Military metaphors and pandemic propaganda: unmasking the betrayal of ‘Healthcare Heroes’

2020 ◽  
pp. medethics-2020-106753
Author(s):  
Zahra Khan ◽  
Yoshiko Iwai ◽  
Sayantani DasGupta
Keyword(s):  
Healthcare Workers ◽  
Recent Article ◽  
Human Life ◽  
Clinical Care ◽  
Narrative Medicine ◽  
Structural Support ◽  
Critical Skills ◽  
The Usa ◽  
Personal Sacrifice ◽  
The U.S

Dr Caitríona L Cox’s recent article expounds the far-reaching implications of the ‘Healthcare Hero’ metaphor. She presents a detailed overview of heroism in the context of clinical care, revealing that healthcare workers, when portrayed as heroes, face challenges in reconciling unreasonable expectations of personal sacrifice without reciprocity or ample structural support from institutions and the general public. We use narrative medicine, a field primarily concerned with honouring the intersubjective narratives shared between patients and providers, in our attempt to deepen the discussion about the ways Healthcare Heroes engenders military metaphor, antiscience discourse, and xenophobia in the USA. We argue that the militarised metaphor of Healthcare Heroes not only robs doctors and nurses of the ability to voice concerns for themselves and their patients, but effectively sacrifices them in a utilitarian bargain whereby human life is considered the expendable sacrifice necessary to ‘open the U.S. economy’. Militaristic metaphors in medicine can be dangerous to both doctors and patients, thus, teaching and advocating for the critical skills to analyse and alter this language prevents undue harm to providers and patients, as well as our national and global communities.

scholarly journals Mistrust and inconsistency during COVID-19: considerations for resource allocation guidelines that prioritise healthcare workers

2020 ◽  
pp. medethics-2020-106801 ◽  
Author(s):  
Alexander T M Cheung ◽  
Brendan Parent
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Healthcare Workers ◽  
Clinical Care ◽  
Standards Of Care ◽  
Public Health Strategy ◽  
Outward Appearance ◽  
Rhetorical Strategy ◽  
Health Strategy ◽  
The Usa

As the USA contends with another surge in COVID-19 cases, hospitals may soon need to answer the unresolved question of who lives and dies when ventilator demand exceeds supply. Although most triage policies in the USA have seemingly converged on the use of clinical need and benefit as primary criteria for prioritisation, significant differences exist between institutions in how to assign priority to patients with identical medical prognoses: the so-called ‘tie-breaker’ situations. In particular, one’s status as a frontline healthcare worker (HCW) has been a proposed criterion for prioritisation in the event of a tie. This article outlines two major grounds for reconsidering HCW prioritisation. The first recognises trust as an indispensable element of clinical care and mistrust as a hindrance to any public health strategy against the virus, thus raising concerns about the outward appearance of favouritism. The second considers the ways in which proponents of HCW prioritisation deviate from the very ‘ethics frameworks’ that often preface triage policies and serve to guide resource allocation—a rhetorical strategy that may undermine the very ethical foundations on which triage policies stand. By appealing to trust and consistency, we re-examine existing arguments in favour of HCW prioritisation and provide a more tenable justification for adjudicating on tie-breaker events during crisis standards of care.

Front-line Healthcare Workers in COVID-19: The Way from Elbow-Bump Greeting to Closing Body Bags

2020 ◽  
Author(s):  
Stefan Bittmann
Keyword(s):  
Health Service ◽  
Healthcare Workers ◽  
Well Being ◽  
The United States ◽  
Angiotensin Ii Receptor ◽  
Front Line ◽  
Resource Center ◽  
Research Activities ◽  
The World ◽  
The Usa

COVID-19 is a serious coronavirus disease that is spreading all over the world. As of the date of this publication, 2.834.134 people have been infected with COVID-19 and 197.924 deaths have been recorded in 185 countries (John Hopkins Corona Resource Center, 25th April 2020) [1]. This overwhelming mortality rate requires intensive research activities around the world. To date, the number of deaths per day in the United States is still killing, indicating an uncontrollable state of infection spread. SARS-CoV-2 binds to the angiotensin II receptor in various tissues of the human body, particularly in the oral cavity and tongue. SARS-CoV-2 requires the cheerful TMPRSS2 to activate this inertia. SARS-CoV-2 uses the ACE2 receptor as a gateway to the lungs. The SARS-CoV-2 virus binds with the spike protein to the ACE2 receptor. COVID-19 is more common among African Americans in the USA (Science 10th April 2020). The comfort and the emotional loading capacity of the employees in the health service are key components for the maintenance of the essential health services during the outbreak of the COVID-19 virus (Coronavirus) [2,3]. Hence, it will be important to anticipate the charges linked with this work and to release support for employees in the health service. The supervision and assessment of the psychic health and the well-being of the employees in the health service will be important, just as the efforts to guarantee a successful reunion with colleagues if they are infected.

