Intellectual Limitations and Doctor’s Orders: Examining the Relationship between Intellectual Humility and Adherence to Medical Advice

Nonadherence to medical advice poses a threat to patients, providers, and the health care system. Intellectual humility reflects one’s ability to recognize their intellectual limitations through the components of independence of intellectand ego, openness to revising one’s viewpoint, respect for other’s viewpoints, and lack of intellectual overconfidence. Possessing more intellectual humility may help improve the way people interact with medical information, thereby increasing their understanding of medical conditions and necessary treatment. Therefore, we investigated the relationship between intellectual humility and adherence by having participants (N = 196) complete the Comprehensive Intellectual Humility Scale and the General Medication Adherence Scale. We found that overall intellectual humility and components of independence of intellect and ego and lack of overconfidence were positively related to overall adherence and its components (behavior, burden, and cost). These findings have the potential to improve adherence and the understanding of intellectual humility in the medical context

Examining the Association between Awareness and Acceptance of Impermanence and Humility

People who appreciate their smallness compared to the vastness of the world can detach themselves from their egos and become humble. We argue that humility is not only about the relative size of the ego, but also about the relativetime in which the ego exists. The current study examined the relationship between awareness and acceptance of the fleeting nature of time (impermanence) and humility. We collected data from 257 adults residing in the United Statesthrough an online study. Participants completed a measure of impermanence and measures of humility. Bivariate correlations suggested that there were significant positive correlations between acceptance and awareness of impermanence and humility. The results suggested people who were more aware and accepting of impermanence had higher reports of being humble, suggesting another strategy to increase humility

1–10-100: Unifying goals to mobilize global action on antimicrobial resistance

Abstract The Bellagio Group for Accelerating AMR Action met in April 2024 to develop the ambitious but achievable 1–10-100 unifying goals to galvanize global policy change and investments for antimicrobial resistance mitigation: 1 Health; 10 million lives saved; and 100% sustainable access to effective antimicrobials. High profile political goals such as the Paris Agreement’s objective to keep global warming well below 2° Celsius compared to pre-industrial levels, UNAIDS’ 90–90-90 goal, and the Sustainable Development Goals challenge global norms, direct attention towards relevant activities, and serve an energizing function to motivate action over an extended period of time. The 1–10-100 unifying goals propose to unite the world through a One Health approach to safeguard human health, animal welfare, agrifood systems, and the environment from the emergence and spread of drug-resistant microbes and infections; save over 10 million lives by 2040 through concerted efforts to prevent and appropriately treat infections while preserving the vital systems and services that depend on sustained antimicrobial effectiveness; and commit to ensuring that antimicrobials are available and affordable for all, used prudently, and secured for the future through innovation. Compared to existing technical targets, these unifying goals offer advantages of focusing on prevention, encouraging multisectoral action and collaboration, promoting health equity, recognizing the need for innovation, and integrating with Sustainable Development Goals. By committing to 1 Health, 10 million lives saved, and 100% sustainable access to effective antimicrobials, we can protect lives and livelihoods today and safeguard options for tomorrow

Environmental Enteropathy, Oral Vaccine Failure and Growth Faltering in Infants in Bangladesh

Background: Environmental enteropathy (EE) is a subclinical enteric condition found in low-income countries that is characterized by intestinal inflammation, reduced intestinal absorption, and gut barrier dysfunction. We aimed to assess if EE impairs the success of oral polio and rotavirus vaccines in infants in Bangladesh. Methods: We conducted a prospective observational study of 700 infants from an urban slum of Dhaka, Bangladesh from May 2011 to November 2014. Infants were enrolled in the first week of life and followed to age one year through biweekly home visits with EPI vaccines administered and growth monitored. EE was operationally defied as enteric inflammation measured by any one of the fecal biomarkers reg1B, alpha-1-antitrypsin, MPO, calprotectin, or neopterin. Oral polio vaccine success was evaluated by immunogenicity, and rotavirus vaccine response was evaluated by immunogenicity and protection from disease. This study is registered with ClinicalTrials.gov, number NCT01375647. Findings: EE was present in greater than 80% of infants by 12 weeks of age. Oral poliovirus and rotavirus vaccines failed in 20.2% and 68.5% of the infants respectively, and 28.6% were malnourished (HAZ < −2) at one year of age. In contrast, 0%, 9.0%, 7.9% and 3.8% of infants lacked protective levels of antibody from tetanus, Haemophilus influenzae type b, diphtheria and measles vaccines respectively. EE was negatively associated with oral polio and rotavirus response but not parenteral vaccine immunogenicity. Biomarkers of systemic inflammation and measures of maternal health were additionally predictive of both oral vaccine failure and malnutrition. The selected biomarkers from multivariable analysis accounted for 46.3% variation in delta HAZ. 24% of Rotarix® IgA positive individuals can be attributed to the selected biomarkers. Interpretation: EE as well as systemic inflammation and poor maternal health were associated with oral but not parenteral vaccine underperformance and risk for future growth faltering. These results offer a potential explanation for the burden of these problems in low-income problems, allow early identification of infants at risk, and suggest pathways for intervention. Funding: The Bill and Melinda Gates Foundation (OPP1017093)