will be given to candidates who exhibit evidence of research interests and demonstrated knowledge in social studies of the pharmaceutical industry, clinical trials (especially Phase I studies), health disparities, and social inequalities. Additionally, Spanish language skills are highly desirable. The postdoctoral fellow will take the lead on collecting and analyzing data, writing articles and reports, and presenting findings at conferences. Periodic out-of-state travel will be required for data collection. The fellow will be expected to be in residence in Chapel Hill, North Carolina, for the duration of the position and be an active colleague in the UNC Center for Bioethics and Department of Social Medicine. Applicants should submit by February 15 a CV, a letter describing suitability for the fellowship, one writing sample, and the names of three references to:

Jill A. Fisher, PhD
UNC Center for Bioethics
333 MacNider Hall, Campus Box 7240
University of North Carolina, Chapel Hill
333 S. Columbia Road
Chapel Hill, NC 27599-7240
https://apps.research.unc.edu/postdoc_job/position_details.cfm?job_id=296

 

Calls for Papers & Nominations

Nominate Fellows for the Tenth Annual Byron Fellowship, May 19-24, 2013 at Turkey Run State Park. Byron Fellowship is an interdisciplinary course in leadership and sustainable community development that uniquely engages participants through place-based learning. Every year, we look forward to each individual, unique in perspective and commitment, coming together to create an experience greater than the sum of its parts. The participants create Byron and your nominations make Byron a success year after year.
Please take a moment to nominate a fellow here:
http://www.byronfellowship.org/participate/nominate/

 

Articles of Interest

In the News

Schwarz, Alan. Drowned in a Stream of Prescriptions. New York Times. 2 February 2013. Every morning on her way to work, Kathy Fee holds her breath as she drives past the squat brick building that houses Dominion Psychiatric Associates. It was there that her son, Richard, visited a doctor and received prescriptions for Adderall, an amphetamine-based medication for attention deficit hyperactivity disorder. It was in the parking lot that she insisted to Richard that he did not have A.D.H.D., not as a child and not now as a 24-year-old college graduate, and that he was getting dangerously addicted to the medication. Continue reading…

Aging

Tran, Alvin. Aggressive Care Still Common for Dying Seniors, Despite Hospice Uptick. NPR. 5 February 2013.
Even as deaths in acute-care hospitals declined between 2000 and 2009, the use of intensive care units in the final 30 days of life increased, as did short-term hospice use. The rate of changes to care for these patients, such as transfers within the last three days of life, also increased.To gerontologist Joan Teno, the study’s lead author, the increased use of hospice is encouraging but she worries about when seniors are referred to hospice care. Continue reading…

Disability

Szalavitz. Maia. New Study Suggests Autism Can Be Outgrown. Time. 22 January 2013.

There is more evidence that a minority of autistic children may eventually overcome their developmental issues, but experts caution that such recovery is rare. It’s long been the hope of parents of autistic children that the right care and support can reduce or even reverse some of the developmental problems associated with the condition. But while a recent study found that behavioral intervention programs are linked with normalization of some brain activity, the question of whether children can outgrow autism remains difficult to answer. Studies to date that have hinted at this possibility were plagued with lingering questions about whether the children who apparently shed their autism were properly diagnosed with the developmental disorder in the first place. Continue reading…

Food

Jargon, Julie. Low-Cal Items Fuel Restaurant Sales. Wall Street Journal. 7 February 2013.
People are placing fewer orders for french fries and sugary drinks at restaurants, giving a boost to establishments that sell more low-calorie items, according to a study scheduled for release Thursday. An analysis of 21 fast-food and sit-down restaurant chains between 2006 and 2011 found that lower-calorie food and beverages fueled the chains’ growth. Continue reading…

Law and Bioethics

Catholic Hospital Says It Was ‘Morally Wrong’ to Argue Fetus is Not a Person. CNN. 5 February 2013.
A Catholic hospital in hot water for claiming in a Colorado court that a fetus is not a person backtracked on Monday, saying it was “morally wrong” to make the argument while defending itself in a wrongful death lawsuit. Continue reading…

