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PubMed2005

Ethical, legal, and social issues: our children's future.

A convergence of issues suggests that protecting child health is not so much a matter of research, but rather a matter of policy and advocacy. First, we have well-articulated views of a vision for child health. Second, we have experience and toxicological research findings demonstrating the adverse health effects of hazardous chemicals on children and recognize that children are more sensitive than adults to chemical exposures. Results from toxicology research have motivated many regulatory and legal actions, and public policy decisions, including the banning of some pesticides, reducing exposures in the workplace, and lowering of acceptable blood lead levels in children. We also know that childhood disabilities from chemical exposure during developmental are often not treatable and therefore must be prevented. Finally, we have an increasingly well-defined framework for discussing social and ethical responsibility to our children. New discoveries in the basic biological and toxicological sciences have challenged our bioethical thinking and societal decision-making. This paper will explore the ethical, legal, and social issues raised by the toxicological sciences first by examining some hard lesson learned about childhood effects of chemicals and then by examining the difficult policy and research decisions that must be made as we address our need for additional information about the health effects of chemicals on adults and children and the impact of having this information. The precautionary principle will be considered as an alternative decision-making approach as well as exploring the concept of the citizen toxicologist (CT). As Garrett Hardin pointed out many years ago, the problems we face often have no technical solutions, but rather require a policy-based approach. This paper will be of interest to the public and health professionals concerned about the broader impact of toxicological research on bioethical and societal decision-making.

Child↗
PubMed2005

[The self healing power of cities--civil qualities of urban life].

Health and hygiene are top issues from the early days down the history of a town or a city. Pestilence, epidemic plagues and infectious diseases are once in a while endangering the delicate equilibrium of a city as an organism. Many infra-structural measures are taken to ensure health in and of the city. What makes a healthy city is not just the absence of illness, a healthy city is inspired by the mentality of their citizens, it is a work of art and based on an consensus of what does mean quality of live for the city and its inhabitants. It is multifaceted and can develop the power to regenerate itself. In times of a demographic change with more elderly people in the future then ever and less money in public pursues we nevertheless have the civic duties and the obligation to look after health of our cities. Many faculties like science, visual art, engineering and design must cooperate and work together toward that goal.

Attitude to Health↗
PubMed2001

Clinical trials face heightened scrutiny as science and commerce appear to merge.

Clinical trials involving human subjects face increased scrutiny and regulation by the federal government that may lead to costly changes to the process. Prompted by a highly publicized death in a gene therapy trial, federal regulators are examining almost all aspects of clinical trial conduct, from how patients are recruited and how they give informed consent, to the relationship between the researchers and the company sponsoring the research. In addition to the heightened regulation, the government has announced that it will seek the power to impose civil money penalties on researchers who do not observe applicable patient protection regulations. In an effort to include more senior citizens in clinical trials, the government for the first time will cover certain costs of Medicare beneficiaries who participate in clinical trials. The risk of increased government involvement includes criminal prosecution of physicians for failing to follow the rules, as an innovative case in California demonstrates.

Aged↗
PubMed1996

Awareness, action, and collaboration: how the self-advocacy movement is empowering for persons with developmental disabilities.

In response to stigmatization and lack of opportunities in the United States, a self-advocacy movement by and for persons with developmental disabilities has grown. In parallel, in the empowerment literature in the social sciences, authors have sought to conceptualize the process of becoming empowered. There is little in the empowerment literature that fosters an understanding of the self-advocacy movement. In this paper, four relevant principles of empowerment (which concern gaining awareness of societal discrimination, individual rights, and personal strengths; taking action through participation in community organizations; and working collaboratively with supportive advisors) were considered. Through awareness, action, and collaborative support, self-advocates can transform themselves from marginalized targets of discrimination to respected citizens.

Awareness↗
PubMed2005

Regulation of biotechnology by executive orders: questions about constitutionality, legality and overall fairness to the American public.

