Readings To Consider vs. The Occasional Perspective - 10/16/20

Books and Articles worth a Review… 

A First! – The October 7, 2020 issue of the New England Journal of Medicine provided an editorial that was a first in the 208-year history of the publication going back to its origin in 1812. “Dying in a Leadership Vacuum” 34 editors weighed in on the decision in support of the decision with Eric Rubin, MD as Editor-in-Chief explaining that the events of the Covid-19 pandemic cut across all levels of leadership from the President, to Governors and other in leadership roles throughout the nation.

Enhanced Listening So We Can Learn and Act – I have recently taken on an old interest that I put on the shelf a number of decades ago (actually a whole bunch of them) and re-energized the interest. It is writing – not just blogs but on more general issues. I have been doing all these readings about how to get in touch with your other self (hmmmm) as part of an embrace for the age I’m now entering. So, check out my new article published on – //">The New Requirement: First Hear and Listen with Intent to Learn and Act. The article basically is a call for moving from the passive act of hearing auditory signals, to listening where we actually absorb what is being said to learning from the exchange with others to acting responsibly on behalf of the needs of society. It emanated from the lack of dialogue, debate and discussion that has taken an overriding grip on the American spirit. Any feedback is appreciated…

Readings and Other Considerations

Books, articles and other worthy perspectives for your a review… 

Activism in Health Care and Science – I was recently introduced to 314 Action, a group of individuals from the STEM community who founded the organization with some other grassroots supporters and political activists who believe in science.  It is an organization that is committed to electing more STEM candidates to office, advocating for evidence-based policy solutions to issues like climate change, and fighting the recent attacks on science from the political community. In essence, their action statement is to elect more leaders who will use their training as STEM professionals to influence policy-making based on facts ranging from climate change to health care to gun violence.  The efforts are not limited to Washington, D.C. and include efforts focused on local and state legislatures as well. Through their efforts, they intend to leverage their network of pro-science advocates to organize and effect change in areas where science is being maligned or disputed. As a unified STEM and pro-science community, we can combat the all-too-common attacks on basic scientific understanding. This activism cuts to the very heart of health care.  Consider their efforts as you make your choices…

JAMA Releases Top 10 Articles of the Decade – There’s so much information being disseminated these days in medicine and health care that it’s hard to stay up to speed.  The JAMA Editors culled through the ones from their journal; however, and came up with a list.  Here you go and, the downloads are free, that way you can catch up:

§  The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) – Mervyn Singer, MD, FRCP; Clifford S. Deutschman, MD, MS; Christopher Warren Seymour, MD, MSc; et al

§  2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) – Paul A. James, MD; Suzanne Oparil, MD; Barry L. Carter, PharmD; et al

§  Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The APPAC Randomized Clinical Trial – Paulina Salminen, MD, PhD; Hannu Paajanen, MD, PhD; Tero Rautio, MD, PhD; et al

§  Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial – Jeff D. Williamson, MD, MHS; Mark A. Supiano, MD; William B. Applegate, MD, MPH; et al for the SPRINT Research GroupAudio Interview: Intensive Blood Pressure Control in Adults Aged 75 Years or Older

§  Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs – Varun Gulshan, PhD; Lily Peng, MD, PhD; Marc Coram, PhD; et al

§  United States Health Care Reform: Progress to Date and Next Steps – Barack Obama, JD

§  Health Care Spending in the United States and Other High-Income Countries – Irene Papanicolas, PhD; Liana R. Woskie, MSc; Ashish K. Jha, MD, MPH Audio Interview: Health Care Spending in the United States and Other High-Income Countries

§  The Association Between Income and Life Expectancy in the United States, 2001-2014 – Raj Chetty, PhD; Michael Stepner, BA; Sarah Abraham, BA; et al

§  Eliminating Waste in US Health Care – Donald M. Berwick, MD, MPP; Andrew D. Hackbarth, MPhil Audio Interview: Association Between Income and Life Expectancy in the United States

§  Silencing the Science on Gun Research – Arthur L. Kellermann, MD, MPH; Frederick P. Rivara, MD, MPH

Readings To Consider vs. The Occasional Perspective

Books and Articles worth a Review… 

HeForShe – The United Nations is sponsoring a website where you can meet the visionary leaders taking action for gender equality in their countries, organizations and beyond. HeForShe IMPACT and Pilot Initiatives are intended to engage key decision makers around the world in the public and private sector to deliver parity by 2020, and drive change from the top.  Consider it!  These global leaders are on a journey to reach parity and achieve a  gender equal world for all. 

Vaping Ads on Television ??? – Are we crazy?  I was taken aback the other night in watching the news when an ad came on encouraging me to go out, buy this product and start vaping!  I was appalled.  On the one hand, we are now allowing vaping ads – which are now countered by FDA ads noting the dangers of vaping – when there is an epidemic of the use of these devices among teenagers.  By all accounts, nearly 20% of high school students now vape or, an 86% increase in vaping among that group in just one year from 2017 to 2018!  For all we know, over the coming weeks there will be the equivalent of the Marlboro Man jumping out of our screens – be they television or computer – counting the attributes of vaping.  LET’S STOP THIS INSANITY NOW!

Distortion By Technology – First, this is not a political statement.  It is warning sign on the veracity of information we see streaming across our devices and into our homes.  The wires went crazy a couple of weeks ago when distorted videos of House Speaker Nancy Pelosi (D-CA) were disseminated with edits that made it appear that she was having trouble speaking.  While it was disturbing, the issue is far greater than Nancy Pelosi and politics.  It is about the ability of technology to distort all sorts of information – with the capability growing by leaps and bounds every month!  I’m a big (huge 😊) fan of technology for solving problems.  But, we also need to keep our eye on technology as it “creates” problems as well.  This is not about politics – be they conservative or liberal.  This is about information upon which our society has become totally dependent.  Think about it.  What needs to be done? 

Seize Diastole – Considering the lessons of physiology and how they can be extrapolated to the world we live in is the focus of this excellent article by Colleen Farrell, MD at NYU.  If you need a copy, let me know.  I have it available.

Media to Consider - 4/19/19

Books and Articles worth a Review…

Eric Topol’s new book, Deep Medicine, is an absolute MUST READ for anyone in the health care world.  It will take you on a whirlwind tour of the technology forces which are being unleashed across all of society which will profoundly alter our notion of medicine and health care in the future.  We are the cusp of a major shift in capability that will make the discovery of antibiotics pale in comparison.  In particular, I believe his last chapter is the most profound.  He notes that we have historically recruited into medicine and the helping professions people who were brainy folks and who had the ability to store large quantities of data in their brains.  With the advent of clinically augmented intelligence where the computer becomes part of our armamentarium, he argues that we will need clinicians with must stronger skills in emotional intelligence.  I think he’s right.  Let’s start the debate now.  I hope there are some Deans reading this blog…

Media to Consider

Books and Articles worth a Review…

Detecting the BS in Health Care – In case you missed it, Lawton Burns, Ph.D. and Mark Pauly, Ph.D. from The Wharton School at the University of Pennsylvania recently released an important piece - Detecting BS in Health Care 1.0. They highlight some of the claims that too frequently are touted as outcomes without the necessary backing of data.  It’s a phenomenon that seems to be seeping into too many aspects of our societal discussions.  We need to be on the alert to such shifts because the reason health care has moved from opinion to solutions over the last couple of centuries is because of the rigor of the medical profession on insisting that scientific research be upheld with transparency and open scrutiny.  

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