The foundation of health can be understood by the heart only : in pursuit of knowledge about health in the light of Blaise Pascal's thinking.

In 2000, the world of anthropology was rocked by a high-profile debate over the fieldwork performed by two prominent anthropologists, Napoleon Chagnon and James V. Neel, among the Yanamamo tribe of South America. The controversy was fueled by the publication of Patrick Tierney's incendiary Darkness in El Dorado which accused Chagnon of not only misinterpreting but actually inciting some of the violence he perceived among these "fierce people". Tierney also pointed the finger at Neel as the unwitting agent of a (...) deadly measles outbreak. Attracting a firestorm of attention, Tierney's book went straight to the heart of anthropology's most pressing questions: What are the right ways to study a tribal people? How can scientists avoid unduly influencing those among whom they live? What guidelines should govern the interactions - economic, social, medical, and sexual - between a scientist in the field and the people being studied? This volume represents anthropology's thoughtful, measured reply to the issues raised by this heated controversy. Placing the dispute within the context of ongoing debates over the ethics of biomedical research among human populations, the contributors to this volume discuss how the interaction between investigators and their subjects can most sensibly be governed. They consider the responsibility of the media in disseminating anti-scientific and pseudo-scientific views, and how scientists might best educate journalists to enable them to effectively educate others. In the wake of what was widely construed as a major scientific scandal, this landmark volume lays out in detail the principles and ground rules of anthropological and scientific fieldwork. (shrink)

The Leipzig anatomist Werner Spalteholz (1861–1940) started studies on the anastomoses between the coronary arteries of the heart in 1906. He confirmed the thesis, that “the transparency of tissues depends first of all on the refraction index of permeating liquid”, and began to produce transparent organ specimens. The 1st International Hygiene Exposition 1911 in Dresden showed 370 specimens produced by Spalteholz and was a great success. Later Spalteholz worked in the scientific Council of the Hygiene Museum. The exhibition “Transparent (...) man”, shown in 1925, testified to the great extent of knowledge that was passed on to the population with the help of these specimens. The “transparent human being” was not only an attractive and instructive collection for exhibition and educational purposes, but also a didactic concept. Fritz Tschackert (1887–1958) created the “transparent man” for the 2nd International Hygiene Exposition in Dresden in 1930. Today the “transparent woman” is the highlight of the museum's permanent exhibition. (shrink)

Despite advances in the treatment of heart failure, the physical symptoms and stress of the disease continue to negatively impact patients’ health outcomes. Technology now offers promising ways to integrate personalized support from health care professionals via a variety of platforms. Digital health technology solutions using mobile devices or those that allow remote patient monitoring are potentially more cost effective and may replace in-person interaction. Notably, digital health methods may not only improve clinical outcomes but (...) may also improve the psycho-social status of HF patients. Using digital health to address biopsychosocial variables, including elements of the person and their context is valuable when considering chronic illness and HF in particular, given the multiple, cross-level factors affecting chronic illness clinical management needed for HF self-care. (shrink)

While ideals of racial purity may be out of fashion, other sorts of purity ideals are increasingly popular in the United States today. The theme of purity is noticeable everywhere, but it is especially prominent in our contemporary fixation on health and hygiene. This may seem totally unrelated to issues of racism and classism, but in fact, the purveyors of purity draw upon the same themes of physical and moral purity that have helped produce white identity and dominance in (...) the US. Historically, this is where the purity rhetoric gets its power. To invoke purity ideals in the US is to mobilize this genealogy of racialized associations. Today's zealous preoccupation with hygiene is part of our living heritage in a racist culture.Just as ideas of race and racial purity were debunked by biologists long before the public would begin to question them, ideals of extreme hygienic purity linger with us, even flourish, despite scientific evidence of their futility and harm. Why are we still so enamored with purity? Because, to some extent, our very self-conceptions are at stake. Other scholars have described how our process of self individuation is based upon exclusion. The unique contribution of a genealogical approach to this issue is that, instead of merely locating the problem in ideologies held by others, it can evoke self-recognition and self-transformation. We will tend to assume the problem lies elsewhere until we learn to recognize ourselves in practices that reproduce cultural ideals. As inheritors of this racist culture, we are all lovers of purity, and we are all responsible for rethinking this value. (shrink)

