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Business experts warn against making important decisions late in the day. Judges are harsher at that time, too. There's increasing evidence that doctors may be just as prone to afternoon slumps as the next person. How to tackle the problem is less clear. A study published in JAMA Open this year found that doctors at primary care practices in New Jersey and Pennsylvania were less likely to order cancer screening tests for eligible patients later in the day. Order rates for mammography dropped by about 16% and order rates for several colorectal cancer tests fell by about 14% from the start to the end of the day. Researchers in Philadelphia tested this idea by \"nudging\" doctors toward giving flu shots. In test practices, assistants recording vital signs got an electronic reminder to order the flu vaccine for eligible patients, so the order was already on the chart for approval when the primary care provider saw the patient.

In a trend that has received surprisingly little attention, contract research organizations (CROs) have gradually taken over much of academia's traditional role in drug development over the past decade. Dr. Miriam Shuchman reports. In a trend that has received surprisingly little attention, contract research organizations (CROs) have gradually taken over much of academia's traditional role in drug development over the past decade. They've been able to do so by offering greater speed and efficiency in conducting clinical trials than academic groups can, but questions have been raised about their qualifications, ethics, accountability, and degree of independence from their pharmaceutical-industry clients. Annual CRO-industry revenues have increased from about $7 billion in 2001 to an estimated $17.8 billion today; of more than 1000 CROs in operation, the four largest — Quintiles, Covance, Pharmaceutical Product Development . . .

In 2014, the Canadian Task Force on Preventive Health Care recommended against using the prostate-specific antigen (PSA) test to screen for prostate cancer in healthy men, concluding that it results in substantial harms via biopsies and surgeries that can lead to infections, impotence or urinary incontinence, and does not save men's lives. A few years later, a survey of family doctors in the Barrie region of Ontario discovered that the task force recommendations barely affected clinical practice. Most of the doctors responding to the survey gave the PSA test to patients and believed it was beneficial.

A woman having a heart attack has a higher risk of dying than a man, possibly because she won't receive life-saving treatments as quickly. To raise awareness of this gender disparity, the Heart and Stroke Foundation of Canada launched a campaign with a video of a woman sent home from an emergency room in the midst of a myocardial infarction. But eliminating gender gaps in clinical care will take more than a video. Gender differences in health and disease first started getting substantial attention in the early 1990s, when the US National Institutes of Health began requiring federally funded researchers to include women in their research, and the US Food and Drug Administration directed companies to enroll female participants in drug studies.

Physician-playwright Jeff Nisker has retired from clinical practice a few years ago, and his teaching duties at Western's Schulich School of Medicine & Dentistry in London, Ontario are on hold while he recovers from prostate cancer. He has been performing plays and musicals at universities and professional meetings across Canada and in other countries. Nisker joined the faculty at Western in the early 1980s as a clinician-scientist, not a writer. But he's always been a voracious reader, and he credits a scornful teacher in grade nine with giving him a view of fiction as a way to understand the world. He'd lost his mother and grandmother to breast cancer, so when the BRCA test became available to identify women at high risk for breast and ovarian cancer, he was appalled that Ontario and other provinces didn't offer it. He started writing and speaking on ethics in women's health and wasn't surprised when the dean asked him to take over bioethics teaching for the medical school.

A new law in Uganda may be sparking more aggressive homophobic actions in other countries across Africa, potentially derailing ongoing HIV prevention efforts. Last month, for example, police in the western Kenya city of Kisumu raided an organization called Men Against AIDS Youth Group, arresting three men after community members complained that the group was recruiting young school boys into homosexuality and pornography, according to a statement released by a local advocacy group. Given the antihomosexual climate, David Balikowa, a Kampala-based communications consultant who works with several nongovernmental organizations (NGOs), worries that clinical researchers may find it harder to recruit trial participants.

When global health researchers in low-income and middle-income countries (LMICs) collaborate with academics in high-income countries (HICs), these partnerships often result in disproportionate benefits for the HIC researchers who gain more opportunities for authorship, more prominent authorship positions, more opportunities to present at conferences, and more funding for administrative and student support for LMIC colleagues. [...]equitable engagement of LMIC collaborators and unfair research practices, such as parachuting or parasitic research,4 should be highlighted. [...]authorship that is based on real collaboration should be incentivised.

The idea of the pilot project, called Stratégie Observation Intégrée (SOI, Integrated Observation Service) is to keep people in a familiar setting unless they clearly have Ebola virus disease. According to Bonhommeau, the project was approved in mid-March and the Ministry has now approved similar projects in two more neighbourhoods in Katwa. [...]all 60 of the hospital's workers were identified as high-risk contacts—they had to stay off work for a month.

A notable difference from the situation in west Africa is that the DR Congo has considerable experience with Ebola: its national lab director is Jean-Jacques Muyembe-Tamfum, the renowned Congolese virologist who first discovered the Ebola virus in 1976, and its Health Ministry have managed previous outbreaks of Ebola virus. [...]Congolese leaders are the major decision makers in this outbreak. Health-care teams want to monitor patients via standard blood tests including the electrolytes, glucose, and blood gases called for in evidence-based guidelines for Ebola care produced in 2017 by a consensus group that included Lamontagne and Clément. Rob Fowler, a Toronto-based critical-care physician and WHO consultant said that for him, renal replacement therapy is an obvious next step to bring the DR Congo's mortality rate closer to the 18% seen among expatriates treated for Ebola virus disease during the west Africa crisis, because those patients received organ support.

Though the island of Taiwan functions as an independent democracy, leaders of communist China claim it as a province, which is accepted by the United Nations and its agencies, including the World Health Organization (WHO). At the conference, a Chinese official asked the WHO to intervene. As a sponsor, the WHO asked the Taiwanese academics to leave, according to blogging and reporting in the journal Tobacco Control. Conference organizers took down the Taiwanese professors' posters and removed their presentation from the agenda. Today, demonstrators in Hong Kong, a semi-autonomous part of China, have gained worldwide support for protests against a proposed law that would remove the firewall between the city's legal system and the politically-controlled courts of Mainland China. On nearby Taiwan, thousands rallied to show solidarity. Taiwan's leaders hope to draw attention to parallels between their situation and Hong Kong's, yet in the global health realm, many academics know little about Taiwan's plight.