Medicine

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

In this paper, we argue that certain theoretical conceptions of health, particularly those described as ‘biomedical’ or ‘naturalistic’, are viciously epistemically unjust. Drawing on some recent work in vice epistemology, we identity three ways that abstract objects (such as theoretical conceptions, doctrines, or stances) can be legitimately described as epistemically vicious. If this is right, then robust reform of individuals, social systems, and institutions would not be enough to secure epistemic justice: we must reform the deeper conceptions of health that (...) underlie them. (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes the initiatives for the sake of mental health are aimed just at reducing mental (...) illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall wellbeing. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of wellbeing is too demanding and potentially oppressive. As a compromise we sketch out a middle position. On this view mental health is a primary good, that is the psychological preconditions of pursuing any conception of the good life, including wellbeing, without being identical to wellbeing. (shrink)

Taiwan and Vietnam have taken successful measures to combat the spread of COVID-19 at the early stages. Many authors attributed the successful policies to the lessons learned by these countries during the severe acute respiratory syndrome (SARS) pandemic in 2002.(Ohara, 2004) This manuscript provides a summary of recent early-stage policies that were successful in mitigating the spread and creating resilience against the negative consequences of COVID-19 in Taiwan and Vietnam. Crucially, these policies go beyond and complement social isolation. As social (...) isolation is expected to have a negative socio-economic impact on the population and adherence is likely to decrease with time(Armitage and Nellums, 2020; Weems et al., 2020), it is important to consider a broad range of policies to promote a steady control of the COVID-19 spread. Initially, we provide a brief introduction to some general concepts related to COVID-19. Thereafter, we introduce a concise review of policies and their dates relative to the first detection case in Taiwan and Vietnam as well as doing a comparative analysis. (shrink)

Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected (...) the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people’s mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan. (shrink)

The COVID -19 is one of the most contagious and fatal diseases known today, which had spread in communities very fast. This deadly virus affecting the lives of many people and causing fatalities. Besides the strong practice of praying and putting trust in Allah for the cure of disease, Islam also recommends taking medications and adopt sufficient precautions for the safety and well-being of the community. Before 1400 years ago, the Prophet Muhammad (peace be upon Him) introduced the quarantining and (...) hygiene practice, at a time there was very little known to combat the contagious diseases. Currently, modern societies are emphasizing on hand hygiene, social distancing, quarantining, and social isolation to combat COVOD-19. Islam has superseded modern societies by establishing the idea of quarantines and hygienic practice for contagious and fatal diseases. The commandments to prevent the spread of COVID-19 by worldwide public health organizations are almost in line with the teachings of Islam. (shrink)

In the last decade Open Science principles, such as Open Access, study preregistration, use of preprints, making available data and code, and open peer review, have been successfully advocated for and are being slowly adopted in many different research communities. In response to the COVID-19 pandemic many publishers and researchers have sped up their adoption of some of these Open Science practices, sometimes embracing them fully and sometimes partially or in a sub-optimal manner. In this article, we express concerns about (...) the violation of some of the Open Science principles and its potential impact on the quality of research output. We provide evidence of the misuses of these principles at different stages of the scientific process. We call for a wider adoption of Open Science practices in the hope that this work will encourage a broader endorsement of Open Science principles and serve as a reminder that science should always be a rigorous process, reliable and transparent, especially in the context of a pandemic where research findings are being translated into practice even more rapidly. (shrink)

Les recherches scientifiques sur la COVID-19 sont à la fois menées et diffusées à une cadence effrénée. Bien qu’il soit inspirant de voir la communauté de la recherche répondre avec autant de vigueur à la crise causée par la pandémie, toute cette activité a par ailleurs engendré un chaos de mauvaises données, de résultats contradictoires et de manchettes exagérées. Alors que la polarisation, la déformation et la médiatisation des résultats scientifiques s’intensifient chaque jour, les inquiétudes se font de plus en (...) plus sentir quant à la perspective que la science pertinente soit présentée au public d’une manière qui puisse causer de la confusion, créer de fausses attentes et éroder la confiance du public. Dans cette note, nous explorons les principaux enjeux associés à la présentation de la science dans le contexte de la pandémie de la COVID-19. Plusieurs de ces enjeux ne sont pas nouveaux. Mais la pandémie de la COVID-19 a braqué les projecteurs sur le processus de la recherche biomédicale et a amplifié les ramifications néfastes des problèmes de communication publique. Nous devons faire mieux. À ce titre, nous conclurons ce rapport en formulant dix recommandations qui s’adressent aux acteurs clés qui interviennent dans la communication de la science sur la COVID-19, notamment les gouvernements, les bailleurs de fonds, les universités, les éditeurs, les médias et les communautés de recherche. (shrink)