In the biotechnology field, researchers often face complex moral and social issues while pursuing their scientific goals. Congress may regulate much of that research by debating the issues and placing restraints on funding granted by the government. In modern times, our presidents have also made some of those funding decisions through the issuance of executive orders. Presidents may issue executive orders with binding legal effect, despite having little constitutional authority to do so. Unless a new president takes office, only Congress or the courts can invalidate an executive order. In the regulation-sensitive biotechnology industry, presidents may exert profound influence by announcing executive orders. Former President Clinton and President George W. Bush are just the latest presidents who have used such orders to influence biotechnology as they have deemed appropriate. In doing so, those presidents have assumed a degree of unilateral lawmaking power over an industry that is fundamentally important to every citizen. This article stresses the need for the other branches of our government to discontinue granting unconstitutional legislative power to the president, and bring more social and scientific balance to important biotechnology policy decisions.

Biotechnology↗
PubMed1995

Presenting uncertainty in health risk assessment: initial studies of its effects on risk perception and trust.

Some analysts suggest that discussing uncertainties in health risk assessments might reduce citizens' perceptions of risk and increase their respect for the risk-assessing agency. We tested this assumption with simulated news stories varying simple displays of uncertainty (e.g., a range of risk estimates, with and without graphics). Subjects from Eugene, Oregon, read one story each, and then answered a questionnaire. Three studies tested between 180 and 272 subjects each. Two focus groups obtained more detailed responses to these stories. The results suggested that (1) people are unfamiliar with uncertainty in risk assessments and in science; (2) people may recognize uncertainty when it is presented simply; (3) graphics may help people recognize uncertainty; (4) reactions to the environmental problems in the stories seemed affected less by presentation of uncertainty than by general risk attitudes and perceptions; (5) agency discussion of uncertainty in risk estimates may signal agency honesty and agency incompetence for some people; and (6) people seem to see lower risk estimates (10(-6), as opposed to 10(-3)) as less credible. These findings, if confirmed, would have important implications for risk communication.

Adult↗
PubMed2002

[Health conditions, diseases and medicine in medieval Wrocław].

The article examines medieval medicine from the point of view of the daily lives of the citizens of Wrocław. The author describes the conditions of daily life, in other words living conditions, personal hygiene, food and surroundings, often influenced by fundamental calamities, the climate, and medieval ideology, among which one can include asceticism, astrology, alchemy, magic and superstition, factors which affected the health of the medieval population. Next, she discusses methods of combating common illnesses, especially infections, in other worlds medieval preventive medicine and therapy, as well as the training and work of physicians and the development of medieval medical science in Silesia.

Disease↗
PubMedDate not supplied

[Ethical foundations of institutional psychotherapy].

