Health Sciences

Опубліковано результати наукових досліджень, викладені на Всеукраїнській науково-практичній інтернет-конференції «Глобальні та регіональні аспекти розвитку туризму та гостинності» 22.05.2020 р. Тези доповідей друкуються методом прямого відтворення тексту, представленого авторами, які несуть повну відповідальність за його форму і зміст. Узагальнено дослідження стану розвитку світової індустрії туризму та гостинності й визначено форми адаптації економічних суб’єктів України до міжнародних тенденцій. Учасники конференції звернули свою увагу на такі аспекти, як: глобальні імперативи розвитку туризму та гостинності; стан і тенденції розвитку туризму та гостинності у країнах світу; (...) розвиток туристичної індустрії в Україні; регіональні аспекти розвитку туризму в Україні. Призначено для науковців, молодих вчених і студентів. (shrink)

Die Wiederaufnahme unterbrochener Handlungen nach der Aussetzung der Maßnahmen zur Eindämmung von CoVid19 veranschaulicht Unveränderlichkeit und Unvergänglichkeit regressives Zustandes, in dem sich weite Teile der Bevölkerung befinden. Nach kurzer Unterbrechung kommt alles in gewöhnten Kreis alltäglicher Routine und Gedankenlosigkeit, mit denen solche Aufgaben erledigt werden. Nichts, aber gar nichts änderte sich nach dem Unglück, das eigentlich, wie in meisten solchen Fällen, die Gelegenheit bietet, über sich selbst und die Welt nachzudenken.

Background: In the first few months of 2020, information and news reports about the coronavirus disease (COVID-19) were rapidly published and shared on social media and social networking sites. While the field of infodemiology has studied information patterns on the Web and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media infodemic. However, there is limited evidence about whether and how the social media infodemic has spread panic and affected (...) the mental health of social media users. Objective: The aim of this study is to determine how social media affects self-reported mental health and the spread of panic about COVID-19 in the Kurdistan Region of Iraq. Methods: To carry out this study, an online questionnaire was prepared and conducted in Iraqi Kurdistan, and a total of 516 social media users were sampled. This study deployed a content analysis method for data analysis. Correspondingly, data were analyzed using SPSS software. Results: Participants reported that social media has a significant impact on spreading fear and panic related to the COVID-19 outbreak in Iraqi Kurdistan, with a potential negative influence on people’s mental health and psychological well-being. Facebook was the most used social media network for spreading panic about the COVID-19 outbreak in Iraq. We found a significant positive statistical correlation between self-reported social media use and the spread of panic related to COVID-19 (R=.8701). Our results showed that the majority of youths aged 18-35 years are facing psychological anxiety. Conclusions: During lockdown, people are using social media platforms to gain information about COVID-19. The nature of the impact of social media panic among people varies depending on an individual's gender, age, and level of education. Social media has played a key role in spreading anxiety about the COVID-19 outbreak in Iraqi Kurdistan. (shrink)

The article considers the relevance of research on the problem of gender in oncology. The existing views on gender differences are given. The directions of further research / within the framework of gender psychology are determined.

The purpose of the research. The main purpose of the study is to find out the experience of researching and solving the problem of professional burnout for physicians including family ones in the United States, by analyzing recent surveys and scientific papers of American and European scientists. Methodology. While working on the article, general scientific theoretical methods were used to accom-plish the tasks and achieve the purpose of the research. The methodological basis of the research was the structural-functional method, which (...) allowed considering the phenomenon of professional burnout as a whole with separate elements and their dependencies. Using a historical method, a brief overview of the research development by US scientists on the problem of professional burnout of physicians with a focus on key events that occurred at each of the stages highlighted in the scientific papers. A comparative method was used to compare the results of surveys of different years and topics, data presented in the proceedings of the scientists, and research approaches. Methods of systematization and generalization were used to formulate the paper’s conclusions, in particular, to highlight the essential features of the American research experience and practical problem solution of professional burnout of physicians. Results. It has been found that the professional burnout of physicians has been a matter of concern for the government, professional medical associations, and the general public for physicians of various US specialties for a long time. Although burnout affects physicians of all disciplines, it has been discovered that, among family physicians, this phenomenon exceeds the average level, especially compared to the general economically active population of the United States. Two approaches to identifying and reducing the risk of occupational burnout in the United States have been identified and characterized: the first approach covers measures aimed directly at a physician, that is, a specific individual, and the second, involves measures aimed at an organization, that is, a medical institution. It has been found that Ameri-can scientists have concluded that organizational measures are more effective, but the first approach should be applied as a first step in overcoming professional burnout. Practical meaning. The results of the research are applicable for further scientific exploration and practical problem solution of professional burnout of physicians, including family ones, in Ukraine. Prospects for further research. Meth-odology of surveys of physicians of various specialties on burnout, depression and professional satisfac-tion. Factors of professional burnout for family physicians in Ukraine. (shrink)

Aim Excellent organization of the internal processes is essential for a well-functioning health care system. Particularly, the process of treatment and interaction with the patients is important because the perception of treatment and interaction has a direct relation to the patients’ satisfaction. The latter has a strong influence on the recovery of the patients. The impact of the maturity level of the treatment and interaction process on patient orientation is investigated at the example of an extensive survey of hospital managers (...) in Ukraine. -/- Method The analysis is based on an empirical data collection conducted with hospital managers and their deputies in a large Ukrainian city, which is acknowledged as a ‘model city’ with regard to a comprehensive health care reform in the country. By means of the Business Process Maturity Model (BPMM) we have tested our hypothesis that a high level of process maturity leads to a high level of patient orientation. For this purpose, we have developed a scale for measuring the level of process maturity and have checked the method on validity and reliability. A total of 79 hospital managers and deputies, who represent all public health care facilities of the city (hospitals, primary care clinics, etc.), participated in the study. -/- Results The study reveals a clear relationship between the level of maturity of the treatment and interaction process and the level of patient orientation of the respective health care facility. The variance, which is explained by the independent variable process maturity level, is 16.3 %. All formative dimensions have a strong significant influence on the construct “patient orientation”. Likewise the maturity level of the treatment and interaction process shows a strong significant influence on patient orientation. -/- Conclusion For health care facilities it is of great importance to achieve a high maturity level of the treatment and interaction process to live up to the claim of being patient oriented. The maturity of the process can be tested using the questionnaire developed in the course of our study. (shrink)