COVID science is being both done and circulated at a furious pace. While it is inspiring to see the research community responding so vigorously to the pandemic crisis, all this activity has also created a churning sea of bad data, conflicting results, and exaggerated headlines. With representations of science becoming increasingly polarized, twisted and hyped, there is growing concern that the relevant science is being represented to the public in a manner that may cause confusion, inappropriate expectations, and the erosion (...) of public trust. Here we explore some of the key issues associated with the representations of science in the context of the COVID-19 pandemic. Many of these issues are not new. But the COVID-19 pandemic has placed a spotlight on the biomedical research process and amplified the adverse ramifications of poor public communication. We need to do better. As such, we conclude with ten recommendations aimed at key actors involved in the communication of COVID-19 science, including government, funders, universities, publishers, media and the research communities. (shrink)

L’épidémie de Covid-19 aurait pu y faire des ravages. Pourtant, ce 11 avril, le Vietnam ne comptait que 258 cas déclarés et aucun décès selon l’université américaine Johns Hopkins. Des chiffres observés avec moins de méfiance que ceux du voisin chinois, avec qui il partage 1 280 kilomètres de frontière. Le résultat est surprenant pour ce pays de 96 millions d’habitants, qui ne consacre que peu de moyens à la santé. À Hô-Chi-Minh-Ville, seuls 900 lits d’hôpitaux sont équipés pour les (...) soins intensifs, soit 1 pour près de 9 000 habitants. (shrink)

Since the “last day” of 2019, a new virus emerged in Asia, which in Feb./2020 was called by the World Health Organization (WHO, 2020) as Coronavirus disease (Covid-19). Due to its fast transmission, after eight months since the first global official case, at 23:59 (GMT) on August 31, 2020, the world has accounted for about 25,620,737 new confirmed cases with 854,222 deaths and 17,921,063 recovered cases (WORLDOMETERS, 2020). The pandemic is the newest challenge for all nations, most of them eager (...) to learn from countries that are successful against the virus. However, until now, no methodology was developed to identify them by taking into account a holistic approach with international rankings concerned to health, innovation, sustainability, image, and competitiveness, as well as the estimated real number of fatal cases by one million population during the first 180 days of facing the pandemic. Thus, the main objective is to develop a holistic methodology to identify twenty benchmark countries that are saving people's lives against Covid-19. The research is applied, as its results and recommendations are useful for academy, government policymakers and authorities. It is descriptive, with a qualitative and quantitative approach, based on bibliographic and documentary research, involving the study of official sites, articles, reports, manuals, and other technical documents related to 13 international rankings. As a result, the fifteen phases of the methodology, far from perfect, shows that among 108 well-evaluated countries, the top six benchmark countries are from Asia (1) Vietnam; 2) Taiwan; 3) Thailand; 4) China; 5) Malaysia; 6) Singapore), which suffered from fatal cases from first SARS-CoV in 2002/2003, followed by 7) South Korea; 8) New Zealand; 9) Australia; 10) Japan; 11) Hong Kong; 12) Cyprus; 13) Greece; 14) Latvia; 15) Iceland; 16) the United Arab Emirates; 17) Czech; 18) Lithuania; 19) Norway, and 20) Estonia. (shrink)

The main research question for this thesis is: How can the complex field of mental health problems among adolescents in Vietnam be understood and addressed with sustainable and accessible developments at the school-level?

This chapter presents a reflection on the main findings of the research performed for this thesis, and the conclusions drawn from the results. The research was guided by the following main research question: How can the complex field of mental health problems among adolescents in Vietnam be understood and addressed with sustainable and accessible developments at the secondary school level?

Background: All research has room for improvement, but authors do not always clearly acknowledge the limitations of their work. In this brief report, we sought to identify the prevalence of limitations statements in the medRxiv COVID-19 SARS-CoV-2 dataset. Methods: We combined automated methods with manual review to analyse manuscripts for the presence, or absence, either of a defined limitations section in the text, or as part of the general discussion. Results: We identified a structured limitations statement in 28% of the (...) manuscripts, and overall 52% contained at least one mention of a study limitation. Over one-third of manuscripts contained none of the terms that might typically be associated with reporting of limitations. Overall our method performed with precision of 0.97 and recall of 0.91. Conclusion: The presence or absence of limitations statements can be identified with reasonable confidence using automated tools. We suggest that it might be beneficial to require a defined, structured statement about study limitations, either as part of the submission process, or clearly delineated within the manuscript. (shrink)

Catch up on the status of the more than 135 vaccines in development against the SARS-CoV-2 virus, ponder the biology and physics of free will and learn how scientists helped win the battle over evolution in US classrooms.

