Search results for: medical ethics

Authors: Hanna Teklu Gebregziabher

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Background: A variety of techniques for medical termination of second-trimester pregnancy can be used, but there is no consensus about which is the best. Even though most evidence suggests the combined use of intracervical Foley catheter and vaginal misoprostol is safe, effective, and acceptable method for termination of second-trimester pregnancy, which is comparable to mifepristone-misoprostol combination regimen with lower cost and no additional maternal risks. The use of mifepristone and misoprostol alone with no other procedure is still the most common procedure in different institutions for 2nd-trimester pregnancy. Methods: A cross-sectional comparative prospective study design is employed on women who were admitted for 2nd-trimester medical abortion and medical abortion failed or if there was no change in cervical status after 24 hours of 1st dose of misoprostol. The study was conducted at St. Paulose Hospital Millennium Medical College. A sample of 44 participants in each arm was necessary to give a two-tailed test, a type 1 error of 5%, 80% statistical power, and a 1:1 ratio among groups. Thus, a total of 94 cases, 47 from each arm, were recruited. Data was entered and cleaned by using Epi-info and analyzed using SPSS version 29.0 statistical software and was presented in descriptive and tabular forms. Different variables were cross-tabulated and compared for significant differences and statistical analysis using the chi-square test and independent t-test, to conclude. Result: There was a significant difference between the two groups on induction to expulsion time and number of doses used. The mean ± SD of induction to expulsion time for those used misoprostol alone was 48.09 ± 11.86 and those who used trans-cervical catheter sequentially with misoprostol were 36.7 ±6.772. Conclusion: The use of a trans-cervical Foley catheter in conjunction with misoprostol in a sequential manner is a more effective, safe, and easily accessible procedure. In addition, the cost of utilizing the catheter is less compared to the cost of misoprostol and is readily available. As a good substitute, we advised using Trans-cervical Catether even for medical abortions performed in the second trimester.

Keywords: second trimester, medical abortion, catheter, misoprostol

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Authors: Zarini Ismail, Nurul Azmawati Mohamed, Shalinawati Ramli, Nurul Hayati Chamhuri, Nur Syahrina Rahim, Khairani Omar

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Choosing a career is one of the most important decisions that people have to make in life. While choosing a suitable career, a person cannot ignore their intrinsic traits such as the type of personality, interests, values, and aptitude. The objective of this study is to ascertain the personality of the pre-clinical medical students and their reasons or intentions for choosing medicine as a career. This study is a cross-sectional study involving Year 3 pre-clinical medical students at Universiti Sains Islam Malaysia. Participants were given a set of validated questionnaires on demographic data and open-ended questions for reasons of choosing medicine. Thematic analysis were used to analyse the open-ended question. The Participants were also required to answer a Career Interest Questionnaire (based on Holland’s Theory). A total of 81 Year 3 medical students were involved in this study. About two third (69%) of them were female and their age ranged from 20 to 21 years old. The majority of them were from middle-income families. From the thematic analysis, there were several reasons given for choosing medicine by the students. The majority of the students stated that it was their passion and interest in the medical field (45.7%). Approximately 24.7% decided to take the medical course because of parents/family influenced and 19.8% mentioned that they wanted to help the society. Other themes emerged were jobs opportunity in future (1.2%) and influenced by friends (3.7%). Based on Holland’s theory, ideally to become a good medical doctor one should score high in investigative and social personality trait. However, 26.3% of the students had low scores in these personality traits. We then looked into the reasons given by these students for choosing medicine. Approximately 28% were due to parents/family decision while 52% admitted that it was due to their interest. When compared with the group of students with high personality scores (investigative and social), there was not much difference in the reasons given for choosing medicine. The main reasons given by the students for choosing medicine were own interest, family’s influence and to help others. However, a proportion of them had low scores in the personality traits which are relevant for medicine. Although some of these students admitted that they choose medicine based on their interest, their strength might not be suitable for their chosen carrier.

