Are community health centers prepared for bioterrorism?

Community health centers (CHCs) are essential in the delivery of primary care services to underserved populations. Given the critical function of CHCs, surprisingly little is known about their role in preparing for or responding to acts of terrorism. This survey-based study examines the state of CHCs in terrorism preparedness and assesses their training needs. Of the administrators who responded to the survey, 87% indicated that their centers had an emergency response or disaster plan. Of those, 78% indicated they had updated their plans within the past year. Among those who had a written plan, 41% addressed bioterrorism preparedness, 38% had contingencies for a mass influx of patients, and 3% indicated that their plans addressed increasing operational capacity. Additionally, while 48% reported having assessed the education and training needs of their professional staff in the area of disease surveillance and reporting, only 24% had assessed these needs in relation to bioterrorism. Our findings suggest that CHCs have made great strides in preparing for some emergencies but that preparedness does not yet extend to specifically include terrorism events. Policy and practice recommendations are included to more fully develop CHCs as a resource.     

Is research into ethnicity and health racist,unsound, or important science?

Much historical research on race, intelligence, and health was racist, unethical, and ineffective. The concepts of race and ethnicity are difficult to define but continue to be applied to the study of the health of immigrant and ethnic minority groups in the hope of advancing understanding of causes of disease. While a morass of associations has been generated, race and ethnicity in health research have seldom given fundamental new understanding of disease. Most such research is "black box epidemiology." Researchers have not overcome the many conceptual and technical problems of research into ethnicity and health. By emphasising the negative aspects of the health of ethnic minority groups, research may have damaged their social standing and deflected attention from their health priorities. Unless researchers recognise the difficulties with research into ethnicity and health and correct its weaknesses, 20th century research in this subject may suffer the same ignominious fate as that of race science in the 19th century.     

Is physiology the locus of health/health promotion?

A current trend in physiology education involves the use of clinical vignettes to demonstrate the importance of knowing normal physiology to appreciate pathophysiology. Although laudable, in effect, such tactics promote the so-called "disease" model of medicine while at the same time suggesting that the only utility for the knowledge of physiology is to understand pathophysiology. This would seem to be at odds with health professions and institutions, who maintain their goal is to promote health. Yet, a search for the locus of "health" education in typical curricula is not easily found. Given the developing interest in biological systems as well as aging, it is suggested that these topics may provide a basis for locating physiology as the locus for understanding "health."     

Is Her Majesty at home?

When Queen Elizabeth is at home in Buckingham Palace, tradition has it that the Royal Standard is raised, so that all may know the fact. Although it is not crucial for most of us to know whether Her Majesty is home, it is in social insects. Endler et al. have recently shown how an ant queen signals her presence to her remote workers: she marks her eggs. This is significant because it provides insight into how queens maintain reproductive monopoly within their colonies.     

Is lycopene beneficial to human health?

Since humans cannot synthesise carotenoids de novo, we depend upon the diet exclusively for the source of these micronutrients. Although the necessity for beta-carotene, as the precursor of vitamin A has been recognised for many years, it is lycopene that has attracted substantial interest more recently. Lycopene is the red-coloured carotenoid predominantly found in tomato fruit, but in few other fruits or vegetables. It has claimed that it may alleviate chronic diseases such as cancers and coronary heart disease. This possibility has been studied extensively, by epidemiological studies and biochemical investigations of its properties and its bioavailability from tomato-based diets. This article summarises the current state of knowledge of the properties of lycopene, its possible role in human health and areas for future research.     

Textbook germinal centers?

Models for the development and function of germinal centers (GCs) have been so widely discussed in the original literature that they now appear in immunology textbooks. Unfortunately, many of the tenets of these models have not yet been subjected to adequate experimental scrutiny. Indeed, recent studies have called several of their principal assumptions into question. In addition, the term germinal center has been applied to a diverse assortment of focal processes of B cell proliferation and differentiation. This variability might be explained by alterations in the progression of a single textbook GC process. Alternatively, distinct developmental pathways may create unique classes of GCs with specialized functions.     

Pain and suffering in invertebrates?

All animals face hazards that cause tissue damage and most have nociceptive reflex responses that protect them from such damage. However, some taxa have also evolved the capacity for pain experience, presumably to enhance long-term protection through behavior modification based on memory of the unpleasant nature of pain. In this article I review various criteria that might distinguish nociception from pain. Because nociceptors are so taxonomically widespread, simply demonstrating their presence is not sufficient. Furthermore, investigation of the central nervous system provides limited clues about the potential to experience pain. Opioids and other analgesics might indicate a central modulation of responses but often peripheral effects could explain the analgesia; thus reduction of responses by analgesics and opioids does not allow clear discrimination between nociception and pain. Physiological changes in response to noxious stimuli or the threat of a noxious stimulus might prove useful but, to date, application to invertebrates is limited. Behavior of the organism provides the greatest insights. Rapid avoidance learning and prolonged memory indicate central processing rather than simple reflex and are consistent with the experience of pain. Complex, prolonged grooming or rubbing may demonstrate an awareness of the specific site of stimulus application. Tradeoffs with other motivational systems indicate central processing, and an ability to use complex information suggests sufficient cognitive ability for the animal to have a fitness benefit from a pain experience. Available data are consistent with the idea of pain in some invertebrates and go beyond the idea of just nociception but are not definitive. In the absence of conclusive data, more humane care for invertebrates is suggested.     

What constitutes fair shared decision-making in global health research collaborations?

Funders (located primarily in high-income countries) and high-income country researchers have historically dominated decision-making within global health research collaborations: from setting agendas and research design to determining how data are collected and analysed and what happens with findings and outputs. The ethical principle of shared decision-making has been proposed as a way to help address these imbalances within collaborations and to reduce semicolonial and exploitative forms of global health research. It is important to be clear about what shared decision-making means in order to ensure that it is not done in a tokenistic, shallow way. Thus far, the principle’s content has not been examined and articulated in detail. This paper aims to start the process of delineating a concept of fair shared decision-making as a minimum standard for global health research. Using two hypothetical case examples, the paper will demonstrate that global health research practice is often inconsistent with ideal shared decision-making. In such instances, it can be difficult to decide whether shared decision-making within collaborations is fair. The paper describes how the two cases do not meet criteria for unfair or non-ideal shared decision-making, despite having potentially morally troubling features. The nuances of these examples of research practice help to generate clearer ideas about how to judge fairness in shared decision-making. The paper concludes by presenting ideas about when soft power can be fairly employed between high-income-country and low- and middle-income-country partners and what fair compromise agreements may look like in shared decision-making.     

Is conservation research money being spent wisely? Changing trends in conservation research priorities

Conservation biology is often defined as a “mission driven crisis discipline”, and as such research priorities should ideally parallel the relative importance of different conservation threats. Conservation research has increased exponentially over the last 22 years, rising from <150 articles in 1990 to >4000 articles in 2012. However, this growth has not and may not necessarily reflect changes in research needs. Consequently, it remains uncertain if growth and prioritization have been consistent between research themes, or subdisciplines. In other words, it is unknown if conservation priorities change in relation to research needs, or if instead to shifts in funding, which may or may not correspond to true research needs. Future conservation research priorities should ideally be based on conservation needs alone and must account for threats at both the immediate and long-term scales.