Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such (...) factors on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

Physicians, so it will be argued have by virtue of their profession a weightier obligation than patients to disclose their HIV infection, and also have a duty to refrain from performing exposure-prone invasive procedures. This argument supports both the AMA and CDC guidelines on HIV infected health care workers (HCWS), while undermining the recommendations against disclosure suggested by the National Commission on AIDS (NCA). The argument is divided into three parts. First, a distinction is made between entrenched and (...) fuzzy roles. Second, the physician-patient relationship is described as essentially fiduciary rather than businesslike or merely contractual. Third, the conflict between patients' and physicians' right to know is portrayed as one between patients' and physicians' right to life. Last, given the the probability of infection from seropositive patients to seronegative physicians, and, conversely, is roughly the same, it is recommended as a fair social policy that whenever an invasive procedure occurs, both physicians and patients have a duty to disclose any serious infection that may jeopardize their lives. (shrink)

Some early phase clinical studies of candidate HIV cure and remission interventions appear to have adverse medical risk–benefit ratios for participants. Why, then, do people participate? And is it ethically permissible to allow them to participate? Recent work in decision theory sheds light on both of these questions, by casting doubt on the idea that rational individuals prefer choices that maximise expected utility, and therefore by casting doubt on the idea that researchers have an ethical obligation not to enrol participants (...) in studies with high risk–benefit ratios. This work supports the view that researchers should instead defer to the considered preferences of the participants themselves. This essay briefly explains this recent work, and then explores its application to these two questions in more detail. (shrink)

Examines Cassie Trentaz's book on Ethics and AIDS/HIV in Africa.

This study analyzed the monitoring and evaluation of HIV/AIDS prevention programs in Southern Senatorial District of Cross River State, Nigeria. The study considered different levels of care/support and tested for locational variations in the monitoring/evaluation of HIV/AIDs prevention programs. A descriptive survey research design was utilized. This study covered 596 public health employees (doctors, nurses, pharmacists, and laboratory employees) in the study area. A sample of 239 respondents was chosen using the proportional stratified random sampling procedure. Data was (...) collected using a questionnaire constructed by the researchers and validated by specialists. Data gathered were analyzed using descriptive and inferential statistics. Results indicated that HIV/AIDs programs have been successfully monitored/evaluated to a high extent. High rates of success in the monitoring/evaluation of HIV/AIDs prevention programs are attributable to high rates of care/support provided to people living with HIV/AIDs. There was a significant variation in the monitoring/evaluation of HIV/AIDs prevention programs based on the location of health facilities, with higher rates recorded for urban areas. Based on the findings, it was concluded that the monitoring/evaluation of HIV/AIDs prevention programs in the Southern Senatorial District of Cross River State had recorded a significant level of success. The study recommended, among others, that there should be even distribution of medical facilities, resources and personnel to both urban and rural areas to promote equity and access to materials needed to contain or mitigate the spread of the pandemic across all locations. (shrink)

Introduction: Research has documented the prevalence of different HIV/AIDS prevention programs launched to reduce the spread of the virus. However, the extent to which the success or otherwise of these programs are achieved is rarely discussed. This study addresses this gap by analyzing the impact of three socioeconomic parameters on the evaluation of HIV/AIDS prevention programs in the Southern Senatorial District of Cross River State, Nigeria. Methods: A sample of 239 health care employees selected using the proportional stratified (...) random sampling technique participated in the study. A priori power analysis (using G*power) indicated that the sample size was large enough to achieve a 96.7% statistical power. Data was collected using a structured questionnaire. Exploratory factor analysis assessed the dimensionality of the instrument. Acceptable construct and discriminant validity and composite reliability coefficients were obtained. At the .05 alpha level, the null hypotheses were tested using a one-way analysis of variance. Findings: Findings indicated that the evaluation of HIV/AIDS prevention programs significantly varied with the level of funding provided (F[2, 236]=81.11, p<.001), human capacity available (F[2, 236]=40.91, p<.001), and stigmatization to people living with AIDS (F[2, 236]=40.79, p<.001). Health facilities with higher funding and human capacity successfully evaluated HIV/AIDS prevention programs. However, the evaluation of HIV/AIDS prevention programs was lower in areas with a high level of stigmatization. Conclusion and implication: This study’s findings provided evidence that funding, human capacity, and stigmatization affect how HIV/AIDS pandemic can be effectively evaluated. This study implies that additional responsibility is required for public health workers to promote quality service delivery across different health facilities. Keywords:. (shrink)

HIV and AIDS is still menace bedeviling society particularly in 3rd world countries such as Zimbabwe. The impacts of HIV/AIDS are gravely felt within workplaces as affected employees suffer from stigma and prejudice. Organizations also suffer as the pandemic leads to high absenteeism and a high rate of employee turnover. This writing therefore addresses the impact of HIV/AIDS in organizations and communities and how the Zimbabwean Government, NGOS, Trade Unions and Companies have been battling this pandemic and (...) the achievements made to date. (shrink)

In this paper I present objections to the Fading Qualia and Dancing Qualia thought experiments, which David Chalmers uses to argue that functional organization fully determines conscious experience.