Novel Drugs and Biologics of 2016: A Boom for Neurodrugs in the Pipelin

2017 ◽  
Vol 10 (5) ◽  
pp. 3809-3814
Author(s):  
D Samba Reddy
Keyword(s):  
Muscular Atrophy ◽  
Clinical Care ◽  
New Drugs ◽  
Essential Medicines ◽  
High Demand ◽  
The Past ◽  
Novel Drugs ◽  
Innovative Products ◽  
Cns Drugs ◽  
The U.S

This article provides a brief overview of novel drugs approved by the U.S. FDA in 2016.  It also focuses on the emerging boom in the development of neurodrugs for central nervous system (CNS) disorders. These new drugs are innovative products that often help advance clinical care worldwide, and in 2016, twenty-two such drugs were approved by the FDA. The list includes the first new drug for disorders such as spinal muscular atrophy, Duchenne muscular dystrophy or hallucinations and delusions of Parkinson’s disease, among several others. Notably, nine of twenty-two (40%) were novel CNS drugs, indicating the industry shifting to neurodrugs. Neurodrugs are the top selling pharmaceuticals worldwide, especially in America and Europe. Therapeutic neurodrugs have proven their significance many times in the past few decades, and the CNS drug portfolio represents some of the most valuable agents in the current pipeline. Many neuroproducts are vital or essential medicines in the current therapeutic armamentarium, including dozens of “blockbuster drugs” (drugs with $1 billion sales potential).  These drugs include antidepressants, antimigraine medications, and anti-epilepsy medications. The rise in neurodrugs’ sales is predominantly due to increased diagnoses of CNS conditions. The boom for neuromedicines is evident from the recent rise in investment, production, and introduction of new CNS drugs.  There are many promising neurodrugs still in the pipeline, which are developed based on the validated “mechanism-based” strategy. Overall, disease-modifying neurodrugs that can prevent or cure serious diseases, such as multiple sclerosis, epilepsy, and Alzheimer’s disease, are in high demand. 

Usacerl's Experiences with Small Wastewater Treatment Plants in the USA

1990 ◽  
Vol 22 (3-4) ◽  
pp. 49-56
Author(s):  
E. D. Smith ◽  
R. J. Scholze
Keyword(s):  
Wastewater Treatment ◽  
Waste Treatment ◽  
Wastewater Treatment Plants ◽  
Remote Site ◽  
Corps Of Engineers ◽  
Military Installations ◽  
Recreation Areas ◽  
The Usa ◽  
Rotating Biological Contactors ◽  
The U.S

This paper presents a review of collected experience of one of the U.S. Corps of Engineers research laboratories in the area of small systems for wastewater treatment. Findings and experiences are presented for the use of package plants such as rotating biological contactors (RBCs), and remote site waste treatment at military installations and recreation areas.

scholarly journals Evaluation of a Cryptococcal Antigen Lateral Flow Assay and Cryptococcal Antigen Positivity at a Large Public Hospital in Atlanta, Georgia

2021 ◽  
Author(s):  
Kristin R V Harrington ◽  
Yun F (Wayne) Wang ◽  
Paulina A Rebolledo ◽  
Zhiyong Liu ◽  
Qianting Yang ◽  
...  
Keyword(s):  
Public Hospital ◽  
Clinical Care ◽  
Latex Agglutination ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
Clinical Implications ◽  
Cryptococcal Antigen ◽  
Cryptococcal Disease ◽  
Percent Positivity ◽  
The U.S