Cyranoski, David. Controversial stem-cell company moves treatment out of the United States. Nature. 30 January 2013.
US citizens who had pinned their hopes on a company being able to offer stem-cell treatments close to home will now need to travel a little farther. Celltex Therapeutics of Houston, Texas, stopped treating patients in the United States last year following a warning from regulators. A 25 January e-mail to Celltex customers indicates that the firm will now follow in the footsteps of many other companies offering unproven stem-cell therapies and send its patients abroad for treatment — but only to Mexico. Continue reading…

Public Health

People With Mental Illness More Likely to Be Smokers, Study Finds. New York Times. 5 February 2013.
People with mental illness are 70 percent more likely to smoke cigarettes than people without mental illness, two federal health agencies reported Tuesday. New data from the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration show that one of every three adults with mental illness smokes, compared with one in five adults without mental illness. Continue reading…

Traffic Fumes Linked to Lower Birth Weight. BBC. 5 February 2013.
Pregnant women who live in areas with significant air pollution risk having babies of low birth weight, the largest study to date suggests. The study, in Environmental Health Perspectives, looked at more than three million births in nine nations. The effect was small and individuals should not be alarmed, but there was a notable impact on the population as a whole, the researchers said. Continue reading…

Alderson, Reevel. Study claims minimum pricing cuts alcohol-related deaths. BBC. 6 February 2013.
Research published in Canada has linked the introduction of minimum pricing with a significant drop in alcohol-related deaths. The findings, in the journal Addiction, were welcomed by health campaigners. But they have been criticised as “misleading and inaccurate” by the drinks industry, which has questioned the statistical basis of the research. Continue reading…

Reproduction

Pear, Robert. Birth Control Rule Altered to Allay Religious Objections. New York Times. 1 February 2013.
The Obama administration on Friday proposed yet another compromise to address strenuous objections from religious organizations about a policy requiring health insurance plans to provide free contraceptives, but the change did not end the political furor or legal fight over the issue. Continue reading…

Research Ethics

Hamilton, Jon. Shortage of Brain Tissue Hinders Autism Research. NPR. 4 February 2013.
Research on autism is being hobbled by a shortage of brain tissue.The brain tissue comes from people with autism who have died, and it has allowed researchers to make key discoveries about how the disorder affects brain development.But there’s not nearly enough tissue because most potential donors aren’t identified, and their family members are never approached about the possibility of donation. The shortage has been especially bad since last summer, when a freezer at a Harvard brain bank failed, allowing dozens of autistic brains to thaw. Continue reading…

Rochman, Bonnie. ‘Both My Sons Deserve to Live’: A Mother’s Plea for Quicker Action from the FDA. Time. 7 February 2013.
Austin and Max Leclaire are brothers. Austin is older, Max is younger. Like most siblings, they have many things in common and just as many that set them apart. For now, though, their strongest bond is over something they share — Duchenne muscular dystrophy (DMD), the most common lethal genetic disorder among children. Because Max, 11, was still able to put one foot in front of another in the summer of 2011, he was eligible to enroll in a drug trial for Eteplirsen, which is designed for children like the Leclaire brothers who have trouble producing a protein called dystrophin. It’s likely that you’ve never heard of dystrophin, but it’s responsible for reinforcing and strengthening muscle fibers to gird them against wear and tear. Without it, normal activity strains the muscles, including the heart and lungs. Without it, kids with DMD die. Continue reading…

Transplants

Graham, Judith. Hospitals Reassess the Age Factor in Evaluating Candidates for Kidney Transplants. Washington Post. 28 January 2013.
Robert Brown was healthy, willing and a good match: So why not give a kidney to his wife, who otherwise would need dialysis? There was just one potential obstacle: Brown was 74, an age once unthinkable for a kidney donor. Continue reading…

Graham, Judith. Rules of Organ Donation Under Reconsideration. Washington Post. 28 January 2013.
Kidneys from deceased donors are carefully rationed under rules established by the nonprofit United Network for Organ Sharing, or UNOS. The system is set up so that kidneys go to people who have spent the longest time on waiting lists and who are a good match, with provisions made for distributing organs to patients within the same region, when possible. Continue reading…

 

In the Journals

Barilan, Y. M. Deliberation at the hub of medical education: beyond virtue ethics and codes of practice. Medicine, Health Care, and Philosophy. February 2013.
Although both codes of practice and virtue ethics are integral to the ethos and history of “medical professionalism”, the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians’ “burn-out”. We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation. Continue reading…

