Allies Not Adversaries: Teaching Collaboration to the Next Generation of Doctors and Lawyers to Address Social Inequality

Recent reports from the Carnegie Foundation for the Advancement of Teaching, as well as from other medical and legal educators, stress that professional training of doctors and lawyers focuses too narrowly on knowledge-based learning, and not enough on context-based problem solving, professionalism, and ethics. Tracing recent calls from both legal and medical educators to increase the teaching of ethics, social responsibility, the lawyer-client and doctor-patient relationship, and holistic problem-solving, this article offers a model of interdisciplinary medical-legal education focused on developing practitioners sensitive to the needs of diverse and disenfranchised clients and patients. It highlights a burgeoning medical-legal partnership model, now in nearly eighty sites across the country, which partners lawyers and doctors to address the underlying social determinants of health for poor children and their families. The medical-legal partnership model, which increasingly includes medical school and law school partners, provides a unique opportunity to engage law and medical students in interdisciplinary problem-solving and ethical reflection, while also expanding their understanding of complex issues of social justice and inequality in our legal and health care systems. An interdisciplinary course offered by Brown Medical School and Roger Williams University School of Law is offered as a model

Health Justice in the Age of Alternative Facts and Tax Cuts: Value-Based Care, Medicaid Reform, and the Social Determinants of Health

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and support for Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a series of legislative and regulatory changes, has undermined many of these efforts, reversing the momentum toward a more preventive and integrated health care system. This article traces how the Trump administration’s policy approach to investments in value-based and integrated care models, state Medicaid waivers, and funding of the safety net backtrack from Obama administration evidence-based reforms that acknowledged the large role that SDOH play in health inequity, worsening population health outcomes in the U.S., and out of control health care costs

Love in the Time of COVID-19: Negligence in the Nicaraguan Response

The response of the Nicaraguan government to the coronavirus disease 2019 (COVID-19) pandemic has been perhaps the most erratic of any country in the world to date. Directly contradicting mitigation strategies recommended by WHO, President Daniel Ortega has refused to encourage any physical distancing measures. Vice President Rosario Murillo (Daniel Ortega\u27s wife) instead called on thousands of sympathisers to congregate in street marches under the slogan \u27love in the time of COVID-19\u27. By downplaying the danger of the pandemic and increasing the risk of community transmission in the second-poorest country in the western hemisphere, the Nicaraguan government is violating the human rights of its citizens

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Health Justice in the Age of Alternative Facts and Tax Cuts: Value-Based Care, Medicaid Reform, and the Social Determinants of Health

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and support for Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a series of legislative and regulatory changes, has undermined many of these efforts, reversing the momentum toward a more preventive and integrated health care system. This article traces how the Trump administration’s policy approach to investments in value-based and integrated care models, state Medicaid waivers, and funding of the safety net backtrack from Obama administration evidence-based reforms that acknowledged the large role that SDOH play in health inequity, worsening population health outcomes in the U.S., and out of control health care costs