Philosophers have been contemplating the nature of the mind for centuries and have produced mountains of intricate jargon, thought experiments, and views, that map a landscape of interminable disputes. One such dispute is between philosophers who believe that the mind can be explained as a mechanism and philosophers who insist it cannot. In this paper I take a look at this dispute and argue that it is unique in philosophy and a key to the nature of the mind.

Ong, Caroline There was once a strong belief amongst global HIV/AIDS organisations that the key to the prevention of the sexual transmission of HIV was condom use. Other measures such as abstinence and being loyal to one partner were seen as beneficial, but secondary. Thirty years later, the evidence is mounting that behavioural change is much more effective in halting the spread of HIV than condoms.

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)

ABSTRACT Many recent articles argue that participants who seroconvert during HIV prevention trials deserve treatment when they develop AIDS, and there is a general consensus that the participants in HIV/aids treatment trials should have continuing post‐trial access. As a result, the primary concern of many ethicists and activists has shifted from justifying an obligation to treat trial participants, to working out mechanisms through which treatment could be provided. In this paper I argue that this shift frequently conceals an (...) important assumption: that if there is an obligation to supply treatment, then any party who could provide it may be prevailed upon to discharge the obligation. This assumption is false. The reasons why trial participants should get ART affect who has the duty to provide it. We should not burden governments with the obligations of sponsors, nor researchers with the obligations of the international community. And we should not deprive a group of treatment because their need is less salient than that of research participants. Insisting otherwise may lead to people being wrongfully deprived of access to antiretrovirals. (shrink)

Routine testing is a practice whereby medical professionals ask all patients whether they would like an HIV test, regardless of whether there is anything unique to a given patient that suggests the presence of HIV. In three respects I aim to offer a fresh perspective on the debate about whether a developing country with a high rate of HIV infection morally ought to adopt routine testing. First, I present a neat framework that organises the moral issues at stake, bringing (...) out the basic principles involved and exhibiting their logical relationships. Second, appealing to the Kantian principle of respect for the dignity of persons, I offer a thorough justification for routine testing when it serves as a gateway to anti-retroviral treatment (ART). Third, I present a respect-based defence of the controversial and novel thesis that routine testing is morally justified even if ART is unaffordable or otherwise unavailable. (shrink)

Placebo-trials on HIV-infected pregnant women in developing countries like Thailand and Uganda have provoked recent controversy. Such experiments aim to find a treatment that will cut the rate of vertical transmission more efficiently than existing treatments like zidovudine. This scenario is first stated as generally as possible, before three ethical principles found in the Belmont Report, itself a sharpening of the Helsinki Declaration, are stated. These three principles are the Principle of Utility, the Principle of Autonomy and the Principle of (...) Justice. These are taken as voices of moral imperative. But although each has intuitive appeal, it can be shown that there are possible scenarios in which they give conflicting prescriptions. To achieve consistency, one must be subordinate to the others. The voice of utility is taken as subordinate to those of justice and autonomy and it is shown that given plausible assumptions about the level of poverty and education in the developing country targeted, the experiment is ruled morally wrong in the name of both justice and autonomy. Moreover, it is argued that no justification can be found for the inclusion of a placebo group, when strictly defined. By contrast, a ‘no- treatment’ control arm might be justified, but only when the demands of autonomy are satisfied, demands that are more stringent than they might appear. A utilitarian defence of the experiment is examined, namely that the would-be participants are in a no-loss situation, and it is shown that this defence is seriously flawed. Finally, it is concluded that there is no justification for amending the Declaration of Helsinki. (shrink)

Die Einführung der HIV-Prophylaxe PrEP ist ein Beispiel für demokratische Biopolitik und macht Hoffnung auf eine Beendigung von Sexnegativität und Stigmatisierung, findet Dr. Karsten Schubert.

Background: The most common hematological abnormality among people infected with Human Immunodeficiency Virus (HIV) is anemia. This is also related to high mortality risk among patients receiving Antiretroviral Therapy (ART). Purpose: This study aimed to identify predictors of anemia among HIV patients taking ART using a regimen of the single-tablet drug contain tenofovir, lamivudine, and efavirenz in Jayapura, Papua. Methods: This was a cross-sectional study conducted at Jayapura regional hospital from June to September 2017. A total of 80 HIV patients (...) were eligible for analysis. Data collection was conducted through an interview, medical record, measurement, and laboratory assay. The significance of differences among categorical variables was analyzed using Fisher’s exact test. The variables with p < 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p < 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) <18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 < OR < 22.19), length on ART ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 < OR < 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 < OR <0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy containing tenofovir, lamivudine, and efavirenz regimen in Jayapura. (shrink)

