Medicine

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)

[In Czech] This article aims to explain how Merleau-Ponty’s phenomenological account of embodiment contributes to the theory and practice of physiotherapy. The mechanistic conception of the body, to which physiotherapy usually refers, assumes a universal model of its functioning and interprets its relationship to the environment causally. In fact, however, it does not allow a satisfactory explanation of the efficiency of the therapeutic methods used in practice. In contrast, Merleau-Ponty’s concept of motor intentionality points to the fact that the body (...) “understands” the practical meaning of a situation. Bodily understanding is then manifested in particular by the ability to adequately differentiate, adapt or vary motor and postural responses to environmental challenges. This change in the conception of embodiment also has important implications for understanding the therapist-patient relationship and the intervention itself. Physiotherapists should draw more on the fact that they are themselves a body and, on this basis, guide the patient’s bodily intentionality towards a more developed understanding of the practical meaning of situations. (shrink)

A large part of contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of healthcare. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we – as embodied beings – engage with health-promoting behaviours. It specifically considers how we (...) engage with oral hygiene regimes to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, as prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint. (shrink)

Existem excelentes livros de fisiologia e manejo da reprodução bovina, nos quais os processos que regulam a reprodução e as técnicas reprodutivas são revistos em pormenor e em profundidade, mas a maioria deles estão escritos em língua inglesa. Em nossa língua há muito poucos livros de reprodução de bovinos com uma abordagem prática e de acordo com as condições do rebanho leiteiro em sistemas confinados de produção intensiva. O presente livro foi concebido neste contexto, nesta obra os estudantes e clínicos (...) da reprodução encontrarão informação útil, abreviada, atualizada e de fácil compreensão, o suficiente para o seu melhorar seu desempenho profissional. Os capítulos foram ordenados de acordo com as diferentes etapas do manejo reprodutivo das vacas leiteiras: Ciclo Estral, Estro e Serviço, Gestação, Puerpério, Anestro, Fertilidade, e Reprodução em Novilhas. Em cada capítulo é revista a fisiologia suficiente para a compreensão dos processos, o manejo da vaca, os principais distúrbios reprodutivos e o seu tratamento. Desejo agradecer a todos os meus professores, não só da área animal, mas também de humanas, ambos colaboraram comigo na escritura e discussão da presente obra. Agradeço, também, aos meus colegas clínicos da reprodução em gado leiteiro, por sua generosidade por compartilhar suas experiências profissionais. Dou graças em especial para Arthur Éden, Éderson Vinícius e Emanuele Vitória (Flor), filhos do coração; e para Alana Thaís e Eduarda Carvalho por me apoiarem psicologicamente e profissionalmente em tudo aquilo que estou disposto a fazer. -/- Sumário: 1. Ciclo Estral. 2. Estro e Serviço. 3. Gestação. 4. Puerpério. 5. Anestro. 6. Fertilidade. 7. Reprodução em Novilhas Leiteiras. -/- Nesse obra, o leitor encontrará informação básica, condensada e atualizada sobre a fisiologia reprodutiva da vaca leiteira. Os processos fisiológicos são descritos de maneira sucinta, e são narrados sua relação com a prática clínica e zootécnica. Se examinam, também, os principais fatores que influenciam a eficiência reprodutiva, as diferentes opções para mitigar seus efeitos e são detalhados os programas modernos de manejo reprodutivo. Este livro é um material útil para os estudantes, médicos veterinários e zootecnistas que desejam aprofundizar seu conhecimento acerca da reprodução da vaca leiteira. (shrink)

In this critical notice, I review and critique ‘Psychiatric Casualties’ (2021) by Mark C. Russell and Charles Figley. In so doing, I analyze a natural experiment from WWII, which has previously only been misinterpreted. The natural experiment leads me to conclude that predisposition results in some individuals being far more likely than others to develop war stress disorders such as PTSD. This point puts me in disagreement with Russell and Figley, though I endorse the general message of their book: that (...) the military has failed in its responsibility to properly care for psychiatric casualties, and that there are steps which could be taken to improve the situation. (shrink)