Background The health care sector is experiencing a drastic transition all over the world. This has an impact not only on the way hospitals, clinics, special-care homes etc. are organized, but also on patients, personnel and other stakeholders involved. The consequences of changes for both physicians and patients are investigated using a comprehensive health care reform in Ukraine as an example. -/- Methods The analysis is based on empirical data collected from general physicians in 2 Ukrainian cities. Based on the (...) Job Demands-Resources Model, we developed a set of hypotheses and tested them using the structural equation modelling technique. A total of 178 general physicians (81% of the approached population) participated in the study. -/- Results Our investigation reveals a clear relationship between the organizational job demands (additional tasks, structural changes, new processes) and their psychological effects (e. g., burnout). The latter have a negative impact on cooperation of physicians in hospitals leading to lower patient satisfaction. -/- Discussion and Conclusions Change in health care is inevitable. The example of Ukraine shows that openness of hospitals towards change reduces the probability of physicians’ burnout and, eventually, increases patient satisfaction. We strongly suggest applying the process management approach in order to increase openness to change, especially in turbulent times. (shrink)

Background: All research has room for improvement, but authors do not always clearly acknowledge the limitations of their work. In this brief report, we sought to identify the prevalence of limitations statements in the medRxiv COVID-19 SARS-CoV-2 dataset. Methods: We combined automated methods with manual review to analyse manuscripts for the presence, or absence, either of a defined limitations section in the text, or as part of the general discussion. Results: We identified a structured limitations statement in 28% of the (...) manuscripts, and overall 52% contained at least one mention of a study limitation. Over one-third of manuscripts contained none of the terms that might typically be associated with reporting of limitations. Overall our method performed with precision of 0.97 and recall of 0.91. Conclusion: The presence or absence of limitations statements can be identified with reasonable confidence using automated tools. We suggest that it might be beneficial to require a defined, structured statement about study limitations, either as part of the submission process, or clearly delineated within the manuscript. (shrink)

A recent study by Vietnamese social scientists looked into the initial success of Vietnam’s response to COVID-19.

Counselling y cuidados paliativos es el título del libro escrito por la doctora Esperanza Santos y el profesor José Carlos Bermejo. En esta obra, de fácil lectura y con consejos muy prácticos y útiles, se presentan elementos fundamentales para brindar un acompañamiento de óptima calidad en el cuidado paliativo, así como la posibilidad de hacer un autoexamen de cómo los cuidadores de los pacientes prestan sus servicios e incluso para no caer en burnout. Este libro es de gran utilidad, tanto (...) para los profesionales de la salud que trabajan en las unidades de cuidados paliativos, como para personas que dedican gran parte de su tiempo al cuidado de familiares con enfermedades terminales, o que pasan por procesos prolongados de enfermedad. Con ejemplos de conversaciones de la vida real entre cuidadores y pacientes, la lectura del libro se hace, a la vez, agradable, divertida y profundamente reflexiva. (shrink)

Taiwan and Vietnam have taken successful measures to combat the spread of COVID-19 at the early stages. Many authors attributed the successful policies to the lessons learned by these countries during the severe acute respiratory syndrome (SARS) pandemic in 2002.(Ohara, 2004) This manuscript provides a summary of recent early-stage policies that were successful in mitigating the spread and creating resilience against the negative consequences of COVID-19 in Taiwan and Vietnam. Crucially, these policies go beyond and complement social isolation. As social (...) isolation is expected to have a negative socio-economic impact on the population and adherence is likely to decrease with time(Armitage and Nellums, 2020; Weems et al., 2020), it is important to consider a broad range of policies to promote a steady control of the COVID-19 spread. Initially, we provide a brief introduction to some general concepts related to COVID-19. Thereafter, we introduce a concise review of policies and their dates relative to the first detection case in Taiwan and Vietnam as well as doing a comparative analysis. (shrink)

Tightened border controls, agile health departments, tech platforms, and a hand-washing song that went viral have added up to a frugal but highly effective response to the threat of COVID-19. The country's success provides a model that other developing and emerging economies should follow.

Vietnam, with a geographical proximity and a high volume of trade with China, was the first country to record an outbreak of the new Coronavirus disease (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 or SARS-CoV-2. While the country was expected to have a high risk of transmission, as of April 4, 2020—in comparison to attempts to contain the disease around the world—responses from Vietnam are being seen as prompt and effective in protecting the interests of its citizens, (...) with 239 confirmed cases and no fatalities. This study analyzes the situation in terms of Vietnam’s policy response, social media and science journalism. A self-made web crawl engine was used to scan and collect official media news related to COVID-19 between the beginning of January and April 4, yielding a comprehensive dataset of 14,952 news items. The findings shed light on how Vietnam—despite being under-resourced—has demonstrated political readiness to combat the emerging pandemic since the earliest days. Timely communication on any developments of the outbreak from the government and the media, combined with up-to-date research on the new virus by the Vietnamese science community, have altogether provided reliable sources of information. By emphasizing the need for immediate and genuine cooperation between government, civil society and private individuals, the case study offers valuable lessons for other nations concerning not only the concurrent fight against the COVID-19 pandemic but also the overall responses to a public health crisis. (shrink)

Along with environmental pollutions, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban (...) design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural- social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, the consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and consequently, the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture. (shrink)

