Ethics, Medicine and Public Health最新文献

{"title":"ChatGPT in medicine: A novel case of Dr Jekyll and Mr Hyde","authors":"M.S. Astorp , J. Emmersen , S. Andersen","doi":"10.1016/j.jemep.2023.100923","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100923","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100923"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49722336","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":"Teaching medicine after COVID-19: The place of museums in the biomedical university curriculum","authors":"P. Charlier","doi":"10.1016/j.jemep.2023.100920","DOIUrl":"10.1016/j.jemep.2023.100920","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100920"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10250146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9680208","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":"Urgent appeal for humanitarian aid in the wake of devastating conflict impact on Sudan's healthcare system","authors":"L.A. Mohamed , A.J. Nashwan","doi":"10.1016/j.jemep.2023.100921","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100921","url":null,"abstract":"","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100921"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49722337","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":"Social robots in care homes in French-speaking Switzerland: A qualitative and reflective study","authors":"S. Perruchoud ,&nbsp;N. Banwell ,&nbsp;Ralf R. Jox ,&nbsp;N. Eggert","doi":"10.1016/j.jemep.2023.100918","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100918","url":null,"abstract":"<div><h3>Background</h3><p>The number of elderly people with dementia in nursing homes is increasing in French-speaking Switzerland. This study investigates the use of social robots to improve and/or maintain the quality of life of these subjects, analyzed from the perspective of beneficence.</p></div><div><h3>Methodology</h3><p>Semi-structured face-to-face interviews were conducted in a selected number of care homes using social robots with their residents in French-speaking Switzerland. The impact of this use was analyzed at anthropological and ethical levels by developing a reflexive analysis around two central themes: truth and beneficence.</p></div><div><h3>Results</h3><p>The reflexive analysis illustrated the importance of several themes in the use of social robots in institutions, including the: (1) fears and hesitations surrounding the use of social robots in care homes; (2) role of interdisciplinarity and training of the nursing staff in this use; (3) necessity of a continuous evaluation guiding the use; and (4) importance of values and attitudes. In particular, this study highlighted the importance of showing at what levels this use is beneficial and identifying the “fuzzy” uncertainties that need to be studied in depth in order to make this practice increasingly ethical.</p></div><div><h3>Conclusions</h3><p>This exploratory study shows that using social robots (in particular in animal form) in care homes, is perceived by the users (health care workers and animators of the visited care homes) as having a generally positive impact on the residents, particularly for those suffering from dementia. These positive impacts occur at the level of bodily experience, as well as the maintenance, or even improvement, of personal capacities. At the same time, this use, when well framed, seems beneficial both for the residents the care team involved, who progressively notice the beneficial effects through the daily care relationship.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100918"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49736776","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":"Factors influencing the involvement of health care professionals in the administration of medical aid in dying in Quebec","authors":"M.-A. Gagné","doi":"10.1016/j.jemep.2023.100911","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100911","url":null,"abstract":"<div><h3>Background</h3><p>On February 16, 2023, the Quebec provincial Minister for Health and Seniors introduced Bill 11, which would allow people suffering from serious and incurable diseases<span> to benefit from medical aid in dying (MAID) through an advanced consent, in anticipation of incapacity. In addition, people with severe neuromotor disabilities such as quadriplegia<span> would also be eligible for MAID if they meet the other eligibility criteria. If this bill is adopted, we can expect the number of MAID to increase in the coming years. Moreover, the number of HCPs who agree to be involved in the process of administering MAID remains relatively stable and objectively low, which generates an additional clinical, psychological and administrative burden for HCPs who agree to provide this care.</span></span></p></div><div><h3>Methodology</h3><p>Through a narrative review of the scientific literature, we found that there have been very few empirical studies about the factors that contribute (positively or negatively) to HCP involvement in the MAID process.</p></div><div><h3>Results</h3><p>The data show that among the factors that have been identified in the scientific literature as discouraging the involvement of HCPs in MAID, some are related to HCPs’ freedom of conscience and their core values, while others are more pragmatic and emerge from the reality of the field.