Abstract Background Cryptococcus neoformans is a major cause of morbidity and mortality among HIV-infected persons worldwide, and there is scarce recent data on cryptococcal antigen (CrAg) positivity in the U.S. We sought to determine the frequency of cryptococcal disease and compare the performance of a CrAg lateral flow assay (LFA) versus latex agglutination (LA) test. Methods All patients from Grady Health System in Atlanta who had a serum or cerebrospinal fluid (CSF) sample sent for CrAg testing as part of clinical care from November 2017 – July 2018 were included. Percent positivity and test agreement were calculated. Results Among 467 patients, 557 diagnostic tests were performed; 413 on serum and 144 on CSF. Mean age was 44 years, most were male (69%) and had HIV (79%). Twenty-four (6.4%, CI95% = 4.1, 9.4) patients were serum CrAg positive, and eight (5.8%, CI95% = 2.6, 11.2) individuals tested positive for CSF CrAg. While overall agreement between the LA and LFA was substantial to high for CSF (κ= 0.71, CI95% = 0.51, 0.91) and serum (κ= 0.93, CI95% = 0.86, 1.00), respectively, there were important discrepancies. Five patients had false-positive CSF LA tests which affected clinical care, and four patients had discordant serum tests. Conclusions We found a moderately high proportion of cryptococcal disease and important discrepancies between the LA test and LFA. Clinical implications of these findings include accurate detection of serum CrAg and averting unnecessary treatment of meningitis with costly medications associated with high rates of adverse events.

scholarly journals Novel repurposing of a Laerdal Airway trainer to simulate aerosolisation

2021 ◽  
pp. bmjstel-2020-000802
Author(s):  
Sven Peter Oman ◽  
Scott Helgeson ◽  
Philip Lowman ◽  
Pablo Moreno Franco ◽  
Jonathan Tomshine ◽  
...  
Keyword(s):  
Airway Management ◽  
Ultraviolet Light ◽  
Healthcare Workers ◽  
Saline Solution ◽  
Size Range ◽  
Ambient Air ◽  
Airborne Particles ◽  
Exposure Risk ◽  
Aerosol Model ◽  
The Usa

COVID-19 has claimed over 200 000 lives in the USA and put healthcare workers at risk. Healthcare workers have an increased exposure risk from aerosol-generating procedures such as endotracheal intubation. New barrier designs such as the acrylic box and horizontal plastic drape have emerged to reduce exposure to airborne particles. Particle generating models are needed to test aerosol generating procedure (AGP) barrier designs. To achieve this, an aerosol model that generates a visible and measurable increase in particles which SARS-CoV-2 could travel on and that can also be intubated was created. The model was created using a Laerdal Airway Management Trainer (Laerdal Medical, Stavanger, Norway) combined with a nebuliser and Ambu bag-valve resuscitator (Ambu, Columbia, Maryland, USA). Nebulised Glo Germ (Glo Germ, Moab, Utah, USA) dissolved in saline solution was moved through the tubing and out of the mannequin’s mouth with compression of the Ambu bag. This nebulisation was visualised under ultraviolet light and the quantity of particles between 0.3 and 10.0 μm was measured with a particle counter. Nebulisation was visible exiting the mouth of the mannequin. Nebulised Glo Germ was visualised under ultraviolet light moving in the ambient air. Particles in the size range of 0.3–0.5 µm increased by 20-fold and 1–10 µm increased by 10 252%. SARS-CoV-2 can travel on aerosol and droplet particles and particle generating models are needed to visualise and measure exposure areas and the path particles take during AGPs. We used existing medical and simulation supplies to create a particle simulator.

scholarly journals Neutralizing Antibodies Titers and Side Effects in Response to BNT162b2 Vaccine in Healthcare Workers with and without Prior SARS-CoV-2 Infection

Vaccines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 742
Author(s):  
José Javier Morales-Núñez ◽  
José Francisco Muñoz-Valle ◽  
Carlos Meza-López ◽  
Lin-Fa Wang ◽  
Andrea Carolina Machado Sulbarán ◽  
...  
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Adverse Effects ◽  
Antibody Production ◽  
Neutralizing Antibodies ◽  
Healthcare Workers ◽  
Vaccination Program ◽  
Expected Result ◽  
Neutralizing Capacity ◽  
The Usa

The main expected result of a vaccine against viruses is the ability to produce neutralizing antibodies. Currently, several vaccines against SARS-CoV-2 are being applied to prevent mortal complications, being Pfizer-BioNTech (BNT162b2) one of the first to be authorized in the USA and Mexico (11 December 2020). This study evaluated the efficacy of this vaccine on antibody production with neutralizing capacity and its side effects in healthcare workers with and without prior SARS-CoV-2 infection and in a group of unvaccinated individuals with prior COVID-19. The main findings are the production of 100% neutralizing antibodies in both groups after the second dose, well-tolerated adverse effects, the possible presence of immunosenescence, and finally, we support that a single dose of this vaccine in individuals with prior COVID-19 would be sufficient to achieve an immunization comparable to people without prior COVID-19 with a complete vaccination program (2 doses).

