Ethics, Medicine and Public Health最新文献

{"title":"Risk management in clinical research: Experience of an Institutional Review Board","authors":"P.A. Albarello ,&nbsp;C. Ocampo-Benavides ,&nbsp;C. Bello ,&nbsp;M. Cañón ,&nbsp;A. de la Torre","doi":"10.1016/j.jemep.2025.101095","DOIUrl":"10.1016/j.jemep.2025.101095","url":null,"abstract":"<div><h3>Background</h3><div>Clinical trial complexity has grown, leading to global efforts to improve quality and safety through risk management (RM). However, clear guidelines for RM at Institutional Review Boards (IRBs) are lacking. This study describes the development and implementation of an RM process within an IRB, focusing on a quantitative risk assessment tool.</div></div><div><h3>Methods</h3><div>The RM process followed ISO 31000 guidelines. Risk assessment was performed using quantitative and qualitative strategies; for the quantitative strategy we developed an online tool (InRisk_Tool) with variables selected using the systematic team approach; analysis was conducted using the semi-quantitative method of risk indexes and the probability-impact matrix. Additionally, IRB members performed the qualitative analysis of each study. Risk treatment activities were implemented mainly according to the risk level established by the InRisk_Tool.</div></div><div><h3>Results</h3><div>The InRisk_Tool comprises 20 variables categorized into two dimensions: <em>Probability</em> and <em>Impact</em>. Categorical variables scored 0 for negative responses and 1 for positive ones. Quantitative variables also scored 0 or 1 based on the number of events. The scores for <em>Probability</em> and <em>Impact</em> ranged from 0 to 14 and 0 to 6, respectively. These scores were categorized into three levels: High, Intermediate, and Low. Combined scores formed a probability-impact matrix to determine overall risk levels.</div></div><div><h3>Conclusions</h3><div>The InRisk_Tool provides systematic, objective risk evaluation for clinical trials. Further refinements and artificial intelligence integration could enhance scoring, analysis, and decision-making, strengthening patient safety.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101095"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic detection of Parkinson’s disease using machine learning and deep learning: A recent literature review","authors":"R.O. Panicker ,&nbsp;D. Yashasvi ,&nbsp;J. James ,&nbsp;S. Ittappa","doi":"10.1016/j.jemep.2025.101079","DOIUrl":"10.1016/j.jemep.2025.101079","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease (PD) is a progressive condition of the brain and central nervous system that causes a gradual deterioration in body movement. Major symptoms of PD are stiffness in the legs, arms, and torso; tremor, slow movement, balance problems, depression, etc. PD can be diagnosed based on the above-mentioned common symptoms. Yet, diagnostic imaging techniques that are noninvasive, such as Positron Emission Tomography (PET) can help the doctors to detect PD. Every year, an estimated 60,000 new cases of PD are diagnosed. Numerous machine learning (ML) and deep learning (DL) approaches have been suggested in the literature for the automated detection of PD. The accurate diagnosis of PD poses a challenge due to the absence of a standardized and objective approach. The integration of ML algorithms into medical diagnostics has enhanced the precision of disease predictions, making the diagnosis more effective.</div></div><div><h3>Methodology</h3><div>This paper presents a systematic review of automatic PD detection used machine ML and DL, from papers published between 2010 and 2024. Through the extensive and careful search procedure, 67 papers were selected from a total of 262. We retrieved these articles from various academic databases such as Google Scholar, IEEE Xplore and Scopus ensuring detailed mention of relevant literature.</div></div><div><h3>Result</h3><div>Through this review, we can understand how ML techniques can be a partner to make the automatic detection of PD faster and efficient. We also addressed the different public database sources of PD such as UCI Parkinson’s Dataset, Parkinson’s Drawing Dataset etc. so that the researchers in this field can easily use these datasets. Furthermore, we identified some benefits, limitations and gaps, which should be addressed in the future.</div></div><div><h3>Conclusion</h3><div>In conclusion, the field of automatic detection of PD has witnessed remarkable advancements through the integration of machine learning, sensor technologies and various techniques. The reviewed literature highlights the efficacy of various classification algorithms such as Support Vector Machines (SVM), Random Forests (RF), etc., with them consistently demonstrating superior accuracy in distinguishing individuals with PD.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101079"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The language of the unheard: Why measles vaccine hesitancy persists in Africa","authors":"S. Pillay ,&nbsp;C. Ewuoso ,&nbsp;L.A. Tandwa","doi":"10.1016/j.jemep.2025.101068","DOIUrl":"10.1016/j.jemep.2025.101068","url":null,"abstract":"<div><h3>Purpose of research and novel approach</h3><div>Childhood measles vaccinations have been a topic of interest again recently following the multitude of measles outbreaks worldwide. While the large number of deaths accompanying these outbreaks is due to several reasons, vaccine hesitancy seems to be the biggest cause. Vaccine mandates remain a common measure for fostering vaccine uptake and maintaining herd immunity. Arguments for (and against) measles vaccine mandates principally focus on scientific facts and consequences, herd immunity, and citizen liberties. Focusing attention primarily on measles vaccination and taking Africa as the context, we advance a different claim- that vaccine hesitancy in some cases is plausibly justifiable. Notably, we contend that vaccine hesitancy, in some circumstances, may be the language of the unheard or the failure to engage previous medical injustices. Thus, it requires us to think deeply about how relevant actors can amend the plight of these exploited communities. To interrogate this question, we draw on the theory of distributive justice grounded in African moral philosophies.