Charity Misconduct on Public Health Issues Impairs Willingness to Offer Help.
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ABSTRACT:
SUBMITTER: Yin L
PROVIDER: S-EPMC8700860 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The field of public health includes a wide scope of activities and professional disciplines, ranging from sanitation, health protection, epidemiology, environmental health, financing, health promotion, including supervision, or the provision of clinical care. Each of these disciplines works in systems that face ethical dilemmas, making it important that public health workers have motivation to understand and practice within the ethical guidelines of their profession, thus making ethics an important component of training and practice. The dangers of ethical lapses are overwhelmingly apparent in the case of the Eugenics movement of the early 20th century which metamorphosed from forced sterilizations in many liberal democratic countries into mass murder of physically and mentally handicapped children and adults in Nazi Germany. Between 1939 and 1941, 180 thousand psychiatric patients along with an equivalent number of handicapped children and adults were killed in an organized extermination program in Germany by lethal gassing. This method was then applied to the industrialized murder or Holocaust of six million Jews and millions of other “untermenschen” (sub human) in the greatest genocide in human history. Shortly after World War II ended the Nuremberg Trials of Nazi war criminals were conducted including medical doctors, and some were executed for crimes against humanity. This was followed by the 1948 United Nations Declaration on Human Rights and by the World Medical Association’s Helsinki Declaration. Both are widely accepted as cornerstone documents—the latter specifically governing ethical standards related to human experimentation—and are revised regularly since being issued in 1964. But genocide has not disappeared, nor has unscrupulous experimentation such as the Tuskegee experiment on black Americans infected with syphilis and left untreated even after the availability of a cure, penicillin. Ethical standards are now required by “Helsinki Committees”—ethical review boards—in most medical facilities worldwide. Ethical frameworks have evolved in part due to bitter experience of ethical failures later recognized and affecting public health standards of practice. Future generations of public health leaders and staff will face many ethical issues such as mandatory immunization of health workers and school children, and assisted death of terminally ill patients.
| S-EPMC7149338 | biostudies-literature
Project description:Metacognition, our ability to reflect on our own beliefs, manifests itself in the confidence we have in these beliefs, and helps us guide our behavior in complex and uncertain environments. Here, we provide empirical tests of the importance of metacognition during the pandemic. Bayesian and frequentist analyses demonstrate that citizens with higher metacognitive sensitivity-where confidence differentiates correct from incorrect COVID-19 beliefs-reported higher willingness to vaccinate against COVID-19, and higher compliance with recommended public health measures. Notably, this benefit of accurate introspection held controlling for the accuracy of COVID-19 beliefs. By demonstrating how vaccination willingness and compliance may relate to insight into the varying accuracy of beliefs, rather than only the accuracy of the beliefs themselves, this research highlights the critical role of metacognitive ability in times of crisis. However, we do not find sufficient evidence to conclude that citizens with higher metacognitive sensitivity were more likely to comply with recommended public health measures when controlling for the absolute level of the confidence citizens had in their COVID-19 beliefs.
| S-EPMC10614760 | biostudies-literature
Project description:BackgroundPublic health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent.MethodsEthical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis.ResultsOur search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures.ConclusionsThis is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.
| S-EPMC5381137 | biostudies-literature
Project description:Over 50% of young people have dated by age 15. While romantic relationship concerns are a major reason for adolescent help-seeking from counselling services, we have a limited understanding of what types of relationship issues are most strongly related to mental health issues and suicide risk. This paper used records of 4019 counselling sessions with adolescents (10-18 years) seeking help from a national youth counselling service for a romantic relationship concern to: (i) explore what types and stage (pre, during, post) of romantic concerns adolescents seek help for; (ii) how they are associated with mental health problems, self-harm and suicide risk; and (iii) whether these associations differ by age and gender. In line with developmental-contextual theory, results suggest that concerns about the initiation of relationships are common in early adolescence, while concerns about maintaining and repairing relationships increase with age. Relationship breakups were the most common concern for both male and female adolescents and for all age groups (early, mid, late adolescence). Data relating to a range of mental health issues were available for approximately half of the sample. Post-relationship concerns (including breakups) were also more likely than pre- or during-relationship concerns to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%). Results draw on a staged developmental theory of adolescent romantic relationships to provide a comprehensive assessment of relationship stressors, highlighting post-relationship as a particularly vulnerable time for all stages of adolescence. These findings contribute to the development of targeted intervention and support programs.
| S-EPMC4931381 | biostudies-literature
Project description:The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.
