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AMA Journal of Ethics Jun 2023Over the past decade, ways of defining self in relation to gender identity and forms of expression have widely expanded. Along with this expansion of identifying...
Over the past decade, ways of defining self in relation to gender identity and forms of expression have widely expanded. Along with this expansion of identifying language, there has been an increase in medical professionals and clinics specializing in providing gender care. Yet many barriers to providing this care still exist for clinicians-including their comfort with and knowledge about collecting and retaining a patient's demographic information, respecting the name and pronouns a patient goes by, and providing overall ethical care. This article shares one transgender person's numerous health care encounters over 20 years as both a patient and a professional.
Topics: Humans; Male; Female; Transgender Persons; Gender Identity; Health Personnel; Patients
PubMed: 37285300
DOI: 10.1001/amajethics.2023.452 -
Vaccine Jan 2022International Nonproprietary Names (INN) are assigned by the World Health Organization (WHO) to pharmaceutical substances to ensure global recognition by a unique name.... (Review)
Review
International Nonproprietary Names (INN) are assigned by the World Health Organization (WHO) to pharmaceutical substances to ensure global recognition by a unique name. INN facilitate safe prescribing through naming consistency, efficient communication and exchange of information, transnational access and pharmacovigilance of medicinal products. Traditional vaccines such as inactivated or live-attenuated vaccines have not been assigned INN and provision of a general name falls within the scope of the WHO Expert Committee on Biological Standardization (ECBS). However, novel vaccines that contain well-defined active ingredients such as nucleic acids or recombinant proteins fulfil the criteria to be assigned INN. In the current environment where multiple SARS-CoV-2 vaccines are being developed to combat the COVID-19 pandemic and with virus variants emerging, assigning INN to well-defined vaccine substances will strengthen pharmacovigilance and ultimately enhance the safety of vaccine recipients. This article examines the background to INN for vaccines and explains the applicability and value of assigning INN to novel well-defined vaccines.
Topics: COVID-19; COVID-19 Vaccines; Humans; Pandemics; SARS-CoV-2; World Health Organization
PubMed: 34844820
DOI: 10.1016/j.vaccine.2021.11.054 -
Journal of General Internal Medicine Feb 2023Despite recognition of the importance of substance use disorder (SUD) terminology, few studies examine terminology preferences among patients with SUDs.
BACKGROUND
Despite recognition of the importance of substance use disorder (SUD) terminology, few studies examine terminology preferences among patients with SUDs.
OBJECTIVE
To examine preferences of patients with opioid use disorder (OUD) concerning the terminology used by addiction counselors.
DESIGN
From January 1, 2019, to February 28, 2020, participants were recruited consecutively from 30-day treatment review sessions at outpatient methadone treatment programs in the Northeastern United States to complete a cross-sectional survey.
PARTICIPANTS
Participants were English-speaking adult patients with OUD enrolled in methadone treatment.
MAIN MEASURES
Participants completed 7-point Likert-type scales from 1 ("Strongly Disagree") to 7 ("Strongly Agree") to rate their preferences for (a) the presenting problem, (b) collective nouns referring to those with the presenting problem, and (c) personal descriptors. We used univariate analysis of covariance (ANCOVA) to examine the associations between demographics (i.e., age, sex, and race) and terminology preferences and ordinal logit regression to explore the association between 12-step program partiality and preference for the term "addict."
KEY RESULTS
We surveyed 450 patients with mean age of 38.5 (SD = 11.1) years; 59.6% self-identified as male, 77.6% as White, and 12.7% as Hispanic. The highest-rated preferences for presenting problem were "addiction," "substance use," and "substance abuse." The highest-rated collective noun terms were "client," "patient," and "guest." "Person with an addiction," "person with substance use disorder," and "substance-dependent person" were the highest-rated personal descriptors. There were significant differences in terminological preference based on race and age. Twelve-step program partiality was associated with greater preference for the term "addict" (F = 21.22, p < .001).
CONCLUSIONS
Terminology preferences among people receiving methadone treatment aligned with existing guidelines recommending that clinicians use medically accurate and destigmatizing terminology when referring to substance use disorders and the persons who have them. Demographic differences emerged in terminological preferences, warranting further examination.
Topics: Adult; Humans; Male; Child; Cross-Sectional Studies; Outpatients; Behavior, Addictive; Ambulatory Care; Methadone; Opioid-Related Disorders; Opiate Substitution Treatment
PubMed: 36163526
DOI: 10.1007/s11606-022-07813-w -
Scientific Reports Apr 2022We often fail to recall another person's name. Proper names might be more difficult to memorize and retrieve than other pieces of knowledge, such as one's profession...