Malaria is a life-threatening disease spread to humans by some types of mosquitoes. It is mostly found in tropical countries. It is preventable and curable. The infection is caused by a parasite and does not spread from person to person. Symptoms can be mild or life-threatening. Mild symptoms are fever, chills and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing. Infants, children under 5 years, pregnant women, travelers and people with HIV or AIDS are at higher (...) risk of severe infection. Discovering this disease is a good step for proper and correct treatment. Determining the treatment with high accuracy depends on the method used in the diagnosis. Correctly, expert systems can greatly help to avoid spreading this disease. The expert system diagnoses malaria disease correctly to facilitate doctors to find the correct treatment based on the appropriate diagnosis. Objectives: An expert system has been established based on CLIPS to diagnose malaria disease. (shrink)

Explanations of former South African President Thabo Mbeki’s public and private views on the aetiology of the HIV/AIDS epidemic in the country remain partial at best without the recognition that the latter presuppose and imply a postmodernist/postcolonialist philosophy of science that erases the line separating the political from the scientific. Evidence from Mbeki’s public speeches, interviews, and private and anonymous writings suggests that it was postmodernist/postcolonialist theory that inspired him to doubt the “Western” scientific consensus on HIV/AIDS and (...) to implement a public health policy that dragged its feet on full roll-out of antiretroviral therapy, causing thousands of avoidable deaths. A weak reductio ad absurdum allows us to conclude from this premise that postmodernist/postcolonial critique of “Western” science ought to be shunned. A comparative argument from consequences further suggests that in a situation where a misguided health policy has lead to a humanitarian catastrophe, and where postmodernist/postcolonialist critique of science can and has been used to justify this policy, an alternative theory ought to be preferred on which such justification would not be possible. The paper closes with a call for a non-relativist alternative to postmodernist/postcolonialist philosophy of science, and evaluates the potential of recent developments in ‘Studies of Expertise” to yield such. (shrink)

The scientific community, we hold, often provides society with knowledge—that the HIV virus causes AIDS, that anthropogenic climate change is underway, that the MMR vaccine is safe. Some deny that we have this knowledge, however, and work to undermine it in others. It has been common to refer to such agents as “denialists”. At first glance, then, denialism appears to be a form of skepticism. But while we know that various denialist strategies for suppressing belief are generally effective, little (...) is known about which strategies are most effective. We see this as an important first step toward their remediation. This paper leverages the approximate comparison to various forms of philosophical skepticism to design an experimental test of the efficacy of four broad strategies of denial at suppressing belief in specific scientific claims. Our results suggest that assertive strategies are more effective at suppressing belief than questioning strategies. (shrink)

Abstract The values of the healthcare sector are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. But their ability to honor these values is significantly determined by the nature of the system they work in. -/- The paper starts with a model of the prevailing pharmacist workforce model in Scotland, in which core roles are predominantly separated into hierarchically disaggregated jobs focused on (...) one professional ‘pillar’: Clinician /Practice Provider; Educator; Leader/Manager; and Researcher. This is the ‘Atomistic’ Model. This skills-segregation yields a workforce of individuals working in isolation rather than collaborating together, and lacking a shared information flow, purpose and identity. Key strategic flaws include suboptimal responsiveness to population and subpopulation needs, inconsistency and inequity of care, an erosion of professional agency, and lower job satisfaction. It is conjectured that this results from a lack of congruence between values, professional ethos, and organizational structure. ‘Atomism’ culminates in a syndrome of widespread professional-level cognitive dissonance. -/- The paper contrasts this with a new emerging workforce vision, The Collaborative Care Model. This new model defines a systems-first-approach, built on the principle that all jobs must include all four professional ‘pillars’. Vertical skills integration, involving education and task sharing, will support sustainability and succession planning. Horizontal skills integration (across practice, leadership and research) is included to improve responsiveness to population need and individual professional agency. The working conditions, supportive ethos, and career structure needed to make the model work are described. Moral theory and workforce theory are used to justify why the model may be more effective for population health, delivering greater job satisfaction for individuals and ultimately helping systematically realize and honor healthcare values. Finally, the paper sketches the first steps needed to implement the model at the national level, starting with the operationalization of new multi-pillar professional curricula across the career spectrum. Potential pitfalls and challenges are also discussed. -/- Co-Authors: 1. Paul Forsyth (PF) Lead Pharmacist Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Writing - original draft (lead author), Writing - review & editing (lead author) 2. Andrew Radley (AR), Consultant in Public Health Pharmacy, NHS Tayside. Contribution: Conceptualization; Model curation; Model Theory; Writing - review & editing 3. Gordon Rushworth (GR), MPharm MSc FFRPS FRPharmS (Consultant). Programme Director, Highland Pharmacy Education & Research Centre, NHS Highland, Inverness. Contribution: Model curation; Writing - review & editing 4. Fiona Marra (FM) National Lead Clinician Scottish Infection and Immunology Network (SPAIIN) / Advanced Pharmacist HCV / HIV, NHS Greater Glasgow & Clyde. Contribution: Model curation; Writing - review & editing 5. Susan Roberts (SR) Associate Postgraduate Pharmacy Dean, NHS Education for Scotland. Contribution: Model curation; Writing - review & editing 6. Roisin O’Hare (RO) Lead Teacher Practitioner Pharmacist, Northern Ireland University Network, Southern Health and Social Care Trust. Contribution: Model curation; Writing - review & editing 7. Catherine Duggan (CD) Chief Executive Officer, International Pharmaceutical Federation (FIP). Contribution: Model curation; Writing - review & editing 8. Barry Maguire (BM) Senior Lecturer, School of Philosophy, Psychology and Life Sciences, The University of Edinburgh. Contribution: Conceptualization; Model Curation; Model Theory; Model Visualization; Supervision; Writing - original draft (senior academic supervisor), Writing - review & editing (senior academic supervisor) -/- . (shrink)