scholarly journals Structural vulnerability: migration and health in social context

2021 ◽  
Vol 6 (Suppl 1) ◽  
pp. e005109
Author(s):  
Lauren Carruth ◽  
Carlos Martinez ◽  
Lahra Smith ◽  
Katharine Donato ◽  
Carlos Piñones-Rivera ◽  
...  
Keyword(s):  
Clinical Care ◽  
Professional Associations ◽  
Humanitarian Assistance ◽  
Structural Vulnerability ◽  
Global Migration ◽  
Humanitarian Interventions ◽  
Care Models ◽  
The Usa ◽  
Mexico Border ◽  
Training And Support

Based on the authors’ work in Latin America and Africa, this article describes and applies the concept ‘structural vulnerability’ to the challenges of clinical care and healthcare advocacy for migrants. This concept helps consider how specific social, economic and political hierarchies and policies produce and pattern poor health in two case studies: one at the USA–Mexico border and another in Djibouti. Migrants’ and providers’ various entanglements within inequitable and sometimes violent global migration systems can produce shared structural vulnerabilities that then differentially affect health and other outcomes. In response, we argue providers require specialised training and support; professional associations, healthcare institutions, universities and humanitarian organisations should work to end the criminalisation of medical and humanitarian assistance to migrants; migrants should help lead efforts to reform medical and humanitarian interventions; and alternative care models in Global South to address the structural vulnerabilities inherent to migration and asylum should be supported.

Reply to “Comment on ‘Which Earthquake Accounts Matter?’ by Susan E. Hough and Stacey S. Martin” by David J. Wald

2021 ◽  
Author(s):  
Susan E. Hough ◽  
Stacey S. Martin
Keyword(s):  
Scientific Community ◽  
Recent Article ◽  
Geological Survey ◽  
Data Sets ◽  
Macroseismic Data ◽  
Education Programs ◽  
Socioeconomic Groups ◽  
Science Projects ◽  
Community Science ◽  
The U.S

Abstract We thank David Wald (Wald, 2021; henceforth, W21) for his interest in our recent article (Hough and Martin, 2021; henceforth, HM21). Although different perspectives are vital in science, we are concerned that W21 misrepresents HM21 as an oblique criticism of the U.S. Geological Survey “Did You Feel It?” (DYFI) system, calling for HM21 to be retracted. Readers who are interested in the issues raised by HM21 and the statements made by us therein are referred to that article. In this brief reply, we respond to specific accusations made by W21 and return to the focus of HM21, calling attention to the extent to which macroseismic data sets and inferences drawn from them can be shaped by a lack of representation among individuals whose observations are available to science. HM21 never questioned the benefits of the community science DYFI project to science. HM21 noted, however, and we reiterate here, that community science also potentially benefits the community. Whether or not it matters for science, if participation in community science projects is unrepresentative across socioeconomic groups, it underscores the need for the scientific community to be proactive in its efforts to reach out to groups that have been underserved by current outreach and education programs. We appreciate this opportunity to continue the important conversation about representation.

scholarly journals Current Nuclear Strategies and Arsenals of the United States of America and the Russian Federation

2021 ◽  
Vol 30 (4) ◽  
pp. 23-44
Author(s):  
Adam Potočňák
Keyword(s):  
Cold War ◽  
United States Of America ◽  
The United States ◽  
The Other ◽  
Nuclear Forces ◽  
Nuclear Strategy ◽  
The Usa ◽  
The Russian Federation ◽  
The Cold War ◽  
The U.S

The article holistically analyses current strategies for the use and development of nuclear forces of the USA and Russia and analytically reflects their mutual doctrinal interactions. It deals with the conditions under which the U.S. and Russia may opt for using their nuclear weapons and reflects also related issues of modernization and development of their actual nuclear forces. The author argues that both superpowers did not manage to abandon the Cold War logic or avoid erroneous, distorted or exaggerated assumptions about the intentions of the other side. The text concludes with a summary of possible changes and adaptations of the American nuclear strategy under the Biden administration as part of the assumed strategy update expected for 2022.

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