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Cell Jun 2024A number of species have recently recovered from near-extinction. Although these species have avoided the immediate extinction threat, their long-term viability remains...
A number of species have recently recovered from near-extinction. Although these species have avoided the immediate extinction threat, their long-term viability remains precarious due to the potential genetic consequences of population declines, which are poorly understood on a timescale beyond a few generations. Woolly mammoths (Mammuthus primigenius) became isolated on Wrangel Island around 10,000 years ago and persisted for over 200 generations before becoming extinct around 4,000 years ago. To study the evolutionary processes leading up to the mammoths' extinction, we analyzed 21 Siberian woolly mammoth genomes. Our results show that the population recovered quickly from a severe bottleneck and remained demographically stable during the ensuing six millennia. We find that mildly deleterious mutations gradually accumulated, whereas highly deleterious mutations were purged, suggesting ongoing inbreeding depression that lasted for hundreds of generations. The time-lag between demographic and genetic recovery has wide-ranging implications for conservation management of recently bottlenecked populations.
PubMed: 38942016
DOI: 10.1016/j.cell.2024.05.033 -
Gaceta Sanitaria Jun 2024
PubMed: 38941884
DOI: 10.1016/j.gaceta.2024.102411 -
Cognition Jun 2024Why were women given the right to vote? "Because it is morally wrong to deny women the right to vote." This explanation does not seem to fit the typical pattern for...
Why were women given the right to vote? "Because it is morally wrong to deny women the right to vote." This explanation does not seem to fit the typical pattern for explaining an event: rather than citing a cause, it appeals to an ethical claim. Do people judge ethical claims to be genuinely explanatory? And if so, why? In Studies 1 (N = 220) and 2 (N = 293), we find that many participants accept ethical explanations for social change and that this is predicted by their meta-ethical beliefs in moral progress and moral principles, suggesting that these participants treat morality as a directional feature of the world, somewhat akin to a causal force. In Studies 3 (N = 513) and 4 (N = 328), we find that participants recognize this relationship between ethical explanations and meta-ethical commitments, using the former to make inferences about individuals' beliefs in moral progress and moral principles. Together these studies demonstrate that our beliefs about the nature of morality shape our judgments of explanations and that explanations shape our inferences about others' moral commitments.
PubMed: 38941763
DOI: 10.1016/j.cognition.2024.105860 -
Boletin Medico Del Hospital Infantil de... 2024This essay challenges the idea of progress as technological development in relation to medicine by focusing on people rather than things. It analyzes how the prevalence...
This essay challenges the idea of progress as technological development in relation to medicine by focusing on people rather than things. It analyzes how the prevalence of such an idea of progress leads contemporary societies to a technofetishism that degrades community life and medical practice, contributing to the medicalization of social life. It is argued that the realization of technological potentialities depends on their forms of use, that the main motive of technological development is unlimited profit, and the priority developments are those that enhance social control which maintains the status quo. Intelligence as an intelligence quotient is criticized by proposing it as an attribute of the human being as a whole, manifested in the ways of thinking and acting of human beings in their circumstances, where affectivity and critical thinking are essential for their development; it is emphasized that its antecedent is the harmonic concert of planetary life, which contrasts with the prevailing human disharmony. It is proposed that artificial intelligence is the latest creation of technofetishism, which deposits vital attributes in technology, and that its use will accentuate the degradation of human and planetary life. Another idea of medical progress is proposed, based on forms of organization that is conducive to the development of inquisitive, critical, and collaborative skills that promote permanent improvement, whose distant horizon is dignified progress: the spiritual, intellectual, moral, and convivial sublimation of collectivities in harmony with the planetary ecosystem.
Topics: Artificial Intelligence; Humans; Medicalization
PubMed: 38941644
DOI: 10.24875/BMHIME.M24000071 -
Boletin Medico Del Hospital Infantil de... 2024This essay questions, with regard to medicine, the idea of progress as technological development by focusing on people rather than things. It analyzes how the...
This essay questions, with regard to medicine, the idea of progress as technological development by focusing on people rather than things. It analyzes how the predominance of such an idea of progress converts today's societies to techno-fetishism that degrades community life and medical practice, contributing to the medicalization of social life. It is argued that the realization of technological potentialities depends on their forms of use; that the main motive of technological development is unlimited profit and that priority developments are those that enhance the social control that maintains the status quo. The intelligence as an intelligence quotient is criticized by proposing it as an attribute of the human being as a whole, manifested in the ways of thinking and proceeding of people in their circumstances, where affectivity and critical thinking are essential for their development; it is emphasized that its antecedent is the harmonic concert of planetary life that contrasts with the prevailing human disharmony. It is proposed that artificial intelligence is the most recent creation of techno-fetishism that deposits vital attributes in technology and that its forms of use will accentuate the degradation of human and planetary life. Another idea of medical progress is proposed, based on forms of organization conducive to the development of inquisitive, critical and collaborative skills that promote permanent improvement, whose distant horizon is dignifying progress: spiritual, intellectual, moral and convivial sublimation of collectivities in harmony with the planetary ecosystem.
Topics: Artificial Intelligence; Humans; Medicalization; Intelligence; Medicine
PubMed: 38941639
DOI: 10.24875/BMHIM.24000007 -
Journal of Primary Health Care Jun 2024Introduction Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent...