The process of medicalization has been analyzed in the medical humanities with disapprobation, with much emphasis placed on its ability to reinforce existing social power structures to ill effect. While true, this is an incomplete picture of medicalization. I argue that medicalization can both reinforce and disrupt existing social hierarchies within the clinic and outside of it, to ill or good effect. We must attend to how this takes place locally and globally lest we misunderstand how medicalization mediates power and (...) justice. I provide concrete examples of how this occurs by considering dysesthesia ethiopsis, autism, chronic fatigue syndrome, depression, and HIV/AIDS. (shrink)

Gay men have been severely affected by the AIDS crisis, and gay subjectivity, sexual ethics, and politics continue to be deeply influenced by HIV to this day. PrEP (Pre-Exposure Prophylaxis) is a new, drug-based HIV prevention technique, that allows disentangling gay sex from its widespread, 40 yearlong association with illness and death. This article explores PrEP's fundamental impact on gay subjectivity, sexual ethics, and politics. It traces the genealogy of gay politics regarding homophobia and HIV stigma, suggesting a new (...) biopolitical and body political framework that accounts for the agency of activists as well as pharmapower, and proposing that PrEP is an example of democratic biopolitics. Highlighting the entanglement of medical technology, sexual ethics, and politics, the article shows how conservative and homonormative gay politics developed as a reaction to HIV stigma and how, by overcoming this stigma, PrEP enables a new era of intersectional queer politics and solidarities. It thereby develops a Foucauldian account of sexual liberation beyond the repression hypothesis that accounts for the ambivalence of sexual subjectification and the political potential of sexuality. (shrink)

The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as an (...) individuals right to health, superceding such secondary rights as intellectual property rights. From a policy perspective, patent protection for pharmaceutical products necessarily entails the balancing of corporate intellectual property interests and public interests in healthcare. The moral dilemma that occurs when these two interests clash is not easily resolved. Aside from corporate and public interests, the state maintains an interest in creating and preserving policies that regulate the moral dilemma itself. This paper analyzes the economic and ethical factors surrounding the production and distribution of the anti-HIV medication, AZT. Potential policy implications and recommendations are also discussed. (shrink)

We have two goals in this paper: first, to provide a diagnosis of global health and underline some of its blockages; second, to offer an alternative interpretation of what the demands for those in global health may be. The assumption that health is a good that requires no further explanation, and that per se it can serve as an actual modus operandi, lays the foundations of the problem. Related blockages ensue and are described using HIV prevention with a focus on (...) vaginal microbicides as a case study. Taking health as a self-evident, and self-explanatory “good” limits other possible goods; and prevents inquiry into the actual practices of creating good. We propose that to create conditions under which global health could be reconstructed, problematization be taken up as a practice, around a series of questions asked in conjunction with those ever-urgent ones of how to ameliorate the condition of living beings. (shrink)

How ought we socially to categorize individuals with respect to sexual orientation? In this paper, I engage with philosophical work on the foundations of political solidarity as well as public health research on the treatment and prevention of HIV/AIDS in order to develop a categorization scheme conducive to the normatively important aims of LGBTQIA+ social movements.

Garrett Cullity contends that fairness is appropriate impartiality (See Cullity (2004) Chapters 8 and 10 and Cullity (2008)). Cullity deploys his account of fairness as a means of limiting the extreme moral demand to make sacrifices in order to aid others that was posed by Peter Singer in his seminal article ‘Famine, Affluence and Morality’. My paper is founded upon the combination of (1) the observation that the idea that fairness consists in appropriate impartiality is very vague and (2) the (...) fact that psychological studies show the self-serving bias is especially likely to infect one’s judgements when the ideas involved are vague. I argue that Cullity’s solution to extreme moral demandingness is threatened by these findings. I then comment on whether some other theories of fairness are vulnerable to the same objection. (shrink)

The term pseudoscience refers to a highly heterogeneous set of practices, beliefs, and claims sharing the property of appearing to be scientific when in fact they contradict either scientific findings or the methods by which science proceeds. Classic examples of pseudoscience include astrology, parapsychology, and ufology; more recent entries are the denial of a causal link between the HIV virus and AIDS or the claim that vaccines cause autism. To distinguish between science and pseudoscience is part of what the (...) philosopher Karl Popper referred to as the demarcation problem, a project that has been dismissed by another philosopher, Larry Laudan, but that keeps gathering much interest in philosophers, scientists, educators, and policymakers. This entry provides the basics of the debate about demarcation, as well as a brief discussion of why it is of vital importance not just intellectually but for society at large. (shrink)

