Harm Reduction

Horseshoe crabs, those almost pre-historic-looking creatures that we occasionally see washed up on the shore, hold a special place in medicine. But that's about to change.
A new study in JAMA Network Open is a follow-up to a 2015 study done by the same researchers. The questions are: Do you store loaded guns at home? Are they locked or not? Do you store guns that are loaded and unlocked? This is not about the right to bear arms, but the responsibility to store them safely around children.
“[From] mid-July through mid-November, 2021, more than one million individuals with COVID-19 were admitted to hospitals, 156,382 of them died of COVID-19 complications. Most of these hospital admissions and patient deaths were preventable through… vaccines.” [1] But vaccine resistance continues to be strong, persuasion, as I’ve written, is ineffective on a large enough scale, and those opposing mandates speak loudly. The situation is likely to continue. If vaccine-resistant intransigence is entrenched, will mandates work?
The media is beginning to run the autopsy on our pandemic responses. (Although to be fair, outlets have been Monday morning quarterbacking from Day 1.) What exactly is the plan for the next pandemic? Of course, the real problem is that in dealing with the future, there's no plan at all.
Electronic Health Records, those over-hyped, energy and time-sucking billing algorithms sold to the American public and healthcare professionals as THE answer continues to search for some valuable clinical role. Clinical decision support are algorithms that scan our data and send timely reminders to our physicians to “Do the Right Thing.” While it may work well in the Ivory Towers, and even that is debatable, when taken out for a real-world test, clinical decision support is nowhere near ready for prime-time.
Another study has found that vaping doesn't prevent smokers from relapsing to cigarettes. The results seem to undermine the efficacy of e-cigarettes as smoking-cessation tools—until you take a closer look at the definition of "relapse."
Deaths of despair were first defined by Anne Case and Angus Deaton, two economists, in 2015. These were deaths due to suicide, overdoses, and alcoholic liver diseases disproportionately impacting White males without a college degree. As Vox [1] so vividly described the problem, “In 2017 alone, there were 158,000 deaths of despair in the US: the equivalent of “three fully loaded Boeing 737 MAX jets falling out of the sky every day for a year.” A new study seeks to understand why these deaths increase in the US, but not 16 other high-income, industrialized nations.
Haven’t we all seen those heart-rending news articles about a child with cancer, their parents unable to pay the bills? Just then a GoFundMe site comes through, helping the child receive necessary care and preventing a financial catastrophe for the parents. However, researchers are finding that the GoFundMe so-called safety net is riddled with holes, and it's basically a lottery that's “rigged” toward those in higher-income communities.
The scarlet “A” was meant to shame Hester Prynne, stigmatizing her to the community as an unworthy individual. Today, the letter is often replaced by words. A new study suggests that physicians, nurse practitioners, and physician assistants often use stigmatizing words in describing their patients. But as you will read, many of their “findings” depend upon whether you believe those words are, in fact, stigmatizing at all.
Methane is a far more potent (30-80 fold) greenhouse gas emission than carbon dioxide, but far less is generated in the Anthropocene era, and carbon dioxide gets most of the headlines. Methane is most frequently blamed on cattle and leaks in our natural gas distribution system. But it made the headlines last week.
A new study suggests that e-cigarette users, known also as vapers, may harm the respiratory health of those around them via "secondhand vaping." Before we draw any conclusions, the paper has some important limitations that restrict its relevance to the real world.
One of our engaged readers raised a new JAMA study on surgical outcomes based on the genders of the surgeon and patient. According to the study, everyone does better with a female surgeon, although you can consider a male surgeon if you’re a male patient. Could this be true?