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Morning Rounds Shraddha Chakradhar

Juul targeted youth in ads on Cartoon Network and other sites, lawsuit claims

A new lawsuit brought by Massachusetts Attorney General Maura Healey alleges that e-cigarette maker Juul bought ads targeting teens on Cartoon Network and other youth-friendly sites, including Nickelodeon and Seventeen magazine. Other websites — including ones where teens can learn about colleges — were also part of the company’s digital strategy, the suit claims. The lawsuit further alleges that Juul rejected a campaign from a marketing firm that targeted Juul products only to adult smokers. A company spokesperson tells STAT that although Juul hasn’t yet reviewed the complaint, it is committed to working with officials to combat underage use of its products. Massachusetts joins a growing list of states suing the vaping company: On Monday, Pennsylvania announced a lawsuit against Juul, alleging that it improperly marketed its products to youth and misled consumers about the addictive nature of its nicotine pods. 

CDC director: More person-to-person coronavirus infections in U.S. likely

CDC Director Robert Redfield tells STAT's Helen Branswell that there are likely to more cases of human-to-human transmission of the new coronavirus in the U.S. It's not going to be possible to seal the country off from the virus, but, he added in an interview yesterday, “we do gain time by prolonging the containment phase as long as we can, provided that we still believe that’s a useful public health effort.” Containment could be achieved by implementing so-called social distancing measures, he said, steps such as closing some public facilities in an effort to limit the number of people who are infected. The U.S. has thus far seen 14 cases of the disease, two of which were caused by human-to-human transmission. If one person's illness begins a chain of three or four other infections in turn, then containment will have failed, Redfield said. The disease, now called Covid-19, has resulted in nearly 60,000 cases worldwide and more than 1,350 deaths. 

Q&A: New symposium will help clinicians prepare for climate change

The Harvard T.H. Chan School of Public Health is holding a symposium today aimed at helping clinicians be better prepared for the impending climate crisis. In an NEJM piece, Renee Salas, an emergency physician and one of the symposium organizers, outlines improvements that others in her field can make in order to respond to heat stress, just one of the anticipated effects of a warming climate. I spoke to Salas to learn more. 

Why should doctors be concerned about climate change?
Climate action is a prescription for health. As a doctor, my job is to improve the health of patients and prevent harm. So, anything that’s harming my patients is something that is completely within my realm to learn about and take into account in my practice. 

Is this effort going to extend beyond today’s symposium?
We are launching a broader initiative and other flagship cities across the U.S. will host their own symposium. The initial places are going to include the University of Washington in Seattle [and six other places in the U.S.]. We also just got Australian National University to sign on. NEJM is also going to have a discussion board on their platform so people can share best practices.  

Inside STAT: Why reports about coronavirus death rates can be misleading 

(Hyacinth Empinado/STAT)

Case fatality rate: That's the term that helps answer the most pressing questions when a new disease emerges, questions like how deadly the disease is and how many people are likely to die. With the current outbreak of Covid-19, experts say it's too soon to tell what the CFR is, which is the percentage of the number of known deaths divided by the number of cases. That's because it's difficult to know the exact number of cases — many people with milder symptoms may not have sought care and could therefore have been missed. Learn more about CFR in a new video from STAT's Hyacinth Empinado here

New BMJ issue highlights racial disparities in medicine

The BMJ is out with a new special issue that looks at racial disparities in the U.K. health care system. Here’s a sampling of what’s inside: 

  • Specialty training: Physicians from minority backgrounds are less likely than white doctors to be deemed eligible for specialty training positions — 75% of white applicants were eligible for such jobs compared to 53% of those who were racial minorities. 

  • Racism in U.K. medical schools: The BMJ surveyed all of the U.K.'s 40 public undergraduate medical schools and found that only half of the 32 that responded collect data on racism-related complaints from students. 

  • New initiative: Based on the findings of the medical school survey, the British Medical Association is launching a charter that would, among other directives, have medical schools put in place policies aimed at improving diversity.

Reviews of hospice agencies reveal poor communication, other issues

A small sampling of hospice agencies’ reviews reveals that people most often have complaints about suboptimal communication and quality of care. Researchers looked at Yelp reviews for agencies in all U.S. states — one for-profit facility and one nonprofit per state, where possible — and found that 67% of them had one-star reviews, fairly evenly split between the two types of agencies. Five main themes emerged from the reviews, including poor communication and the hospice experience not aligning with what people were told to expect. Two themes concerned larger issues about the role of hospice and the meaning of a “good death.” Family members, for instance, wrote about the suffering that their loved ones endured during their last days. Given people’s increased reliance on online reviews for health care decisions, the authors suggest more government oversight of hospice agencies. 

What to read around the web today

  • Opinion: Why autism research needs more input from autistic people. Spectrum
  • Insulin makers object to FDA proposal for speeding arrival of biosimilar insulins. STAT Plus
  • Scientists offered €1,000 to publish null results. Times Higher Education
  • Coronavirus test kits sent to states are flawed, CDC says. The New York Times
  • How hospitals changed how they deal with stillbirth. The Atlantic

Thanks for reading! More tomorrow,


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Thursday, February 13, 2020


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