Ethics, Medicine and Public Health最新文献

{"title":"Attitudes to organ donation in Lebanon: A cross-sectional survey","authors":"Ahed El Abed El Rassoul ,&nbsp;Rawane Abdul Razzak ,&nbsp;Adam Alwardany ,&nbsp;Mohamad Moubarak ,&nbsp;Hashim Talib Hashim","doi":"10.1016/j.jemep.2023.100952","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100952","url":null,"abstract":"<div><h3>Background</h3><p>The optimum approach for managing terminal illnesses is organ transplantation. However, the transplant waiting list is long due to the very high demand and low supply of donated organs. One's willingness to donate is governed by their knowledge and attitude towards organ donation. The perception of organ donation among the Lebanese general population and their desire to donate organs has not been previously explored. This study aims to assess the attitudes of Lebanese to organ donation and evaluate the public's relative knowledge about this particular notion and their willingness to donate organs.</p></div><div><h3>Methodology</h3><p>This study is a cross-sectional design including a self-administered questionnaire that was distributed through an online link during June and July, 2022. The study population consisted of Lebanese respondents of ages eighteen years old and above from the different governorates of Lebanon. The respondents’ knowledge, attitudes and willingness to organ donation were collected by a cross-culturally adapted questionnaire from Chinese-based previous research. Knowledge is measured by 10 items and presented as a 10-point score, attitude is scored by 20 items on a 5-step Likert scale, and the total score ranges from 0 to 80; while the willingness to donate is assessed as a trinomial variable (Yes, No, Maybe). Statistical analysis was carried out using the statistical software SPSS version 26.0. Multivariate regression was applied to adjust factors associated with organ donation attitudes, controlling for demographic and socioeconomic confounders. All tests were reported two-tailed, with a significance level of <em>P-</em>value<!--> <!-->&lt;<!--> <!-->0.05.</p></div><div><h3>Results</h3><p>A total of 500 respondents completed the questionnaire, where most have heard about organ donation (100%) and brain death (92.6%). The overall median (±<!--> <!-->IQR) score of attitudes to organ donation was 48 (<!--> <!-->±<!--> <!-->11), and was higher among participants who were willing to donate organs. The total attitude score was found statistically significant across different age groups (<em>P</em> <!-->&lt;<!--> <!-->0.05), gender (<em>P</em> <!-->&lt;<!--> <!-->0.01), residency districts (<em>P</em> <!-->&lt;<!--> <!-->0.05), and average monthly income (<em>P</em> <!-->&lt;<!--> <!-->0.05). The willingness to organ donation was predominantly indifferent (47.4%) with only 21.6% willing to donate organs. However, if religion and law were encouraging organ donation, the majority were willing to donate organs (59.6%). The correlation between total attitude score and the variables is positive (<em>R<!--> </em>=<!--> <!-->0.295) and 8.7% of the variation seen in the total attitude score is explained by the variables (<em>R</em>^<em>2</em> <!-->=<!--> <!-->0.087). After adjustment, the adjusted <em>P</em>-values for the total attitude score on willingness, knowledge, and gender remained significan","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100952"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91987282","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":"Iconodiagnosis: Guidelines and recommendations","authors":"P. Charlier ,&nbsp;A. Perciaccante ,&nbsp;N. Kluger ,&nbsp;A.G. Nerlich ,&nbsp;O. Appenzeller ,&nbsp;S.T. Donell ,&nbsp;V. Asensi ,&nbsp;P.A. Mackowiak ,&nbsp;V. Ferrara ,&nbsp;R. Bianucci","doi":"10.1016/j.jemep.2023.100951","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100951","url":null,"abstract":"<div><p>Iconodiagnosis consists of a retrospective medical diagnosis carried out on a work of art depicting a human person. For a hundred years, physicians have embarked on this practice, making it possible to supplement epidemiological data on the existence of diseases in ancient periods or past populations, but also to train physicians in their clinical and semiological sense. Faced with the exponential increase in publications in this field, it was necessary to propose clear rules and a precise and rigorous methodology allowing a serious practice of iconodiagnosis.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100951"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352552523000828/pdfft?md5=601c1f298da03aadec0fbaa6e0bb75c8&pid=1-s2.0-S2352552523000828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92100511","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":"Research is a duty for health professionals and in the best interest of patients in times of a pandemic: Empirical exploration and ethical implications of the Research Ethics in Times of Pandemic (RESET-PAN) survey","authors":"T. Haaser ,&nbsp;L. Ferretti ,&nbsp;P.-J. Maternowski ,&nbsp;S. Marty ,&nbsp;D. Berdai ,&nbsp;E. Augier ,&nbsp;V. Avérous ,&nbsp;V. Berger ,&nbsp;H. Hoarau ,&nbsp;B. L’Azou ,&nbsp;C. Morin ,&nbsp;M.-C. Saux","doi":"10.1016/j.jemep.2023.100949","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100949","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has led to an unprecedented global mobilization of biomedical research, especially as some countries have experienced a shortage of medical resources. Bioethicists have proposed to question the entanglement of care and research in the event of a pandemic. Above all, research could be seen as a moral duty for professionals but also as the best interest of patients in a context of uncertainty. In addition, participating in biomedical research could be a decisive factor in the prioritization decision in the event of a shortage of medical resources. However, these proposals from American bioethicists have not been submitted for approval by French health professionals.</p></div><div><h3>Methodology</h3><p>The Research Ethics Committee of the University Hospital of Bordeaux, France, has conceived a survey exploring the opinion of health professionals of the institution concerning the current French regulations on research ethics in the pandemic, on the intertwining of care and research during a pandemic, and concerning proposals on reciprocity between care and research in a context of a global pandemic.