ObjectivesThis study aimed to describe the experiences and challenges faced by adolescents with moderate and severe congenital heart defects or Chronic Rheumatic Heart Disease and to determine their needs in order to develop an Adolescent Transition Psychoeducational Program.MethodsThe study involved seven adolescents with moderate to severe CHD/CRHD, six parents, and four health care providers in Institute Jantung Negara. Participants were invited for a semi-structured interview. Qualitative data were analyzed through the Atlas.ti 7 program using triangulation methods.Results/conclusionsWe identified (...) five themes concerning the experience and challenges of adolescents relating to: emotional/psychological issues; the progress of the illness; relationship issues; future preparation; and, school and community. These themes were identified together with eleven subcategories. The staff expressed support for the development of the Adolescent Transition Psychoeducational Program and adolescents with CHD/CRHD and their parents were willing to participate in the program if their schedule allowed. Their suggestions to improve the program were classified into six categories, with two main themes, the self-management of illness in life and the future; and, social support. In conclusion, the findings from the situation analysis act as a basis for a conceptual framework that will contribute to the development of an Adolescent Transition Psychoeducational Program that aims to empower adolescents with CHD/CRHD, enabling them to manage challenges during the transition phase between childhood and adulthood. (shrink)

Digital health and welfare technologies and artificial intelligence are proposed to revolutionise healthcare systems around the world by enabling new models of care. Digital health and welfare technologies enable remote monitoring and treatments, and artificial intelligence is proposed as a means of prediction instead of reaction to individuals’ health and as an enabler of proactive care and rehabilitation. The digital transformation not only affects hospital and primary care but also how the community meets older people's needs. Community (...) care is often provided by informal and formal care‐givers, most of whom are women. Gender equality is at the heart of many national strategies, but do all genders have equal rights, responsibilities and opportunities when it comes to community care and its digital transformation? The digital transformation of community care is entangled with how care is provided to older people and the working conditions of community‐care professionals. Current and, even more so, future community‐care systems are and will be partly constituted by networks of technological artefacts. These health and welfare technological artefacts and the discourse surrounding them mediate and constitute social relations and community care. This article looks into how health and welfare technology and artificial intelligence‐based devices and systems mediate and constitute gender relations in community care and presents an argument for reflexivity, embodiment, pluralism, participation and ecology as an alternative strategy to treating community care as one‐size‐fit‐all and being blind to gender‐related issues. (shrink)

In 1878, amid a rapidly proliferating social interest in public health and cleanliness, a group of sanitary scientists and reformers founded the Parkes Museum of Hygiene in central London. Dirt and contagion knew no social boundaries, and the Parkes's founders conceived of the museum as a dynamic space for all classes to better themselves and their environments. They promoted sanitary science through a variety of initiatives: exhibits of scientific, medical and architectural paraphernalia; product endorsements; and lectures and certificated courses (...) in practical sanitation, food inspection and tropical hygiene. While the Parkes's programmes reified the era's hierarchies of class and gender, it also pursued a public-health mission that cut across these divisions. Set apart from the great cultural and scientific popular museums that dominated Victorian London, it exhibited a collection with little intrinsic value, and offered an education in hygiene designed to be imported into visitors’ homes and into urban spaces in the metropole and beyond. This essay explores the unique contributions of the Parkes Museum to late nineteenth-century sanitary science and to museum development, even as the growth of public-health policy rendered the museum obsolete. (shrink)

Global governance of emerging, disruptive biomedical technologies presents a multitude of ethical problems. The recent paper by Shoziet alraises some of these problems in the context of a discussion of what could be themostdisruptive (and most morally fraught) emerging biomedical technology—human germline genome editing. At the heart of their argument is the claim that, for something like gene editing, there is likely to be tension between the interests of specific states in crafting regulation for the technology, and disagreement about (...) what would be necessary to meet the requirements for responsible translation of gene editing into the clinic. This complicates hopes for a tidy, algorithmic process of crafting global governance via frameworks for regulation built around core ‘ethical values and principles’ (as they are called in the WHO Framework), and also forces us to confront deeper philosophical questions about biotechnology and global health. (shrink)