Transhumanism is a movement that seeks to transcend certain limits inherent in the human condition as we know it. However, does it justify leaving aside the dignity of current human beings to fulfill the desire to increase human potential and improve the human being as such to obtain other human beings? Does it justify passing over the dignity of women in order to obtain new human beings through fertilization? To answer these questions we have made a sweep over the ideas (...) of transhumanism that drives this type of techniques, to later understand the vision that women have in the use of in vitro fertilization, the hidden discrimination under these procedures and the clarification of the true emancipation and restoration of women’s rights in rela- tion to the use of in vitro fertilization. -/- El transhumanismo es un movimiento que busca trascender ciertos límites inherentes a la condición humana como la conocemos. Sin embargo, ¿justifica dejar de lado la dignidad de los seres humanos actuales por cumplir el deseo de aumentar el potencial humano y mejorar al ser humano como tal para obtener otros seres humanos?, ¿justifica pasar por encima de la dignidad de una mujer para obtener nuevos seres humanos a través de la fertilización in vitro? Para responder a estas preguntas hemos hecho un barrido sobre las ideas del transhumanismo que impulsa este tipo de técnicas, para luego comprender la visión que se tiene de la mujer en el uso de la fertilización in vitro, la discriminación oculta bajo estos procedimientos y la aclaración de la verdadera emancipación y restablecimiento de los derechos de la mujer en relación con el uso de la fertilización in vitro. (shrink)

Este essay-paper busca aportar algunos elementos para el debate de la caracterización del acceso a los medicamentos como un derecho global, partiendo de una serie de reflexiones que teóricos realizan sobre un asunto que se constituye en uno de los principales focos de desigualdad en el mundo.

This volume considers forms of information manipulation and restriction in contemporary society, paying special attention to contemporary paternalistic practices in big data and scientific research, as the way in which the flow of information or knowledge might be curtailed by the manipulations of a small body of experts or algorithms.

The modern concept of ideology was established by the liberal politician and philosopher Destutt de Tracy, with the objective of creating an all-embracing and general science of ideas, which followed the sensualist and empiricist trend initiated by Locke that culminated in the positivism of Comte. Natural selection and immunity are two key concepts in the history of biology that were strongly based on the Malthusian concept of struggle for existence. This concept wrongly assumed that population grew faster than the means (...) of existence. This “natural” law contained implicitly the idea that the poor and least gifted would not survive. This idea led to the progressive development of the concept of natural selection, whose definitive version was given by Darwin. Mechnikov took the concepts of struggle for existence and natural selection and conceived infectious diseases as a struggle between a host and its invader, the so-called phagocytosis theory. This theory created the necessity to possess mechanisms to discriminate between the own and the foreign, and led to the conception of the immune self. These concepts were not developed from ideas coming from perceptions or sensations, but from ideas coming from their values: individual interest, inevitable inequality, property, utility and profit. Values are ideals that constitute an ideological matrix which exerts a numinous activity and influence the development of our future actions. In consequence, science and its practice cannot avoid and ignore the values that drive them and impulse them towards certain directions. (shrink)

The influence of Kurt Goldstein on the thinking of Georges Canguilhem extended throughout his entire work. This paper seeks to examine this relationship in order to conduct a study of the norm as a nexus or connection between the concept and life. Consequently, this work will be a reflection on the approach to life as a normative activity and self-realization. For this, it will be necessary to redefine the concepts of health and disease, and make a crossover between the two. (...) At the end of this trajectory, it will be found that these concepts can explain the identity between the concept and life, which leads to the unexpected conclusion that the cure is ultimately self-healing. (shrink)

Resilience. The Science of mastering life's greatest challenges es el título del libro que conjuntamente escribieron los profesores Steven Southwick y Dennis Charney. En esta obra los autores exponen qué es la resiliencia, pero sobre todo se concentran en desarrollar diez factores fundamentales para ser resilientes ante situaciones traumáticas que cualquier persona puede experimentar en su vida como lo es la pérdida de un ser querido, el secuestro, la enfermedad, la pérdida del trabajo o incluso el descalabro económico. De manera (...) muy organizada y sistemática, los autores logran profundizar en cada uno de esos diez factores, manteniendo siempre un sólido hilo conductor y exponiendo ejemplos que ayudan a clarificar conceptos y a hacer más amena y llevadera la lectura del libro. (shrink)

Human rights protect the conditions of a minimally decent life of which mental health is an indispensable element. Adequate care for mental health is thus recognized as part of the human right to health. However, for populations living far from urban centers, adequate in-person (mental) health care is often extremely costly and thus not provided. Digital mental health care options have become an effective alternative to in-person treatment. Benefitting from these new digital opportunities, though, requires sufficient access to the internet. (...) Because everyone has a human right to adequate health care, and digital mental health care is now an effective option for progressively realizing this human right for people who live in remote regions, these people also have to be understood to have a right to access to the internet. This right to internet access creates duties for public authorities and the international community to create the required digital infrastructure and (where needed) to cover the costs of internet access where this is the only feasible way of delivering, or progressively realizing, the mental health care that is indispensable for having the opportunity to lead minimally decent lives. (shrink)

The Global Burden of Disease Study (GBD) is one of the largest-scale research collaborations in global health, distilling a wide range of health information to provide estimates and projections for more than 350 diseases, injuries, and risk factors in 195 countries. Its results are a critical tool informing researchers, policy-makers, and others working to promote health around the globe. A study like the GBD is, of course, extremely complex from an empirical perspective. But it also raises a large number of (...) complex ethical and philosophical questions that have been explored in a series of collaborations over the past twenty years among epidemiologists, philosophers, economists, and policy scholars. The essays in this volume address issues of current and urgent concern to the GBD and other epidemiological studies, including rival understandings of causation, the aggregation of complex health data, temporal discounting, age-weighting, and the valuation of health states. The volume concludes with a set of chapters discussing how epidemiological data should and should not be used. Better appreciating the philosophical dimensions of a study like the GBD can make possible a more sophisticated interpretation of its results, and it can improve epidemiological studies in the future, so that they are better suited to produce results that can help us to improve global health. (shrink)