The study investigated ethical considerations and science diplomacy on coronavirus disease (Covid-19) pandemic in Nigeria. The outbreak of the coronavirus disease (Covid-19) in Nigeria has spread quickly to about 34 states out of the 36 states and over 5000 persons have tested positive as at the time of this research after the first index case of an Italian and there is a projection that in coming days and weeks the number of infected persons and states will increase. The study was (...) guided by two objectives and also adopted the normative ethical theory. The study employed the methods of exposition and critical analysis to explain better the ethical issues and science diplomacy of Covid-19 pandemic in Nigeria. Data was sourced from secondary sources such as journal articles, newspaper, books and internet sources. The findings of the study showed that the citizens have some obligations that will aid the containment of the virus and as well as the government. The study also found out that science diplomacy was used, which has led to Nigeria collaborating with China to get medical aids to effectively fight the pandemic. Consequently, the study recommended amongst others that the Ministry of Health and the Nigeria Center for Disease Control (NCDC) should adopt and enforce the World Health Organization (WHO) Guidance for Managing Ethical Issues in Infectious Disease Outbreak as a working document in crisis like the Covid-19 pandemic that has ravaged Nigeria and the government should involve more in science diplomacy with other countries so that it will help in the fight against Covid-19 and other diseases that may occur in the future. (shrink)

Life expectancy prediction, a pivotal facet of public health and policy formulation, has witnessed remarkable advancements owing to the integration of neural network models and comprehensive datasets. In this research, we present an innovative approach to forecasting life expectancy in diverse countries. Leveraging a neural network architecture, our model was trained on a dataset comprising 22 distinct features, acquired from Kaggle, and encompassing key health indicators, socioeconomic metrics, and cultural attributes. The model demonstrated exceptional predictive accuracy, attaining an impressive 99.27% (...) and an average error of 0.0034, underscoring the potency of deep learning in tackling complex, real-world challenges. Furthermore, our study delved into feature importance analysis, identifying critical determinants such as HIV/AIDS prevalence, income composition of resources, and socioeconomic status that significantly influence life expectancy. These findings provide actionable insights for healthcare policymakers and practitioners, emphasizing the importance of addressing health disparities, promoting economic development, and implementing targeted interventions. This research bridges the gap between data-driven methodologies and global health, offering a robust predictive tool and enriching our understanding of the multifaceted dynamics that shape life expectancy across nations. (shrink)

Presently, there is a lack of psychological and quantitative studies in Singapore about discriminatory attitudes. This paper aimed to contribute to this aspect. However, to examine actual behavior can be difficult due to the sensitive nature of the needed data. Hence, this study approached discrimination at an attitudinal level. Six vulnerable groups were examined in this study. They consisted of people of a different race, immigrants or foreign workers, homosexuals, people living with HIV/AIDS, people of a different religion, and (...) unmarried couples living together. Two research questions were posed: 1) What is the prevalence of having discriminatory attitude toward vulnerable groups? and 2) What are the predictors of these discriminatory attitudes? Using a sample population of 1,972 Singaporeans, descriptive analysis and binomial logistic regression analysis were conducted. Firstly, based on the results, the prevalence ranged between 10.76% to 42.46%. Singaporeans have discriminatory attitude toward vulnerable groups who can be categorized into two: the least discriminated (three groups ranging between 10.76% to 15.48%) and the highly discriminated (three groups ranging between 30.86% to 42.46%). Secondly, binomial logistic regression showed support for several significant predictors such as emphasis on the importance of religion and tradition, and employment status, depending on the model assessed. However, one pattern was observed in all the models, that a person who discriminates one group is more likely to discriminate another group. The findings were then discussed and explained within the context of Singapore. (shrink)

In this paper we make a simple theoretical point using a practical issue as an example. The simple theoretical point is that robustness is not 'all or nothing': in asking whether a system is robust one has to ask 'robust with respect to what property?' and 'robust over what set of changes in the system?' The practical issue used to illustrate the point is an examination of degrees of linkage between sub-networks and a pointed contrast in robustness and fragility between (...) the dynamics of (1) contact infection and (2) information transfer or belief change. Time to infection across linked sub-networks, it turns out, is fairly robust with regard to the degree of linkage between them. Time to infection is fragile and sensitive, however, with regard to the type of sub-network involved: total, ring, small world, random, or scale-free. Aspects of robustness and fragility are reversed where it is belief updating with reinforcement rather than infection that is at issue. In information dynamics, the pattern of time to consensus is robust across changes in network type but remarkably fragile with respect to degree of linkage between sub-networks. These results have important implications for public health interventions in realistic social networks, particularly with an eye to ethnic and socio-economic sub-communities, and in social networks with sub-communities changing in structure or linkage. (shrink)