This article aims at investigating the history of the institutionalization of experimental hygiene teaching in Italy during the second half of the nineteenth century. Looking to France as the pioneering country in the international hygiene movement, this contribution investigates the process of institutionalizing experimental hygiene in universities and para-university context as an indispensable prerequisite for the organization of public health. With hygiene becoming a matter of global interest due to its importance in preventing the deleterious effects of epidemic diseases, (...) the Italian case will be studied in comparison with developments in the field of hygiene sciences in the German context. With these premises in mind, the focus will be on Luigi Pagliani, who, holding institutional and academic roles in the cities of Rome and Turin, devoted his entire scientific career to the consolidation of experimental hygiene in Italy. (shrink)

This book fills a critical niche that has long been overlooked. It specifically focuses on somatic practices to decrease stress and improve heart health. It will combine science, time-tested somatic mindfulness techniques, and patient stories to provide hope and help.

Sense of agency is a compelling but fragile experience that is augmented or attenuated by internal signals and by external cues. A disruption in SoA may characterise individual symptoms of mental illness such as delusions of control. Indeed, it has been argued that generic SoA disturbances may lie at the heart of delusions and hallucinations that characterise schizophrenia. A clearer understanding of how sensorimotor, perceptual and environmental cues complement, or compete with, each other in engendering SoA may prove valuable (...) in deepening our understanding the agency disruptions that characterise certain focal neurological disorders and mental illnesses. Here we examine the integration of SoA cues in health and illness, describing a simple framework of this integration based on Bayesian principles. We extend this to consider how alterations in cue integration may lead to aberrant experiences of agency. (shrink)

From an aging research and life-course perspective, the transition to retirement marks a significant life-event and provides a unique opportunity to study psychological health and coping during a period of substantial change in everyday life. The aim of the present paper is to: (a) outline the rationale of the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) study, (b) describe the study sample, and (c) to present some initial results from the two first waves regarding the association between (...) retirement status and psychological health. The HEARTS study is designed to annually study psychological health in the years before and following retirement, and to examine change and stability patterns related to the retirement event. Among a representative Swedish population-based sample of 14 990 individuals aged 60 to 66 years, 5 913 completed the baseline questionnaire in 2015. The majority of the participants (69%) completed a web-based survey, and the rest (31%) completed a paper version. The baseline HEARTS sample represents the general population well in terms of gender and age, but is more highly educated. Cross-sectional findings from the first wave showed that retired individuals demonstrated better psychological health compared to those who were still working. Longitudinal results from the first and second waves showed that individuals who retired between waves showed more positive changes in psychological health compared with those still working or previously retired. (shrink)

Background: Ethics in nursing care are traditionally discussed in terms of moral norms or principles. When taking an ontological approach to ethics, ethics is about ethos. Ethos involves both an internal and an external side of ethics. Considering ethics and health from an ontological perspective can provide a different understanding of ethics and health in caring and nursing. Aim and research question: The aim of this study is to deepen the ontological understanding of ethics and health in (...) caring and nursing. The research question is as follows: What is the ontology of health and ethics in caring and nursing? Research design: The study follows a hermeneutical design inspired by Gadamer. Participants and research context: essays about ethics and health were gathered from PhD students in nursing and caring sciences. Ethical considerations: The research follows Responsible conduct of research guidelines provided by the Finnish Advisory Board on Research Integrity. Findings: An ethos with the values of freedom and responsibility seem to ontologically be important for ethics and health. These values allow a movement between the internal and the external sides of ethics that is important for health. Discussion: The ethos of freedom and responsibility that is essential for ethics and health can provide the current ethical debate a new starting point that previous research asks for. Conclusion: Ontologically, an ethos of freedom and responsibility is essential for ethics and health in nursing and caring. (shrink)