</p></div><div><h3>Results</h3><p>Out of 439 responses collected, the main results showed that a large majority of healthcare professionals agreed that research constitutes an ethical duty for professionals but must also be considered as the best interests of patients in the event of pandemic (90.6% and 75.5% respectively). Health professionals also considered a possible reciprocal commitment of patients through their inclusion in biomedical research since they benefit from care in situations of scarcity of medical resources (from 55.6% to 86.2% depending on the type of study). Contrary to recommendations, the respondents were mostly opposed to the prioritization of patients included in biomedical research in the event of a prioritization process for the allocation of medical resources (64.7% against the use of this criterion in triage decisions).</p></div><div><h3>Discussion</h3><p>This survey showed that health professionals of our institution were ready to consider a paradigm shift in the way care and research could be considered in times of a pandemic of an emerging infectious agent, and in a context of tension for access to medical resources. A deeper entanglement of care and research needs careful consideration given the possible implications for consent processes and the ethical review of research protocols. In addition, it involves the preparedness and coordination of health professionals and health systems on a large scale.</p></div><div><h3>Conclusion/Perspectives</h3><p>Additional studies, including in-depth explorations with stakeholders, especially representatives of patients and society, are needed to better understand how a pandemic context should induce major adaptations in the way of considering the interaction between care and research.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100949"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92100514","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":"Physical activity and dietary behavior in relation to perceived stress levels among young adults during the transition to endemic phase of Covid-19","authors":"G.Q. Teh ,&nbsp;S.S. Tan ,&nbsp;S.T. Tan ,&nbsp;H. Hariyono ,&nbsp;C.X. Tan","doi":"10.1016/j.jemep.2023.100948","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100948","url":null,"abstract":"<div><h3>Background</h3><p><span>Stress is widely acknowledged to have an influence on physical activity and dietary habits. The prevalence of stress levels has drastically increased following the unprecedented Covid-19 outbreak. The transition to the endemic phase of Covid-19 is currently underway in Malaysia. This study aims to investigate the </span>perceived stress levels, physical activity habits, and dietary behaviors of young adults in Malaysia during this transition to the endemic phase.</p></div><div><h3>Methods</h3><p>This cross-sectional study was conducted from 5th November to 30th December 2022, using an online questionnaire consisting of three main sections: sociodemographic, physical activity and dietary behavior scale, and perceived stress scale.</p></div><div><h3>Results</h3><p>The prevalence of low perceived stress (LPS) was found to be greater than high perceived stress (HPS), with LPS accounting for 54% and HPS accounting for 46%. HPS young adults exhibited significantly higher levels (<em>P</em> <!-->&lt;<!--> <!-->0.05) of stress eating, overeating, and skipping main meals compared to LPS. Positive correlations were observed between perceived stress and stress eating (<em>P</em> <!-->=<!--> <!-->0.001), skipping breakfast (<em>P</em> <!-->=<!--> <!-->0.025), skipping lunch (<em>P</em> <!-->=<!--> <!-->0.005), skipping dinner (<em>P</em> <!-->=<!--> <!-->0.001), and overeating (<em>P</em> <!-->=<!--> <!-->0.007).</p></div><div><h3>Conclusion</h3><p>The present study reveals the need to implement health interventions focusing on nutrition and stress management for young adults experiencing high levels of perceived stress.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100948"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92100513","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":"Covid-19 pandemic and scientific knowledge: logical implications for dealing with truth","authors":"M. Simões Mendes","doi":"10.1016/j.jemep.2023.100947","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100947","url":null,"abstract":"<div><h3>Background</h3><p>Unfortunately, many unreasonable measures and biased positions constituted the pandemic scenario in the last years worldwide.</p></div><div><h3>Methodology</h3><p>It is a critical theoretical essay.</p></div><div><h3>Discussion</h3><p>Reinforcement of dilemmas without criteria fostered the impoverishment of the discourses. In the current stage, when many measures, research data, and government documents are reviewed in depth, dealing with truth becomes a big challenge.</p></div><div><h3>Perspectives</h3><p>Considering the possibility that countless lives could have been preserved if the real principles of science and rational debate were not misrepresented, the near future will not be easy.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100947"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92100515","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":"Language inclusivity in health research: An institutional current state quality assessment","authors":"K. An ,&nbsp;J. Claydon ,&nbsp;M.L. Woodward ,&nbsp;J. Zhao ,&nbsp;S. Chhina ,&nbsp;B. Udall ,&nbsp;Q. Doan","doi":"10.1016/j.jemep.2023.100946","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100946","url":null,"abstract":"<div><h3>Background</h3><p>To address health inequity with evidence-based care, research needs to be inclusive. One of the most common practices when facing language barriers is the exclusion of participants with limited English proficiency (LEP). Language provisions in clinical research are necessary to ensure diversity and inclusion in research, and thus health equity. We evaluated the inclusion or exclusion of participants with LEP through provisions (or lack thereof) of language accommodations in research study designs and protocols at our institution.