On the basis of PM2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact and valuation functions. Annual avoided premature deaths driven by the average concentration of PM2.5 decrease were evaluated, and the economic benefits were computed by using the value of statistical life (VSL) method. Results showed that the number of avoided premature deaths (...) in Wuhan are 21,384 (95% confidence interval (CI): 15,004 to 27,255) during 2013–2017, due to the implementation of the Air Improvement Action Plan. According to the VSL method, the obtained economic benefits of Huangpi, Wuchang, Hongshan, Xinzhou, Jiang’an, Hanyang, Jiangxia, Qiaokou, Jianghan, Qingshan, Caidian, Dongxihu, and Hannan District were 8.55, 8.19, 8.04, 7.39, 5.78, 4.84, 4.37, 4.04, 3.90, 3.30, 2.87, 2.42, and 0.66 billion RMB (1 RMB = 0.1417 USD On 14 October 2019), respectively. These economic benefits added up to 64.35 billion RMB (95% CI: 45.15 to 82.02 billion RMB), accounting for 4.80% (95% CI: 3.37% to 6.12%) of the total GDP of Wuhan in 2017. Therefore, in the process of formulating a regional air quality improvement scheme, apart from establishing hierarchical emission-reduction standards and policies, policy makers should give integrated consideration to the relationship between regional economic development, environmental protection and residents’ health benefits. Furthermore, for improving air quality, air quality compensation mechanisms can be established on the basis of the status quo and trends of air quality, population distribution, and economic development factors. (shrink)

We can say that it is necessary for every human being to walk towards the comprehension of the contingent and limited reality of the human person, starting with those whose work involves dealing with patients, as well as those who dedicate themselves to bioethical reflection, and even the patients themselves. In this way, at the time when these people face a situation of pain and suffering, they will be able to assume it with integrity and strength, always choosing to protect (...) the valuable gift of human life, and not simply looking for it. to make the pain disappear as it may, tearing it up at the root, often ending up with a human life, be it at the moment of conception, as an embryo, with disabilities, sick or aging. -/- Podemos decir que es necesario que todo ser humano camine hacia la comprensión de la realidad contingente y limitada de la persona humana, empezando por aquellos cuyo trabajo involucra el trato con pacientes, así como quienes se dedican a la reflexión bioética, e incluso los mismos pacientes. De esta manera, en el momento en que estas personas se enfrenten a una situación de dolor y sufrimiento, podrán asumirla con entere-za y fortaleza, optando siempre por proteger el valioso don de la vida humana, y no simplemente buscando hacer desaparecer el dolor a como dé lugar, arrancándolo de raíz, muchas veces terminando con una vida huma-na, sea en el momento de la concepción, como embrión, con discapacidades, enferma o envejecida. (shrink)

Paul Ricoeur argues that narration is lived life. Therefore, human experience has a narrative dimension, ie, it has a narrative structure and every effort you want to make for the human need to consider the narrative. For this reason, the text theory is converted to Ricoeur in a general model for the study of human action, since this is conceived as an open work to anyone who can read it. Given this general framework for discussion, we have deepened the notion (...) of the patient as “text”, and described their richness for reflection of bioethics and medical act, rescuing the value of listening, prudence, responsibility and rediscovering a place for the principle of autonomy and casuistry. -/- Paul Ricoeur sostiene que la narración es vida vivida. Por lo tanto, la experiencia humana posee una dimensión narrativa, es decir, tiene una estructura narrativa y todo esfuerzo que quiera dar cuenta de lo humano tendrá que contar con lo narrativo. Por esta razón, la teoría del texto se convierte para Ricoeur en un modelo general para el estudio de la acción humana, pues esta es concebida como una obra abierta a cualquiera que pueda leer. Teniendo en cuenta este marco general de reflexión, hemos profundizado en la noción del paciente como “texto”, y describimos su riqueza para la reflexión de la bioética y el actuar médico, rescatando el valor de la escucha, la prudencia, la responsabilidad y redescubriendo un lugar para el principio de autonomía y la casuística. (shrink)

In society, human vulnerability is associated with multiple causes such as poverty, injustice, discrimination and illnesses, among others. In the midst of this panorama of external agents that lead human beings to situations of vulnerability, some clearly see – although others not so much – a vulnerability proper to the human person, simply because they exist. This approach to vulnerability is considered to be a conditio humana that affects everyone. Precisely because it is a conditio humana, vulnerability is closely related (...) to autonomy. For this reason, in this article we have attempted to deepen in the interrelationship between autonomy and vulnerability, focusing on an anthropological vulnerability, and determining whether vulnerability constitutes an impediment for autonomy, as vulnerability and autonomy seem to be the representatives of polar opposites: one that is limited and can do nothing or very little, and the other that can do everything and has no limits. -/- La vulnerabilidad humana está asociada en la sociedad a múltiples causas, tales como la pobreza, la injusticia, la discriminación, las enfermedades, entre otras. En medio de este panorama de agentes externos que lleven a los seres humanos a situaciones vulnerables, se deja ver, para unos claramente, para otros no tanto, una vulnerabilidad propia a la persona humana por el simple hecho de existir. Uno de los enfoques de la vulnerabilidad es considerarla como una conditio humana que nos afecta a todos, asunto que ha sido insistentemente ratificado por el pensamiento contemporáneo. Justamente, por ser una conditio humana, la vulnerabilidad se encuentra en estrecha relación con la autonomía. Es así que en este trabajo nos hemos propuesto ahondar en ese entramado de autonomía y vulnerabilidad, tomando el enfoque de la vulnerabilidad antropológica con el fin de describir la interrelación entre dichos principios y determinando si la vulnerabilidad constituye un “freno” o no para la autonomía, pues vulnerabilidad y autonomía parecen ser los representantes de dos polos opuestos, el del que se encuentra limitado y no puede hacer nada o hace poco, y el del que puede hacerlo todo sin ningún límite. (shrink)