Public health is concerned with how to improve the population’s health. At times, though, actions to improve the community’s health may collide with individual civil rights. For example, a public health response to a bioterrorism attack, such as smallpox, may require relaxing an individual’s due process protections to prevent the smallpox from spreading. This tension lies at the heart of public health policy. It also must be considered in discussing the concept of human rights (...) in health.Proponents of incorporating the concept of human rights in health emphasize the importance of both individual rights and collective rights. They argue that observing human rights is not only consistent with broad public health goals, but necessary to their attainment. To many human rights advocates, the concept is not limited to protecting against governmental intrusion. Accordingly, they emphasize the government’s obligation to promote attainment of human rights by, for instance, providing adequate health care. (shrink)

This practical and accessible guide tackles the challenges that busy childcare educators face with their mental health in what is a wonderful, rewarding, but often exhausting role. Drawing from 'day-in-the-life' experiences and case studies, this book sets out high-quality staff wellbeing practices that can revolutionise the way childcare practitioners approach their job and their own health. Chapters guide the reader through a process of reflection and development, encouraging and empowering them to create a workplace culture that positively contributes (...) to their personal wellbeing. This book: Focuses on the realities of early years education, combining the authors' lived experience with examples of real-life practice; Encourages educators to think and feel positively about themselves; to identify the individual skills, strengths and talents they bring to their work; Can be used individually or collaboratively by team members, with guidance on creating a positive workplace culture with a shared vision, core values and beliefs. Essential reading for anybody who finds that the job they love can sometimes leave them feeling worn out, stressed and depleted, this book has been written to enrich the lives of all training and practising early years educators. (shrink)

The Heart of Judgment explores the nature, historical significance, and continuing relevance of practical wisdom. Primarily a work in moral and political thought, it also relies extensively on research in cognitive neuroscience to confirm and extend our understanding of the faculty of judgment. Ever since the ancient Greeks first discussed practical wisdom, the faculty of judgment has been an important topic for philosophers and political theorists. It remains one of the virtues most demanded of our public officials. The greater (...) the liberties and responsibilities accorded to citizens in democratic regimes, the more the health and welfare of society rest upon their exercise of good judgment. While giving full credit to the roles played by reason and deliberation in good judgment, the book underlines the central importance of intuition, emotion, and worldly experience. (shrink)

This cross sectional study was carried out among the workers of British American Tobacco Company, Dhaka with a view to explore their nutritional status, personal hygiene and health seeking behavior as because they are working on a tobacco processing company. The sample size was 179 which were selected purposively. The study showed that out of 179 respondents 89 (49.7%) were in the age groups of 30-39 years and the mean age of the respondents were 31.99 ± 6.01 years. A (...) large number of respondents (55.9%) had monthly family income of Taka 10001-20000 and the mean family income was Taka 12776.54 ± 5230.13. Maximum respondents (73.7%) were Muslim, more than half (54.2%) were shift in charge, 39.1% of the respondents consisted of 4 family members, 43.6% respondents were accustomed to other type of eating habit and 38.5% respondents knew that malnutrition was the effect of lack of proper nutrition, 59.8% of the respondents knew that night blindness was the disease due to malnutrition, most of the respondents (91.6%) performed duties to maintain health, majority (62.0%) respondents used to do nothing to maintain healthcare for their children and 35.9% visited doctor’s single time in a month, 40.2% of the respondents told regular tooth brushing as type of healthy habits. Majority (64.8%) respondents used to brush twice a day, majority (50.8%) respondents used to wash hand after toileting, majority (62.08%) respondents used to bath daily, 43.0% and 31.8% of the respondents told that dysentery and diarrhea was due to eating without proper hand washing respectively. Majority (53.6%) respondents informed that they learned about personal hygiene from television, 45.8% respondents understood that use of safe water in every work as sanitation. Majority (50.84%) came from nuclear family; most (84.92%) had exercise habit and 40.22% had education level of class VIII. Most (75.42%) of the respondents had semi pucca houses and majority (69.83%) of the respondents used only water as materials for hand washing. This study provided some important information which might help the concerned authority to take appropriate measures to improve the health status of the workers. (shrink)

