How to think about health promotion ethics

Health promotion ethics is moral deliberation about health promotion and its prac­ tice. Although academics and practitioners have been writing about ethics, and especially values, in health promotion for decades, health promotion ethics is now regaining attention within the broader literature on public health ethics. Health promotion is difficult to define, and this has implications for health promotion ethics. Health promotion can be approached in two complementary ways: as a normative ideal, and as a practice. We consider the normative ideal of health promotion to be that aspect of public health practice that is particularly concerned with the equity of social arrangements: it imagines that social arrangements can be altered to make things better for everyone, whatever their health risks, and seeks to achieve this in collaboration with citizens.This raises two main ethical questions. First: what is a good society? And then: what should health promotion contribute to a good society? The practice of health promotion varies widely. Discussion of its ethical implications has addressed four main issues: the potential for health promotion to limit or increase the freedom of individuals; health promotion as a source of collective benefit; the possibility that health promotion strategies might “blame the victim” or stigmatise those who are disabled, sick or at higher risk of disease; and the importance of distributing the benefits of health promotion fairly. Different people will make different moral evaluations on each of these issues in a way that is informed by, and informs, their vision of a good society and their understanding of the ends of health promotion. We conclude that future work in health promotion ethics will require thoughtfully connecting social and political philosophy with an applied, empirically informed ethics of practice. Key Words:Ethics, health education, health promotion, moral philosophy, political philosophy, public healthNHMR

Transcriptional programs regulating neuronal differentiation are disrupted in DLG2 knockout human embryonic stem cells and enriched for schizophrenia and related disorders risk variants

Coordinated programs of gene expression drive brain development. It is unclear which transcriptional programs, in which cell-types, are affected in neuropsychiatric disorders such as schizophrenia. Here we integrate human genetics with transcriptomic data from differentiation of human embryonic stem cells into cortical excitatory neurons. We identify transcriptional programs expressed during early neurogenesis in vitro and in human foetal cortex that are down-regulated in DLG2−/− lines. Down-regulation impacted neuronal differentiation and maturation, impairing migration, morphology and action potential generation. Genetic variation in these programs is associated with neuropsychiatric disorders and cognitive function, with associated variants predominantly concentrated in loss-of-function intolerant genes. Neurogenic programs also overlap schizophrenia GWAS enrichment previously identified in mature excitatory neurons, suggesting that pathways active during prenatal cortical development may also be associated with mature neuronal dysfunction. Our data from human embryonic stem cells, when combined with analysis of available foetal cortical gene expression data, de novo rare variants and GWAS statistics for neuropsychiatric disorders and cognition, reveal a convergence on transcriptional programs regulating excitatory cortical neurogenesis

Chemotherapy for upper gastrointestinal tumours

*This article is free to read on the publisher's website* The aim of this review is to identify current chemotherapy treatment for tumours of the oesophagus, stomach, pancreas, and liver. The role of both neoadjuvant, adjuvant, and palliative chemotherapy regimens will be discussed. This review will be of interest to oncologists in clarifying current issues regarding chemotherapy, and to physicians in other medical specialties, to increase their general understanding of benefits and drawbacks of chemotherapy in this patient group