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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 -
Journal of Integrative Neuroscience Jun 2024With over 16 years of experience in clinical, research, and educational activities related to transcranial magnetic stimulation (TMS), I have written this article... (Review)
Review
With over 16 years of experience in clinical, research, and educational activities related to transcranial magnetic stimulation (TMS), I have written this article exploring the ethical dimensions of TMS. This article aims to provide valuable and informative content for those unfamiliar with TMS as well as those just starting in the field. Specifically, this article elaborates on four principles of medical ethics, including those applicable to TMS therapy, the disparity between public medical insurance coverage and medical indications in private practice for TMS therapy, and issues concerning research ethics in practice. I also provide recommendations regarding roles and strategies for adoption by academia and those in this field dedicated to making TMS therapy accessible to a larger patient population in a suitable manner. Lastly, it is my hope that this article will serve as a contemporary "Ethics of TMS Neuromodulation", resonating with the inherent human pursuit of "truth, goodness, and beauty" for a sound mind and spirit.
Topics: Transcranial Magnetic Stimulation; Humans; Ethics, Medical
PubMed: 38940094
DOI: 10.31083/j.jin2306112 -
Frontiers in Psychology 2024Children autonomously make sound moral judgments based on internal criteria, but they tend to make erroneous judgments in the presence of social influences, and the...
Children autonomously make sound moral judgments based on internal criteria, but they tend to make erroneous judgments in the presence of social influences, and the reasons for these errors are not well understood. Thus, the current research investigated how the presence of observers who can see and listen to 3-year-old children's judgments but who do not present their opinions influences children's conformity in moral judgment behavior. In Experiment 1, the children ( = 30) were presented with pictures depicting prosocial behaviors and asked whether the behaviors were acceptable. The children's tendency to change their answers after hearing the counterintuitive opinions of informants was then measured. The results showed that the children's moral judgments were more likely to conform to that of the group in the presence of observers. Experiment 2 aimed to determine the reason children were more likely to conform to a group when being watched by observers in Experiment 1. Children ( = 30) were randomly assigned to two conditions with different observer conditions as follows. Observers were either wearing headsets, indicating that they could not hear the children's responses, or had them hanging around their necks, indicating that they could. The results showed that children's conformity behavior depended on whether observers could hear what they were saying. The current findings are expected to help elucidate not only social factors that affect children's moral judgments but also the developmental mechanism of an observer effect.
PubMed: 38939221
DOI: 10.3389/fpsyg.2024.1289292 -
Journal of Extracellular Biology Jul 2023Interest in the use of extracellular vesicles (EVs) as biomarkers of disease is rapidly growing. However, one main unsolved issue in the EV field is finding a technique...
Interest in the use of extracellular vesicles (EVs) as biomarkers of disease is rapidly growing. However, one main unsolved issue in the EV field is finding a technique able to eliminate non-EV contaminants present in biofluid samples in a one-step isolation protocol. Due to the expansion and value of size exclusion chromatography (SEC) as one of the best EV isolation methods, we have tested several agarose resins with different agarose percentages, bead sizes and crosslinking features to optimize EV isolation. For this optimization of SEC, we first employed conditioned media from a melanoma cell culture, a simpler sample in comparison to biological fluids, but which also contains abundant contaminants such as soluble protein and lipoproteins (LPPs). The distinct agaroses and the combinations of resins with different agarose percentages in the same column were tested. Soluble protein, EVs and LPPs levels from the different eluted fractions were quantitated by immunodetection or absorbance measurements. Samples were also analysed by NTA and TEM to verify the yield and the LPP contamination. Different percentages of agarose resins (2%, 4% and 6%) yielded samples with increasing LPP contamination respectively, which was not improved in the columns that combined them. Crosslinking of the agarose did not affect EV isolation yield nor the LPP contamination. In contrast, reducing the bead size greatly improved EV purity. We thus selected 4% Rapid Run Fine agarose beads as the resin that more efficiently isolated EVs with almost no contamination of other particles. Using blood plasma samples, this resin also demonstrated an improved capacity in the isolation of EVs from LPPs in comparison to the agaroses most commonly used in the field and differential ultracentrifugation.
PubMed: 38939075
DOI: 10.1002/jex2.100 -
JACC. Advances Mar 2024
PubMed: 38938843
DOI: 10.1016/j.jacadv.2024.100847 -
JACC. Advances Oct 2023Clinical outcomes of bicuspid aortic valve (BAV) patients with ascending aortic diameters ≥50 mm who are under surveillance are poorly defined.
BACKGROUND
Clinical outcomes of bicuspid aortic valve (BAV) patients with ascending aortic diameters ≥50 mm who are under surveillance are poorly defined.
OBJECTIVES
The purpose of this study was to assess clinical outcomes in BAV patients with ascending aorta ≥50 mm.
METHODS
Multicenter retrospective cohort study of BAV adults with ascending aorta diameters ≥50 mm by transthoracic echocardiography (TTE). Patients were categorized into 50 to 54 mm and ≥55 mm groups. Clinical outcomes were aortic dissection (AoD), aorta surgery, surgical mortality, and all-cause death.