The accelerated development of science and technology, along with the economical growth of countries and the rise of the phenomenon of globalization have had consequences in different aspects of human life. Social injustice, inequality, violence, fighting within and between countries, along with ecological misfortunes calls out for an ethical system that regulates and brings new light to human behaviour in this globalized world. The globalization dynamic of the techno-scientific, world market economic culture suggests the need of an urgent formation of (...) conscience of a global ethics. Having in mind this world panorama, in this process of ethical development we must analyze how bioethics can respond to the great challenge that this globalization plants. We propose that the key to the answer lies within the proposal developed by the personalistic current, which looks to solve real moral problems of concrete human persons, without leaving out anyone and looking to respond to all the dimentions of the human person. -/- El acelerado desarrollo de la ciencia y la tecnología, junto con el crecimiento económico de los países y la consolidación del fenómeno de la globalización ha tenido consecuencias en los diferentes ámbitos de la vida del ser humano. La injusticia social, la desigualdad, la violencia, las luchas dentro de los países y entre los países, así como el descalabro ecológico reclaman un sistema ético que regule y dé nuevas luces al comportamiento humano en este mundo globalizado. La dinámica de globalización de la cultura tecnocientífica y económica de mercado mundial, sugiere la necesidad de una urgente toma de conciencia de una ética global. Teniendo en cuenta este panorama mundial, en este trabajo analizamos cómo la bioética puede responder a este gran desafío que plantea la globalización. Proponemos que la clave fundamental de la respuesta está en la propuesta que ha sido desarrollada por la corriente personalista, la cual plantea y da solución a los problemas morales reales de rostros humanos concretos, sin dejar fuera a nadie y sin dejar fuera ninguna de las dimensiones del hombre. (shrink)

By the early 2000s, it was already being mentioned that one of the issues affecting bioethics was a lack of wonder or amazement. Today, we see the patient, the weak and the helpless have become clients or objects placed at the disposal of personal, community and entrepreneurial whims based on functionality or utility that can take on a life of its own. Accordingly, the authors of this article propose wonder or amazement as an attitude that not only makes it possible (...) to place the human being at the center and starting point of bioethical reflection, but it is those who suffer the most, the weak and the defenseless, who are predominantly at that center or starting point. -/- A comienzos de la década del 2000 ya se mencionaba que una de las cuestiones que aquejaba la Bioética era la falta de asombro. En la actualidad vemos que el paciente, el débil y el indefenso han pasado a ser clientes u objetos puestos a disposición de caprichos personales, comunitarios o empresariales basados en la funcionalidad o utilidad que pueda tener una vida en particular. Es por eso que en este trabajo proponemos el asombro como una actitud que permite no solo situar a la persona humana como centro y punto de partida de la reflexión bioética, sino que en dicho centro esté de manera preponderante el que más sufre, el débil y el indefenso. (shrink)

One of the many proposals put forth recently in the revival of bioethics concerns solidarity, which is part of the agenda for the discipline in the twenty-first century. In this article, solidarity is proposed as a bioethical value, inasmuch as it cannot be achieved without considering the person towards whom one shows solidarity and without taking into account his or her environment. It is not possible to make bioethical judgments or to accomplish in-depth biological thinking when forgetting the person who (...) is at the source or heart of the matter. Based on a study of the experience of a group of health volunteers in Medellin (Colombia), this research found evidence of the existence of three elements that, together, serve as a hinge between solidarity and bioethics. -/- Entre las muchas propuestas que se han hecho recientemente en ese resurgir de la bioética se encuentra la solidaridad, consti­tuyéndose parte de la agenda del siglo XXI sobre esta disciplina. Proponemos la solidaridad como un valor bioético puesto que así como no se puede ser solidario sin tener en cuenta a la persona con quien soy solidario y su entorno, no se pueden emitir juicios bioéticos o hacer una reflexión bioética de fondo olvidando a quien se tiene en frente. A partir de un estudio de la expe­riencia de una población de voluntarios del sector salud en Medellín, Colombia, se logró evidenciar que existen tres elementos que, en conjunto, sirven de bisagra entre la solidaridad y la bioética. (shrink)

Saint Pope John Paul II focused on the question about Man and the defense of his dignity, he made an effort to establish a solid and meaningful teaching on the reality of the human being. He knew pain and suffered in many moments of his life, and as a philosopher, theologian and pastor, showed his preoccupation in most of his encyclicals in which he tried to transmit, throughout his pontificate, the faith of the Catholic Church gathering the teaching of the (...) Holy Scriptures and the Holy Tradition. Through a revision of the encyclicals that he wrote, we show how the Holy Father evidences, above all, a deep interest that the man of today understands himself and in this way, comprehends the dynamics of pain, in order to not despair in difficult times but live in hope and thus fill his life with meaning. -/- El Santo Papa Juan Pablo II centrado en la pregunta por el hombre y la defensa de su dignidad, se preocupó por dejar una sólida y significativa enseñanza sobre esta realidad del ser humano. Padeció el dolor y el sufrimiento en muchos momentos de su vida y, como filósofo, teólogo y Pastor, manifestó esta gran preocupación en casi todas sus encíclicas, en las que buscó transmitir, a lo largo de todo su pontificado, la fe de la Iglesia Católica recogiendo las enseñanzas de la Sagrada Escritura y la Sagrada Tradición. A través de una revisión de las encíclicas que escribió, ilustramos cómo el Santo Padre evidencia, ante todo, un profundo interés de que el hombre de hoy se entienda principalmente a sí mismo y de esta manera, comprenda el dinamismo del dolor, para que, antes que desesperar en los momentos difíciles, viva la esperanza y pueda así llenar de sentido su vida entera. (shrink)

If the health sciences are to be humanized, health professionals must first humanize themselves. This investigation deepens in the paradigmatic aspects that enrich and form the foundation of being compassionate, a key element in this process of humanization. For this reason, an emphasis has been placed on the sensibility that is found at the base of a compassionate attitude. It is proposed that this sensibility involves wonder as a starting point, which allows one to connect with reality and to encounter (...) the reality of the human person, who in turn discovers himself called to communion with another like to himself. In this way, compassion is considered as a movement of heart and the particularities and consequences of this movement are determined in order to respond to objections to compassion, principally those of the German philosopher Friedrich Nietzsche. It is determined that his critiques are directed toward a compassion understood as pity, while compassion understood as a movement of heart distances itself from falling into the sentimentalization of pity and helps highlight once again the positive dimension of compassion. -/- Si se quiere humanizar las ciencias de la salud, han de comenzar a humanizarse los profesionales de la salud. Por esta razón, en esta investigación se profundiza en aspectos paradigmáticos que fundamentan y enriquecen el ser compasivo, considerado como un elemento clave en dicho proceso de humanización. Para ello, se ha puesto énfasis en la sensibilidad que se encuentra al fondo de la actitud compasiva. Se ha planteado que dicha sensibilidad involucra el asombro como punto de partida, que conecta con la realidad y que permite encontrarse con la realidad de la persona humana, que a su vez se descubre llamada a la comunión con el otro semejante a ella. De esta manera, se llega a considerar la compasión como un movimiento del corazón, y a partir de allí, se determinan las particularidades y consecuencias de este movimiento para responder a las objeciones que se le hacen a la compasión, principalmente las del filósofo alemán Friedrich Nietzsche. Se ha determinado que sus críticas están dirigidas a una compasión entendida como lástima, mientras que la compasión entendida como movimiento del corazón, se aleja de caer en la sentimentalización de la lástima y da luces para retomar la dimensión positiva que posee la compasión. (shrink)