Cigman, Ruth. How not to think: medical ethics as negative education. Medicine, Health Care, and Philosophy. April 2012.
An implicit rationale for ethics in medical schools is that there is a perceived need to teach students how not to think and how not to act, if they are to avoid a lawsuit or being struck off by the GMC. However, the imperative to keep within the law and professional guidance focuses attention on risks to patients that can land a doctor in trouble, rather than what it means to treat a patient humanely or well. In this paper I explore the gap between learning how not to think and act as a doctor, and learning to be reflective and responsive to patients as fellow human beings. This gap is exposed by the difference between a GMC web resource for doctors, and a detailed ethical discussion by Gawande in his book Complications. The latter raises fundamental questions of meaning, and exemplifies an approach to ethical thinking as the appropriate management of doubt that, according to the argument of this paper, is of utmost importance for doctors. Continue reading…

Swetz, Keith M. Balancing Evidence-Based Medicine, Justice in Health Care, and the Technological Imperative: A Unique Role for the Palliative Medicine Clinician. Journal of Palliative Medicine. April 2012.
This article discusses the unique role of palliative medicine clinicians in balancing evidence based medicine, justice in health care, and the technological imperative. The technological imperative suggests that any new technology that is introduced must be accepted and even embraced, with little reflection on its impact. Hemodialysis (HD) and end-stage renal disease (ESRD) provide an interesting paradigm for exploring the tension that often exists with practicing evidence-based medicine, using technology, and appreciating cost in the health care system. In a study, it is noted that US patients with ESRD who were nursing-home residents and began HD were noted to have a concurrent, “substantial and sustained decline in functional status.” Fatigue is often associated with participation in HD. Few other studies have recently looked at the efficacy of HD and note that patients who have a 48-hour interval between HD treatments are more likely to have adverse events. The findings of these studies seem to juxtapose an important consideration at the heart of this concern. Palliative care clinicians are well poised to bridge the current evidence available to guide practice and to go beyond the evidence to frame options within the goals of an individual patient and are likely to be called upon to do this increasingly in the foreseeable future. Continue reading…

Fournier, Véronique. The ethics of living donation for liver transplant: beyond donor autonomy. Medicine, Health Care, and Philosophy. February 2013.
This paper will present and discuss our conclusions about the ethics of living donation for liver transplant (LDLT) after 8 year of collaboration between our clinical ethics consultation service and liver transplant teams, in the course of which we met with all donor-candidates. We will focus on the results of a follow-up study that was conducted in order to evaluate the long-term consequences for potential donors and to interview them on the ethical aspects of the screening process. This study was conducted from April 2007 to November 2009 and consisted of interviews with donor-candidates, regardless of whether they underwent harvest surgery, at least 1 year after the recipient’s transplant. We explored their views about their own and the recipients’ physical and psychological condition, changes in family and career dynamics, their experience as potential or real donors, and their views about LDLT process in general. Results shed new light on the ethical grounds of LDLT and allow us to envisage new ways of improving the ethical soundness of current procedures and practices. In particular, we argue that the purpose of an ethics committee should be to provide follow-up support for the donors rather than merely to check the freedom of donors’ consent. We also suggest that the recipient’s consent deserves more attention than it currently receives. Continue reading…

 

Opinion

Ars Technica

Johnson, Scott. Tree ring history spurs actual climate science debate. February 4, 2013.
Climate reconstructions based on tree rings have become a major point of contention. In 1998, a climate scientist by the name of Michael Mann had the misfortune of publishing a Northern Hemisphere temperature reconstruction dubbed “the hockey stick,” due to the appearance of the abrupt warming of the last century. He quickly became a favorite target for several high-profile contrarians, which has brought him a great deal of harassment. Continue reading…

Shaw, Kate. Did antibiotics spur the sexual revolution? February 1, 2013.
The 1960s saw a wealth of changes in the US, from crime waves to shifts in political activism. But perhaps the most defining social trend in this era was a cultural revolution in which sex became more socially acceptable and “free love” became a mantra for young people across America. Continue reading…

