(Kaiser Health News) – Some experts estimate that at least $200 billion is wasted annually on excessive testing and treatment. This overly aggressive care also can harm patients, generating mistakes and injuries believed to cause 30,000 deaths each year. “The changes that need to be made don’t appear unrealistic, yet they seem to take an awful lot of time,” said Dr. Jeff Rideout, chief executive of the Integrated Healthcare Association, an Oakland, Calif., nonprofit group that promotes quality improvement. “We’ve been patient for too long.”
(Vox) – According to CBS News, the coroner’s office in Montgomery County ran out of space for the second time this year after it received 13 bodies on Monday, 12 of which were for overdoses. And that came after the office expanded its cooler to hold 42 bodies, up from 36, after facing similar issues last year. “If this pace continues, I’m not really sure what we’re going to do,” Kent Harshbarger, the coroner, told the Tribune-Review. “It’s full every night.” According to Harshbarger, he’s looking at 2,900 autopsies this year, 2,000 of which are for drug overdoses. Last year, he reportedly handled fewer than 2,000 autopsies total. His office handles autopsies for Montgomery County and the surrounding rural areas in southwest Ohio.
(Wired) – Since then, researchers have been racing to develop treatments and vaccines, the first of which entered mid-stage human trials at the end of March. But according to new genetic evidence published today, public health efforts to contain and fight the disease could have—and should have—gotten underway much sooner. Zika, it turns out, had established itself in Brazil as early as 2013.
(Nature) – Studies of thousands of pregnant women that were set up to probe the link between Zika and birth defects may not provide definitive answers because of a sharp drop in the number of new cases, researchers have warned. The unexpected development is making the disease harder to study, and threatens to hamper trials of experimental vaccines that might protect pregnant women in future outbreaks. “We’re seeing few, if any, cases, particularly in southern Brazil, which we thought might be the next big area to be hit this year,” says Oliver Brady, an epidemiologist at the London School of Hygiene and Tropical Medicine.
(Medscape) – The field of palliative care encompasses the broad trajectory from diagnosis of a serious illness until the time of death. There has been extensive interest in the final hours or days before death as a specific period in which patients may experience new symptoms or concerns that affect both patients and their families.
(Toronto Life) – For some doctors, the aftermath is difficult. Just because doctors are regularly exposed to death doesn’t mean they’re comfortable performing euthanasia. A 2006 study on the emotional effects of physician-assisted death in the Netherlands and Oregon found that doctors often felt isolated and powerless after performing the procedure. At UHN, Li has seen physicians who deal with death on a daily basis break down after conducting a medically assisted death. Since MAID became legal, the number of willing providers in Ontario has shrunk, as nearly 30 doctors have pulled their names from the ministry’s list.
(Quartz) – This inability arises from the opacity of AI systems, which—as a side effect of how machine-learning algorithms work—operate as black boxes. It’s impossible to understand why an AI has made the decision it has, merely that it has done so based upon the information it’s been fed. Even if it were possible for a technically literate doctor to inspect the process, many AI algorithms are unavailable for review, as they are treated as protected proprietary information. Further still, the data used to train the algorithms is often similarly protected or otherwise publicly unavailable for privacy reasons. This will likely be complicated further as doctors come to rely on AI more and more and it becomes less common to challenge an algorithm’s result.
(New Scientist) – A cholera outbreak in Yemen has killed 332 people, and left more than 32,000 ill in the last four weeks, the World Health Organization reports. The disease, which is caused by ingesting food or water contaminated with Vibrio cholerae bacteria, has spread faster than any previous known outbreak in Yemen. It could affect as many as 300,000 people over the next 6 months, the WHO says.
(Quartz) – When it comes to killer diseases in Africa many people think of infectious diseases like tuberculosis, malaria, or even Ebola. But the reality is that diseases like cancer, diabetes and heart disease – known as non-communicable diseases (NCDs)—are a major threat. It’s estimated that there will be about 3.9 million deaths from these diseases in Africa by 2020. The rising burden will have an impact not only on people’s health. It will also affect economic productivity and the social fabric of societies. This is why there’s been an increasing focus on NCDs – they’re been included in the Sustainable Development Goals and will be the focus of the upcoming World Health Assembly.
(Wired) – Two years ago this week, Ross Ulbricht was sentenced to life in prison without parole for running the Silk Road, an unprecedented dark web bazaar for drugs and other contraband. The judge intended the sentence to serve as a warning to other would-be internet narcotraffickers. But new research suggests more clearly than ever before that the strategy of making an example of Ulbricht didn’t deter Silk Road users. In fact, it may have had the opposite effect. In a study published in a forthcoming issue of the British Journal of Criminology, Boston College sociologist Isak Ladegaard provides some of the strongest quantitative evidence yet that the dark web drug trade actually received a sales bump following the news of Ulbricht’s surprisingly harsh sentence.