Narrations have been able to influence medicine, giving rise to a new approach call " narrative medicine ". In this paper we consider the patient as a text, such is, an open book that the physician intervenes, but also from which the physician may and need to learn a lot. To deepen a little in the narrative perspective of patient understanding and his/her situation helps us to discover how the patient is object of compassion by physicians, but also how he/she (...) turns into subject of compassion. We conclude that it is important for physicians to dedicate time in their initial medical training, as well as in their permanent training, to explore and exploit the value of narrations, that help them to categorize their living experiences and that of the patients. -/- As narrativas estão chegando a influenciar na medicina, dando origem a uma nova abordagem chamada " medi-cina narrativa ". Neste trabalho consideramos o paciente como um texto, em outras palavras, um livro aberto que o médico intervém, mas também, que deve aprender muito. Aprofundar-se um pouco na perspectiva narrativa da compreensão do paciente e de sua situação ajuda a descobrir como o paciente é objeto da compaixão dos médicos, embora também como se converte em sujeito desta compaixão. Concluímos que é importante que os médicos dediquem mais tempo em sua formação médica inicial, bem como em sua formação permanente, para explorar o valor das narrativas que ajudam a categorizar suas experiências e a dos pacientes. -/- Las narraciones han llegado a influir en la medicina, dando lugar a un nuevo enfoque llamado " medicina narrativa ". En este trabajo consideramos al paciente como un texto, es decir, un libro abierto que el médico interviene, pero también del que el médico puede y necesita mucho aprender. Ahondar un poco en la perspectiva narrativa de la comprensión del paciente y de su situación nos ayuda a descubrir cómo el paciente es objeto de la compasión de los médicos, pero también cómo se convierte en sujeto de esa compasión. Concluimos que es importante que los médicos dediquen tiempo en su formación médica inicial, así como en su formación permanente, a explorar y explotar el valor de las narraciones, que les ayuden a categorizar sus experiencias vividas y las de los pacientes. (shrink)

Palliative care seeks to offer holistic care in order to provide a better quality of life for the sick, particularly when they are nearing the end of their existence. Delving into the spiritual dimension of the human person is attractive, since it offers answers to the meaning of life. It has been found that spiritual care brings great benefits to patients. That is why in this paper we wish to delve into the importance of the spiritual dimension in palliative care; (...) we highlight the act of listening as a key piece of spiritual care, which shows that the doctors’ burnout is the main obstacle to enhance listening as a suitable provision that is both comforting and healing. -/- Los cuidados paliativos buscan ofrecer una atención holística para brindar una mejor calidad de vida a los enfermos, especialmente cuando se aproximan al fin de su existencia. Profundizar en la dimensión espiritual de la persona humana resulta atractivo puesto que ofrece respuestas al sentido de la vida. Se ha constatado que la atención espiritual aporta grandes beneficios para el paciente. Es por eso que en este trabajo hemos querido profundizar en la importancia de la dimensión espiritual en los cuidados paliativos; se destaca la actitud de la escucha como pieza clave de dicha atención espiritual, lo que evidencia que el burnout de los médicos es el principal obstáculo para potenciar la escucha como una adecuada disposición que resulte consoladora y sanadora. (shrink)

Chest pain is the pain felt in the chest by infants, children and adolescents. In most cases the pain is not associated with the heart. It is mainly recognized by the observance or report of pain by the infant, child or adolescent by reports of distress by parents or care givers. Chest pain is not unusual in children. Lots of children are seen in ambulatory clinics, emergency rooms and hospitals and cardiology clinics. Usually there is a benign cause for the (...) pain for utmost children. Certain patients have conditions that are serious and perhaps life-threatening. Chest pain in pediatric patients needs careful physical examination and a detailed history that would point to the possibility of a serious cause. Researches of pediatric chest pain are scarce. It has been difficult to create evidence-based guidelines for evaluation. In this paper we propose an expert system to help doctors and parents, and care giver in diagnosing chest pain in infants and children. This expert System is design and implemented in SL5 Object language. (shrink)

Though hair loss (alopecia) is not a debilitating or life threatening sickness, the very thought of becoming bald can lead to emotional stress and traumatic experience for those who suffer from premature or excessive hair loss. Many will try anything and everything to bring back their locks. Or at least, some of their once full head of hair. Hair loss sufferers spend billions of dollars annually on remedies ranging from drugs, vitamins to special tonics and shampoos. Conventional treatments of hair (...) thinning includes drugs therapy and hair transplant. Minoxidil and Propecia (Finasteride) are the only two drugs approved by the FDA for hair growth in men. Minoxidil is the only drug available for women with and rogenetic alopecia. These drugs have been proven to show positive results for balding conditions on the vertex region of the scalp. Though these drugs are effective, many are wary of their unknown long-term effect and potential side-effects. This has led to increase interest in alternative remedies such as herbal medicine. (shrink)

Deutsche Krankheit: eine Diagnosestellung mit Rückblick und Ausblick auf Krankheitsverlauf.