Chicago Tribune

Editorial. Religious freedom and contraception. February 3, 2013.
Americans of different faiths differ on the morality of contraceptives. The Roman Catholic Church rejects their use, and most other Christian denominations accept it. Thanks to the First Amendment’s guarantee of the right of free exercise of religion, each group gets to follow its conscience without penalty. That’s what religious liberty guarantees. Continue reading…

Editorial. ‘Gene Jockeys’ and the killer flu. February 2, 2013.
Americans are still in the grip of a scary flu season. Who can forget the alarming headlines about the swift spread and virulence of this year’s bug? Everyone’s still on high alert should someone sneeze or cough on the bus, train, restaurant or office. Violators are dealt with harshly. Continue reading…

Los Angeles Times

Editorial. DNA’s crime-fighting role. February 7, 2013.
This week it was announced that DNA testing of bones found buried beneath a parking lot in Leicester, England, had established that they belonged to King Richard III, who was killed in battle in 1485. Researchers were able to match DNA recovered from the skeleton with that of a living descendant of the much-vilified monarch’s sister. The find was just the latest reminder of the immense power of DNA evidence, power that is expanding history and criminal justice but that also is subject to misuse. Continue reading…

Editorial. Regulating corporate payments to doctors. February 1, 2013.

Though few patients realize it, many doctors receive thousands of dollars from pharmaceutical companies for each patient enrolled in an experimental drug trial. The medication might be the best thing for the patient’s condition. The doctor’s motives might be pure. But patients should be able to find out about such payments so they can discuss them with their doctors and decide for themselves whether the doctor’s participation in an experiment might compromise his medical advice. Continue reading…

Miami Herald

Editorial. Justice denied. February 5, 2013.
Florida’s death penalty system is terribly flawed. Lawmakers have known that since at least 2006, when the American Bar Association released an exhaustive report calling the system “fraught with problems,” including racial disparities. But almost no fixes were made. Meanwhile, evidence of a system gone awry has piled up. Continue reading…

New York Times

Editorial. A Death Penalty Case in Puerto Rico. February 4, 2013.
Puerto Rico abolished the death penalty in 1929 and, a generation later, made it unconstitutional. The island’s Bill of Rights expressly decrees that “the death penalty shall not exist” there. But as a commonwealth of the United States, the island is subject to federal law, including the death penalty for many federal crimes. Continue reading…

Kugelman, Michael. The global farmland rush. February 5, 2013.
Over the last decade, as populations have grown, capital has flowed across borders and crop yields have leveled off, food-importing nations and private investors have been securing land abroad to use for agriculture. Poor governments have embraced these deals, but their people are in danger of losing their patrimony, not to mention their sources of food. Continue reading…

Bate, Roger. Feeding a disease with fake drugs.  February 5, 2013.
More than eight million people get sick with tuberculosis every year, according to the World Health Organization. In 2011, 1.4 million died from it, making it the world’s deadliest infectious disease after AIDS. Thanks to billions of dollars spent on diagnosis and treatment over the past decade, deaths and infections are slowly declining. Yet a disturbing phenomenon has emerged that could not only reverse any gains we’ve made, but also encourage the spread of a newly resistant form of the disease. Continue reading…

Washington Post

Editorial. A contraception compromise in good faith. February 5, 2013.
President Obama’s 2010 health-care law requires large employers to provide health insurance and, according to the Department of Health and Human Services (HHS), that contraception be covered by those policies. From a policy perspective, the contraception mandate makes sense. But when the employers in question are affiliated with religious groups that object to birth control, balancing their religious liberty against public health is far from simple. Continue reading…

Editorial. FDA should do more with its authority over tobacco products. February 4, 2013.
In 2009, President Obama signed the Tobacco Control Act, which gave the Food and Drug Administration (FDA) authority over tobacco products. It was a signal moment in the fight against smoking. Tobacco use is the leading cause of preventable death in the country, racking up 400,000 premature deaths in America every year and holding 40 million Americans in the grip of addiction. After decades of education campaigns, cessation programs and increasing taxes, the U.S. smoking rate is stuck at about a fifth of the adult population. And after a string of headline-worthy achievements, the FDA’s tobacco program has been a little quiet lately. Continue reading…

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