A recent study by Vietnamese social scientists looked into the initial success of Vietnam’s response to COVID-19.

This viewpoint provides an explanation from the public health policies of Vietnamese government to contain the contagious disease with regard to COVID-19 pandemic. A combination of an early lockdown, increase in “virality” of the health information, encouragement in health declaration, regulation for wearing mask in the public, and country’s unity have been the effective ways to cope with this deadly virus in Vietnam, a developing country, which became the first country to halt the SARS spread successfully in 2003.

Hynek Bartos does the field of ancient philosophy a great service by detailing the influence of early Greek thinkers (such as Heraclitus, Empedocles, Anaxagoras, Democritus, and Diogenes of Apollonia) on the Hippocratic work On Regimen, and by demonstrating that work’s innovative engagement with contemporary scientific and philosophical concepts as well as its direct influence on Plato and Aristotle. His study usefully counteracts the lamentable tendency among ancient philosophers to ignore or downplay the influence of medical literature on philosophy in general, (...) and to heap scorn on this text in particular, which Kirk, Raven, and Schofield considered ‘an eclectic and very superficial quasi- philosophical treatise’ and Barnes famously called ‘a silly farrago of ill-digested Presocratic opinions’. (shrink)

The present article is presenting the ‘Healthcare Hazards and Its Impact on Health Insurance Business – An Overview during COVID-19’. The present paper studied the health insurance, health insurance plans in India, Indian market size, health care industry, government actions for the COVID-19, and healthcare business in India, private health insurance in India, hazardous of the healthcare industry and health insurances, and Indian healthcare issues in 2019. The author has concluded that all insurance policies are levied higher taxes by the (...) government, these lead higher income to the companies, and these are creating how commissions to the agents and other insurance organizations under reinsurance, but no benefits to the insured. It may not be a long term benefit, why because there is no maturity fund/income, because of these are shortterm benefits; how many of the policyholders are getting the benefits from the general health insurance companies. Hence, the research is required to calculate for the need of levy-the tax from the non-claimant portion of the income of the general health insurance on an annual basis to the health department of the nation. (shrink)

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential health care services (...) that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately. (shrink)

Being dubbed as an authoritarian government (The Economist, 2019), Vietnam Is under suspicion of hiding the real data about COVID-19 real data about COVID-19 (Dan Tri, 2020). The doubt is based on the monopoly of the Communist Party in controlling the data, which is similar to China (BBC, 2020). Despite this conspiracy, Vietnam’s success is widely recognised for its handling of the pandemic by the international community (IMF, 2020).

• A number of reasons have been offered for Vietnam’s success in containing the COVID-19 pandemic during the first four months of 2020, including Vietnam’s experience in fighting epidemics and its single-party system which allows for timely and aggressive infection control. • Contentions that Vietnam’s measures, being dependent on its particular political and social structures, are not replicable elsewhere is incomplete, if not outright wrong. • Vietnam’s successful pandemic control required a high level of preparedness and a host of coordinated (...) efforts to provide accurate and credible information to the public about epidemic risks and ongoing infection control measures. • A proactive communication strategy was in place from the very beginning, utilizing various platforms such as online news sites, low-cost text messaging, user-friendly apps, local community loudspeakers, and pandemic awareness campaigns. • Open communication ensured public understanding of and support for the government response, thereby facilitating effective government-citizen cooperation. This is a lesson for other countries as much as for Vietnam in the post-pandemic period. (shrink)

Tightened border controls, agile health departments, tech platforms, and a hand-washing song that went viral have added up to a frugal but highly effective response to the threat of COVID-19. The country's success provides a model that other developing and emerging economies should follow.

The COVID-19 pandemic is considered a global disaster that affects all areas of the world; however, it is also seen as a motivation for domestic and foreign scientists to focus on researching solutions to reduce its damage. This article aims to explore the correlation of scientific publications of countries in Southeast Asia, among research fields in Vietnam and among topics published by Vietnamese educational institutions in the context of a pandemic. 1392 Southeast Asian countries’ publications related to COVID-19 were referenced (...) from the Scopus database, including 123 articles from Vietnam (up to August 27th, 2020). Statistics show that Vietnam ranks fifth in the number of scientific publications with research cooperation of researchers from 20 different countries. Regarding the research fields of Vietnam, medicine is the main research topic, social science ranks third following environmental science. In the field of social science, articles focus on four key topics: epidemic prevention, reduction of pandemic effects on life and socioeconomics, factors related to online learning of students, healthcare for the elderly. From the analysis results, the authors recommend that researchers should pay attention to other topics in the social sciences that have not been published, such as psychological effects of infected or suspected nCovi, the impact of COVID-19 to disadvantaged groups in society... (shrink)

