Escaping Policy Traps: Strategic Options for Overcoming Entrenchment.

Policy entrenchment per se is a neutral concept; both good and bad policies may become entrenched. A policy trap, however, is entrenchment's pathological form: a self-reinforcing array of policies that simultaneously creates (1) well-established, often widely recognized failures in society, and (2) high barriers to change. A familiar type of policy trap arises when the benefits of a policy are concentrated while the costs, albeit greater, are widely diffused, opaque to many who bear them, or seemingly remote.

Immunology Update: Primary Immunodeficiency Diseases.

There are 264 primary immunodeficiencies (PIDs), most of which are rare. They are caused by complement deficiencies, defects in phagocyte function, impaired T-cell function, and/or impaired B-cell function with antibody deficiencies. Most patients with PIDs will present, at varying ages, with frequent infections.

Immunology Update: New Vaccines.

A new 9-valent human papillomavirus (HPV) vaccine is effective against more cancer-causing HPV types than previous vaccines. HPV vaccine series started with previous vaccines can be completed with the 9-valent vaccine. Two new influenza vaccines are available for adults 65 years and older: a high-dose vaccine and an enhanced adjuvant vaccine.

Immunology Update: Long-Term Care of Solid Organ Transplant Recipients.

Nearly 31,000 US patients received solid organ transplants in 2015 and the number is increasing. Care of transplant recipients includes management of a variety of common posttransplantation issues. Skin cancers are common because of immunosuppression and require skin examinations at intervals.

Immunology Update: Biologics.

Biologics are substances made from a living organism or its products. These include genes, proteins (eg, antibodies, receptors, enzymes, inhibitors), recombinant proteins, and fusion proteins. Biologics often are produced using recombinant DNA technology.

Cirrhosis: diagnosis, management, and prevention.

Cirrhosis is the 12th leading cause of death in the United States. It accounted for 29,165 deaths in 2007, with a mortality rate of 9.7 per 100,000 persons.

Incidence and onset of delayed seizures after overdoses of extended-release bupropion.

Background: Delayed seizures have been reported with overdoses of bupropion extended-release (XL). This study systematically evaluates the frequency and timing of seizures and an association between other toxic effects (ie, agitation, tremors, and hallucinations) and seizures.

Methods: A 3-year multi-poison center observational study of hospitalized patients with ingestion of bupropion XL >or=600 mg in adults and >or=4 mg/kg in children was performed.

Professionalization and public health: historical legacies, continuing dilemmas.

Professionalization in public health reflects wider institutional and political forces. Depending on the historical context in different countries, public health has developed as a medical specialty or as an independent field, entirely within the state or in mixed public-private institutions, closely or weakly tied to social movements, and in varying relations to fields such as engineering, nursing, environmental science, and the military. In early 20th-century America, the rise of the medical profession and the biomedical model of disease had a formative influence on public health, leading to a different institutional pattern from Britain.

Précis of Paul Starr's The Social Transformation of American Medicine. 1982.

The following is a presentation of selected passages from The Social Transformation of American Medicine (original pages numbers enclosed in parentheses) in tandem with the names of the authors in this retrospective issue and the various themes and issues they address.