</div></div><div><h3>Methodology</h3><div>This was a purely normative study. The research method comprised a literature search on the primary sources while research articles on the causes of measles outbreaks and vaccine hesitancy were reviewed. From these materials, using African moral values, we developed an ethical argument in support of the thesis.</div></div><div><h3>Findings and conclusion</h3><div>This research highlights that in Africa there is a moral duty to initiate measures to address the power dynamics (that is, where one party in the communal relationship is more powerful) and empower communities. Only then vaccine uptake campaigns can be successful.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101068"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing on the Brink: Somalia’s Silent Health Crisis","authors":"Y.S.A. Hasan ,&nbsp;S.A. Hussein","doi":"10.1016/j.jemep.2025.101093","DOIUrl":"10.1016/j.jemep.2025.101093","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101093"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another one bites the dust: contribution of neurologists to STI prevention strategies","authors":"A. Demas","doi":"10.1016/j.jemep.2025.101048","DOIUrl":"10.1016/j.jemep.2025.101048","url":null,"abstract":"<div><div>In the realm of sexually transmitted infection (STI) prevention, the contribution of neurology and neuroscience emerges as pivotal. This abstract explores how insights from these fields inform and enhance the understanding of human cognitive-behavioral dynamics in STI risk-taking. Neurologists and neuroscientists offer valuable perspectives on the interplay between brain function, behavior, and societal influences, shedding light on the underlying mechanisms driving risky sexual behavior. By integrating cognitive-behavioral data provided by neurologists, future STI prevention strategies can be optimized, fostering a comprehensive approach to sexual health promotion and disease prevention.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101048"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond truth and profit: The show must go on, still","authors":"J. Park","doi":"10.1016/j.jemep.2025.101063","DOIUrl":"10.1016/j.jemep.2025.101063","url":null,"abstract":"<div><h3>Background</h3><div>The stem cell research manipulation scandal involving Dr. Woo Suk Hwang sparked widespread ethical and scientific debate. Previous work published in the <em>Eubios Journal of Asian and International Bioethics</em> [1] explored suspicions surrounding the scandal. This discussion builds on that foundation in light of a recent publication, <em>Ethical Innovation for Global Health</em>, and aims to examine the broader implications of the case.</div></div><div><h3>Objective</h3><div>To analyze the lessons learned from the Hwang case with an alternative perspective and propose solutions to prevent similar occurrences in the future.</div></div><div><h3>Methods</h3><div>This paper revisits the details of the Hwang scandal, focusing on ethical, financial, and political dimensions, and reviews subsequent developments, including a reevaluation of Hwang’s scientific contributions and their recognition through patents.</div></div><div><h3>Results</h3><div>Despite the fabrications, key scientific achievements were later corroborated, with the <em>Science</em> journal’s chief editor asserting that the main discoveries remained valid. Hwang’s techniques were even patented by the United States Patent and Trademark Office. However, political forces shifted public focus away from core issues, finally undermining research integrity.</div></div><div><h3>Conclusions</h3><div>The Hwang scandal highlights the complex interplay of ethics, science, and politics in research misconduct. This paper argues for revisiting the role of social scientists in addressing and understanding scientific scandals to better uphold the integrity of research practices.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101063"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public perspectives on ethical issues in lung cancer screening policy design and implementation in Ontario, Canada","authors":"M. Pahwa ,&nbsp;J. Abelson ,&nbsp;L. Schwartz ,&nbsp;P.A. Demers ,&nbsp;K. Shen ,&nbsp;H. Shaikh ,&nbsp;M. Vanstone","doi":"10.1016/j.jemep.2025.101061","DOIUrl":"10.1016/j.jemep.2025.101061","url":null,"abstract":"<div><h3>Purpose</h3><div>Public perspectives on ethical issues in cancer screening may contribute to informing policymaking. Lung cancer screening is being implemented with the aim of reducing lung cancer mortality. Inequitable lung carcinogen exposure and lung cancer disparities are key ethical challenges in screening. This research aimed to examine public perspectives about ethical issues in lung cancer screening.