</p></div><div><h3>Discussion</h3><p>Many factors influence negatively HCP participation in MAID. However, some of these factors, specifically those that are not related to the exercise of freedom of conscience, may potentially be mitigated by the implementation of appropriate resources, such as the creation of a space for safe dialogue.</p></div><div><h3>Conclusion</h3><p>This article highlights the heterogeneity of factors that can interfere with the involvement of HCPs in MAID and, above all, the need for further investigation of these issues in order to adequately take them into consideration in the organization and provision of care.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100911"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49722101","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 economic impact of different blood glucose monitoring systems in the diabetic patient: Analysis of real-world data from an Italian local health authority","authors":"C. Procacci ,&nbsp;L. Degli Esposti ,&nbsp;C. Furno ,&nbsp;C. Nappi ,&nbsp;M. Dovizio ,&nbsp;D. Ancona ,&nbsp;A. Cicchetti","doi":"10.1016/j.jemep.2023.100912","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100912","url":null,"abstract":"<div><h3>Background</h3><p>This analysis compared the direct healthcare costs of two blood glucose self-monitoring systems, conventional strips vs. flash glucose monitoring (FGM) in a real-world clinical practice setting of an Italian Local Health Unit (LHU). Cost-effectiveness evaluation of FGM was also performed.</p></div><div><h3>Methodology</h3><p><span>A retrospective analysis was conducted using administrative databases of the LHU of Barletta-Andria-Trani province (BAT). During the inclusion period (January 2017–June 2019), patients with at least one prescription for multiple daily injection (MDI) insulin therapy were identified, and stratified by prescriptions for either FGM, or ≥ 1100 strips/year or &lt; 1100 strips/year. The index-date was that of the first FGM/strip prescription. After balancing groups by </span>propensity score matching (PSM), total direct healthcare costs at one-year follow-up were analysed.</p></div><div><h3>Results/Discussion</h3><p>Among 3560 strip users, 809 (22.7%) had ≥ 1100 strips/year, 2751 (77.3%) &lt; 1,100 strips/year, while 101 used FGM. The average annual costs were €3614 in the patients with ≥ 1100 strips and €4064 for FGM (<em>P</em> <!-->=<!--> <span>0.288), with similar expenses for drugs (respectively €1981 vs. €2251, </span><em>P</em> <!-->=<!--> <span>0.336), and outpatient services (€382 vs. €520, </span><em>P</em> <!-->=<!--> <span>0.263). Hospitalization costs tended to be lower in FGM users than strips users (respectively €271 vs. €459, </span><em>P</em> <!-->=<!--> <!-->0.393) and this difference compensated the higher device costs (€1,022 and €791, <em>P</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusion/Perspectives</h3><p>The present real-life analysis showed that above 70% diabetics receive lower strip prescriptions than recommended. The economic data revealed that, in front of a higher device cost, FGM resulted in reduced expenditures for hospitalizations, demonstrating an Incremental Cost-effectiveness ratio (ICER)<!--> <!-->=<!--> <span>€362.90/quality-adjusted life years (QALY) for patients adherent to the treatment, with controlled diabetes. The limitations of the analysis lie in its observational design and the reduced availability of passive mobility data (related to the flows of the pharmaceutical database, that of hospitalizations and specialist services) as to 2019, which could have led to cost underestimation.</span></p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100912"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49722329","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":"Religion in times of epidemics, a matter of public health: Great plague of Marseille (FRA, 1720–1722) Covid-19 (2020–…), a narrative review","authors":"M. Willot","doi":"10.1016/j.jemep.2023.100922","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100922","url":null,"abstract":"<div><h3>Background</h3><p>Humans have always referred to religion in History to make sense of disasters and epidemics, especially when science could not explain them. Religion has often been invoked as a mean of protection. The Covid outbreak in 2020 and the initial medical impotence brought up old fears, reminiscent of the plague for some people. Unable to rely on science only, some turned back to religion.</p></div><div><h3>Methodology</h3><p>A narrative review was conducted to compare the role of religion during the Great Plague of Marseille versus the early stages of Covid-19 pandemic. We mostly studied contemporary documents on the Great Plague of Marseille, and collected press articles on Covid-19.</p></div><div><h3>Results/Discussion</h3><p>For both epidemics, some people see in the outbreak a sign of God's revenge. Logically, intensifying spiritual life and multiplying religious demonstrations can be a way to fight both epidemics. Studying religion in these times of epidemics also highlights its roles in public health: sometimes facilitating the contaminations if not regulated, sometimes supporting public health policies with some positions, as for Covid vaccines.</p></div><div><h3>Conclusion/Perspectives</h3><p>The comparison of an ancient epidemic with the current pandemic allowed us to take a broader look at the current vision of contagious disease, in societies that have become highly medicalized. The fight against epidemics remains polymorphous, and one of the aspects is religious. Integrating this information in our practices can help improving holistic management of patients, and public health policies efficiency.