Keywords: career, medical students, medicine, personality

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Authors: Gorkem Algan, Ilkay Ulusoy, Saban Gonul, Banu Turgut, Berker Bakbak

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Computer vision systems recently made a big leap thanks to deep neural networks. However, these systems require correctly labeled large datasets in order to be trained properly, which is very difficult to obtain for medical applications. Two main reasons for label noise in medical applications are the high complexity of the data and conflicting opinions of experts. Moreover, medical imaging datasets are commonly tiny, which makes each data very important in learning. As a result, if not handled properly, label noise significantly degrades the performance. Therefore, a label-noise-robust learning algorithm that makes use of the meta-learning paradigm is proposed in this article. The proposed solution is tested on retinopathy of prematurity (ROP) dataset with a very high label noise of 68%. Results show that the proposed algorithm significantly improves the classification algorithm's performance in the presence of noisy labels.

Keywords: deep learning, label noise, robust learning, meta-learning, retinopathy of prematurity

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Authors: Vichayada Laohapiboolkul

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Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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Authors: Prosper Kudzanai Mushauri

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In issues of anomalous experiences commonly referred to as madness or mental illness, attempts have been made to deal with it so that people manage to live their lives in a more functional way. It is in this stance that psychiatry has sort of portraying itself as seeking to ameliorate perturbations which individuals live with via nosological systems and use of medicine to anomalous experiences. It is from this hegemony that has led to the untold harm which people living with madness have endured from antique to contemporary life. The paper reflects via a literature review on the history of psychiatry and argues that it is akin to contemporary psychiatry to be involved in iatrogenic acts. As antique psychiatry meddled with gory issues of inhumanity, deceit and mass murders which some of those the contemporary psychiatry has not weaned itself from such diabolical acts. The objective of the paper is to suggest to psychiatry that it has not comported to the mores of psychological ethics. In doing this, the paper hopes that psychiatry will reflect and reform its curricular and praxis so that it comports to ethical standards in psychological science in ameliorating anomalous experiences.

Keywords: nosology, psychiatry, madness, diagnosis, eugenics

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Authors: Waleed Mandour

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This study presents multidimensional scrutiny of Benson et al.’s seven-category taxonomy of lexical collocations used by Egyptian medical authors and their peers of native-English speakers. It investigates 212 medical papers, all published during a span of 6 years (from 2013 to 2018). The comparison is held to the medical research articles submitted by native speakers of English (25,238 articles in total with over 103 million words) as derived from the Directory of Open Access Journals (a 2.7 billion-word corpus). The non-native speakers compiled corpus was properly annotated and marked-up manually by the researcher according to the standards of Weisser. In terms of statistical comparisons, though, deployed were the conventional frequency-based analysis besides the relevant criteria, such as association measures (AMs) in which LogDice is deployed as per the recommendation of Kilgariff et al. when comparing large corpora. Despite the terminological convergence in the subject corpora, comparison results confirm the previous literature of which the non-native speakers’ compositions reveal limited ranges of lexical collocations in terms of their distribution. However, there is a ubiquitous tendency of overusing the NS-high-frequency multi-words in all lexical categories investigated. Furthermore, Egyptian authors, conversely to their English-speaking peers, tend to embrace more collocations denoting quantitative rather than qualitative analyses in their produced papers. This empirical work, per se, contributes to the English for Academic Purposes (EAP) and English as a Lingua Franca in Academic settings (ELFA). In addition, there are pedagogical implications that would promote a better quality of medical research papers published in Egyptian universities.

Keywords: corpus linguistics, EAP, ELFA, lexical collocations, medical discourse

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Authors: Shahriar M. Saadullah, Abdul-Quddoos Abdul-Basith, Zaki K. Abushawish

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As a part of academic research in Islamic Accounting it is important to know how the word Accounting is discussed in the Qur’aan. This paper identifies and analyzes the word Accounting in the Qur’aan, which is significant to know and understand. The paper uses a methodology of identifying the root word of Accounting Hasaba (حسب) in the Qur’aan with the help of Islam 360 software and analyzes the use of the relevant words derived from the root word. Then the paper attempts to connect the findings to the contemporary Accounting issues. The paper finds that the root word of Accounting Hasaba (حسب) appears in the Qur’aan 109 times but it is only used in the sense Account, Accountable, or Accounting 45 times. These words appear in 44 different verses in the Qur’aan, appearing twice in one of the verses. The paper divides these verses into 8 different themes namely, Day of Accounting, without any Accounting, Accounting of Time, Self-Accounting, Swift in Accounting, Accounting is only with God, Awareness and the Good Accounting, and Heedlessness and the Bad Accounting. The way the words Account, Accounting, and Accountable is discussed in the Qur’aan links to the contemporary accounting issues including Ethics, Agency Theory, and Internal Control. The links discovered in the paper clearly shows the timeless nature of the message of the Qur’aan.