A NOVA PECUÁRIA LEITEIRA – PRODUÇÃO MUNDIAL DE LEITE EM 2018 -/- NEW DAIRY LIVESTOCK - WORLD PRODUCTION OF MILK IN 2018 -/- Produção mundial de Leite em 2018: análise sobre o crescente aumento da produção e da produtividade -/- No mundo foram produzidos aproximadamente 843 milhões de toneladas de leite, isso corresponde à 843 bilhões de litros de leite produzidos em 2018, e comparado ao ano de 2017 que a produção foi de 812 bilhões de litros a variação média (...) percentual foi de 2,2% crescente (FAO, 2019), em 2015 foram produzidos 656 bilhões de litros, entre 2015 e 2019, a produção mundial leiteira aumentou em 28,5% aproximadamente, e isso deve-se à implementação de tecnologias, manejos nutricionais, sanitários e outras técnicas que fazem a produção leiteira ser cada vez mais promíscua todos os anos mesmo com variações e quedas produtivas em determinados países como o próprio Brasil. Vale salientar, também, que o crescimento médio anual é variável mediante alguns países produtores, todavia, essa variação média anual é crescente e gira em torno de 3 à 4% nos últimos 5 anos de dados obtidos (FAO, 2018). Os gráficos abaixo, tratam da produção leiteira mundial no ano de 2017 e 2018 por continentes; observe com atenção os dados obtidos pela FAO e atente às conclusões que se seguem: -/- Os dados obtidos e expressos supra são da FAO dos Estados Unidos, ele nos mostra uma ascendente produção leiteira dos continentes e a participação de ambos nesse mercado promissor. A Ásia, em 2017, foi responsável por mais de 40% da produção mundial de leite, foram mais de 320 bilhões de litros produzidos e um aumento percentual de 1,9% comparado ao ano de 2016; esse aumento aconteceu mesmo com o segundo declínio seguido da China na produção leiteira. Os países da União Europeia estão em segundo lugar com uma produção de mais de 224 bilhões de litros produzidos em 2017, um aumento percentual de 1,3% comparado ao ano de 2016, e com participação de quase 28% de toda produção global; todo esse aumento da produção e da produtividade europeia deve-se ao incremento de novas tecnologias aplicadas ao manejo das vacas, incluindo a atenção dobrada à sanidade e ao bem-estar dos animais. A América do Norte veio em terceiro lugar na produção e na participação mundial. Com uma participação de 13% e uma produção de 106 bilhões de litros em 2017, o continente conseguiu um acréscimo de 1,7% comparado ao ano de 2016. Os EUA é o responsável por esse grande acréscimo; produzindo em 2017 90% de todo total produzido e detendo um rebanho promissor de 9,3 milhões de cabeças leiteiras. A América do Sul, ao qual o Brasil está localizado, deteve a quarta colocação na participação e na produção mundial, participando com quase 8% de toda a produção mundial e produzindo 62 bilhões de litros de leite em 2017, uma acréscimo de 2,7% comparado ao ano de 2016. Os maiores produtores do continente foram o Brasil que dos 62 bilhões produziu mais de 50%, em torno de 35 bilhões de litros, mesmo com declínio relativo, o país ainda é um dos maiores produtores mundiais; o Peru e a Colômbia. A Argentina também é uma grande produtora, todavia, passou por uma crise leiteira, sendo o mesmo “marginalizado”, isto é, impróprio para o consumo. A África produziu em média 46 bilhões de litros de leite em 2017, ficando em quinto lugar na participação mundial, com quase 6% de toda produção global, não havendo variação positiva ou negativa significativa comparado com 2016. O continente oceânico (Oceania) produziu em torno de 31 bilhões de litros em 2017, um declínio de 2,9% comparado ao ano de 2016; participando de 3,8 da produção global. Esse declínio provém da Nova Zelândia, basicamente, que deteve um défice de 1,1% em sua produção, que chegou a 21,3 bilhões de litros; porém, o país continua sendo o maior produtor de leite do continente. A América Central produziu no ano de 2017, aproximadamente 18 bilhões de litros, participando de 2,2% da produção global; deteve um aumento de 1,1% comparado ao ano de 2016. Os dados supra, foram obtidos pela FAO que é a Organização das Nações Unidas para a Alimentação e a Agricultura. Com ele, podemos concluir que a cada ano que se passa, o mercado leiteiro têm variações positivas e negativas, todavia as negativas subjazem as positivas e, sendo assim, cada ano a produção e a produtividade nos países e nos continentes ascendem em proporções significativas; e esse aumento demonstra uma junção de fatores entre eles a implementação de novas tecnologias, a atenção com a sanidade e o bem-estar das vacas e do manejo nutricional e geral das fazendas e propriedades leiteiras espalhadas pelo mundo. A partir de toda essa análise supracitada, podemos apresentar o panorama do leite mundial em 2018, obtido através da FAO, e analisar as ascensões e possíveis declínios dos continentes e enfatizar os países que obtiveram pontos positivos ou negativos nessa participação leiteira de 2018. Observe os gráficos 3 e 4 abaixo e, posteriormente, e atente às análises: Em 2018, a produção leiteira mundial foi de 843 bilhões de litros, um aumento de 2,2% comparado ao ano de 2017. O gráfico 3 apresenta os continentes e a participação de ambos na produção leiteira mundial. O gráfico 4 apresenta os continentes e a produção de ambos expressas em bilhões de litros. Com esses dados, atualizados pelo autor em questão, apresentam mais uma vez um crescente mercado que gera empregos e emprega tecnologia de ponta para aumentar a produtividade dos animais e, consequentemente, a produção anual das fazendas e propriedades leiteiras. O continente asiático, em 2018, produziu 347 bilhões de litros de leite, a ascensão de 4% comparado ao ano de 2017. Ainda continua detendo a maior participação na produção mundial, passando de 40,3% em 2017 para quase 41% em 2018. A ênfase aos países produtores serão à Índia e ao Paquistão. A Índia teve um aumento de 5,6% de sua produção comparada ao ano de 2017; toda essa expansão é proveniente de uma equipe de veterinários, criadores, zootecnistas e outros especialistas que empregam mão-de-obra qualificada, tecnologias contemporâneas para obtenção do leite, manejo, sanidade, bem-estar às