Low back pain (LBP) carries a high risk of chronicization and disability, greatly impacting the overall demand for care and costs, and its treatment is at risk of scarce adherence. This work introduces a new scenario based on the use of a mobile health tool, the Dress-KINESIS, to support the traditional rehabilitation approach. The tool proposes targeted self-manageable exercise plans for improving pain and disability, but it also monitors their efficacy. Since LBP prevention is the key strategy, the tool also (...) collects real-patient syndromic information, shares valid educational messages and fosters self-determined motivation to exercise. Our analysis is based on a comparison of the performance of the traditional rehabilitation process for non-specific LBP patients and some different scenarios, designed by including the Dress-KINESIS’s support in the original process. The results of the simulations show that the integrated approach leads to a better capacity for taking on patients while maintaining the same physiotherapists’ effort and costs, and it decreases healthcare costs during the two years following LBP onset. These findings suggest that the healthcare system should shift the paradigm towards citizens’ participation and the digital support, with the aim of improving its efficiency and citizens’ quality of life. (shrink)

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the (...) different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)

The diabetic foot is a global threat to public health because it can result in infection and amputation, as well as cause the patient to experience considerable pain and incur financial costs. The condition of patients with diabetic foot in North China is distinguished by more severe local ulcers, a worse prognosis, and a longer duration of disease than that of patients with diabetic foot in the south. Through appropriate preventive measures, the diabetic foot can be effectively avoided. This study (...) assesses the existing knowledge, attitudes and practices associated with diabetic foot prevention among adults with diabetes living in rural areas of North China. (shrink)

Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report on the (...) difficult task of operationalizing the principles of beneficence, non-maleficence and patient autonomy, and describe how we selected suitable input parameters that we extracted from a training dataset of clinical cases. The first performance results are promising, but an algorithmic approach to ethics also comes with several weaknesses and limitations. Should one really entrust the sensitive domain of clinical ethics to machine intelligence? (shrink)

The New Collection is a peer-reviewed interdisciplinary academic journal published by the Middle Common Room of New College, University of Oxford.

Đại dịch Covid-19 đã gây ảnh hưởng tiêu cực đến thị trường lao động Việt Nam, hàng triệu lao động giảm giờ làm, giảm thu nhập, thậm chí mất việc làm. Đây là lần đầu tiên trong 10 năm qua, nền kinh tế Việt Nam bị sụt giảm nghiêm trọng về số lượng người tham gia thị trường lao động và việc làm. Thu nhập bình quân của người lao động cũng bị thâm hụt. Tỷ lệ thất nghiệp, thiếu việc (...) làm và tỷ lệ lao động làm việc phi chính thức tăng mạnh so với xu hướng giảm của những năm gần đây. Vì vậy, bài viết này nghiên cứu về những ảnh hưởng của đại dịch Covid-19 đến tình hình lao động: thực trạng và giải pháp. (shrink)

Objectives: This study aimed to fill the gap between Vietnamese diabetic patients' needs and care through a qualitative study asking about their experiences with diabetes and quality of care. -/- Methods: Interviews with five diabetic patients were conducted at a tertiary general hospital located in southern Vietnam. The transcribed data were first subjected to quantitative text analysis using KH Coder to identify major categories of frequently used words, followed by a qualitative analysis of selected cases using the Steps for Coding (...) and Theorization (SCAT) method. -/- Results: The major categories of frequently used words were chronic health conditions, services, facilities, insurance, patient-doctor communication, and medication. SCAT analysis of three selected cases identified six themes: “Disregarding the disease at the early stage,” “Fear of complications,” “Satisfaction with hospital services and medical staff,” “Insurance-related problems,” “Long waiting times,” and “Communication barriers between patients and doctors.” Patients were satisfied with improved hospital facilities and services; however, the overloading of one hospital led to long waiting times and communication difficulties with doctors. Difficulties with health insurance were also observed, and patients were rather passive in disease management and needed to be empowered through improved communication with doctors and other care providers. -/- Conclusion: These findings from our trial of introducing a qualitative study into service evaluation suggest that listening to patients can help health providers learn their perspectives and be more responsive to their needs. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Background: In prevalence studies of sexually transmitted infections (STIs), investigators often provide syndromic management for symptomatic participants, but may not provide specific treatment for asymptomatic individuals with positive laboratory test results due to the delays between sample collection and availability of results as well as logistical constraints in recontacting study participants. Methods: To characterize the extent of this issue, 80 prevalence studies from the World Health Organization’s Report on global sexually transmitted infection surveillance, 2018, were reviewed. Studies were classified as (...) to whether clinically relevant positive results were returned or if this was not specified. Results: More than half (56%) of the cited studies did not specify if participants were notified of clinically relevant positive STI test results. The percentages were similar for low- and middle-income country populations (57%) and high-income country populations (53%). Conclusions: The absence of documentation of the provision of test results raises the possibility that in some instances, results may not have been communicated, with potential negative effects for participants, their sexual partners, and newborns. From an ethical perspective, clinically relevant results should be returned to study participants and treating clinicians in a timely fashion to ensure appropriate management of identified infections. Study authors should document if they returned test results to study participants and report on numbers lost to follow-up. (shrink)

Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. -/- Methods: We searched the curriculum websites of all accredited medical schools in Canada, the UK and the US to check (...) which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta-analysis. -/- Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. -/- Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. (shrink)

Uno de los grandes retos para los estudiantes de cualquier disciplina es poder poner en práctica los conocimientos aprendidos en la teoría. La salud pública no se escapa de este desafío. Research Methods for Public Health es un libro que busca ayudar a comprender de manera sencilla cómo introducirse en la práctica de la investigación en salud pública. Este libro se destaca por su fácil lectura, pero especialmente porque pone el énfasis en la existencia de los métodos cuantitativos y cualitativos, (...) así como en la combinación de ambos métodos. Por otro lado, los autores dejan ver entrelíneas, y a veces más claramente, la importancia del trabajo en equipo en los grupos de investigación, elemento clave para evitar errores, validar procedimientos o instrumentos y aumentar la confia-bilidad de los resultados, así como la importancia de criterios de validez, confiabilidad, precisión, relevancia, transparencia y credibilidad, entre otros. (shrink)

Розглянуто питання формування системи управління соціальною відповідаль-ністю закладу охорони здоров’я. Класифіковано теоретичні підходи до визначення поняття «соціальна відповідальність». Наведено фактори, які заважають або сприяють введенню системи соціальної відповідальності у закладах охорони здоров’я на поточному етапі медичної реформи в Україні. Виокремлені складові, критерії та коефіцієнти ефективності соціальної відповідальності закладу охорони здоров’я. Запропоновано схему механізму управління соціальною відповідальністю закладу охорони здоров’я. Виділені можливі напрямки впровадження програм соціальної відповідальності та очікувані результати. -/- Authors research questions of formation of the management system of social (...) responsibility of health care institution. The theoretical approaches to definition of social responsibility are classified, it is given factors that hinder or facilitate the implementation of social responsibility in health care institutions on current stage of medical reform in Ukraine. Constituents, criteria, and effectiveness coefficients of social responsibility of health care institutions are outlined. It is offered the scheme of management system mechanism of social responsibility of health care institutions. Possible ways of application of social responsibility programs are featured and expected results after implementation. (shrink)

This study aims to describe the COVID-19 related information searching behaviors and the relationship between those behaviors and the satisfaction with the COVID-19 related information searched on the Internet among university students during first wave of the COVID-19 pandemic in Vietnam.

The book consists of articles in various fields written by graduate students. The articles were selected among many which applied to the "International Student's Work Competition". Then divided into two categories and published a two-volume "The World After the Pandemic" book series. Articles in this volume are related to "Life Sciences and Medicine", "Lifestyle and Urban Planning", "Technology" and "Education" regarding the world after the COVID-19 pandemic.