HISTORICAL ASPECTS: The idea behind this work is to have an ethical examination of the institutional psychotherapy movement which has long influenced French public psychiatry and which has progressively, since the 80s, been subject to growing doubts. In the first part, institutional psychotherapy is presented. It is a model for theoretical development and practice in psychiatric care. It came into being just following the end of the Second World War at the same time as modern medical ethics. Its principles come on the one hand, from recognition of asylums' pathogenic effects--which led to the crushing of the patient's being--and on the other, through recognition of the uniqueness of each person and the subjectivity of mental suffering. These elements gave rise to creativity within the world of medicine and, in the sector, generated the science of psychiatry which advocated for continuity in care (both inpatient and outpatient) and preventive work directed at the population. This movement called for the use of the institution in its dynamic aspect which promotes exchanges and allows patients to situate or resituate themselves in historic and symbolic dimensions. It privileges a high level of transversality, maximum communication, favouring speaking out loud and responsibility. It requires a permanent analysis of the institutional counter transference (emotional reactions of the caregivers involved, their interrelations and the social and material organization of the institution) which determines the therapeutic action itself. THEORICAL BASIS: In a second part, its theoretical foundations and its practice shall be investigated in light of the guiding concepts of medical ethics (justice, autonomy, beneficence, non-malfeasance). Institutional psychotherapy responds to the need for justice by considering the patient as a whole and by conceiving each patient as being like oneself despite the differences (associated with the mode of hospitalization, the social or diagnostic category). The principle of autonomy lies always at care's horizon, made concrete in practice by notions of habitability, orientation to place and time, references, by activities and by meetings. The principle of beneficence was the basis for round-the-clock intakes, the use of an established theoretical model and clinical practice centred on the patient's words. Institutional analysis attempts not to repeat the alienation felt by the patient, alienation being associated with the treatment environment, and draws from the principle of non-malfeasance. It therefore appears that the approach of institutional psychotherapy conforms with ethical requirements, given its major interest in the subject who aspires to find meaning in life. CURRENT SITUATION: The third part discusses current orientations in care related to the explosion in neuroscience and technology, the promotion of the citizen as an individual, and legal doctrine, budgetary constraints, and new demands made on psychiatry from the social and political domains. The widespread trend towards simplification, swollen with hypotheses from neuroscientific research, is progressively reducing mental illness to target symptoms. The recovery of the notion of citizenship through technological capture and ideological strains in contemporary culture have also affected a suspension of the subject as a thinking and desiring being, and exempted caregivers from considering transferral phenomena, indicated with the appearance of new signifiers: user, stress, plague, network. The new medical-technical jargon of scales, tables, and management participates in the same process of patient objectification and care compartmentalization. In this context, under the cover of science and generally good actions, psychiatry has become biologisized, whilst being diluted from its social aspect, even as it becomes more repressive for patients. CONCLUSION: This observation leads to the conclusion, in the fourth part, that there is a need for psychiatry, which within its own discipline has a hard time finding sufficient resources, to refocus itself ethically. This enlightenment could come within a multi-disciplinary ethical space, uniting practitioners and psychiatric caregivers, psychoanalysts, philosophers, sociologists, neurobiologists etc. The research should concern the legitimacy of the principles that underlie psychiatric action in its care and preventive aspects.

Ethics, Clinical↗
PubMed2005

Geographers of Mars: cartographic inscription and exploration narrative in late Victorian representations of the red planet.

Over two decades spanning the turn of the twentieth century, astronomers' claims about the landscape and climate of Mars spurred widespread scientific and popular interest in the possibility that the red planet might be inhabited. This essay offers a new explanation for the power with which the notion of an inhabited Mars gripped noted scholars and everyday citizens on both sides of the Atlantic. Rather than pointing to a rekindling of age-old philosophical interest in the plurality of worlds, it argues that turn-of-the-century scientific narratives about Mars derived much of their power and popularity from ties with the newly established discipline of geography. From mapmaking to travelogue-style writing, astronomers borrowed powerful representational strategies from the discipline of geography to legitimize their claims about the red planet. In making the link between geographical and astronomical science more explicit, the essay further suggests that turn-of-the-century representations of Mars could be productively recontextualized alongside geographical works produced in the same period.

Astronomy↗
PubMed2002

[Bernard Schapiro--an orthodox Jew as an early andrologist in the 20th century].

The unusual history and professional background of one of the first andrologists is reported. Bernhard Schapiro, born in 1888 in Dvinsk in Latvia, then a city in the Russian Pale of Settlements for Jews, grew up as an orthodox (hassidic) Jew receiving exclusively talmudic lessons until he was 18 years old. During the final years of this period of life he was educated at the famous Slobodka Talmud Academy Kenesset Israel in Kovno where he absorbed the ideals of Musar-doctrines, thus being influenced for the rest of his life. The Rogachover Gaon J. Rozin supported his desire to study medicine. After a brief stay in Frankfurt/Main he acquired by own efforts the necessary general knowledge to matriculate for access to university. Medical studies at Zurich University (1913-1919) were followed by a one-year-internship at a dermatologic department in Breslau/Silesia. The thesis for his doctorate at Zurich University in 1920 was on, Relations between Nodular Erythema and Tuberculosis'. He spent two years training in dermatology at Breslau University under Jadassohn. Back in Berlin, he married and had four children, while he worked at Magnus Hirschfeld's Institute for Sexual Sciences. After initial clinical studies in venerology he more and more turned to andrological problems, including treatment of underdeveloped male genitals, premature ejaculation and impotence in general. In this context he tested the new drug Praehormon and developed the two remedies Testifortan and Praejaculin. He was the first to describe the effect of anterior pituitary lobe hormone on the descent of cryptorchid testicles, thus initiating a treatment modality still in motion today. When Hitler came to power he and his family were spared as Swiss citizens, but he lost his base for working after the Institute was looted. He established an andrologic practice at Zurich. What he had witnessed in Germany caused him to set up a Swiss branch of Mizrachi, the spiritually based center of Zionism in Switzerland. He left Europe in 1940 for New York/USA. After compulsory repetition of medical exams in a new language he managed to establish a new existence as andrologist. His practice flourished, the more as he was trusted to treat Jewish patients according to Jewish Law. The decisive step brought him to Jerusalem, in 1951, where he founded and headed an Endocrinologic Department of the University, pursuing andrologic questions, until his death on December 31, 1966. What actually controlled his life can be read on his tombstone: 'He remained a pupil of Slobodka all the days of his life'.