RESULTS
Of 875 consecutive BAV patients (age 60 ± 13 years, 86% men, aortic diameter 51 mm [interquartile range (IQR): 50-53 mm]), 328 (37%) underwent early surgery ≤3 months from index TTE. Of the remaining 547 patients under surveillance, 496 had diameters 50 to 54 mm and 51 had diameters ≥55 mm and were collectively followed for 7.51 (IQR: 3.98-12.20) years. Of 496 patients with diameters 50 to 54 mm under surveillance, 266 (54%) underwent surgery 2.0 (IQR: 0.77-4.16) years from index TTE. AoD occurred in 9/496 (1.8%) patients for an incidence of 0.4 cases per 100 person-years, surgical mortality was 5/266 (1.9%); and ≥moderate aortic stenosis (but not aorta size) was associated with all-cause death, hazard ratio: 2.05 (95% CI: 1.32-3.20), = 0.001. Conversely, in 547 total patients under surveillance (including 50-54 mm and ≥55 mm), both aorta size and ≥moderate aortic stenosis were associated with all-cause death (both ≤ 0.027). AoD rate in patients ≥55 mm under surveillance was 5.9%.
CONCLUSIONS
In BAV patients with ascending aorta 50 to 54 mm under surveillance, AoD incidence is low and the overall rates of AoD and surgical mortality are similar, suggesting clinical equivalence between surgical and surveillance strategies. Conversely, patients with aortas ≥55 mm should undergo surgery. Aortic stenosis is associated with all-cause death in these patients.
PubMed: 38938356
DOI: 10.1016/j.jacadv.2023.100626 -
The British Journal of Educational... Jun 2024Morality and moral reasoning develop over the course of life, but such development may encounter obstacles. Psycho-educational interventions could be designed to improve...
BACKGROUND
Morality and moral reasoning develop over the course of life, but such development may encounter obstacles. Psycho-educational interventions could be designed to improve moral reasoning and attitude towards prosociality. In the last decades, many interventions employed digital technologies ranging from multicomponent online platforms to serious games and virtual reality, making use of interactivity and immersive properties that could make moral stimuli more engaging.
AIMS
This study aimed at reviewing the literature on digital interventions to support morality and moral reasoning, carried out with subjects of all age groups.
METHODS AND RESULTS
Two electronic databases were searched with a systematic approach, and retrieved publications were scanned by authors against inclusion criteria. Twenty-three articles were reviewed. In general, the literature describes encouraging results of digital interventions to support morality. Moreover, a huge variety of morality conceptualizations emerged across various contexts (e.g., professional, school and sports) as well as various outcome measurements (e.g., change in attitudes and change in behaviour).
CONCLUSIONS
Effectiveness of digital interventions may relate to immersive and interactive simulations in particular, in that they allow participants not only to learn about moral rules and principles but also to actively exercise their own morality to make decisions. Future research may build on the present scoping review to analyse specific types of interventions' effectiveness with a meta-analytical approach.
PubMed: 38937872
DOI: 10.1111/bjep.12706 -
International Journal For Equity in... Jun 2024Addressing the sexuality of individuals with disabilities is important within the framework of global health and societal inclusivity. Despite comprising 16% of the...
Addressing the sexuality of individuals with disabilities is important within the framework of global health and societal inclusivity. Despite comprising 16% of the world's population, this demographic faces sexual autonomy inequality. Acknowledging this intersection is pertinent for achieving inclusive healthcare and upholding the commitments of the 1994 International Conference on Population and Development and the 2006 United Nations Convention on the Rights of Persons with Disabilities. Dispelling stereotypes and promoting dialogue are key to empowering individuals with disabilities and ensuring equitable access to sexual health resources. Integrating sexual health and rights into broader healthcare systems is vital for creating an inclusive society where no one is left behind. This article advocates for the need to address the specific sexual health needs and rights of individuals with disabilities, to implement inclusive policies, and to foster a healthcare environment that respects and supports their autonomy and dignity.
Topics: Humans; Disabled Persons; Sexuality; Human Rights; Sexual Health; Personal Autonomy; Global Health; Health Services Accessibility
PubMed: 38937839
DOI: 10.1186/s12939-024-02219-y -
Scientific Reports Jun 2024Behavioural nudges are often criticised because they "work best in the dark". However, recent experimental evidence suggests that the effectiveness of nudges is not...
Behavioural nudges are often criticised because they "work best in the dark". However, recent experimental evidence suggests that the effectiveness of nudges is not reduced when they are delivered transparently. Most people also endorse transparent nudges. Yet, transparent nudging may undermine human autonomy-a minority may oppose to being nudged and feel manipulated, even if they know what is happening. We propose an alternative way of maintaining autonomy that is not reducible to transparency: individuals can be asked if they consent in advance to being nudged. To assess whether consensual nudges are effective, we ask consent from 1518 UK citizens to be nudged. Subsequently, we default all participants into donating to a charity of their choice, irrespective of self-reported consent. We find that the default nudge is equally effective for both consenting and non-consenting individuals, with negligible difference in average donations. However, non-consenting individuals report higher levels of resentment and regret and lower levels of happiness and support compared to the consenting group. Based on these findings, we argue that ignoring consent can have serious ethical ramifications for policy-making with nudges.
Topics: Humans; Male; Female; Informed Consent; Choice Behavior; Adult; Personal Autonomy; United Kingdom; Middle Aged
PubMed: 38937507
DOI: 10.1038/s41598-024-65122-0 -
Behavior Therapy Jul 2024Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible... (Review)
Review
Reckoning With Our Past and Righting Our Future: Report From the Behavior Therapy Task Force on Sexual Orientation and Gender Identity/Expression Change Efforts (SOGIECEs).
Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, Behavior Therapy published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The Behavior Therapy Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in Behavior Therapy and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in Behavior Therapy and outlines the Task Force's deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to k = 24 SOGIECE papers in the form of digital "black box" disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field's history, and the pages of today's scientific journals include practices that will be at odds with tomorrow's moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.
Topics: Humans; Sexual Behavior; Sexual and Gender Minorities; Gender Identity; Behavior Therapy; Advisory Committees; Female
PubMed: 38937042
DOI: 10.1016/j.beth.2024.05.006