An Internet for Some threatens health for All: What effects could the repeal of net neutrality in the USA have on individual and population health?

In the United States of America, the Federal Communications Commission's repeal of the popular Open Internet Order (a.k.a 'net neutrality') has yielded pointed criticism from many different sectors, but it has yet to be examined for its potential effect on the public's health. In this commentary, we focus on the health implications of this policy change, considering expert opinion on the subject, past history, and global perspectives. We argue that the repeal of net neutrality has the potential to compromise health education and promotion efforts by widening the 'digital divide', thereby impairing health literacy and exacerbating health inequities. By negatively affecting people's ability to access, understand, and use unbiased, evidence-based health information to improve and maintain their health, the repeal of net neutrality may hinder the World Health Organization's vision of 'Health for All' by dismantling public protections in the name of corporate profit.

Limited English proficiency and disparities in clinical research.

Patients with Limited English Proficiency (LEP) are a protected class under the Civil Rights Act. However, clinical trials continue to remain largely inaccessible to this population. This article lays out the scientific, legal, and ethical rationales for the inclusion of LEP subjects in clinical research.

Short-Term Outcomes of a Diversity, Equity, and Inclusion Institute for Nursing Faculty.

BACKGROUND: Student populations in the United States are increasingly diverse, prompting the need to make learning environments in schools of nursing more inclusive. Training for faculty is needed to support this work; however, evidence regarding best practices to make classrooms more inclusive is lacking. METHOD: A 3-day Diversity, Equity, and Inclusion (DEI) Institute was developed and conducted to create inclusive learning environments; facilitate crucial conversations on racism and other -isms, especially in the context of nursing and health equity; and practice these skills and develop or transform at least one actual class activity. RESULTS: DEI Institute satisfaction and impact were overwhelmingly positive, and statistically significant increases in DEI-related teaching self-efficacy were observed post-Institute (p values ranging from .0004 to < .0001). CONCLUSION: The DEI Institute is one example of a successful approach that can create inclusive learning environments and address issues related to health equity. [J Nurs Educ. 2019;58(11):633-640.].

Social factors affecting treatment of cervical cancer: ethical issues and policy implications.

Health care in the United States has become a privilege rather than a right. Patients who have the greatest need are the ones most likely to be denied this privilege. Despite recent advances in disease detection and treatment, many patients do not receive even the bare minimum of care. The high complexity of the health care system in the setting of patients with low levels of health literacy significantly affects the ability to seek and receive treatment in a timely fashion. In addition, lack of insurance, transportation, and social support further complicate access to care. To truly provide a standard of care to all patients, regardless of resources, our health care system must evolve to address the needs of the population. In this paper, we report a tragic case where social factors affected the outcome of a single mother with advanced cervical cancer.

Marking Twain.

The first of the following two narratives is a personal reflection by the instructor of "Narrative Approaches to Bioethics," an elective in the PhD program at the Albert Gnaegi Center for Health Care Ethics at Saint Louis University. The author argues that perhaps the primary goal of medical ethics education should be to show how to construct plausible and defensible interpretations of human experience and sensibly resolve the problems that these happenings occasion. To that end, the author engaged the sympathetic reading capacities of his students by "thwarting" their expectations for medicalized case studies to "dissect" and instead chose works that invited careful readings of morally-complex literary works. One such reading was Huckleberry Finn, which the class read on the book's 100(th) anniversary. Huckleberry Finn chronicles Huck's search for truth, goodness and justice on the Mississippi River-a location the class explored on a field trip. The second narrative is the personal reflection of one of the students in this class and attests to the moral pedagogical power of Huck Finn. He relates the insights gleaned from a particular passage where Huck confronts moralistic dogmas.

Ethical issues in mental health research: the case for community engagement.

PURPOSE OF REVIEW: To describe community-engaged research (CEnR) and how it may improve the quality of a research study while addressing ethical concerns that communities may have with mental health and substance abuse research. This article includes a review of the literature as well as recommendations from an expert panel convened with funding from the US National Institute of Mental Health. RECENT FINDINGS: CEnR represents a broad spectrum of practices, including representation on institutional ethics committees, attitude research with individuals from the study population, engaging community advisory boards, forming research partnerships with community organizations, and including community members as co-investigators. SUMMARY: CEnR poses some challenges; for example, it requires funding and training for researchers and community members. However, it offers many benefits to researchers and communities, and some form of CEnR is appropriate and feasible in nearly every study involving human participants.