This paper studies the connection between social media addiction and mental disorder from the existing investigation among undergraduate students. A comprehensive document search was conducted by using six electronic databases, including PubMed, Scopus, ScienceDirect, Web of Science, JSTOR, ProQuest Education to identify articles published before November 21st, 2019. All collected papers focused on studying social media addiction and psychosis. Two reviewers individualistically evaluated the quality of the study by using the Joanna Briggs Institute’s approach. Five articles were filtered out through (...) the screening process and included in the review. The high prevalence of social addiction among college students (9.7% ~ 41%) has been clarified. The association between social media addiction and mental disorders is positive for student health. This article contributes to raising awareness and finding solutions to these risk problems. The study also confirms the connection between online shopping addiction and eating disorders among social addicts. We also discuss the causes and harms of social media addiction. (shrink)

In this chapter, we consider ethical and philosophical aspects of trust in the practice of medicine. We focus on trust within the patient-physician relationship, trust and professionalism, and trust in Western (allopathic) institutions of medicine and medical research. Philosophical approaches to trust contain important insights into medicine as an ethical and social practice. In what follows we explain several philosophical approaches and discuss their strengths and weaknesses in this context. We also highlight some relevant empirical work in the section on (...) trust in the institutions of medicine. It is hoped that the approaches discussed here can be extended to nursing and other topics in the philosophy of medicine. (shrink)

Outbreaks of novel influenza viruses are continually occurring on many places on our planet, with the ultimate and most extreme consequence being a full-scale pandemic. Modern communication technology is widely used for risk communication regarding recommended change in behavior patterns and other precautions in order to mitigate the transmission. However, the assumption and bias that modern communication technology constitutes the norm causes vulnerable groups to be at possible risk of systematic exclusion to correct and updated information. Through conducting a literature- (...) and case analysis, the aim of this study is to identify insufficient or inadequate risk communication efforts in South Korea and Vietnam during influenza outbreaks, especially with concern of vulnerable groups. Further, to analyze how national influenza preparedness plans observe or ignore these insufficiencies. Results show that vulnerable groups are explicitly recognized in the preparedness plan of Vietnam. However, the South Korean preparedness plan show a more homogenous approach. Both South Korea and Vietnam showed a broad variety of channels used in their risk communication strategies which could be positive in terms of a broad outreach to a heterogenous population, including vulnerable groups. Four key factors that moderate the outcomes of risk communication were identified: Channels, Messages, Transparency and Trust. (shrink)

E-learning has taken it full fudged emergence with regards to Covid Scenario. Also, the lockdown of schools and playgrounds, the restriction of outdoor activities, physical and social isolation leads to the behavioural change among school children. Students are more attached to their schools, teachers and friends. But Covid 19 has changed the entire situation changed and they were held in their home itself. Students were not able to meet their friends and teachers, they especially miss their school and class environment. (...) It is to be noted that maintaining social isolation and following “Stay at Home” plays a very high impact among school students. Also, the lockdown created for families and children sit inside their homes. Which ,We cannot leave children’s education as it is. In order to continue their education, Indian Government has taken many efforts .Even schools are doing their best to bridge the gap between teachers and students by providing online education because of the absence of regular classroom education. Because of the introduction of online class by schools, on the one side students are not missing the education, on the other side students and parents faces a lot of problems (Physical and mental. It also puts them at the risk of unsupervised access to websites and other unwanted sites in internet. (shrink)

When talking about sexual abuse of children we can understand culture as one of the leading determinants of child health. As a public health problem, sexual abuse has different causes, from which we can distinguish the silence and secrecy that is kept by third parties. In every single abuse there is a person or people that are present at the moment of the abuse, or without being present know that the abuse is in progress, or even help in any way (...) the perpetrator to commit the abuse. In order to work consistently in this type of abuse of children, we need to work in adding values to a culture that contribute to freely and openly talk about sexuality and to teach how to gain transparency in communities that could help disclose sexual abuses. (shrink)

Featuring the questionable transparency of some COVID-19 data, retraction notices and clinical trial results, what COVID-19 has taught us about open access, a centralized archive of COVID-19 preprints, and how the pandemic may affect the public’s trust in science.

