Hiatal Hernia Associated with Higher Odds of Dysplasia in Patients with Barrett’s Esophagus

Digestive Diseases and Sciences - Patients with Barrett’s esophagus (BE) are more likely to have associated hiatal hernia (HH) compared to the general population. Studies show that HH are...     

Actor–observer asymmetry in perceptions of parole board release decisions

In the current study, the actor–observer effect is tested with both mock parole board members and the public evaluating the responsibility of parole board members for a decision resulting in a parolee reoffending and committing a murder. Participants (two samples with a combined N = 1317) were randomly assigned to act as a mock parole board member and make a decision (which ended in the parolee reoffending) or as a member of the public who read a story about the same parole decision and outcome. Findings suggest that the traditional actor–observer asymmetry emerged across blame and responsibility concepts, emotion and moral judgments. Overall, the public held harsher judgments than the mock parole board members. Implications regarding self-enhancement, methodology and attribution theory are discussed.Key words: actor–observer, attributions, blame, decision-making, emotion, parole, responsibility

Parole has been a part of corrections reform since the early twentieth century, and it shares many goals with a more rehabilitative criminal justice approach seen gaining momentum recently (Cullen, 2017; Petersilia, 2000). Perceptions that prison sentences were too harsh and did not allow any room for rehabilitation spurred support for a more lenient approach to parole, and models of releasing less violent inmates that have shown good behavior were adopted (Clear & Cole, 1997). In general, there are two types of parole decisions; discretionary and mandatory parole (Maruschak & Bonczar, 2013). Discretionary parole involves a decision process through which parole board members review an inmate’s files and decide whether to grant or deny supervised release (parole). There is no required action given to the board, but the action is left up to the discretion of the board. In contrast, mandatory parole is a decision process by which inmates are released under specific circumstances after they have served a certain period of time in prison and do not have major violations or other factors barring their release (Hughes et al., 2001). Under mandatory release guidelines, the parole board is often obligated to release inmates to supervised release, usually based on determinate sentencing and good behavior, unless some major factor prevents such action (Abadinsky, 2012). Recently, discretionary parole has been used at a higher rate than mandatory parole, creating a trend over the past several years (Kaeble, 2018; Maruschak & Bonczar, 2013).In the United States, there are currently about 875,000 inmates on parole, with over 450,000 inmates being released on parole in 2016 (Kaeble, 2018). With an increase in discretionary parole decisions and a large parole population, the parole board likely faces scrutiny for the outcomes of its decisions and is held accountable by the public for ensuring safety and economy (e.g. Abadinsky, 2012; Mackenzie, 2001; National Parole Resource Center, 2012; Paparozzi & Guy, 2009). Parole board members’ perspectives and the public’s perspective might differ as they relate to how parole decisions are perceived and the accountability of the boards’ decisions. This divergence is important because legislation applicable to parole board decisions is intended to incorporate both perspectives, and any dialogue about parole should involve an attempt at mutual understanding. However, it is possible that the divergence in perspectives is due to experience and observational standpoint. The purpose of the current study is to apply an attribution framework to better understand the difference between perspectives of actors (parole board members) and observers (the public) by using a mock parole decision-making paradigm and comparing both parole board and public perspectives on the decision process and outcome with a focus on blame and responsibility for negative outcomes.     

Should upper gastrointestinal endoscopy be part of the evaluation for supraesophageal symptoms of GERD?

The past decade has witnessed increasing interest in the supraesophageal (ear, nose, and throat (ENT)) symptoms potentially caused by gastroesophageal reflux disease (GERD). Hoarseness, halitosis, problems with vocal presentations, excessive phlegm, frequent throat clearing, globus sensation, sore throat, cough, aspiration, laryngospasm, and laryngeal carcinoma are some, but not all of the ENT symptoms that have been attributed to GERD (1). The availability of highly effective medical and surgical therapies allows for control of these symptoms in many patients adding to the importance of accurately diagnosing GERD.     

Recurrent Barrett's esophagus and adenocarcinoma after esophagectomy

Background  

Esophagectomy is considered the gold standard for the treatment of high-grade dysplasia in Barrett's esophagus (BE) and for noninvasive adenocarcinoma (ACA) of the distal esophagus. If all of the metaplastic epithelium is removed, the patient is considered "cured". Despite this, BE has been reported in patients who have previously undergone esophagectomy. It is often debated whether this is "new" BE or the result of an esophagectomy that did not include a sufficiently proximal margin. Our aim was to determine if BE recurred in esophagectomy patients where the entire segment of BE had been removed.     

Treatment of achalasia: recent advances in surgery

Achalasia is an uncommon motility disorder of the esophagus with an uncertain etiology. Considerable debate exists regarding the most effective treatment for long-term relief of symptoms. For decades, pneumatic dilatation has been the primary treatment option, and surgery was reserved for patients who required repeated dilations or for those who were not willing to undergo the risk of perforation associated with dilatation. Recently botulinum toxin injection of the lower esophageal sphincter has been shown to provide substantial short-term relief from dysphagia; however, its effect only lasts for a short period of time. Recently, minimally invasive surgical techniques have been developed to perform a Heller myotomy effectively with an antireflux procedure. This has become a primary treatment option for many patients. We present a review of the outcome of different therapeutic options of achalasia with a special focus on laparoscopic procedures.