Keywords: accounting, contemporary accounting issues, Qur'aan, root word of accounting hasaba

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Authors: Thuvanan Borvornvitchotikarn, Werasak Kurutach

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Mutual information (MI) is widely used in medical image registration. In the different medical images analysis, it is difficult to choose an optimal bins size number for calculating the probability distributions in MI. As the result, this paper presents a new adaptive bins number selection approach that named a hybrid EMPCA-Scott approach. This work combines an expectation maximization principal component analysis (EMPCA) and the modified Scott’s rule. The proposed approach solves the binning problem from the various intensity values in medical images. Experimental results of this work show the lower registration errors compared to other adaptive binning approaches.

Keywords: mutual information, EMPCA, Scott, probability distributions

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Authors: Rakan Alajmi, Rahaf Alnazzawi, Yara Aljefri, Abdullah Alafif, Ali Alraddadi, Awadh Alamri

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Background: The distribution of physicians in different specialties across Saudi Arabia is determined by the career choices of medical students. Dermatology residency program is one of the highly competitive programs here in Saudi Arabia. Assessing and understanding the factors perceived to be attractive in choosing dermatology will aid the directors of the specialty programs to plan for a more balanced workforce distribution to better suit the needs of the specialties. Aim: The aim of our study is to determine and assess the factors perceived to be significantly attractive when choosing dermatology as a future specialty. Methods: The study is a cross-sectional study conducted in King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia. A validated questionnaire was sent electronically to clinical year medical students. In addition to the questionnaire, gender, grade point average, preferred specialty, and other socio-demographic data were assessed. Results: A total of 121 clinical years medical students completed the questionnaire, 8 (6.6%) preferred dermatology as a specialty. 76 (62.8%) of the participants score a grade point average of more than 4.5 and 83 students (68.6%) chose their specialty during clinical years. The appeal of being a dermatologist (P= 0.047), the portrayal of different specialities in the media (P= 0.005), and the likelihood that dermatologists can influence patients’ lives (P=0.010) were shown to be significantly attractive factors. Conclusion: There are many factors that are affecting students’ choices when choosing a medical specialty. The appeal of being a dermatologist, the portrayal of different specialities in the media, and the likelihood that dermatologists can influence patients’ lives were shown to be significantly attractive factors when choosing dermatology as a future specialty. Recognizing medical students’ specialty perception will lead them to a proper specialty tailored to their needs.

Keywords: dermatology, career choice, medical specialties, student's perception

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Authors: Shahid Mahmood, Ghulam Mueen-Ud-Din, Farah Naz Akbar, Yousaf Quddoos, Syeda Mahvish Zahra, Wajiha Saeed, Tayyaba Sami Ullah

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Obesity is an epidemic across the globe that affects all the segments of the population. Physical inactivity, passionate consumption of junk food, inadequate water intake and an unhealthy lifestyle are evident among university girls that are ruining their health gravely especially fat accumulation. The study was carried out to investigate the potential etiological factors of obesity development in university girls. The cross sectional study was carried out after approval of the Departmental Review Committee for Ethics (DRCE) as the par Declaration of Helsinki at Institute of Food Science and Nutrition (IFSN), University of Sargodha, Sargodha-Pakistan and Department of Food Science and Home Economics, G. C. Women University, Faisalabad-Pakistan. 400 girls were selected randomly from different departments of both universities. Nutritional status of the volunteers was assessed through approved protocols for demographics, anthropometrics, body composition, energetics, vital signs, clinical signs and symptoms, medical/family history, and dietary intake assessment (FFQ), water intake and physical activity level. The obesity was determined on body fat (%). Alarming and unheeded etiological factors for the development of obesity in girls were explored by the study. About 93 % girls had a sedentary level of physical activity, zealous consumption of junk food (5.31±1.23 servings), drank little water (1.09±0.26 L/day) that consequent high heaps of fat (35.06±3.02 %), measly body water (52.38±3.4 %), poor bone mass (05.14±0.31 Kg), and high BMI (26.68±1.14 Kg/m²) in 34% girls. The malnutrition also depicted by poor vital signs i.e. low body temperature (97.11±0.93 °F), slightly higher blood pressure (124.19±4.08 / 85.25±2.97 mmHg), rapid pulse rate (99.2 ± 6.85 beats/min), reduced blood O₂ saturation (96.53±0.96 %), scanty peak expiratory flow rate (297 ± 15.7 L /min). The outcomes of the research articulated that physical inactivity; extreme intakes of junk food, insufficient water consumption are etiological factors for obesity development among girls which are usually overlooked in Pakistan.