We often fail to recall another person's name. Proper names might be more difficult to memorize and retrieve than other pieces of knowledge, such as one's profession because they are processed differently in the brain. Neuroimaging and neuropsychological studies associate the bilateral anterior temporal lobes (ATL) in the retrieval of proper names and other person-related knowledge. Specifically, recalling a person's name is thought to be supported by the left ATL, whereas recalling specific information such as a person's occupation is suggested to be subserved by the right ATL. To clarify and further explore the causal relationship between both ATLs and proper name retrieval, we stimulated these regions with anodal, cathodal and sham transcranial direct current stimulation (tDCS) while the participants memorized surnames (e.g., Mr. Baker) and professions (e.g., baker) presented with a person's face. The participants were then later asked to recall the surname and the profession. Left ATL anodal stimulation resulted in higher intrusion errors for surnames than sham, whereas right ATL anodal stimulation resulted in higher overall intrusion errors, both, surnames and professions, compared to cathodal stimulation. Cathodal stimulation of the left and right ATL had no significant effect on surname and profession recall. The results indicate that the left ATL plays a role in recalling proper names. On the other hand, the specific role of the right ATL remaines to be explored.
Topics: Face; Humans; Mental Recall; Names; Temporal Lobe; Transcranial Direct Current Stimulation
PubMed: 35388106
DOI: 10.1038/s41598-022-09781-x -
BMJ Health & Care Informatics Dec 2021Different stakeholders may hold varying attitudes towards artificial intelligence (AI) applications in healthcare, which may constrain their acceptance if AI developers... (Review)
Review
OBJECTIVES
Different stakeholders may hold varying attitudes towards artificial intelligence (AI) applications in healthcare, which may constrain their acceptance if AI developers fail to take them into account. We set out to ascertain evidence of the attitudes of clinicians, consumers, managers, researchers, regulators and industry towards AI applications in healthcare.
METHODS
We undertook an exploratory analysis of articles whose titles or abstracts contained the terms 'artificial intelligence' or 'AI' and 'medical' or 'healthcare' and 'attitudes', 'perceptions', 'opinions', 'views', 'expectations'. Using a snowballing strategy, we searched PubMed and Google Scholar for articles published 1 January 2010 through 31 May 2021. We selected articles relating to non-robotic clinician-facing AI applications used to support healthcare-related tasks or decision-making.
RESULTS
Across 27 studies, attitudes towards AI applications in healthcare, in general, were positive, more so for those with direct experience of AI, but provided certain safeguards were met. AI applications which automated data interpretation and synthesis were regarded more favourably by clinicians and consumers than those that directly influenced clinical decisions or potentially impacted clinician-patient relationships. Privacy breaches and personal liability for AI-related error worried clinicians, while loss of clinician oversight and inability to fully share in decision-making worried consumers. Both clinicians and consumers wanted AI-generated advice to be trustworthy, while industry groups emphasised AI benefits and wanted more data, funding and regulatory certainty.
DISCUSSION
Certain expectations of AI applications were common to many stakeholder groups from which a set of dependencies can be defined.
CONCLUSION
Stakeholders differ in some but not all of their attitudes towards AI. Those developing and implementing applications should consider policies and processes that bridge attitudinal disconnects between different stakeholders.
Topics: Artificial Intelligence; Attitude; Delivery of Health Care; Humans; Names
PubMed: 34887331
DOI: 10.1136/bmjhci-2021-100450 -
CMAJ : Canadian Medical Association... Jun 2021
Topics: Female; Hospitalization; Humans; Intensive Care Units; Pneumonia; Sepsis; Students, Medical
PubMed: 34155051
DOI: 10.1503/cmaj.210454 -
Scientific Data May 2023We provide the largest compiled publicly available dictionaries of first, middle, and surnames for the purpose of imputing race and ethnicity using, for example,...
We provide the largest compiled publicly available dictionaries of first, middle, and surnames for the purpose of imputing race and ethnicity using, for example, Bayesian Improved Surname Geocoding (BISG). The dictionaries are based on the voter files of six U.S. Southern States that collect self-reported racial data upon voter registration. Our data cover the racial make-up of a larger set of names than any comparable dataset, containing 136 thousand first names, 125 thousand middle names, and 338 thousand surnames. Individuals are categorized into five mutually exclusive racial and ethnic groups - White, Black, Hispanic, Asian, and Other - and racial/ethnic probabilities by name are provided for every name in each dictionary. We provide both probabilities of the form ℙ(race|name) and ℙ(name|race), and conditions under which they can be assumed to be representative of a given target population. These conditional probabilities can then be deployed for imputation in a data analytic task for which self-reported racial and ethnic data is not available.