Background Previous analyses of democracy and population health have focused on broad measures, such as life expectancy at birth and child and infant mortality, and have shown some contradictory results. We used a panel of data spanning 170 countries to assess the association between democracy and cause-specific mortality and explore the pathways connecting democratic rule to health gains. -/- Methods We extracted cause-specific mortality and HIV-free life expectancy estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (...) and information on regime type from the Varieties of Democracy project. These data cover 170 countries and 46 years. From the Financing Global Health database, we extracted gross domestic product (GDP) per capita, also covering 46 years, and Development Assistance for Health estimates starting from 1990 and domestic health spending estimates starting from 1995. We used a diverse set of empirical methods—synthetic control, within-country variance decomposition, structural equation models, and fixed-effects regression—which together provide a robust analysis of the association between democratisation and population health. -/- Findings HIV-free life expectancy at age 15 years improved significantly during the study period (1970–2015) in countries after they transitioned to democracy, on average by 3% after 10 years. Democratic experience explains 22·27% of the variance in mortality within a country from cardiovascular diseases, 16·53% for tuberculosis, and 17·78% for transport injuries, and a smaller percentage for other diseases included in the study. For cardiovascular diseases, transport injuries, cancers, cirrhosis, and other non-communicable diseases, democratic experience explains more of the variation in mortality than GDP. Over the past 20 years, the average country's increase in democratic experience had direct and indirect effects on reducing mortality from cardiovascular disease (−9·64%, 95% CI −6·38 to −12·90), other non-communicable diseases (−9·14%, −4·26 to −14·02), and tuberculosis (−8·93%, −2·08 to −15·77). Increases in a country's democratic experience were not correlated with GDP per capita between 1995 and 2015 (ρ=–0·1036; p=0·1826), but were correlated with declines in mortality from cardiovascular disease (ρ=–0·3873; p<0·0001) and increases in government health spending (ρ=0·4002; p<0·0001). Removal of free and fair elections from the democratic experience variable resulted in loss of association with age-standardised mortality from non-communicable diseases and injuries. -/- Interpretation When enforced by free and fair elections, democracies are more likely than autocracies to lead to health gains for causes of mortality (eg, cardiovascular diseases and transport injuries) that have not been heavily targeted by foreign aid and require health-care delivery infrastructure. International health agencies and donors might increasingly need to consider the implications of regime type in their efforts to maximise health gains, particularly in the context of ageing populations and the growing burden of non-communicable diseases. (shrink)

Le politologue, philosophe et sociologue Karsten Schubert examine le lien entre sexualité et politique gay et se demande quel type de politique a été favorisé ou au contraire entravé suivant la situation liée à la pandémie de VIH. Il présente deux thèses à cet égard.

In order to at least begin addressing the extensive the problem of moral clarity in aiding the deprived to some degree, I first argue that the duty to aid the deprived is not merely a charitable one, dependent on the discretion, or the arbitrary will, of the giver (1). Then, before further analysing the individual duty to aid, I critically examine whether deprivation is better alleviated or remedied through the duties of corrective justice. I argue that the perspective of corrective (...) justice is important, but not sufficient when it comes to dealing with deprivation (2). I then argue that non-domination cannot serve as a first-order principle of justice. It is too minimalistic, since it would not require duties of justice where deprivation exists, but dominating relations and institutions do not. (3). Going back to the individual duty to help, I argue that the duties to aid the needy must be assessed according to the situation at hand (4). In order to avoid meaninglessness and morality’s excessive demands, one should be able to identify the responsible agents by constructing a shared and, in the last resort, institution-based duty to help (5). The institutional approach in this paper argues that we should create and reform institutions in order to realize the pre-existing requirement to alleviate global deprivation. This is a form of “global political justice” that does not start with politics, but ends with global political institutions. (shrink)

In the article, ‘Being Good in a World of Need: Some Empirical Worries and an Uncomfortable Philosophical Possibility,’ Larry Temkin presents some concerns about the possible impact of international aid on the poorest people in the world, suggesting that the nature of the duties of beneficence of the global rich to the global poor are much more murky than some people have made out. -/- In this article, I’ll respond to Temkin from the perspective of effective altruism—one of the targets (...) he attacks. I’ll argue that Temkin’s critique has little empirical justification, given the conclusions he wants to reach, and is therefore impotent. (shrink)

This paper is in two parts. Part I outlines three traditional approaches to the teaching of critical thinking: the normative, cognitive psychology, and educational approaches. Each of these approaches is discussed in relation to the influences of various methods of critical thinking instruction. The paper contrasts these approaches with what I call the “visualisation” approach. This approach is explained with reference to computer-aided argument mapping (CAAM) which uses dedicated computer software to represent inferences between premise and conclusions. The paper presents (...) a detailed account of the CAAM methodology, and theoretical justification for its use, illustrating this with the argument mapping software Rationale™. A number of Rationale™ design conventions and logical principles are outlined including the principle of abstraction, the MECE principle, and the “Holding Hands” and “Rabbit Rule” heuristics. Part II of this paper outlines the growing empirical evidence for the effectiveness of CAAM as a method of teaching critical thinking. (shrink)