Andrology↗
PubMed2005

"Science in a democracy": the contested status of vaccination in the Progressive Era and the 1920s.

In the first decades of the twentieth century, a heterogeneous assortment of groups and individuals articulated scientific, political, and philosophical objections to vaccination. They engaged in an ongoing battle for public opinion with medical and scientific elites, who responded with their own counterpropaganda. These ideological struggles reflected fear that scientific advances were being put to coercive uses and that institutions of the state and civil society were increasingly expanding into previously private realms of decision making, especially child rearing. This essay analyzes the motivations and tactics of antivaccination activists and situates their actions within the scientific and social climate of the Progressive Era and the 1920s. Their actions reveal how citizens of varied ideological persuasions, activists and nonactivists alike, viewed scientific knowledge during a period of swift and unsettling change, when the application of biologic products seemed to hold peril as well as promise.

Adult↗
PubMed1998

Historical databases in Scandinavia.

"Researchers and archivists in Denmark, Sweden, and Norway have created several databases containing transcripts of historical, nominative sources such as censuses and ministerial records. In this way they continue a century-long tradition of record keeping that tracks virtually every Nordic citizen. The characteristics of the databases differ from country to country, however, requiring different research strategies in each. This article reviews how the data bases are built, what they contain, and how they can be accessed by the worldwide community of scholars."

Data Collection↗
PubMed1999

[Psychosocial research during the war in Sarajevo].

War in Bosnia and Herzegovina has caused many psychic and social breakdowns. The consequences on mental health of the war which caused stress are of importance, as well as influences on psychic functioning of individuals are caused by changes in social structure of population and economic potential of the society. Project "Psycho-social aspects of war in BiH" carried out within the frame of the Academy of Sciences and Arts of Bosnia and Herzegovina and the Department of Psychiatry of Clinical Center of Sarajevo University. In this article are given the results of the Project, but only partially. The investigations showed that the number of patients visiting hospitals during the war was greatly increased in the field of stress reactions and reactive psychoses. But incidence and prevalence of alcohol psychoses decreased. Findings are the same for out patient clinics. The field investigation on the free territories of Sarajevo s communities shows enormous increase of mental disorders among the citizens: neurotic over 40%, psychotic about 20% and that is, together, more than 60% of the population of the town Sarajevo were disturbed at that time. Among the children and adolescents there was an increase of neurotic and psychotic disorders in the very beginning of the first year of the war, and decrease of the same diagnoses during the second year. This might be explained by particular adaptation of the youngsters to war conditions. When we are talking about invalidity of neurological and psychiatric disorders, the investigations showed that illness is the mostly caused by invalidity (85.1%) among the global invalidity during the war in Sarajevo. Injuries before the war were at 3%, during the war are 11% of cases. But, all those shows temporary, because war caused invalidity more and we are expecting to registration later. Our investigation among the refugee camps and population in Sarajevo shows that "life equipment" among the displaced persons was lower than domestic people. That shows that after the phase of surviving this part of the population was at risk of many psycho-social problems. Also, our investigation shows that very low socio-economical level of inhabitants of Sarajevo leads to the potential of absolutely poverty. The indicators of this trend are: low level of education, very low life standard, unemployment, bad health conditions etc. Among refugees all those indicators are worse. Criminality in Sarajevo during the war has been increased, particularly among adolescents. One fifth of contents of daily newspaper "Oslobodenje" has been during the war oriented to the health system problems.

