If We Pay Football Players, Why Not Kidney Donors

Ethicists who oppose compensating kidney donors claim they do so because kidney donation is risky for the donor’s health, donors may not appreciate the risks and may be cognitively biased in other ways, and donors may come from disadvantaged groups and thus could be exploited. However, few ethical qualms are raised about professional football players, who face much greater health risks than kidney donors, have much less counseling and screening concerning that risk, and who often come from racial and economic groups deemed disadvantaged. It thus seems that either ethicists—and the law—should ban both professional football and compensated organ donation, allow both, or allow compensated organ donation but prohibit professional football. The fact that we choose none of those options raises questions about the wisdom of the compensation ba

If We Allow Football Players and Boxers to be Paid for Entertaining the Public, Why Don’t We Allow Kidney Donors to be Paid for Saving Lives?

We contrast the compensation ban on organ donation with the legal treatment of football, boxing, and other violent sports where both acute and chronic injuries to participants are common. Our claim is that there is a stronger case for compensating kidney donors than for compensating participants in violent sports. If this proposition is accepted, one implication is that there are only three logically consistent positions: allow compensation for both kidney donation and for violent sports; allow compensation for kidney donation but not for violent sports; or allow compensation for neither. Our current law and practice is perverse in endorsing a fourth regime, allowing compensation for violent sports but not kidney donation. We base our argument chiefly on the medical risk to participants, the consent process, social justice concerns, and social welfare considerations. The medical risks to a professional career in football, boxing, and other violent sports are much greater both in the near and long term than the risks of donating a kidney. On the other hand, the consent and screening process in professional sports is not as developed as in kidney donation. The social justice concerns stem from the fact that most players are black and some come from impoverished backgrounds. Finally, the net social benefit from compensating kidney donors – namely, saving thousands of lives each year and reducing the suffering of 100,000 more receiving dialysis – far exceeds the net social benefit of entertaining the public through professional sports. In sum, the arguments against compensating kidney donors apply with equal or greater force to compensating athletes in these sport

Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football

IMPORTANCE: Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). OBJECTIVE: To determine the neuropathological and clinical features of deceased football players with CTE. DESIGN, SETTING, AND PARTICIPANTS: Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history. EXPOSURES: Participation in American football at any level of play. MAIN OUTCOMES AND MEASURES: Neuropathological diagnoses of neurodegenerative diseases, including CTE, based on defined diagnostic criteria; CTE neuropathological severity (stages I to IV or dichotomized into mild [stages I and II] and severe [stages III and IV]); informant-reported athletic history and, for players who died in 2014 or later, clinical presentation, including behavior, mood, and cognitive symptoms and dementia. RESULTS: Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia. CONCLUSIONS AND RELEVANCE: In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.This study received support from NINDS (grants U01 NS086659, R01 NS078337, R56 NS078337, U01 NS093334, and F32 NS096803), the National Institute on Aging (grants K23 AG046377, P30AG13846 and supplement 0572063345-5, R01 AG1649), the US Department of Defense (grant W81XWH-13-2-0064), the US Department of Veterans Affairs (I01 CX001038), the Veterans Affairs Biorepository (CSP 501), the Veterans Affairs Rehabilitation Research and Development Traumatic Brain Injury Center of Excellence (grant B6796-C), the Department of Defense Peer Reviewed Alzheimer’s Research Program (grant 13267017), the National Operating Committee on Standards for Athletic Equipment, the Alzheimer’s Association (grants NIRG-15-362697 and NIRG-305779), the Concussion Legacy Foundation, the Andlinger Family Foundation, the WWE, and the NFL

Quantification of multi-lumen blood vessel pathology in chronic traumatic encephalopathy

BACKGROUND: Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disorder that had been largely ignored for decades since its initial characterization in 1928 by Dr. H. Martland. Within the last several years, a dramatic increase of attention in the media has been given to the subject and is now a household term. As a consequence of repetitive concussive and subconcussive events, CTE has been clearly distinguished form other neurodegenerative disorders such as Alzheimer’s Disease and Parkinson’s. Its prominence in military personnel and professional athletes has established the importance for its characterization in order to develop preventative approaches and regulations. Recently, characterization and staging of CTE has been achieved and interventional approaches are already being implemented in response to this increased understanding. However, not everything is known about the pathology and its underlying mechanisms. No known studies have been done to quantify the connection between MLV pathology and CTE. OBJECTIVE: To determine if MLV pathology observed in CTE may serve as a potential biomarker. METHODS: The white and grey matter of brains from subjects with CTE and control subjects without CTE were analyzed for the presence and characteristics of multilumen vessels (MLVs) in the dorsolateral frontal cortex (DLFC). A total of 123 slides were analyzed, 88 from CTE cases and 35 from Non-CTE cases. The quantification of overrepresented MLVs and their features was the primary endpoint of the study. Associations were then made between the characteristics of multilumen vessels and controlling factors such as age at death and years of exposure to repetitive head injuries (RHIs). Finally, regression analysis was used to test for the predictive qualities of the density and average number of lumen for stage of CTE while controlling for age at death and years of exposure. RESULTS: It was found that MLVs are overrepresented in the CTE cohort in comparison to the Non-CTE cohort. There is also a possible connection between the presence of MLVs with their pathologic observable features to the progressive nature of CTE. In addition, the MLVs found in CTE have observable characteristics that are dissociable from MLVs in Non-CTE. Furthermore, for increased confidence of the findings, results remain significant even with the application of stricter parameters for defining MLVs. Finally, there was evidence of a connection between the development of MLVs to the progression of CTE. CONCLUSIONS: The findings suggest there is a strong relationship between age of death and the frequency of MLVs. Furthermore, the development of MLVs is likely positively impacted by the progression of CTE