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"29 ","pages":"Article 100922"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49736777","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":"Knowledge, practice and attitude towards foot care among adults living with diabetes in Gadarif State, Eastern Sudan: Cross-sectional study","authors":"M.A. Idris ,&nbsp;O.S. Osman ,&nbsp;S.E. Salah ,&nbsp;M.A. Latif ,&nbsp;A.O. Almobarak ,&nbsp;S. Badi ,&nbsp;M. Ahmed ,&nbsp;M.H. Ahmed","doi":"10.1016/j.jemep.2023.100898","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100898","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Diabetic foot </span>ulceration (DFU) represents a serious medical challenge for all countries across the globe, especially in Sudan. The main aim of this study was to assess the knowledge, practice, and attitude among individuals with diabetes toward foot care in Gadarif state in Eastern Sudan.</p></div><div><h3>Methods</h3><p>This cross-sectional study recruited 430 individuals with diabetes in the Gadarif Diabetes Center located in the Eastern Sudan. We have used Chi-square test and logistic regression analysis.</p></div><div><h3>Result</h3><p><span><span>Almost 96.3% of the participants had type 2 diabetes. The median duration since diagnosis was 7 years. More than one-third of them (34.7%) used insulin while 70.7% used </span>metformin<span>. Only 10% of the participants reported they had experienced a foot ulcer before, while only 10.9% reported that they currently have a foot ulcer. 60.5% of the participants reported that they do not inspect their foot. Only 13.7% of them reported that they wear diabetic shoes. Chi-square test and logistic regression analysis showed a significant association between knowledge and employment status, inspecting foot, and washing foot with soap and water are the predictors of the participants’ knowledge towards DFU (</span></span><em>P</em> <!-->=<!--> <!-->0.006, &lt;<!--> <!-->0.001, &lt;<!--> <!-->.001), respectively.</p></div><div><h3>Conclusion</h3><p>Despite poor practice and attitude towards diabetic foot, knowledge about diabetic foot is increased among those with formal education, employment, and health education classes about diabetic foot. Therefore, more investment is needed in raising health awareness about diabetic foot in Sudan.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"28 ","pages":"Article 100898"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778793","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":"Philoctetes, pain, and physicians: Using Greek tragedy in medicine","authors":"L.K.-P. Wang ,&nbsp;P. Paidisetty ,&nbsp;J.D. Reisler","doi":"10.1016/j.jemep.2023.100887","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100887","url":null,"abstract":"<div><h3>Background</h3><p>Learning about the human condition through Greek tragedies offers a dynamic way for medical students and professionals to reflect on their own experiences.</p></div><div><h3>Methodology</h3><p>In this article, we discuss <em>Philoctetes</em> by Sophocles, which depicts an example of human vulnerability and offers powerful lessons on the nature and taxonomy of pain.</p></div><div><h3>Results/Discussion</h3><p>We describe how we used the lessons learned from <em>Philoctetes</em> to empathize with the different types of pain experienced by a patient with heart failure at a student-run clinic.</p></div><div><h3>Conclusion/Perspectives</h3><p>We hope that our experience using Greek tragedy to foster stronger patient-provider relationships and improve treatment outcomes encourages other medical students and healthcare professionals to use the humanities to inform our role as healers.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"28 ","pages":"Article 100887"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49861736","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":"Identification and skin in Sande masks (women's secret society – Sierra Leone/Liberia)","authors":"C. Kauer","doi":"10.1016/j.jemep.2023.100889","DOIUrl":"https://doi.org/10.1016/j.jemep.2023.100889","url":null,"abstract":"<div><h3>Context</h3><p>It is within the framework of the helmet-masks of Sande, worn only by women, that this study aims to develop the medical observation of the different sculpted elements on the face, the hairstyle, the neck, and to make a diagnosis to identify a possible pathology.</p></div><div><h3>Methodology</h3><p>The skin, represented by the black patina of the mask, will serve as a link to examine all the characteristics of the mask, the scarifications, the abundant hair, the appearance of the folds of the neck.</p></div><div><h3>Result</h3><p>These observations lead to the identification of a young initiate in full health.</p></div><div><h3>Conclusion</h3><p>No pathology is detected on the helmet-masks of Sande, only persists, after examination, the image of a feminine ideal.</p></div><div><h3>Perspectives</h3><p>It seems interesting to develop the icono-diagnosis to other masks of different ethnicities knowing that some, rare, express a pathology.</p></div>","PeriodicalId":37707,"journal":{"name":"Ethics, Medicine and Public Health","volume":"28 ","pages":"Article 100889"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49774082","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}