While it is largely agreed upon that solidarity is a kind of unity among persons, this agreement is short-lived – for if solidarity involves unity, what kind of unity is this? That is, does solidarity coalesce around shared identity or simply fellow-feeling? Shared action or fate? Or is solidarity merely a matter of commitment to a particular cause to achieve certain ends? Below, I look to examples of Mutual Aid to reject a piece-meal model of solidarity (where solidarity is this (...) but not that) in favor of a more pluralistic account. The notion of solidarity need not be constrained, all or nothing, by a specific strain of interpretation. Instead, we should recognize that solidarity is a matter of variety and degree. (shrink)

Over the last few decades, psychologists have amassed a great deal of evidence that our thinking is strongly influenced by a number of biases. This research appears to have important implications for moral methodology. It seems likely that these biases affect our thinking about moral issues, and a fuller awareness of them might help us to find ways to counteract their influence, and so to improve our moral thinking. And yet there is little or no reference to such biases in (...) the philosophical literature on many pressing, substantive moral questions. In this paper, I make a start on repairing this omission in relation to one such question, the 'Aid Question', which concerns how much, if anything, we are morally required to give to aid agencies. I begin by sketching a number of biases that seem particularly likely to affect our thinking about that question. I then go on to review the psychological research on 'debiasing' - that is, on attempts to counteract the influence of such biases. And finally I discuss and illustrate certain strategies for counteracting the influence of the biases in question on our thinking about the Aid Question. (shrink)

Introduction The major burden of the COVID-19 pandemic has been mainly on healthcare workers (HCWs) and as a result many of them have been afflicted with the disease thus far. -/- Purpose The present study was an effort to investigate Tehran University of Medical Sciences HCWs' experiences of COVID-19 during the pandemic in Tehran, Iran. -/- Methods This study is essentially a conventional qualitative content analysis. Twenty-six HCWs (including 7 physicians, 16 nurses, and 3 physiotherapists) were purposefully selected to participate (...) in the study. The data were collected from April 2020 to January 2021 through semi-structured face-to-face interviews. The interviews were transcribed and then analyzed based on the Graneheim and Lundman method using MAXQDA 12. -/- Results Based on the qualitative content analysis which resulted in 364 initial codes, three themes and eight subthemes were extracted. The extracted themes were “support,” “control,” and “improvement.” -/- Conclusions HCWs are in close contact with COVID-19 patients as part of their professional careers and the provision of quality patient care in times of crises is unattainable unless HCWs enjoy support and their own health is maintained. Making institutional, national, and international preparations for their protection is an obligation. (shrink)

Part I of this paper outlined the three standard approaches to the teaching of critical thinking: the normative (or philosophical), cognitive psychology, and educational taxonomy approaches. The paper contrasted these with the visualisation approach; in particular, computer-aided argument mapping (CAAM), and presented a detailed account of the CAAM methodology and a theoretical justification for its use. This part develops further support for CAAM. A case is made that CAAM improves critical thinking because it minimises the cognitive burden of prose and (...) the demands that arguments in prose typically place on memory. CAAM also has greater usability, complements the imperfect human cognitive system, and adopts a logic of semi-formality which is both natural and intuitive. The paper claims that CAAM is an important advance given that traditional stand-alone critical thinking courses do not teach critical thinking as well as they as they are assumed to do. It is also important given that tertiary education fails to deliver improvements in critical thinking gains for too many students. The paper outlines results from a number of empirical studies that demonstrate that CAAM yields robust gains in critical thinking as measured by independent tests. Students themselves also believe CAAM to be beneficial as noted in coded responses to surveys. I conclude the paper by comparing the traditional approaches to the teaching of critical thinking to the visualisation approach. I argue that CAAM should taken seriously in the context of contemporary educational practices. (shrink)

Philosophy is the study of the most general and fundamental problems of human life. The main areas of study in philosophy includes metaphysics, epistemology, logic, ethics and aesthetics etc. there are other several branches of philosophy which characterize different branches of knowledge. Philosophy being a very abstract branch of study, has not much scope of using equipment on a large scale to supplement the normal lecture schedules. However, in some papers/areas there are comparatively better scope to make the lectures more (...) concrete and interesting through proper use of various teaching aids and modes. We include logic, philosophy of science, applied philosophy, applied ethics, social and political philosophy, philosophy of mind, philosophy of cognitive science and history of philosophy etc., we can use various modern aids. In this article my attempt is to draw out an outlines of aids and modes for effective philosophy teaching. (shrink)

A strong, but underexplored linkage exists between the current global order, world poverty and the politics of aid. Exploring this linkage, which is the key concern of this article, is crucial for a fuller understanding of the symbiotic injustice of the global order and the politics of aid. Using a conceptual thought experiment that portrays the framework of post-war global order as an intrinsically unjust “Global Games Arena”, I attempt a “vivisection” of the problematic relationship between the global order and (...) the politics of aid. In the real world, I follow decolonial scholars like Adom Getachew and Olúfẹmi O. Táíwò to argue that the modern and current global order and its social, economic and political structures are founded on the unfair gains of trans-Atlantic slavery and colonialism. The empirical and analytical consequence of this situation, the article shows, is that to make aid effective or altogether end its penurious impact in Africa in particular, would require, at first, a jettisoning or remaking of the current international order. In other words, I argue that aid would not be necessary in the absence of a world order that in fact requires aid to maintain a system of global injustice and inequality. (shrink)