Many scholars have historicized biopolitics with reference to the emergence of sovereign nations and their colonial extensions over the 18th, 19th and 20th centuries. This article begins to conceptualize and trace the history of biopolitics beyond the nation, arguing that the history of world health - the great 20th-century reach of 19th-century health and hygiene - should be understood as a vital politics of population on a newly large field of play. This substantive history of world health (...) and world population is analysed as sites for thinking about global bio-politics; and the article looks seriously at the interwar period as a point at which ‘the world’ (or Hardt and Negri’s ‘Empire’) was already challenging the idea of ‘inter/national’. (shrink)

Hospitalization is a unique health-illness transition for most elderly people. Whether the patient's health-related needs are met or not often iiifluence his or her appraisal of quality of life during hospitalization. This qualitative study explored the health needs of elderly Chinese male cardiac patients during their hospitalization. Eighteen subjects were recruited from a veterans' hospital in northern Taiwan. These men all lived alone before their hospital admission. Data were gathered using semistructured interviews and then analysed by content (...) analysis. Ninety-four per cent of the subjects described up to three categories of needs: met needs (72%), unmet needs (78%), and expected needs (50%0). Needs that participants believed were met were those for psychological support, spiritual support, tangible support and information. Unmet needs were those for participation in decision making, maintaining daily activities and resuming a preadmission lifestyle. The expected needs included those for learning self-care strategies to maintain their daily activities after discharge from the hospital. The factors that framed the participants' perceptions of different health needs were identified to be lack of family support and locus of control. Finally, a discussion of the context background of this phenomenon, as well as some suggestions for its implications, are provided from a culturally sensitive ethical aspect. (shrink)

The hygiene hypothesis offers an explanation for the correlation, well-established in the industrialized nations of North and West, between increased hygiene and sanitation, and increased rates of asthma and allergies. Recent studies have added to the scope of the hypothesis, showing a link between decreased exposure to certain bacteria and parasitic worms, and increased rates of depression and intestinal auto- immune disorders, respectively. What remains less often discussed in the research on these links is that women have higher rates than (...) men of asthma and allergies, as well as many auto-immune disorders, and also depression. The current paper introduces a feminist understanding of gender socialization to the epidemiological and immunological picture. That standards of cleanliness are generally higher for girls than boys, especially under the age of five when children are more likely to be under close adult supervision, is a robust phenomenon in industrialized nations, and some research points to a cross- cultural pattern. I conclude that, insofar as the hygiene hypothesis successfully identifies standards of hygiene and sanitation as mediators of immune health, then attention to the relevant patterns of gender socialization is important. The review also makes clear that adding a feminist analysis of gender socialization to the hygiene hypothesis helps explain variation in morbidity rates not addressed by other sources and responds to a number of outstanding puzzles in current research. Alternative explanations for the sex differences in the relevant morbidity rates are also discussed (e.g., the effects of estrogens). Finally, new sources of evidence for the hygiene hypothesis are suggested in the form of cross-cultural and other natural experiments. (shrink)

Ethics: The Heart of Health Care - a classic ethics text in medical, health and nursing studies - is recommended around the globe for its straightforward introduction to ethical analysis. In this new edition David Seedhouse demonstrates tangibly and graphically how ethics and health care are inextricably bound together, and creates a firm theoretical basis for practical decision-making. He not only clarifies ethics but, with the aid of the acclaimed Ethical Grid, teaches an essential practical skill (...) which can be productively applied in day-to-day health care. This edition, which is even more readable than the first, includes additional case studies and teaching exercises, contains new material on ethical theory and offers two further decision-making tools - The Rings of Uncertainty and the Autonomy Test. The engaging new introduction reveals the genesis of the Ethical Grid, illuminates the intent and argument of the first edition, and explains why the book is needed today as much as ever. Intended for all who work in health care or health studies - indeed for anyone with an interest in health issues - this is a highly original, innovative and accessible work on a subject traditionally regarded as lofty and obscure. It clarifies a wide variety of complex ethical issues and will give the reader fresh inspiration and renewed confidence in dealing with the demands of modern health work. (shrink)