Keywords: informed consent, junk food, obesity, physical inactivity

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Authors: Manal Rauf

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Trained medical practitioners are produced from medical colleges serving in public and private sectors. Prime responsibility of teaching faculty is to inculcate required work ethic among the students by serving as role models for them. It is an observed fact that classroom incivility behaviours are providing a friction in achieving these targets. Present study aimed at identification of classroom incivility behaviours observed by teachers and students of public and private medical colleges as per Glasser’s Choice Theory, making a comparison and investigating the strategies being adopted by teachers of both sectors to control undesired class room behaviours. Findings revealed that a significant difference occurs between teacher and student incivility behaviours. Public sector teacher focussed on survival as a strong factor behind in civil behaviours whereas private sector teachers considered power as the precedent for incivility. Teachers of both sectors are required to use verbal as well as non-verbal immediacy to reach a healthy leaning environment.

Keywords: classroom incivility behaviour, glasser choice theory, Mehrabian immediacy theory

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Authors: Yoko Yamada, Chizumi Yamada

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Narrative psychology is based on the dialogical relationship between self and other. The dialogue can consist of divided, competitive, or opposite communication between self and other. We constructed models of coexistent dialogue in which self and other were positioned side by side and communicated sympathetically. We propose new mediation models for narrative relationships. The mediation models are based on triadic relationships that incorporate a medium or a mediator along with self and other. We constructed three types of mediation model. In the first type, called the “Joint Attention Model”, self and other are positioned side by side and share attention with the medium. In the second type, the “Triangle Model”, an agent mediates between self and other. In the third type, the “Caring Model”, a caregiver stands beside the communication between self and other. We apply the three models to the illness narratives of medical professionals and patients. As these groups have different views and experiences of disease or illness, triadic mediation facilitates the ability to see things from the other person’s perspective and to bridge differences in people’s experiences and feelings. These models would be useful for medical education in various situations, such as in considering the relationships between senior and junior doctors and between old and young patients.

Keywords: illness narrative, mediation, psychology, model, medical education

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Authors: Ali Akbar Zeinali

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Lack of appropriate equivalences for the terms or technical words is the result of ineffective translation guidelines adopted in the translation processes. The increasing number of foreign words and specific terms incorporated into the native language are due to the ongoing development of technology and science. Many problems appear in medical translation when the Persian translators try to employ non-Persian or imported words in medical texts, in which multiple equivalents may be created for one particular word based on the individual preferences of authors and translators in the target language due to lack of standardization. The study attempted to discuss the findings based on the compatibility of the international naming criteria, considering the translation procedures. About 67% of 339 equivalents under this study were grouped as incompatible words while about 33% of them were compatible terms. The similarities and differences were investigated and discussed according to the compatibility status of the equivalents with Sager’s criteria. Such equivalents have been classified into several groups through bi-dimensional descriptions that were different features of translation procedures related to the international naming criteria. In review of the frequency distribution of compatibilities, the equivalents were divided into two categories of compatibles and incompatibles, indicating the effectiveness of the applied translation procedures.

Keywords: linguistics, medical translation, naming, terminology

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Authors: Abdul Razzaq Azad

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It is known that every human society throughout the world and throughout history, the various religions and their theologies, ethics, and traditions influence everything in their life, shaping socio-economic and political ideas, attitudes and institutions. It is observed that religious teachings and traditions shape how people respond to each other in their daily social inter-course and interaction in the community at large. The majorities of us preserves and protect our own religious beliefs and traditions as generally they symbolize our essential identities, theologically, historically, culturally, socially, and even politically. Our religious faiths symbolize our dignity as persons and our very souls as communities and individuals. It thus goes without saying that in our multi racial and multi religious society, the only way for us to live in peace and harmony is for us to live in peaceful co-existence. It is important for us to recognize, understand, accept and respect each other regardless of our respective belief. The history of interfaith is as ancient as the religions since men and women when not at war with their neighbors have always made an effort to understand them (not least because understanding is a strategy for defense, but also because for as long as there is dialogue wars are delayed).