Using as case studies two early diagrams that represent mechanisms of the cell division cycle, we aim to extend prior philosophical analyses of the roles of diagrams in scientific reasoning, and specifically their role in biological reasoning. The diagrams we discuss are, in practice, integral and indispensible elements of reasoning from experimental data about the cell division cycle to mathematical models of the cycle’s molecular mechanisms. In accordance with prior analyses, the diagrams provide functional explanations of the cell cycle and (...) facilitate the construction of mathematical models of the cell cycle. But, extending beyond those analyses, we show how diagrams facilitate the construction of mathematical models, and we argue that the diagrams permit nomological explanations of the cell cycle. We further argue that what makes diagrams integral and indispensible for explanation and model construction is their nature as locality aids: they group together information that is to be used together in a way that sentential representations do not. (shrink)

One of the ways in which transnational medical agencies (TMAs) such as Medicins Sans Frontieres aim to increase the access of the global poor to health services is by supplying medical aid to people who need it in developing countries. The moral imperative supporting such work is clear enough, but a variety of factors can make such work difficult. One of those factors is the wrongdoing of other agents and agencies. For as a result of such wrongdoing, the attempt to (...) supply medical aid can sometimes lead to significant negative effects. What should TMAs do in such situations? On one view, TMAs should take account of any negative effects arising from the wrongdoing of others in just the same way in which they take account of negative effects arising more directly from their own actions, or from natural forces. To many people, this view seems wrong. In this paper, I articulate and discuss several different reasons why one might think this. In doing so, I hope to contribute to a debate about the more general question of how TMAs should respond to the wrongdoing of others. (shrink)

Upon separation of the protein from the nucleic acid component of tobacco mosaic virus by phenol, using a fast and gentle procedure, the nucleic acid is infective in assays on tobacco leaves. A series of qualitative and quantitative control experiments demonstrates that the biological activity cannot depend on residual proteins in the preparation, but is a property of isolated nucleic acid which is thus the genetic material of the virus.

In order to understand the transmission of a disease across a population we will have to understand not only the dynamics of contact infection but the transfer of health-care beliefs and resulting health-care behaviors across that population. This paper is a first step in that direction, focusing on the contrasting role of linkage or isolation between sub-networks in (a) contact infection and (b) belief transfer. Using both analytical tools and agent-based simulations we show that it is the structure (...) of a network that is primary for predicting contact infection—whether the networks or sub-networks at issue are distributed ring networks or total networks (hubs, wheels, small world, random, or scale-free for example). Measured in terms of time to total infection, degree of linkage between sub-networks plays a minor role. The case of belief is importantly different. Using a simplified model of belief reinforcement, and measuring belief transfer in terms of time to community consensus, we show that degree of linkage between sub-networks plays a major role in social communication of beliefs. Here, in contrast to the case of contract infection, network type turns out to be of relatively minor importance. What you believe travels differently. In a final section we show that the pattern of belief transfer exhibits a classic power law regardless of the type of network involved. (shrink)

PrEP (Pre-Exposure Prophylaxis) is a relatively new drug-based HIV prevention technique and an important means to lower the HIV risk of gay men who are especially vulnerable to HIV. From the perspective of biopolitics, PrEP inscribes itself in a larger trend of medicalization and the rise of pharmapower. This article reconstructs and evaluates contemporary literature on biopolitical theory as it applies to PrEP, by bringing it in a dialogue with a mapping of the political debate on PrEP. As PrEP changes (...) sexual norms and subjectification, for example condom use and its meaning for gay subjectivity, it is highly contested. The article shows that the debate on PrEP can be best described with the concepts ‘sexual-somatic ethics’ and ‘democratic biopolitics’, which I develop based on the biopolitical approach of Nikolas Rose and Paul Rabinow. In contrast, interpretations of PrEP which are following governmentality studies or Italian Theory amount to either farfetched or trivial positions on PrEP, when seen in light of the political debate. Furthermore, the article is a contribution to the scholarship on gay subjectivity, highlighting how homophobia and homonormativity haunts gay sex even in liberal environments, and how PrEP can serve as an entry point for the destigmatization of gay sexuality and transformation of gay subjectivity. ‘Biopolitical democratization’ entails making explicit how medical technology and health care relates to sexual subjectification and ethics, to strengthen the voice of (potential) PrEP users in health politics, and to renegotiate the profit and power of Big Pharma. (shrink)

Effective altruism has a strategy problem. Overreliance on a strategy of donating to the most effective charities keeps us on the firefighter's treadmill, continually pursuing the next-highest quantifiable marginal gain. But on its own, this is politically shortsighted. Without any long-term framework within which these individual rescues fit together to bring about the greatest overall impact, we are almost certainly leaving a lot of value on the table. Thus, effective altruists' preferred means undercut their professed aims. Alongside the charity framework, (...) the more effective altruist ought to consider a mutual aid framework, which better acknowledges and honors the unavoidably political commitments of effective altruism to reimagine and remake the world. (shrink)