The paper examines the conception of health of the Graeco-Roman medical and philosophical author Galen. On the basis of a range of texts, especially Matters of Health and Thrasybulus, the most significant and influential characteristics of this conception are considered: the twofold definition of health in terms of balance of elements and of organic function; the notion of a latitude within health; the extent to which health is conceived as a specialist expertise, and against this (...) the possible role of the patient in understanding his/her own health. Galen's health writings are also considered in their social-historical context and in relation to their intellectual predecessors – Hippocrates, Plato, Aristotle and a range.. (shrink)

Many current assumptions about health provision in medieval English cities derive not from the surviving archival or archaeological evidence but from the pronouncements of Victorian sanitary reformers whose belief in scientific progress made them dismissive of earlier attempts to ameliorate the quality of urban life. Our own tendency to judge historical responses to disease by the exacting standards of modern biomedicine reflects the same anachronistic attitude, while a widespread conviction that England lagged centuries behind Italy in matters of (...) class='Hi'>health and hygiene seems to reinforce presumptions of ‘backwardness’ and ‘ignorance’. By contrast, this paper argues that a systematic exploration of primary source material reveals a very different approach to collective health, marked by direct intervention on the part of the crown and central government and the active involvement of urban communities, especially after the Black Death of 1348-49. A plethora of regulations for the elimination of recognized hazards was then accompanied by major schemes for environmental improvement, such as the introduction of piped water systems and arrangements for refuse collection. (shrink)

Growing evidence suggests that natural environments – whether in outdoor or indoor settings – foster psychological health and physiological relaxation, indicated by increased wellbeing, reduced stress levels, and increased parasympathetic activity. Greater insight into differential psychological aspects modulating psychophysiological responses to nature-based relaxation videos could help understand modes of action and develop personalized relaxation interventions. We investigated heart rate variability as an indicator of autonomic regulation, specifically parasympathetic activity, in response to a 10-min video intervention in two consecutive (...) studies as well as heart rate. We hypothesized that a nature-based relaxation video elicits HRV increase and HR decrease, with response magnitude being affected by aspects of early life adversity and trait mindfulness. In Study 1, N = 60 participants watched a relaxation video intervention depicting different natural scenery. We analyzed changes in HR and respiratory sinus arrhythmia as a standard HRV measure, both based on 3-min segments from the experimental session, in multiple growth curve models. We found a decrease in HR and increase of RSA during the video intervention. Higher paternal care and lower trait mindfulness observing skills were associated with higher RSA values before but not during video exposure. In Study 2, N = 90 participants were assigned to three video conditions: natural scenery from Study 1, meditation video, or short clip from “The Lord of the Rings.” Again, HR decreased, and RSA increased during video segments, yet without expected group differences across different video types. We found higher parental care and lower parental overprotection to predict higher RSA at different times during the experiment. Interestingly, lower paternal overprotection predicted overall higher RSA. These results suggest a generic relaxation effect of video interventions on autonomic regulation that we discuss in light of different theories mapping restorative effects of natural environments. Further, psychological characteristics like aspects of early life adversity and trait mindfulness could contribute to individual differences in autonomic regulation. This study contributes to a better understanding of autonomic and psychological responses to relaxation videos. (shrink)

BROOKS J and RAFFERTY AM. Nursing Inquiry 2010; 17: 142–150Education and role conflict in the health visitor profession, 1918–39Health visiting was the public health profession in the UK, which arose during the Victorian period to support and supervise the mothers of the nation. The health visitor was expected to teach the new mothers hygiene, infant feeding and diet, help them in the home when necessary and then report back to the Medical Officer for Health. Her role (...) therefore was multifaceted and required education and training from a number of differing bodies. She needed nursing skills to help with the practicalities of observation and home care, sanitary knowledge to ensure that the buildings were safe and training in law and epidemiology. In order to fulfil these professional requirements, by the middle of the twentieth century the health visitor was expected to be a nurse by background, be educated for health visiting in a university and understand community medicine. These differing and sometimes opposing requirements meant that the health visitor was often caught in-between conflicting ideologies. It is this idea of ‘in-betweenness’ from the work of the anthropologist Marilyn Strathern and its relation to the work and education of the health visitor that this article will focus. (shrink)

Her careful building of positions, her unique approaches to analyzing problems, and her excellent insights make this an important work for feminists, those ...