Keywords: interfaith harmony, world piece order, Islam, religions, lightness,

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Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

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Authors: Clive Greenstone, Kiara Lawrence

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This conceptual paper explains certain influences of urban planning and urban form on the design layout of housing specific vulnerable members of society. It reimagines how to use vulnerable groups and spaces that are designed for them as interventions instead of using outside intervention within these vulnerable groups. Questions of what are needed to ensure that collective values, ethics and certain moral principles are taken into consideration when creating spaces for individuals and communities are challenging. This conceptual paper offers a more appropriate approach to both offer better urban settlements as well as help solve several challenges facing the most vulnerable groups in society, namely, the elderly, vulnerable children and vulnerable domestic animals into new housing settlements that create better social connections and physical and emotional well-being, labeled urban moral clusters. This conceptual paper offers two potential case studies where these new moral clusters can be implemented.

Keywords: vulnerability, inclusivity, urban planning, social capital, moral clusters

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Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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Authors: Monia Hejaiej

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The fable has lent itself to memorable imitations and reinventions. The writing of fables, in prose and verse, was widely cultivated not only in pre-Islamic Arabia but also in the middle ages, reaching its culmination with the Egyptian poet and man of letters Ahmad Shawqī (1989-1932), who revived the ancient tradition, a relatively minor and unexploited genre in the modern era, and re-wrote rimed fables with an Arab Islamic flavor, articulating a set of modern ethico-political concepts and sensibilities such as a belief in good judgment in governance, individual liberty, democracy, a sense of the brotherhood of man and justice. This essay aims to restore the 20th Century poet to his rightful place in the international pantheon of literary achievement, and offers an examination of the Arabian fabulist tradition as it appears in Arabic literature, and a treatment of this genre re-visiting a few representative samples of Ahmad Shawqī collection of fables and their implications for contemporary politics in the Middle East.

Keywords: fable, politcs, governace, democracy, ethics of care

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Authors: O. Starineca, I. Voronchuk

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Human Resources (HR) selection and training have various implementation possibilities depending on an organization’s abilities and peculiarities. We propose to base HR selection and training decisions about on a competence-based approach. HR selection and training of employees are topical as there is room for improvement in this field; therefore, the aim of the research is to propose rational decision-making approaches for an organization HR selection and training choice. Our proposals are based on the training development and competence-based selection approaches created within previous researches i.e. Analytic-Hierarchy Process (AHP) and Linear Programming. Literature review on non-formal education, competence-based selection, AHP form our theoretical background. Some educational service providers in Latvia offer employees training, e.g. motivation, computer skills, accounting, law, ethics, stress management, etc. that are topical for Public Administration. Competence-based approach is a rational base for rational decision-making in both HR selection and considering HR training.

Keywords: competence-based selection, human resource, training, decision-making

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Authors: S. J. Yune, K. H. Park

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The purpose of this study was to understand the experiences of medical students in volunteer activities and to draw implications for medical education. For this purpose, the questionnaire and the reflection essay on the volunteer experience of 54 students in the first year and 57 students in the second year were analyzed and analyzed. As a result, the participation of the students in the volunteer activities was the highest in the first semester and once a month in the second grade. Activities were mostly through volunteer organizations. The essence of the volunteering activities experience revealed through reflection essays was 'I want to avoid with fear' and 'I feel far away' in the recognition before volunteering activities. In terms of knowledge after participating in volunteer activities, 'breaking eggs and getting to know the world' and 'intellectual growth through social experience' appeared. In terms of attitude, it revealed 'deep reflection on me and others', 'understanding of service life'. And in terms of behavior, 'Begin preparing for a life of service' appeared. The results of this study revealed that volunteering activities provide students with opportunities for growth and development. In order to obtain more meaningful results, consciousness education related to social service should be done in advance.