Neste trabalho, são apontadas as principais causas decorrentes das infecções da mastite bovina ocasionadas por diversos microrganismos contagiosos, pelos impactos econômicos, além dos seus efeitos para a saúde da população devido à propagação de suas toxinas por meio do leite através da resistência bacteriana. Entre os agentes que mais se destacam, está o Staphylococcus aureus, sendo um dos microrganismos contagiosos mais frequentes da mastite bovina, o qual ocasiona prejuízos econômicos no rebanho leiteiro no Brasil. Assim, verificando o tipo de sensibilidade (...) dos medicamentos antimicrobianos destacados no rebanho bovino e utilizando associações de bacitracina, tetraciclina e neomicina (NBT), além de nafcilina, penicilina e dihidroestreptomicina (PND), também foram analisadas as baixas taxas de resistência bacteriana aos grupos cefalosporinas, cefquimona, ceftiofur e cefalotina. Já os fármacos aminoglicosídeos apresentaram resistência à neomicina e gentamicina. Também se constatou elevado nível de resistência para polimixina B (82%), seguindo beta-lactâmicos penicilina (80,45%) e ampicilina (80,92%), enquanto os níveis intermediários de resistência foram para cefoperazona, lincomicina e sulfazotrim. As respostas apresentaram elevadas variação nos tipos de resistência aos medicamentos antimicrobianos, de modo que houve o acontecimento de diferentes resistências diante de algumas origens analisadas, ressaltando a importância do teste de antibiograma para a seleção dos medicamentos antimicrobianos mais propícios para a prevenção ou, até mesmo, o tratamento da mastite bovina. PALAVRAS-CHAVE: Mastite bovina. Impacto econômico. Medicamentos. Resistência bacteriana. Tratamento. Prevenção. -/- In this paper, the main causes of bovine mastitis infections caused by several contagious microorganisms, due to their economic impacts, in addition to their effects on the health of the population because of the spread of its toxins through milk of bacterial resistance are pointed out. Among the agents that are stood out, the most is Staphylococcus aureus, being one of the most frequent contagious microorganisms of bovine mastitis, which causes economic losses in the dairy herd in Brazil. Thus, aiming at the type of sensitivity of antimicrobial drugs highlighted in the cattle herd and using associations of bacitracin, tetracycline and neomycin (NBT), in addition to nafcillin, penicillin and dihydrostreptomycin (PND), the low rates of bacterial resistance to cephalosporin cefquimona, ceftiofur and cephalothin groups were also analyzed. Aminoglycoside drugs, on the other hand, were resistant to neomycin and gentamicin. There was also a high level of resistance to polymyxin B (82%), followed by beta-lactam penicillin (80.45%) and ampicillin (80.92%), while intermediate levels of resistance were to cefoperazone, lincomycin and sulfazotrim. The answers showed high variation in the types of resistance to antimicrobial drugs, so that there was the occurrence of different resistances in some of the analyzed sources, highlighting the importance of the antibiogram test for selecting the most suitable antimicrobial drugs for prevention or, even, the treatment of bovine mastitis. KEYWORDS: Bovine mastitis. Economic impact. Medicines. Bacterial resistance. Treatment. Prevention. (shrink)