When is giving an impulse? An ERP investigation of intuitive prosocial behavior

Human prosociality is often assumed to emerge from exerting reflective control over initial, selfish impulses. However, recent findings suggest that prosocial actions can also stem from processes that are fast, automatic and intuitive. Here, we attempt to clarify when prosocial behavior may be intuitive by examining prosociality as a form of reward seeking. Using event-related potentials (ERPs), we explored whether a neural signature that rapidly encodes the motivational salience of an event\u2014the P300\u2014can predict intuitive prosocial motivation. Participants allocated varying amounts of money between themselves and charities they initially labelled as high- or low-empathy targets under conditions that promoted intuitive or reflective decision making. Consistent with our predictions, P300 amplitude over centroparietal regions was greater when giving involved high-empathy targets than low-empathy targets, but only when deciding under intuitive conditions. Reflective conditions, alternatively, elicited an earlier frontocentral positivity related to response inhibition, regardless of target. Our findings suggest that during prosocial decision making, larger P300 amplitude could (i) signal intuitive prosocial motivation and (ii) predict subsequent engagement in prosocial behavior. This work offers novel insight into when prosociality may be driven by intuitive processes and the roots of such behaviors

Between compassion and conservatism: a genealogy of British humanitarian sensibilities

Abstract: The chapter explores continuities in modern British humanitarianism at its birth two hundred years ago and today. Modern British humanitarianism arose out of the contradictions between humanist ideals, expanding social sympathies, and fears of radical political change following the French Revolution. Its development was strongly influenced by middle class evangelical reform circles, exemplified by the abolitionist William Wilberforce. The chapter argues that British humanitarianism today follows Wilberforce’s conservative humanitarian tradition and his anti-progressive views. A final proofed version of this paper was published as a chapter:- Vanessa Pupavac (2010) ‘Between Compassion and Conservatism: A Genealogy of British Humanitarian Sensibilities’, in Didier Fassin and Mariella Pandolfi (eds) States of Emergency: Anthropology of Military and Humanitarian Intervention. New York: Zone Books (distributed by MIT Press), pp. 47-77

Sustained inflation at birth did not alter lung injury from mechanical ventilation in surfactant-treated fetal lambs.

BackgroundSustained inflations (SI) are used with the initiation of ventilation at birth to rapidly recruit functional residual capacity and may decrease lung injury and the need for mechanical ventilation in preterm infants. However, a 20 second SI in surfactant-deficient preterm lambs caused an acute phase injury response without decreasing lung injury from subsequent mechanical ventilation.HypothesisA 20 second SI at birth will decrease lung injury from mechanical ventilation in surfactant-treated preterm fetal lambs.MethodsThe head and chest of fetal sheep at 126±1 day GA were exteriorized, with tracheostomy and removal of fetal lung fluid prior to treatment with surfactant (300 mg in 15 ml saline). Fetal lambs were randomized to one of four 15 minute interventions: 1) PEEP 8 cmH2O; 2) 20 sec SI at 40 cmH2O, then PEEP 8 cmH2O; 3) mechanical ventilation with 7 ml/kg tidal volume; or 4) 20 sec SI then mechanical ventilation at 7 ml/kg. Fetal lambs remained on placental support for the intervention and for 30 min after the intervention.ResultsSI recruited a mean volume of 6.8±0.8 mL/kg. SI did not alter respiratory physiology during mechanical ventilation. Heat shock protein (HSP) 70, HSP60, and total protein in lung fluid similarly increased in both ventilation groups. Modest pro-inflammatory cytokine and acute phase responses, with or without SI, were similar with ventilation. SI alone did not increase markers of injury.ConclusionIn surfactant treated fetal lambs, a 20 sec SI did not alter ventilation physiology or markers of lung injury from mechanical ventilation

If We Pay Football Players, Why Not Kidney Donors

Ethicists who oppose compensating kidney donors claim they do so because kidney donation is risky for the donor’s health, donors may not appreciate the risks and may be cognitively biased in other ways, and donors may come from disadvantaged groups and thus could be exploited. However, few ethical qualms are raised about professional football players, who face much greater health risks than kidney donors, have much less counseling and screening concerning that risk, and who often come from racial and economic groups deemed disadvantaged. It thus seems that either ethicists—and the law—should ban both professional football and compensated organ donation, allow both, or allow compensated organ donation but prohibit professional football. The fact that we choose none of those options raises questions about the wisdom of the compensation ba

Donor Retention: What Do We Know & What Can We Do About It?

Donor retention is key to a sustainable base of individual giving. What drives customers to stay, and what affects their behavior? This paper outlines the actions nonprofits can take to improve donor loyalty