Topics: Humans; Bayes Theorem; Black People; Ethnicity; Hispanic or Latino; Self Report; United States
PubMed: 37208389
DOI: 10.1038/s41597-023-02202-2 -
Archives of Endocrinology and Metabolism Nov 2022" (Juliet, from by William Shakespeare). Shakespeare's implication is that a name is nothing but a word and it therefore represents a convention with no intrinsic...
" (Juliet, from by William Shakespeare). Shakespeare's implication is that a name is nothing but a word and it therefore represents a convention with no intrinsic meaning. Whilst this may be relevant to romantic literature, disease names do have real meanings, and consequences, in medicine. Hence, there must be a very good rational for changing the name of a disease that has a centuries-old historical context. A working group of representatives from national and international endocrinology and endocrine pediatric societies now proposes changing the name of "diabetes insipidus" to "Arginine Vasopressin Deficiency (AVP-D)" for central etiologies, and "Arginine Vasopressin Resistance (AVP-R)" for nephrogenic etiologies This editorial provides both the historical context and the rational for this proposed name change.
Topics: Humans; Child; Diabetes Insipidus; Arginine Vasopressin; Diabetes Mellitus
PubMed: 36219203
DOI: 10.20945/2359-3997000000528 -
Fertility and Sterility Apr 2023Intended parents engage with gestational carriers (GCs) to achieve their personal reproductive goals. All GCs have a right to be fully informed of the risks as well as...
Intended parents engage with gestational carriers (GCs) to achieve their personal reproductive goals. All GCs have a right to be fully informed of the risks as well as the contractual and legal aspects of the gestational-carrier process. The GCs have autonomy in making their own decisions regarding medical care and should be free from undue influences by the stakeholders involved. They should have free access to and receive psychological evaluation and counseling before, during, and after participating. In addition, GCs require separate independent legal counsel regarding the contract and arrangement. This document replaces the document of the same name, last published in 2018 (Fertil Steril 2018;110:1017-21).
Topics: Pregnancy; Female; Humans; Surrogate Mothers; Ethics Committees; Counseling; Reproductive Techniques, Assisted
PubMed: 36863967
DOI: 10.1016/j.fertnstert.2023.01.015 -
Law and Human Behavior Aug 2020Child neglect is often initially identified via adults who come into contact with children and report their suspicions to the authorities. Little is known about what...
OBJECTIVE
Child neglect is often initially identified via adults who come into contact with children and report their suspicions to the authorities. Little is known about what behaviors laypersons view as constituting neglect and hence worth reporting. We examined laypersons' perceptions of neglect and poverty, particularly how these factors independently and jointly shaped laypersons' decisions about what warrants official reporting of neglect, and how laypersons' socioeconomic background related to their decisions.
HYPOTHESES
We anticipated that neglect would be correctly perceived as such, but that extreme poverty would also be perceived as neglect, with these latter perceptions being most pronounced among laypersons of higher socioeconomic background.
METHOD
In 2 studies, adults read vignettes about a mother's care of her daughter and rendered decisions about whether the mother's behavior met the legal standard of neglect and should be reported. In Study 1 (N = 365, 55% female, mean age = 37.12 years), indicators of poverty and neglect were manipulated. In Study 2 (N = 474, 53% female, mean age = 38.25 years), only poverty (housing instability: homelessness vs. not) was manipulated.
RESULTS
Laypersons often conflated poverty and neglect, especially in circumstances of homelessness. Laypersons of lower socioeconomic background were less likely to perceive neglect in general and to report an obligation to make a referral (R2s ranged from 17-26%, odds ratios ranged from 2.24-3.08).
CONCLUSIONS
Laypersons may overreport neglect in circumstances of poverty. Increasing public awareness of how to recognize and separate neglect from poverty may enhance identification of vulnerable children and families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Topics: Adult; Aged; Aged, 80 and over; Child; Child Abuse; Decision Making; Ethnicity; Female; Ill-Housed Persons; Humans; Male; Mandatory Reporting; Middle Aged; Poverty
PubMed: 32673001
DOI: 10.1037/lhb0000415