</p></div><div><h3>Methodology</h3><p>A cross-sectional quality improvement evaluation reviewed approved submissions to the University of British Columbia Children's &amp; Women's (UBC C&amp;W) research ethics board (REB) between 2017 to 2021 inclusively. Qualitative data was thematically coded and quantitatively analyzed to assess provisions for research activities to be completed in non-official languages.</p></div><div><h3>Results/Discussion</h3><p>Six hundred and ninety-eight prospective study submissions involving interaction with patients and public participants approved by the UBC C&amp;W REB were reviewed. Just under a third (228/698) of submissions specifically excluded participants based on English language proficiency. Of the submissions that included participants with LEP, only 53.0% (249/470) made any mention of provisions for participants with LEP. All studies providing full language provisions, including translation of study documents and interpretation for the informed consent process, were funded in some capacity.</p></div><div><h3>Conclusion/Perspectives</h3><p>A third of REB submissions at the UBC C&amp;W make provisions for research participants with LEP to include them in clinical research. Insufficient funding may be a key factor prohibiting provision of language accommodations, which may be a targetable barrier in designing accessible and inclusive clinical studies.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100946"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49736642","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 World Health Organization's recommendations on postnatal mental health: The advances made and consolidated limitations","authors":"R. Behl","doi":"10.1016/j.jemep.2023.100940","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100940","url":null,"abstract":"<div><h3>Background</h3><p><span>The attainment of sustainable development goals<span> has necessitated shifting focus from maternal mortality to maternal morbidity arising from perinatal mental health (PMH) conditions. In 2014, the World Health Organization (WHO) informed about insufficient evidence to recommend routine briefing for </span></span>postnatal depression (PPD). However, the WHO Recommendations, published in the year 2022, provide for routine screening for PMH conditions including PPD, and anxiety, using validated tools.</p></div><div><h3>Method</h3><p>By adopting methods including comparative content analysis, and thematic analysis, this work underscores the health policy changes suggested by the 2022 Recommendations in contrast to the 2014 Recommendations, regarding the PMH conditions. The limitations and gaps left uncovered by the 2022 Recommendations will also be discussed in the context of findings of epidemiological studies.</p></div><div><h3>Result</h3><p>The 2022 Recommendations, unlike the 2014 Recommendations, consolidated positioning of PMH services<span> in the postnatal healthcare framework and introduced road map for managing PMH conditions. However, the issues which still remained unattended can impede attainment of objectives of the 2022 Recommendations, and its positive impact. Policymakers need to be precautious about these limitations while formulating health policies based on the 2022 Recommendations.</span></p></div><div><h3>Conclusion</h3><p>There is an urgent need of adopting more holistic approach while introducing PMH related health laws and policies. Preclusion of antenatal care guidelines, and high-risk populations from the scope of these Recommendations warrants introduction of new recommendations, at the earliest, to fill the void.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100940"},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49736640","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":"Medical ethics must facilitate the integration of planetary health into the physician-patient relationship","authors":"N. Faure","doi":"10.1016/j.jemep.2023.100924","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100924","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100924"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49718010","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":"A physician's meditation on war: Historical examples and responsibilities","authors":"M.H. Malloy","doi":"10.1016/j.jemep.2023.100939","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100939","url":null,"abstract":"<div><h3>Background</h3><p>Do physicians have a moral obligation to oppose war? Historical examples suggest the conundrum associated with dealing with that issue. During the First World War some 16,000 men were identified as Conscientious Objectors in England. Conspicuously absent from these men were any physicians.</p></div><div><h3>Historical Examples</h3><p>William Osler (1849–1919) put on a public face of supporting the War effort, yet he and his wife Grace worried privately about the possibility of their son, Revere, participating. With the loss of Revere to the War, Osler's attitude towards war changed dramatically and he bemoaned the cost associated with war and questioned whether Science would be the salvation or the ruin of mankind. Several of Osler's contemporaries took pacifist stances against war.</p></div><div><h3>Contemporary Perspective</h3><p>Contemporarily, how should physicians project their authority in a world still aflame with the possibility of war? This paper will provide contemporary thoughts on the issue and provide insight into the dilemmas faced by physicians and war.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100939"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49735167","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 impact of the current conflict in Sudan on women's health","authors":"R.M. El Tahir ,&nbsp;N.M. Bedri ,&nbsp;A.J. Nashwan","doi":"10.1016/j.jemep.2023.100936","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100936","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"31 ","pages":"Article 100936"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49717971","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}