</div></div><div><h3>Methods</h3><div>A qualitative description study was conducted in Ontario, Canada, where a provincial lung cancer screening program is being implemented. Using maximum variation sampling, Ontario residents aged 55–85 years were recruited via family medicine clinics, social media, and personal networks. Semi-structured interviews were conducted with individual participants to elicit their perspectives on established ethical issues in cancer screening, with questions focused on potential lung cancer screening benefits and harms, who should be eligible, and why.</div></div><div><h3>Findings</h3><div>Twenty-six individuals participated in this study. Participants were aged 61−70 years and of various education levels. Sixty-five percent were women. No participants currently smoked commercial tobacco. Participants believed screening was important for reducing lung cancer mortality and saving healthcare costs. Participants stated that screening should consider and prioritize a wider range of lung cancer risk factors, such as occupational exposures and family history of lung cancer, than factors currently being used to offer screening to those at high risk. Participants gave less priority to screening for people who currently smoke.</div></div><div><h3>Conclusion</h3><div>Public perspectives supported screening high-risk candidates; however, support may be undermined by smoking stigma. Screening policies should more effectively mitigate stigma and ethically justify screening candidacy decisions.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101061"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143213599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A welfare-based approach to accessing mental health services","authors":"S. Ahir-Knight","doi":"10.1016/j.jemep.2025.101086","DOIUrl":"10.1016/j.jemep.2025.101086","url":null,"abstract":"<div><h3>Background</h3><div>Mental health resource allocation is complex, as it involves a diverse range of people and circumstances. Determining eligibility for access to mental health services requires navigating a complex interplay of considerations.</div></div><div><h3>Aim</h3><div>This theoretical paper introduces a welfare-based approach for determining access to mental health services. This approach emphasises both individual and collective welfare, blending subjective welfare, such as psychological states and personal desires, with objective welfare, like social functioning and quality of life.</div></div><div><h3>Contribution</h3><div>This theoretical approach lays the groundwork for future empirical and theoretical research alongside direct health policy recommendations in different contexts. Ultimately, this welfare-based approach aims to create a more inclusive, effective, and humane mental health system, addressing a wider range of needs and creating a more flourishing society.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101086"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics in medicine: protecting patient privacy from commercial exploitation in Somalia","authors":"A.S. Ali ,&nbsp;O.J. Okesanya ,&nbsp;M.M. Ahmed ,&nbsp;B. Garba ,&nbsp;N.I. Dirie","doi":"10.1016/j.jemep.2025.101043","DOIUrl":"10.1016/j.jemep.2025.101043","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101043"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing reentry challenges for women: The NJ Women’s Project","authors":"R. Sinha ,&nbsp;J. McGreevey ,&nbsp;G. Bachmann","doi":"10.1016/j.jemep.2025.101073","DOIUrl":"10.1016/j.jemep.2025.101073","url":null,"abstract":"<div><h3>Background</h3><div>Incarcerated women face unique and significant challenges with their reentry, with significant obstacles that include poor job opportunities for financial stability, social stigma, substance abuse, and mental health issues, to name a few.</div></div><div><h3>Objective</h3><div>The New Jersey Reentry Corporation (NJRC) Women’s Project aims to address the healthcare and reentry challenges of incarcerated women through tailored support services, ultimately improving their wellness and reducing recidivism.</div></div><div><h3>Methods</h3><div>A review of the NJRC Women’s Project is presented as a template that provides a comprehensive set of medical, behavioral, and reentry services designed to meet the specific needs of women. Specialized programs such as the Veterans Justice Outreach Initiative and Espiritu Latino further address the unique needs of specific subgroups. A two-year program review was conducted, assessing outcomes in healthcare access, mental health support, addiction treatment, and employment opportunities.</div></div><div><h3>Results</h3><div>The program demonstrates substantial improvements in participants’ overall wellness:</div><div>1. Increased healthcare access and utilization.</div><div>2. Enhanced mental health support and addiction treatment services.</div><div>3. Improved employment opportunities and housing stability. Additionally, subgroup-specific initiatives showed effectiveness in addressing unique needs, contributing to reduced recidivism rates across New Jersey.</div></div><div><h3>Conclusion</h3><div>The NJRC Women’s Project serves as a model for addressing previously incarcerated women’s complex healthcare and reentry needs. Continued investment in such tailored services effectively provides essential support for successful reintegration and further reduces recidivism rates.</div></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"33 ","pages":"Article 101073"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}