| S-EPMC9408569 | biostudies-literature
Project description:AimTo compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking.MethodsThe surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex, age, level of education, and political party affiliation. The random sampling of the person within the household was done using the table of random numbers.ResultHealth and health care system was the most important issue (58%) during the 2007 parliamentary election and the second most important issue during the 2005 and 2009 elections (46% and 28%). In the 2007 election, health care was viewed as most important by women, respondents with lower education levels, and respondents with lower income. In 2005, the most important health care issues were corruption and lack of funding (45% and 43%, respectively), in 2007 poor organization and lack of funding (43% and 42%, respectively), and in 2009 lack of funding and corruption (51% and 45%, respectively).ConclusionHealth and health care system were consistently among the top two issues in all elections from 2005 to 2009. The top three most important health care sector issues were corruption, poor organization, and lack of funding. This indicates that political parties should include solutions to these issues in their health care policymaking.
| S-EPMC3195967 | biostudies-literature
Project description:Inquiry activities have become increasingly common in Ecology and Evolution courses, but the rapid shift to remote instruction for many faculty members in response to the COVID-19 pandemic has created new challenges for maintaining these student-centered activities in a distance learning format. Moving forward, many instructors will be asked to create flexible course structures that allow for a mix of different teaching modalities and will be looking for resources to support student inquiry in both online and in-person settings. Here, we propose the use of data-driven inquiry activities as a flexible option for offering students experiences to build career-relevant skills and learn fundamental ecological concepts. We share lessons learned from our experiences teaching a two-semester course-based research experience in global change ecology that leverages publicly available datasets to engage students in broadly relevant scientific inquiry.
| S-EPMC7679546 | biostudies-literature
Project description:BackgroundThe insufficient knowledge regarding the serological status of people affected with human immunodeficiency virus (HIV) is a concern in Brazil. HIV self-testing (HIVST) has been proved to have great potential for increasing testing, especially among vulnerable populations. The large-scale distribution of HIVST by the Brazilian public health system has increased in recent years. We aimed to investigate the awareness of HIVST among health care providers (HCP) from specialized HIV/AIDS care services in the state of Bahia, Northeast Brazil. Further we investigated HCP acceptability and willingness to offer its use.MethodsA cross-sectional study on HCP from 29 specialized care services (SCS) located in 21 cities in the state of Bahia. HCP working in the service for at least 6 months were included. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Descriptive statistics were carried out. Bivariate, and multivariate analyses estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) using logistic regression were conducted.ResultsThe awareness and acceptability of HIVST and the willingness to provide it were 79.8, 55.2, and 47.1%, respectively. Few HCP reported that the SCS where they worked dispensed HIVST (3.6%), and 13.5% received some information or training on HIVST. Factors associated with willingness to offer HIVST were: HIVST acceptability (aOR = 9.45; 95% CI: 4.53-19.71), willingness to use HIVST on themselves (aOR = 4.45; 95% CI: 1.62-12.24), confidence in offering HIVST to clients (aOR = 5.73; 95% CI: 2.26-12.72), and considering everyone eligible for HIVST (aOR = 2.88; 95% CI: 1.25-6.59).ConclusionsAlthough most HCP were aware of HIVST, acceptability and willingness to provide it to the clients was moderate. The scale up of HIVST as a mean for the HIV prevention and control policy in Brazil, requires further training of HCP and better implementation of this program.
| S-EPMC9149328 | biostudies-literature
Project description:BackgroundIf Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted.MethodsElectronic databases and organisation websites were searched using a 22 year time horizon (1990-2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers.ResultsWe identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist.ConclusionsIn this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader paradigm with respect to public health economics. We offer a 12 point checklist to support government, NHS commissioners and individual health economists in their consideration of economic evaluation methodology with respect to the additional challenges of applying health economics to public health.
| S-EPMC4015185 | biostudies-literature
Project description:BackgroundTo achieve universal health coverage by 2030, sub-Saharan African countries are planning to develop large scale tele-consultation public health services. However, there is a lack of knowledge regarding the level of peoples' willingness to use this kind of tele-health services. To address this gap and inform policymakers, the present study aims at accessing the Mozambican people's willingness to use tele-consultation public health services and the determinants associate to their willingness.MethodsA total of 403 adults participated in the study. The material consisted of 32 vignettes (scenarios) describing realistic health problem situations in which an individual was proposed to use a tele-consultation public health service, varying as a function of five factors: consultation category, health problem category, health problem severity, physician category, and the consultation price. For each health problem situation presented in the vignettes, the participants were asked to rate their willingness to use the proposed tele-consultation service on an 11-point scale. A cluster analysis using the K-means procedure was applied to the quantitative raw data to capture the participants' different perspectives. ANOVA, x2 and t-test analyses were also conducted to examine the effects of the different health problem situations and the sociodemographic characteristics on the participant ratings.ResultsFive different perspectives (clusters) were found: never-willing (15% of the sample), severity (26%), consultation-category (22%), undecided (16%), and price-severity (21%). These perspectives were associated with participants' sociodemographic characteristics.ConclusionAccording to the main results, it seems that the majority of the participants (69%) were highly willing to use tele-consultation public health services in the case of mild illness, cheaper prices and follow-up consultation. In addition, the participants' willingness was significantly affected by some of the participants' sociodemographic characteristics.
| S-EPMC8132030 | biostudies-literature