Keywords: volunteering activity, pre-medical school student, reflection essay, qualitative analysis

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Authors: Mohammad Amin Mozaheb, Mahnaz Saeidi, Saeideh Ahangari, Saeideh Ahangari

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The present genre-driven study aims at comparing moves and sub-moves deployed by Iranian and English medical writers while writing their research articles in English. To obtain the goals of the study, the researchers randomly selected a number of medical articles and compared them using Nwogu (1997)’s model. The results of relevant statistical tests, Chi-square tests for goodness of fit, used for comparing the two groups of the articles dubbed IrISI (Iranian ISI articles) and EISI (English ISI articles) have shown that no significant difference exists between the two groups of the articles in terms of the moves and sub-moves used in the method and results sections of them. The findings can be beneficial for people interested in English for Specific Purposes (ESP) and medical experts. The findings can also increase language awareness and genre awareness among researchers who are interested in publishing their research outcomes in ISI-indexed journals in the Islamic Republic of Iran and some other world countries.

Keywords: writing, ESP, research articles, medical sciences, language, scientific writing

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Norbert W. Paul

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In 1988, parts of the scientific community still heralded findings to support that AIDS was likely to remain largely a ‘gay disease’. The value-ladden terminology of some of the articles suggested that rectum and fragile urethra are not sufficiently robust to provide a barrier against infectious fluids, especially body fluids contaminated with HIV while the female vagina, would provide natural protection against injuries and trauma facilitating HIV-infection. Anal sexual intercourse was constituted not only as dangerous but also as unnatural practice, while penile-vaginal intercourse would follow natural design and thus be relatively safe practice minimizing the risk of HIV. Statements like the latter were not uncommon in the early times of HIV/AIDS and contributed to captious certainties and an underestimation of heterosexual risks. Pseudo-scientific discourses on the origin of HIV were linked to local and global health politics in the 1980ies. The pathways of infection were related to normative concepts like deviant, subcultural behavior, cultural otherness, and guilt used to target, tag and separate specific groups at risk from the ‘normal’ population. Controlling populations at risk became the top item on the agenda rather than controlling modes of transmission and the virus. Hence, the Thai strategy to cope with HIV/AIDS by acknowledging social and sexual practices as they were – not as they were imagined – has become a role model for successful prevention in the highly scandalized realm of sexually transmitted disease. By accepting the globalized character of local HIV-risk and projecting the risk onto populations which are neither particularly vocal groups nor vested with the means to strive for health and justice Thailand managed to culturally implement knowledge-based tools of prevention. This paper argues, that pertinent cultural collisions regarding our strategies to cope with HIV/AIDS are deeply rooted in misconceptions, misreadings and scandalizations brought about in the early history of HIV in the 1980ties. The Thai strategy is used to demonstrate how local values can be balanced against globalized health risk and used to effectuated prevention by which knowledge and norms are translated into local practices. Issues of global health and injustice will be addressed in the final part of the paper dealing with the achievability of health as a human right.

Keywords: bioethics, HIV, global health, justice

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Authors: Mohit Kumar, Mayur Betharia

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Healthcare domain, with the emergence of Electronic Medical Record (EMR), collects a lot of data which have been attracting Data Mining expert’s interest. In the past, doctors have relied on their intuition while making critical clinical decisions. This paper presents the means to analyze the Medical workflows to get business insights out of huge dumped medical databases. Market Basket Analysis (MBA) which is a special data mining technique, has been widely used in marketing and e-commerce field to discover the association between products bought together by customers. It helps businesses in increasing their sales by analyzing the purchasing behavior of customers and pitching the right customer with the right product. This paper is an attempt to demonstrate Market Basket Analysis applications in healthcare. In particular, it discusses the Market Basket Analysis Algorithm ‘Apriori’ applications within healthcare in major areas such as analyzing the workflow of diagnostic procedures, Up-selling and Cross-selling of Healthcare Systems, designing healthcare systems more user-friendly. In the paper, we have demonstrated the MBA applications using Angiography Systems, but can be extrapolated to other modalities as well.