The public health crisis is started with emergence of new coronavirus on 11 February 2020 which triggered as coronavirus disease-2019 (COVID-19) pandemics. The causative agent in COVID-19 is made up of positively wrapped single-stranded RNA viruses ~ 30 kb in size. The epidemiology, clinical features, pathophysiology, and mode of transmission have been documented well in many studies, with additional clinical trials are running for several antiviral agents. The spreading potential of COVID-19 is faster than its two previous families, the severe (...) acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Apart from clinical manifestation, comorbid status is playing key role for prevalence of COVID-19 infection and mortalities. The comorbid effects associated with COVID-19 are diabetes, cardiovascular, digestive, hepatitis-B, cerebrovascular, hypertension, liver injury, coronary heart disease, cancer, rheumatoid arthritis, and neurological impairment. Antimalarial drugs (chloroquine and hydroxychloroquine), remdesivir, Tocilizumab, clopinavir/ritonavir, convalescent plasma therapy, spike protein-angiotensin-converting enzyme 2 (ACE2) inhibitors, human monoclonal antibodies, mRNA-1273, mesenchymal stem cells, Indian and Chinese traditional medicine, small molecules antioxidant, natural products and dietary supplements, high doses of vitamin-E, -C, -D, minerals, flavonoids,and IFN-beta are therapeutic intervention running to develop treatment against COVID-19. Although clinical usage of these therapeutic agents against COVID-19 is well documented, cytokine storms, absence of appropriate animal model have limited its therapeutic use. This review explores the clinical information currently available on COVID-19 on the mechanisms of infection, prevention, management, comorbid status, and current drug treatment options. (shrink)

Objectives The study aims to evaluate the impact of the Revised Health Insurance Law 2014 on the utilisation of outpatient and inpatient care services, healthcare services utilisation at different levels of providers, types of providers and types of visits across different entitlement groups. Design/setting Secondary data from two waves of the Vietnam Household Living Standard Survey (VHLSS) 2016, VHLSS 2014 were used. A cross-sectional study applying propensity score matching was conducted. Participants A total of 4900 individuals who reported using healthcare (...) services are analysed. Outcomes measure Numbers of outpatient and inpatient visits, frequency of healthcare service utilisation at commune health stations, district hospitals, provincial hospitals, public and private health facilities, number of visits at health facility for medical treatment and health checks per year. Results The result indicates that health insurance (HI) policy increased the number of outpatient visits for the enrolled between 0.87 and 1.29. The greatest impact was found on participants of heavily subsidised health insurance (HSHI) programmes with 1.29 visits per person per year. Similarly, an increase between 0.08 and 0.16 in the number of inpatient admissions was because of participation in HI. With regard to type of healthcare providers, the study found that participation in HI has the most effect on the use of healthcare services at district hospitals. However, the study demonstrated that the impacts of HI on the increase in the frequency of visiting commune health stations, number of visits at the provincial hospital for HSHI groups, and number of visits at health facilities for health check and consultation were sensitive to unobserved characteristics. Conclusion Our findings imply that policy-makers in Vietnam could continue expanding health insurance coverage to increase access to healthcare services for citizens, especially vulnerable groups. In addition, the government should draw more attention to primary healthcare level. (shrink)

An alliance of established experts on critical care, Front Line COVID-19 Critical Care Alliance (FLCCC), has published two protocols for treatment of COVID-19. The first one, methylprednisolone, ascorbic acid, thiamine, and heparin (MATH+), is intended for hospital and intensive care unit treatment of pulmonary phases of the disease. It is based on affordable, commonly available components: anti-inflammatory corticosteroids (methylprednisolone, "M"), high-dose vitamin C infusion (ascorbic acid, "A"), vitamin B1 (thiamine, "T"), anticoagulant heparin ("H"), antiparasitic agent ivermectin, and supplemental components ("+") (...) including melatonin, vitamin D, elemental zinc, and magnesium. -/- The MATH+ protocol has received scarce attention due to the World Health Organization (WHO) advising against the use of corticosteroids in the beginning of the pandemic. In addition, randomized controlled clinical trials were required as a condition for adoption of the protocol. As the hospital mortality rate of MATH+ treated patients was approximately a quarter of the rate of patients receiving a standard of care, the authors of the protocol considered performing such trials unethical. Other parties have later performed clinical trials with corticosteroids and anticoagulants, which has led to a more widespread adoption of these components. -/- In October 2020, ivermectin was upgraded from an optional component to an essential component of the protocol. According to the authors, ivermectin is considered the first agent effective for both prophylaxis (prevention) of COVID-19 and for treatment of all phases of COVID-19 including outpatient treatment of the early symptomatic phase. Therefore, at the end of October 2020, a separate ivermectin-based I-MASK+ protocol for prophylaxis and early outpatient treatment of COVID-19 was published. (shrink)