An exploratory pilot study with a small homogenous sample of Christian English speaking participants provided support for an alternative research hypothesis that a Christ consciousness contemplation with Heart Prayer of HeartMath techniques was significantly associated with increasing psychophysiological coherence, sense of coherence, spirituality and health perceptions. Participants described feelings of a peaceful place in oneness and connection with Christ. Integrative findings point towards Christ consciousness as an ultimately non-dual process of sensing vibrational resonance radiating from the human (...) class='Hi'>heart. Implications for further research are discussed. (shrink)

Numerous issues confront women's healthcare today, among them the medicalization of women's bodies, cosmetic genital surgery, violence against women, HIV, perinatal mental health disorders. This volume uniquely explores such difficult topics and others at the intersection of clinical practice, policy, and bioethics in women's health care through a feminist ethics lens. With in-depth discussions of issues in women's reproductive health, it also broadens scholarship by responding to a wider array of ethical challenges that many women experience in (...) accessing health care. Contributions touch on many themes previously tackled by feminist ethics, but in new, contemporary ways. Some chapters expand into new fields in the bioethics literature, such as the ethical issues related to the care of Indigenous women, uninsured refugees and immigrants, women engaged in sex work, and those with HIV at different life stages and perinatal mental health disorders. Authors seek to connect theory and practice with users of the health system by including women's voices in their research. Bringing to bear their experience in active clinical practice in medicine, nursing, and ethics, the authors contemplate new conceptual approaches to important issues in women's healthcare, and make ethical practice recommendations for those grappling with these issues. Topical and up-to-date, this book provides a valuable resource for physicians, nurses, clinical ethicists, and researchers working in some of the most critical areas of women's health and applied ethics today. (shrink)

Personal health technologies such as apps and wearables that generate health and behavior data close to the individual patient are envisioned to enable personalized healthcare - and self-care. And yet, they are consumer devices. Proponents of these devices presuppose that measuring will be helpful, and that data will be meaningful. However, a growing body of research suggests that self-tracking data does not necessarily make sense to users. Drawing together data studies and digital health research, we aim to (...) further research on data ambivalence, a term we use to refer to the ambiguities and uncertainties people experience when interpreting their own data, as well as the critical obligation towards cultivating ethically sound uses and responses to such data in context. We develop the relationship between data, interpretation, and context as a central theoretical and practical problem in the datafication of healthcare. We then show how interpretation and context matter for data ambivalence through an empirical study of heart patients with an implanted advanced pacemaker who were offered a Fitbit wristband for self-tracking as part of a research project. We argue that the hope, anxiety, and doubt connected to the promise and accuracy of data are tempered by the context and purpose of self-tracking, and by individual circumstances. Finally, we link the findings on context-sensitivity in data interpretation to questions about response-ability in cloud-based care infrastructures. We discuss the ethical dilemmas associated with the use of commercial wellness-technologies in healthcare, and with researching such emerging practices. (shrink)

Spiritual practices such as prayer have been shown to improve health and quality of life for those facing chronic or terminal illness. The early Christian healing tradition distinguished between types of prayer and their role in healing, placing great emphasis on the healing power of more integrated relational forms of prayer such as prayers of gratitude and contemplative prayer. Because autonomic tone is impaired in most disease states, autonomic homeostasis may provide insight into the healing effects of prayer. I (...) report on observations in five volunteers engaging in five types of prayer. Using heart rate variability as a measure of autonomic tone and adaptability, I review the potential correlation of type of prayer with autonomic rebalance as measured specifically by psychophysiological coherence ratios. The five types—supplication, devotion, intercession, gratefulness, and contemplative prayer—elicited varying degrees of improvements in heart rate variability and corresponding psychophysiological coherence. These observations suggest a correlation of innate healing to prayer type that is consistent with teachings from the Christian healing tradition and with modern research. Further research is warranted to verify these hypotheses. (shrink)

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the (...) field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim’s and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health. (shrink)