Keywords: data mining, market basket analysis, healthcare applications, knowledge discovery in healthcare databases, customer relationship management, healthcare systems

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Authors: Neil Michael Walsh, Angelique Lombarts

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The authors propose that hospitality is ‘made’ (constituted and performed) in the encounters on the Silk-Routes. Inspired with an initial Derridean perspective on hospitality (the conditional/unconditional) and methodologically underpinned with a Delueuzian relational-rhizomatic approach, the authors contend that hospitality is (re)produced in the encounters of self/other, east/west (among others). Thus, in the spirit of performativity and using the temporal-spatial conduit of the Silk Routes (the sites of ethical, cultural, economic, and material interaction of such exchange), the authors concur that hospitality is produced at the moment in which it is performed. Key themes engaged as units of analysis become welcome, reception, hostility, (and so on) which the authors engage and examine –as they unfold- in the narratives and accounts and material legacies of those who travelled the Silk Routes between the 2nd and 18th Centuries. The preliminary results suggest that these earlier performative moments in hospitality-making on the silk routes continue to resonate and ‘form’ the hospitalities of today. Indeed, these acts of hospitality continue to reconstitute and are never a final state of affairs.

Keywords: hospitality-genealogy, interactions, hospitality-making, Silk-Routes, rhizome, relationality

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Authors: Trevor Stephen, Joshua D. Aceves, David Guyer, Jona Jacobson

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As a profession, social work has much to offer individuals, groups, and organizations. A multidisciplinary approach to understanding and solving complex challenges and a commitment to developing and training ethical practitioners outlines characteristics of a profession embedded with leadership skills. This presentation will take an overview of the historical context of social work leadership, examine social work as a unique leadership model composed of its qualities and theories that inform effective leadership capability as it relates to our code of ethics. Reflect critically on leadership theories and their foundational comparison. Finally, a look at recommendations and implementation to social work education and practice. Similar to defining leadership, there is no universally accepted definition of social work leadership. However, some distinct traits and characteristics are essential. Recent studies help set the stage for this research proposal because they measure views on effective social work leadership among social work and non-social leaders and followers. However, this research is interested in working backward from that approach and examining social workers' leadership preparedness perspectives based solely on social work training, competencies, values, and ethics. Social workers understand how to change complex structures and challenge resistance to change to improve the well-being of organizations and those they serve. Furthermore, previous studies align with the idea of practitioners assessing their skill and capacity to engage in leadership but not to lead. In addition, this research is significant because it explores aspiring social work leaders' competence to translate social work practice into direct leadership skills. The research question seeks to answer whether social work training and competencies are sufficient to determine whether social workers believe they possess the capacity and skill to engage in leadership practice. Aim 1: Assess whether social workers have the capacity and skills to assume leadership roles. Aim 2: Evaluate how the development of social workers is sufficient in defining leadership. This research intends to reframe the misconception that social workers do not possess the capacity and skills to be effective leaders. On the contrary, social work encompasses a framework dedicated to lifelong development and growth. Social workers must be skilled, competent, ethical, supportive, and empathic. These are all qualities and traits of effective leadership, whereas leaders are in relation with others and embody partnership and collaboration with followers and stakeholders. The proposed study is a cross-sectional quasi-experimental survey design that will include the distribution of a multi-level social work leadership model and assessment tool. The assessment tool aims to help define leadership in social work using a Likert scale model. A cross-sectional research design is appropriate for answering the research questions because the measurement survey will help gather data using a structured tool. Other than the proposed social work leadership measurement tool, there is no other mechanism based on social work theory and designed to measure the capacity and skill of social work leadership.

Keywords: leadership competencies, leadership education, multi-level social work leadership model, social work core values, social work leadership, social work leadership education, social work leadership measurement tool

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Authors: Marisa Almeida AraúJo

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Artificial intelligence (AI) tools are being used (including in the criminal justice system) and becomingincreasingly popular. The many questions that these (future) super-beings pose the neuralgic center is rooted in the (old) problematic between rationality and morality. For instance, if we follow a Kantian perspective in which morality derives from AI, rationality will also surpass man in ethical and moral standards, questioning the nature of mind, the conscience of self and others, and moral. The recognition of superior intelligence in a non-human being puts us in the contingency of having to recognize a pair in a form of new coexistence and social relationship. Just think of the humanoid robot Sophia, capable of reasoning and conversation (and who has been recognized for Saudi citizenship; a fact that symbolically demonstrates our empathy with the being). Machines having a more intelligent mind, and even, eventually, with higher ethical standards to which, in the alluded categorical imperative, we would have to subject ourselves under penalty of contradiction with the universal Kantian law. Recognizing the complex ethical and legal issues and the significant impact on human rights and democratic functioning itself is the goal of our work.

Keywords: ethics, artificial intelligence, legal rules, principles, philosophy

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Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

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Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

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Authors: Arash Sepehri bonab

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One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

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