Adolescent↗
PubMed1999

A historical review on the recognition of well-being and diseases in Japanese literature: its multiplex construction.

In 1997 the Japanese government enacted a law concerning organ transplantation offered by brain-dead patients. However, there were no cases of transplantation carried out according to this law during this one year. This might be partly explained by the psychological background of the recognition of well-being, disease or death among Japanese citizens. This investigation was performed in an attempt to reveal the psychological background of matter among Japanese citizens as shown in Japanese literature from ancient to modern times. The result showed that a multiplex construction exists in the recognition of well-being, disease or death which is partly inherited by modern Japanese citizens. (1) Pre-Buddhist era: people believed that soul and spirit were immortal, and also believed in the miraculous power of language. (2) Old-Buddhist era: people believed in the power of an evil spirit or imprecation, and incantation and prayers were very common procedures to avoid such ill omens. (3) New-Buddhist era: people felt themselves drawn toward yearning for the world of Buddha, and believed in the future existence. (4) Confucianism and Buddhism era: people worshiped God and Buddha, and accepted any trouble as misfortune. (5) Modern science era: people recognize the value of rationality.

Attitude to Death↗
PubMed2000

Health information outreach: the land-grant mission.

Service to the state is one of the core principles of the land-grant mission. This concept of service is also fundamental to a significant number of outreach activities in academic health sciences libraries, particularly those libraries affiliated with the public land-grant universities. The Dana Medical Library at the University of Vermont has a lengthy tradition of outreach to health care providers and health care consumers of the State of Vermont. Building on the foundation of the land-grant institution-which grew out of federal legislation introduced in the mid nineteenth century by Justin Morrill, Vermont's congressional representative--the Dana Medical Library has based its outreach activities on its dedication of service to the state in the promotion of healthy citizens through information dissemination in support of health care delivery. Reengineering library services designed to meet the specific information needs of its diverse clientele, partnering with disparate health care organizations, and relying on fees for service to expand its outreach activities, the Dana Medical Library has redefined the concept of health information outreach for the new millennium.

History, 19th Century↗
PubMed1979

The nutrition program for older Americans. Evaluation and recommendations.

A nutrition program for older Americans, funded under Title VII of the Older Americans Act of 1965, as amended, which served 547 persons over fifty-nine years of age, was evaluated. The results indicate the desirability of: (a) Employing dietitians to administer the program at regional, state, and area levels; (b) serving meals at least five days a week; and (c) including more than one-third of the Recommended Dietary Allowances in the meals served. Women, the socioeconomically disadvantaged, and the oldest senior citizens appeared to be helped the most by these programs. Analysis of blood samples indicated that emphasis on serving vitamin A- and ascorbic acid-rich fruits and vegetables and 3 oz. meat in each meal is warranted.

Aged↗
PubMed2002

The Space Factor--fundamental and applied research benefiting Europe's citizens and economy.

Although "made in space" products are not expected to appear in the near-future, space is gaining interest as an area for industrial or applied R&D. ESA is supporting a growing number of projects involving non-space industries and other third parties. This article gives an overview of the potential of research in space to develop valuable applications on Earth.

Biotechnology↗
PubMed1998

Cardiac transplantation.

Cardiac transplantation has proven to be an effective and life-saving option for those patients with congestive heart failure who deteriorate despite maximal medical management. The recipients have been able to return to life as productive citizens with improved quality as well as quantity of life. Advances in assist-device technology will mean that more patients will survive until donor hearts become available and ultimately may supplement the organ supply by serving as an alternative to transplant in some patients.

Heart Failure↗