Academic physiology, as it was taught by John Hughes Bennett during the 1870s, involved an understanding of the functions of the human body and the physical laws which governed those functions. This knowledge was perceived to be directly relevant and applicable to clinical practice in terms of maintaining bodily hygiene and human health. The first generation of medical women received their physiological education at Edinburgh University under Bennett, who emphasised the importance of physiology for women due to its relevance (...) for the hygienic needs of the family and of society. With the development of laboratory-based science as a distinct aspect of medical education during the later nineteenth century, however, so the direct application of physiology to clinical practice diminished. The understanding of physiology as hygiene was marginalised by the new orthodoxy of scientific medicine. This shift in the physiological paradigm enabled medical women to stake out a specific field of interest within medicine which was omitted from the new definition of physiology as pure medical science: hygiene and preventive medicine. Women physicians were able to take advantage of the shift towards science as the basis of medical theory and practice to define their own specific role within the profession. (shrink)

Automatized scalable healthcare support solutions allow real-time 24/7 health monitoring of patients, prioritizing medical treatment according to health conditions, reducing medical appointments in clinics and hospitals, and enabling easy exchange of information among healthcare professionals. With recent health safety guidelines due to the COVID-19 pandemic, protecting the elderly has become imperative. However, state-of-the-art health wearable device platforms present limitations in hardware, parameter estimation algorithms, and software architecture. This paper proposes a complete framework for health systems (...) composed of multi-sensor wearable health devices, high-resolution parameter estimation, and real-time monitoring applications. The framework is appropriate for real-time monitoring of elderly patients' health without physical contact with healthcare professionals, maintaining safety standards. The hardware includes sensors for monitoring steps, pulse oximetry, heart rate, and temperature using low-power wireless communication. In terms of parameter estimation, the embedded circuit uses high-resolution signal processing algorithms that result in an improved measure of the HR. The proposed high-resolution signal processing-based approach outperforms state-of-the-art HR estimation measurements using the photoplethysmography sensor. (shrink)

Le volume édité par Christian Promitzer, Sevasti Trubeta et Marius Turda, Health, Hygiene and Eugenics in Southeastern Europe to 1945 a été publié en 2011 par le Central European University Press dans sa collection d’études consacrées à l’histoire de la médecine. Le volume, divisé en deux parties, propose un tour d’horizon diversifié de la façon dont les États et sociétés de l’Europe du Sud-Est ont perçu les enjeux de santé propres à leurs territoires ; il s’interroge sur les paradigmes (...) scien... (shrink)

Many assume that theories of distributive justice must obviously take people’s lifetimes, and only their lifetimes, as the relevant period across which we distribute. Although the question of the temporal subject has risen in prominence, it is still relatively underdeveloped, particularly in the sphere of health and healthcare. This paper defends a particular view, “momentary sufficientarianism,” as being an important element of healthcare justice. At the heart of the argument is a commitment to pluralism about justice, where theorizing (...) about just principles demands paying attention to the role particular goods play in our lives. This means that different approaches to the temporal subject—as well as other relevant issues—may be appropriate for different goods, including different goods within healthcare. In particular, the paper discusses two central goods targeted by healthcare: life-saving and pain relief. The view is offered as complementary to, rather than competitive with, lifetime approaches. As such, the paper finishes by considering how a pluralist approach, which engages both with people’s lives as a whole and with their states at particular moments, can reconcile the potentially competing claims in healthcare that emerge from these two perspectives. (shrink)

The lead article in this January‐February 2021 issue—the first of the Hastings Center Report's fiftieth year of publication—does not set out to change medicine. It tries instead to understand it. In “A Heart without Life: Artificial Organs and the Lived Body,” Mary Jean Walker draws on work in phenomenology and on empirical research with people who have received artificial heart devices to argue that such devices may have two very different effects on how a patient experiences the body (...) and the self. Several other pieces in this issue address the ongoing slew of patient care and health policy problems surrounding the Covid‐19 pandemic, and a special report titled Democracy in Crisis: Civic Learning and the Reconstruction of Common Purpose considers the requirements for public involvement in policy‐making about bioethical issues. (shrink)

Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do (...) clinical practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes. (shrink)