O exame ultrassonográfico é uma ferramenta diagnóstica de grande relevância na rotina veterinária, uma vez que, apresenta ampla difusão entre os atendimentos de animais e permite a avaliação de órgãos e estruturas de forma não invasiva, segura e rápida, auxiliando na determinação de diversas afecções, levando ao tratamento adequado e contribuindo de forma positiva no prognóstico do paciente. Atualmente, em muitos casos, a avaliação testicular não faz parte da rotina ultrassonográfica em exames de ênfase abdominal, devido à sua localização anatômica (...) no escroto, podendo assim levar ao diagnóstico limitado e ao tratamento inadequado do paciente quando na ausência da avaliação dos testículos, posto que diversas são as afecções testiculares que podem acometer cães e que apresentam características ultrassonográficas de fácil detecção. Dentre as principais alterações observadas por meio da ultrassonografia, os casos de orquite, criptorquidismo, torção e também neoformações neoplásicas testiculares correspondem à maior casuística, sendo o método ultrassonográfico um exame com 98% a 100% de sensibilidade e acurácia para diagnóstico destas. Dessa forma, o objetivo deste artigo de revisão bibliográfica é elucidar a importância da avaliação testicular em exames ultrassonográficos de rotina, discorrendo inicialmente sobre os aspectos anatômicos e ultrassonográficos, e posteriormente acerca das afecções mais comumente diagnosticadas na rotina veterinária, apresentando ainda as alterações ultrassonográficas causadas no parênquima testicular. PALAVRAS-CHAVE: Cães. Diagnóstico. Neoplasias testiculares. Ultrassonografia. -/- THE IMPORTANCE OF INCLUDING TESTICULAR ASSESSMENT IN THE TWO-DIMENSIONAL ABDOMINAL ULTRASOUND ROUTINE IN DOGS FOR THE DIAGNOSIS OF TESTICULAR DISEASES ABSTRACT: The ultrasound examination is a diagnostic tool of great relevance in the veterinary routine, as it is widespread in the current reality and allows the assessment of organs and structures in a non-invasive, safe and fast way, helping in the diagnosis of various conditions, leading to adequate treatment and positively contributing to the patient’s prognosis. Currently, in many cases, testicular evaluation is not part of the ultrasound evaluation in exams with abdominal emphasis, due to its anatomical location in the scrotum, which can lead to limited diagnosis and inadequate treatment of the patient in the absence of ultrasound evaluation of the testicles, since there are several testicular affections that can affect dogs and that present ultrasonographic characteristics that are easily detected. Among the main alterations observed during ultrasonographic exams, cases of orchitis, cryptorchidism, torsion and also testicular neoplastic neoformations correspond to the largest sample, with the ultrasonographic method being an exam with 98% to 100% sensitivity and accuracy for their diagnosis. Thus, the aim of this literature review article is to elucidate the importance of testicular evaluation in routine ultrasound examinations, initially discussing the anatomical and ultrasound aspects, and later on the most commonly diagnosed conditions in the veterinary routine, also presenting the ultrasound changes caused in the testicular parenchyma. KEYWORDS: Dogs. Diagnosis. Testicular neoplasm. Ultrasound. -/- REFERÊNCIAS AMANN, R.P. Functional Anatomy of the Adult Male. In: MCKINNON, A. O.; SQUIRES, E.L.; WENDY, E.V.; VARNER, D.D. Equine Reproduction. 2nd edition. Oxford: Wiley-Blackwell, 2011. Cap. 95, p. 867 – 880 ARGENTA, F.F.; PEREIRA, P.R.; CAPRIOLI, R.A.; VIELMO, A.; SONNE, F.; PAVARANI, S.P.; DRIEMEIER, D. Neoplasmas testiculares em cães no Rio Grande do Sul, Brasil. Acta Scientiae Veterinariae, v.44, n.1413, p.1-6, 2016. DA SILVA, E.I.C. Anatomia e Fisiologia do Sistema Reprodutivo dos Animais Domésticos. Instituto Federal de Pernambuco. Departamento de Reprodução Animal. 2020. DAVIDSON, A. P; BAKER, T. W. Reproductive ultrasound of the dog and tom. Topics in companion animal medicine, v.24, n.2, p.64-70, 2009. DOMINGOS, T. C. S.; SALOMÃO, M. C. Meios de diagnóstico das principais afecções testiculares em cães: revisão de literatura. Revista Brasileira de Reprodução Animal, Belo Horizonte, v.35, n.4, p.393-399, out./dez. 2011. FELDMAN, E. C.; NELSON, R. W. Disorders of the Testes and Epidymides. In FELDMAN, E. C.; NELSON, R. W. (Eds.), Canine and Feline Endocrinology and Reproduction. 3 ed., St. Louis Missouri: WB Saunders Co. 2004. p. 961 – 977. FONSECA, C.V.C.V. Prevalência e tipos de alterações testiculares em canídeos. Dissertação de Mestrado Integrado em Medicina Veterinária. Universidade Técnica de Lisboa, Faculdade de Medicina Veterinária. Lisboa, 2009. HECHT, S. Trato Reprodutivo Masculino. In: PENNICK, D.; D’ANJOU, M.A. Atlas de Ultrassonografia de pequenos animais. Rio de Janeiro: Guanabara Koogan, 2011. p.415-438. (shrink)

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir (...) and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions. (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 well-being. 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 well-being 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 well-being, without being identical to well-being. (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?

One of the Belmont Report’s most important contributions was the clear and serviceable distinction it drew between standard medical practice and biomedical research. A less well-known achievement of the Report was its conceptualization of innovative practice, a type of medical practice that is often mistaken for research because it is new, untested, or experimental. Although the discussion of innovative practice in Belmont is brief and somewhat cryptic, this does not reflect the significant progress its authors made in understanding innovative practice (...) and the distinctive ethical issues it raises. This article explores the history and broader context of Belmont’s conception of innovative practice, its strengths and weaknesses, and its contemporary relevance for scholars working in bioethics and health policy. While this conception of innovative practice deserves our attention, it is inherently limited in some important ways. (shrink)

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)

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)

An Islamic approach from its theological sources to address the spiritual pain related to palliative care of terminally ill patients can be established on attaining a spiritual stage of soul or spirit termed as reassured soul. The attainment of such stage is based on hope of the patient to receive mercy and forgiveness of God. And the way of attainment of hope is possible by doing the repentance, praying, and patience. In combating the pain and suffering, the patient is supposed (...) to understand that the life in its reality is a test and facing such a test is possible by two ways, one is patient centric by building patience within to endure the suffering and second is seeking help from God by praying. For the spiritual wellbeing, the patient should understand that his suffering is in fact expiation for his sins. On the other hand, the visitors and caregivers of patients have certain responsibilities that contribute to enhancing of the spiritual well-being of the patient, including comforting them by giving hope to the patients and at the same time praying for their recovery. These all elements enhance the spiritual well-being of patients and help in prevention of suffering by spiritual means. (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.

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)