Introduction Community-based primary care physiotherapy has developed through private practice, fee-for-service model in Aotearoa New Zealand where independent businesses operate in competition. Aim We aimed to explore how the private practice model of physiotherapy impacts patient care, physiotherapists, and professional behaviour. Methods Six physiotherapists managing musculoskeletal conditions in a primary care private practice in Aotearoa New Zealand were recruited using maximum variation purposive sampling. In-depth individual face-to-face semi-structured interviews were audio-recorded, transcribed verbatim, and analysed using Interpretive Description. Inductive data analysis synthesised and contextualised data, creating a thematic framework that developed across interviews. Results All physiotherapy participants discussed concerns about culture and professionalism in private practice physiotherapy despite not being asked about these. Three themes were identified. 'Competitive business model and lack of collaboration' - participants thought that competition between practices resulted in a lack of trust, collegiality, and collaboration, and pressure on clinicians to maintain income. '(Un)professional behaviour' - participants thought that physiotherapists were defensive and averse to scrutiny, resulting in reluctance to admit when they needed help, or to undertake peer review or seek second opinions. 'Lack of support and mentoring' - the professional culture in private practice was perceived to reduce support and mentoring, with negative impacts that affected physiotherapists at all stages of career. Conclusion This exploratory qualitative study suggests that competition dominates communication and collaboration in private practice physiotherapy and may have wider implications for professionalism and the quality of patient care. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour.
Topics: Humans; New Zealand; Qualitative Research; Private Practice; Male; Female; Physical Therapists; Adult; Interviews as Topic; Professionalism; Attitude of Health Personnel; Primary Health Care; Middle Aged; Trust; Cooperative Behavior; Organizational Culture; Physical Therapy Modalities; Competitive Behavior
PubMed: 38941259
DOI: 10.1071/HC23150 -
Journal of Primary Health Care Jun 2024
Substitution of regulated health professionals such as doctors and nurses with unregulated health professionals such as physician assistants gives rise to concerns around patient safety and accountability issues: Yes.
Topics: Humans; Patient Safety; Physician Assistants; Social Responsibility; Physicians; Nurses
PubMed: 38941250
DOI: 10.1071/HC24075 -
Journal of Primary Health Care Jun 2024
Substitution of regulated health professionals, such as doctors and nurses, with unregulated health care workers, such as physician assistants, gives rise to concerns around patient safety and accountability issues: No.
Topics: Humans; Patient Safety; Physician Assistants; Social Responsibility; Physicians; Nurses
PubMed: 38941249
DOI: 10.1071/HC24077 -
Expanding Access to Contraception for Adolescents-Reproductive Justice and the Emergency Department.JAMA Network Open Jun 2024
Topics: Humans; Adolescent; Emergency Service, Hospital; Female; Health Services Accessibility; Contraception; Social Justice; Pregnancy; United States; Pregnancy in Adolescence
PubMed: 38941102
DOI: 10.1001/jamanetworkopen.2024.18194 -
JAMA Health Forum Jun 2024Sponsorship of promotional events for health professionals is a key facet of marketing campaigns for pharmaceuticals and medical devices; however, there appears to be...
IMPORTANCE
Sponsorship of promotional events for health professionals is a key facet of marketing campaigns for pharmaceuticals and medical devices; however, there appears to be limited transparency regarding the scope and scale of this spending.
OBJECTIVE
To develop a novel method for describing the scope and quantifying the spending by US pharmaceutical and medical companies on industry-sponsored promotional events for particular products.
DESIGN AND SETTING
This was a cross-sectional study using records from the Centers for Medicare & Medicaid's Open Payments database on payments made to prescribing clinicians from January 1 to December 21, 2022.
MAIN OUTCOMES AND MEASURES
An event-centric approach was used to define sponsored events as groupings of payment records with matching variables. Events were characterized by value (coffee, lunch, dinner, or banquet) and number of attendees (small vs large). To test the method, the number of and total spending for each type of event across professional groups were calculated and used to identify the top 10 products related to dinner events. To validate the method, we extracted all event details advertised on the websites of 4 state-level nurse practitioner associations that regularly hosted industry-sponsored dinner events during 2022 and compared these with events identified in the Open Payments database.
RESULTS
A total of 1 154 806 events sponsored by pharmaceutical and medical device companies were identified for 2022. Of these, 1 151 351 (99.7%) had fewer than 20 attendees, and 922 214 (80.0%) were considered to be a lunch ($10-$30 per person). Seven companies sponsored 16 031 dinners for the top 10 products. Of the 227 sponsored in-person dinner events hosted by the 4 state-level nurse practitioner associations, 168 (74.0%) matched events constructed from the Open Payments dataset.
CONCLUSIONS AND RELEVANCE
These findings indicate that an event-centric analysis of Open Payments data is a valid method to understand the scope and quantify spending by pharmaceutical and medical device companies on industry-sponsored promotional events attended by prescribers. Expanding and enforcing the reporting requirements to cover all payments to all registered health professionals would improve the accuracy of estimates of the true extent of all sponsored events and their impact on clinical practice.
Topics: Humans; Cross-Sectional Studies; United States; Drug Industry; Marketing; Conflict of Interest; Centers for Medicare and Medicaid Services, U.S.
PubMed: 38941087
DOI: 10.1001/jamahealthforum.2024.1581