Large-scale Social Limitation (hereinafter referred to as PSBB) is one form of concern. The government and local governments are Pendemic throughout Indonesia and the world, namely Pandemic Corona Virus Disease (Covid-19). Bogor Regency, which is one of the buffer cities of the Republic of Indonesia, is an area that is quite vulnerable in spreading the Corona virus. Why? because many DKI Jakarta employees / laborers live in Bogor Regency, whose mobility is very high. With the birth of Regent Regulation No. (...) 16 of 2020 concerning Implementation of Large- Scale Social Restrictions in Handling COVID-19 in order to conserve the use of Covid 19. The purpose of this study is to analyze the Implementation of Large Scale Social Limitation Policies in the Government of Bogor Regency. This research method uses Qualitative Methods with Literature Study research methods. (Huberman, Miles, 1994). The technique of inviting data is by searching Scientific Journals, Online Mass Media, Legislation and Books. The technique to determine Online Media by Pusposive, while for data analysis using Nvivo 12 Plus. Test the validity of the data by testing the data source. The results of the study show that the implementation of the Large-Scale Social Limitation Policy in the Bogor District Government has not yet proceeded, starting from the clash of authority between the Central Government and the Regional Government so that it cannot make improvements, and many more are in accordance with the provisions of Covid-19 and its distribution. Social assistance to the community. (shrink)

Penelitian ini bertujuan untuk menganalisis penggunaan media sosial dikalangan mahasiswa selama pandemi Covid-19. Penelitian ini menggunakan pendekatan deskriptif. Jenis penelitian kuantitatif. Lokasi Penelitian di Universitas Mataram. Penelitian dilaksanakan pada bulan Mei 2020. Subjek dalam penelitian ini adalah mahasiswa Universitas Mataram. Pengambilan sampel dalam penelitian ini menggunakan teknik random sampling. Sampel yang terpilih sebagai responden penelitian terdiri dari mahasiswa di Program studi Pendidikan Sosiologi dan Program studi Pendidikan Guru Sekolah Dasar. Instrumen yang digunakan berupa angket. Pengumpulan data menggunakan survei. Analisis data (...) menggunakan teknik statistik deskriptif. Penelitian diawali dengan penentuan topik, pembuatan instrumen, pengumpulan data, tabulasi data, penyajian data, analisis data dan pengambilan kesimpulan. Masalah utama dalam penelitian ini antara lain: bagaimana mahasiswa menggunakan media sosial di tengah pandemi Covid-19, informasi apa saja yang paling banyak ditemukan, bagaimana mahasiswa menyikapi teror informasi dan komedi parodi, serta media sosial apa yang sering digunakan untuk mengakses informasi Covid-19. Hasil penelitian menunjukkan bahwa mahasiswa dalam menggunakan media sosial cukup bijak. Mahasiswa menggunakan media sosial untuk mengakses dan menyebarkan informasi yang benar dan bernilai edukasi. Sikap mahasiswa terhadap teror informasi adalah tidak mudah menyebarkan informasi sebelum diketahui kebenarannya serta tidak ikut-ikutan membuat konten yang berisi berita hoax. (shrink)

Background: Community-based education (CBE) involves educating the head (cognitive), heart (affective), and the hand (practical) by utilizing tools that enable us to broaden and interrogate our value systems. This article reports on the use of virtue ethics (VE) theory for understanding the principles that create, maintain and sustain a socially accountable community placement programme for undergraduate medical students. Our research questions driving this secondary analysis were; what are the goods which are internal to the successful practice of CBE in medicine, (...) and what are the virtues that are likely to promote and sustain them? -/- Methods: We conducted a secondary theoretically informed thematic analysis of the primary data based on MacIntyre’s virtue ethics theory as the conceptual framework. -/- Results: Virtue ethics is an ethical approach that emphasizes the role of character and virtue in shaping moral behavior; when individuals engage in practices (such as CBE), goods internal to those practices (such as a collaborative attitude) strengthen the practices themselves, but also augment those individuals’ virtues, and that of their community (such as empathy). We identified several goods that are internal to the practice of CBE and accompanying virtues as important for the development, implementation and sustainability of a socially accountable community placement programme. A service-oriented mind-set, a deep understanding of community needs, a transformed mind, and a collaborative approach emerged as goods internal to the practice of a socially accountable CBE. The virtues needed to sustain the identified internal goods included empathy and compassion, connectedness, accountability, engagement [sustained relationship], cooperation, perseverance, and willingness to be an agent of change. -/- Conclusion: This study found that MacIntyre’s virtue ethics theory provided a useful theoretical lens for understanding the principles that create, maintain and sustain CBE practice. (shrink)