(UPI) – Major U.S. teaching hospitals are often considered more expensive than the competition, but a new study suggests they may have an important quality advantage. Older adults treated at major teaching facilities are less likely to die in the weeks and months following their discharge than patients admitted to “non-teaching” or community hospitals, the study found. The study involved more than 21 million hospitalizations of Medicare beneficiaries from 2012 through 2014.
(Nature) – The World Health Organization (WHO) has its first head to hail from Africa. Ethiopia’s Tedros Adhanom Ghebreyesus will take up the post of the agency’s director-general from 1 July – succeeding Margaret Chan – after winning a 23 May vote by WHO member states at the World Health Assembly, their annual gathering in Geneva, Switzerland. Tedros, 52, is a public health expert who has formerly been both a health minister and a foreign minister in Ethiopia’s government, and will lead the WHO for a 5-year term.
(Wired) – When Bakul Patel started as a policy advisor in the US Food and Drug Administration in 2008, he could pretty much pinpoint when a product was going to land in front of the reviewers in his division. Back when medical devices were heavy on the hardware—your pacemakers and your IUDs—it would take manufacturers years to get them ready for regulatory approval. FDA reviewers could keep up pretty well. But as computer code took on more complex tasks, like spotting specious moles and quantifying blood flow, their duties began to accelerate. Software developers needed months, not years, to make it to the market. And there were a lot of them. It got harder to match pace. And then came artificial intelligence.
(Medscape) – Ethics is not something one should avoid or defer to a philosopher for. “As physicians, we can be ethicists as well, and we should not shy away from using our voice,” said Dr King. In reproductive medicine, you often have two patients in front of you, she explained. For example, when you have a woman with diabetes not using her medications appropriately, the risk for stillbirth and other adverse outcomes is high. “How do you maintain a relationship with the patient while protecting the child? How do you go about addressing that in a meaningful way? How far should you go?” she asked.
(The Guardian) – Facebook’s secret rules and guidelines for deciding what its 2 billion users can post on the site are revealed for the first time in a Guardian investigation that will fuel the global debate about the role and ethics of the social media giant. The Guardian has seen more than 100 internal training manuals, spreadsheets and flowcharts that give unprecedented insight into the blueprints Facebook has used to moderate issues such as violence, hate speech, terrorism, pornography, racism and self-harm.
(PhysOrg) – Monitoring the quality of these drugs has proven challenging, however, because protein production by living cells is much more difficult to control than the synthesis of traditional drugs. Typically these drugs consist of small organic molecules produced by a series of chemical reactions. MIT engineers have devised a new way to analyze biologics as they are being produced, which could lead to faster and more efficient safety tests for such drugs. The system, based on a series of nanoscale filters, could also be deployed to test drugs immediately before administering them, to ensure they haven’t degraded before reaching the patient.
(The Japan Times) – A major genetic testing company in Japan plans to provide a service from as early as next year to check the probability that future children will have genetic disorders, The Yomiuri Shimbun has learned. By examining the genetic codes of a couple, the testing can ascertain the incidence rate of about 1,050 conditions, including certain types of muscular dystrophy and Parkinson’s disease, according to the company. However, related academic societies are considering whether to issue a statement expressing their concerns, as they believe that while there is a need for such testing, there are also concerns that it will promote new forms of discrimination.
(CNN) – Instagram is the most detrimental social networking app for young people’s mental health, followed closely by Snapchat, according to a new report by the Royal Society for Public Health in the UK. Their study, #StatusofMind, surveyed almost 1,500 young people aged 14 to 24 on how certain social media platforms impact health and well-being issues such as anxiety, depression, self-identity and body image. YouTube was found to have the most positive impact, while Instagram, Snapchat, Facebook and Twitter all demonstrated negative affects overall on young people’s mental health.
(Wired) – For $150, you can buy a Crispr kit online and use it to engineer heartier gut bacteria in your kitchen. That’s thrilling, but the technology is giving Jennifer Doudna, an inventor of the gene-editing method, nightmares. Easy genetic modification could mean cures for cancer (yay!), kitty-sized pigs (squee!), and, yes, designer babies (ack). In her new book, A Crack in Creation, Doudna urges innovators to slow their roll. Here she considers the daunting prospects and promises of the monster-maker she created.
(The Conversation) – A technique that effectively “unblocks” a woman’s fallopian tubes by flushing them with liquid to help her conceive has been used for decades, with varying levels of success. Now a study has confirmed that the method significantly improves fertility, and that a certain type of fluid – one that is oil-based rather than water-based – shows strong results. Published in The New England Journal of Medicine, our H2Oil study involved 1,119 women in 27 medical centres in The Netherlands. All women were younger than 38 and had been trying to conceive for 18 months on average.