Host-microbiome interactions (HMIs) are critical for the modulation of biological processes and are associated with several diseases, and extensive HMI studies have generated large amounts of data. We propose that the logical representation of the knowledge derived from these data and the standardized representation of experimental variables and processes can foster integration of data and reproducibility of experiments and thereby further HMI knowledge discovery. A community-based Ontology of Host-Microbiome Interactions (OHMI) was developed following the OBO Foundry principles. OHMI leverages established (...) ontologies to create logically structured representations of microbiomes, microbial taxonomy, host species, host anatomical entities, and HMIs under different conditions and associated study protocols and types of data analysis and experimental results. (shrink)

The modern concept of ideology was established by the liberal politician and philosopher Destutt de Tracy, with the objective of creating an all-embracing and general science of ideas, which followed the sensualist and empiricist trend initiated by Locke that culminated in the positivism of Comte. Natural selection and immunity are two key concepts in the history of biology that were strongly based on the Malthusian concept of struggle for existence. This concept wrongly assumed that population grew faster than the means (...) of existence. This “natural” law contained implicitly the idea that the poor and least gifted would not survive. This idea led to the progressive development of the concept of natural selection, whose definitive version was given by Darwin. Mechnikov took the concepts of struggle for existence and natural selection and conceived infectious diseases as a struggle between a host and its invader, the so-called phagocytosis theory. This theory created the necessity to possess mechanisms to discriminate between the own and the foreign, and led to the conception of the immune self. These concepts were not developed from ideas coming from perceptions or sensations, but from ideas coming from their values: individual interest, inevitable inequality, property, utility and profit. Values are ideals that constitute an ideological matrix which exerts a numinous activity and influence the development of our future actions. In consequence, science and its practice cannot avoid and ignore the values that drive them and impulse them towards certain directions. (shrink)

What process ought to guide decision making for pediatric patients? The prevailing view is that decision making should be informed and guided by the best interest of the child. A widely discussed structural model proposed by Buchanan and Brock focuses on parents as surrogate decision makers and examines best interests as guiding and/or intervention principles. Working from two recent articles by Ross on “constrained parental autonomy” in pediatric decision making (which is grounded in the Buchanan and Brock model), I discuss (...) (supportively) features of Ross’s effort visa-vis the best interest standard. I argue that any pediatric decision-making model that brackets or formally limits an engagement with the child patient assumes too much. Further, any model that under appreciates the place of parents and their autonomy, and the dynamic parent-child relationship, misses an opportunity to broaden the clinical encounter by considering questions of justice for the child (Rawls) and within a family (Ross). In this context, I focus on the child’s emerging and ongoing emotional and intellectual development and autonomy—their capabilities and identifying primary goods. (shrink)

Counselling y cuidados paliativos es el título del libro escrito por la doctora Esperanza Santos y el profesor José Carlos Bermejo. En esta obra, de fácil lectura y con consejos muy prácticos y útiles, se presentan elementos fundamentales para brindar un acompañamiento de óptima calidad en el cuidado paliativo, así como la posibilidad de hacer un autoexamen de cómo los cuidadores de los pacientes prestan sus servicios e incluso para no caer en burnout. Este libro es de gran utilidad, tanto (...) para los profesionales de la salud que trabajan en las unidades de cuidados paliativos, como para personas que dedican gran parte de su tiempo al cuidado de familiares con enfermedades terminales, o que pasan por procesos prolongados de enfermedad. Con ejemplos de conversaciones de la vida real entre cuidadores y pacientes, la lectura del libro se hace, a la vez, agradable, divertida y profundamente reflexiva. (shrink)

The “Expert System for Diagnosing Breast Cancer" is used to assist medical students to improve their education on diagnosis and counseling the process of analyzing the biopsy image of the microscope, determining the type of tumor and the treatment method for each case and identifying the disease related questions. According to the Ministry of Health in its annual report in Gaza, between 2009 and 2014 there are 7069 cases of breast cancer, and in 2014 there are 1502 cases of breast (...) cancer . We are now in the age of visual information where 65% of the populations are visual learners; the expert system is the easiest way to ensure students remember the information in the long term, using visual and textual information. The expert system has an easy-to-use interface to help students diagnose the disease and enhance their information about the disease; the system can be used on smart phones. This expert system can be divided into three main parts: The first part is specific questions for the patient, to help student to know questions type. The second part is the process of analyzing the biopsy sample image, to see if the biopsy image is intact or infected. The last part is the video shows ways to treat breast cancer in the form of animation. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

Medicine is a space to meet the weak and the defenseless. Its environment,professional object and the agents that participate directly or indirectly in the exercise of medicine have a potential generator of culture of life opposing the prevailing culture of death in today's world. In this paper we have described how the exercise of a profession, in this case of medicine, has the potential to evangelize culture. To do this, we delved into the concept of culture, its current context, the (...) generalities of the evangelization of culture, andthen to consider different angles in which medicine demonstrates its potential to evangelize culture. This potential is highlighted to sensitize young people who want to be doctors, who by being fully integrated, scientifically sound and based on ethical, moral and evangelical principles, have a significant impact on society. On the other hand, by generating a culture of solidarity, always seeking to heal escape from pain and suffering, attending mainly to the poorest and most needy. Finally, by generating spaces and initiatives to transmit ideas,reflections, knowledge and disseminating values in the exercise of the profession. -/- La medicina es un espacio para salir al encuentro del débil y el indefenso. Su entorno, objeto profesional y los agentes que participan directa o indirectamente en el ejercicio de la medicina posee un potencial generador de cultura de vida oponiéndose a la cultura de muerte imperante en el mundo de hoy. En este trabajo hemos descrito de qué manera el ejercicio de una profesión, en este caso de la medicina, tiene potencial para evangelizar la cultura. Para ello, se ahondó en el concepto de cultura, su contexto actual, las generalidades de la evangelización de la cultura, para luego al considerar diferentes ángulos en los que la medicina evidencia su potencial para evangelizar la cultura. Se destaca dicho potencial para sensibilizar a los jóvenes que quieren ser médicos, quienes, al formarse integralmente, científicamente sólidos y fundamentados en principios éticos, morales yevangélicos, ejercen un impacto significativo en la sociedad. Por otro lado, al generar una cultura de solidaridad, buscando salir siempre al encuentro del dolor y el sufrimiento,atendiendo principalmente a los más pobres y necesitados. Finalmente, al generar espacios e iniciativas para trasmitir ideas, reflexiones, conocimientos y difundiendo valores en el ejercicio de la profesión. (shrink)

Peer review process helps in evaluating and validating of research that is published in the journals. U.S. Office of Research Integrity reported that data fraudulence was found to be involved in 94% cases of misconduct from 228 identified articles between 1994–2012. If fraud in published article are significantly as high as reported, the question arise in mind, were these articles peer reviewed? Another report said that the reviewers failed to detect 16 cases of fabricated article of Jan Hendrick Schon. Superficial (...) peer reviewing process does not reveals suspicion of misconduct. Lack of knowledge of systemic review process not only demolish the academic integrity in publication but also loss the trust of the people of the institution, the nation, and the world. The aim of this review article is to aware stakeholders specially novice reviewers about the peer review system. Beginners will understand how to review an article and they can justify better action choices in dealing with reviewing an article. (shrink)

This chapter provides an outline of consent in the history of medical ethics. In doing so, it ranges over attitudes towards consent in medicine in ancient Greece, medieval Europe and the Middle East, as well as the history of Western law and medical ethics from the early modern period onwards. It considers the relationship between consent and both the disclosure of information to patients and the need to indemnify physicians, while attempting to avoid an anachronistic projection of concern with patient (...) autonomy too far back into the historical record. The chapter also includes a survey of the development of the social and intellectual infrastructure that underpins modern medical consent. It concludes with a brief discussion of possible future directions for ethical approaches to medical consent and competence that would depart from the models that arose in the twentieth-century. (shrink)

Decision-making regarding healthcare expenditure hinges heavily on an individual's health status and the certainty about the future. This study uses data on propensity of general health exam (GHE) spending to show that despite the debate on the necessity of GHE, its objective is clear—to obtain more information and certainty about one’s health so as to minimise future risks. Most studies on this topic, however, focus only on factors associated with GHE uptake and overlook the shifts in behaviours and attitudes regarding (...) different levels of cost. To fill the gap, this study analyses a dataset of 2068 subjects collected from Hanoi (Vietnam) and its vicinities using the baseline-category logit method. We evaluate the sensitivity of Vietnamese healthcare consumers against two groups of factors (demographic and socioeconomic-cognitive) regarding payment for periodic GHE, which is not covered by insurance. Our study shows that uninsured, married and employed individuals are less sensitive to cost than their counterparts because they value the information in reducing future health uncertainty. The empirical results challenge the objections to periodic health screening by highlighting its utility. The relevance of behavioural economics is further highlighted through a look at the bounded rationality of healthcare consumers and private insurance companies in using and providing the service, respectively. (shrink)