vacas, genética de qualidade e manejo nutricional concentrado na alta produção e produtividade dos animais. O Paquistão, mesmo com dificuldades nos processos de coleta do leite e em demais processos, obteve um acréscimo de 3% de sua produção em 2018 comparada a produção de 2017. A China, por sua vez, obteve o terceiro declínio em 4 anos, o declínio da produção em 2018 foi de 1,1% comparado ao ano de 2017; juntos, a China perdeu 15% de sua produção em apenas 5 anos. Note que o mercado produtor do leite tem suas variáveis extremas e difíceis de compreender, pois, à medida em que um país como o Paquistão tem toda uma dificuldade de obtenção do leite, nos processos de exportação e de industrialização do mesmo, consegue alavancar sua produção em 3% em um único ano; um país como a China, que é ainda um dos grandes produtores leiteiros, consegue uma perda inaceitável em sua produção de incríveis 15% em menos de 5 anos; daí a importância e a necessidade de uma equipe que consiga conciliar todos os fatores supracitados como emprego de mão-de-obra qualificada para manejar os animais e elencar a produção. Os países da União Europeia conseguiram uma participação de 27,1% na produção mundial de 2018, obtendo uma produção de 230 bilhões de litros no ano em questão, um acréscimo de 0,8% comparado ao ano de 2017. A ênfase é a Rússia que conseguiu um acréscimo de 1,1% comparado ao ano de 2017 e uma produção de 32 bilhões de litros em 2018. A junção da produção da Rússia e demais países europeus supriram o declínio da Ucrânia que passou por uma crise entre a desvalorização dos produtos agrícolas e a baixa no preço do leite. A América do Norte produziu, em 2018, 109 bilhões de litros de leite tendo uma participação mundial de 13% em toda produção global e com um acréscimo de 1,1% comparado ao ano de 2017. Os Estados Unidos continua sendo o maior produtor do continente, sendo responsável por mais de 90% de toda essa produção, produzindo no ano em questão, 98,6 bilhões de litros. Vale ressaltar que os EUA, com suas altas tecnologias e o emprego de alta genética nos animais, conseguiu aumentar a produtividade das vacas por ano, passando de 10.525 kg/ano/vaca em 2017 para 10.632kg/ano/vaca em 2018. A América do Sul foi responsável por 7,7% da produção mundial, produzindo 65 bilhões de litros, um aumento de 1,6% comparado ao ano de 2017. O Brasil, por sua vez, reduziu seu aumento, passando de 1% em 2017 para 0,8% em 2018, um aumento no ano comparado à produção de 2017 mas um declínio comparado ao aumento percentual de 2017. O continente africano aumentou sua produção em 1,1% comparada ao ano de 2017, chegando à 46,6 bilhões de litros produzidos em 2018; obtendo uma participação de 5,5% na produção global. A Oceania, depois de passar por dois anos de declínios seguidos na produção leiteira, conseguiu um acréscimo de 1% comparado ao ano de 2017. Produzindo 31,5 bilhões de litros em 2018, a maior responsável por esse aumento foi a Nova Zelândia, responsável pelos declínios, a mesma expandiu sua produção em 4,4%, todavia, o aumento do continente não foi maior por causa do declínio australiano que foi de 3,8% comparado ao ano de 2017. A participação global da Oceania foi de 3,7% em 2018. A América Central produziu 18,2 bilhões de litros em 2018, comparado com a produção de 2017 o aumento foi de 1,1%. O México é o maior produtor da região e aumentou sua produção em 1,6% no ano de 2018. A região ainda participou com 2,2% na produção mundial sem alterações comparadas ao ano de 2017. Os dados supra, obtidos pela FAO, traduzidos e atualizados pelo autor em questão, demonstram que o mercado do leite continua sendo promissor e empregador de milhares e milhões de empregos por todo o planeta. Como citado anteriormente, a junção de profissionais, potencial genético dos animais, sanidade, medicina preventiva, medidas profiláticas, bem-estar dos animais entre outros fatores tiveram impacto direto na alta produção e produtividade dos animais e na lucratividade dos países produtores que industrializam o leite ou mantém um mercado exportador do mesmo ou do leite in natura. Os países desenvolvidos responsáveis por 2/3 (dois terços) da produção mundial, isto é, produtores de 570 bilhões de litros, apresentam taxa de crescimento variável conforme as implicações nas propriedades e no mercado, porém essa taxa de variação de crescimento gira em torno de 0,5 à 1% ao ano e produtividade média entre 6.000-7000 litros/vaca/ano. Esses países, principalmente os europeus e os EUA, contam com elevados subsídios, que vêm apresentando tendência declinante nos últimos anos conforme apontam especialistas (FAO, 2019). Nos países subdesenvolvidos, em desenvolvimento, a produção em 2018 foi de 270 bilhões de litros e a taxa de crescimento é de 3-5% ao ano muito superior aos países já desenvolvidos. A produtividade, de 1500-2500 litros/vaca/ano, também vem se elevando nos países em desenvolvimento, em média 3-4% ao ano, contribuindo com major volume para a oferta mundial de leite. Observe a tabela construída a partir dos dados da FAO da produção mundial de países desenvolvidos e subdesenvolvidos de 2007 a 2018: Tabela 1: Produção mundial de leite em países desenvolvidos e subdesenvolvidos, 2007-2018. FONTE: FAO. Os dados da tabela atribuem ao avanço da produção de leite, bem como a análise sobre a crescente produção leiteira dos países em desenvolvimento. Especialistas apontam que a crescente produção dos países subdesenvolvidos e a implementação de técnicas mais especializadas e qualificadas terá uma consequência, essa será a equidade da produção com os países desenvolvidos e, futuramente, a produção leiteira dos países subdesenvolvidos ultrapassará a produção dos países já desenvolvidos. Nos países desenvolvidos, a produção leiteira passou de 334 bilhões para 504 bilhões de litros, ou seja, um aumento de 50% em média, já nos países subdesenvolvidos o aumento passou de 227 bilhões em 2007 para 336 bilhões de litros em 2018, um acréscimo de 48% na produção. Esses dados nos mostram que o aumento da produção nos países desenvolvidos já é alcançado na mesma escala pelos países em desenvolvimento; sendo assim, ambos estão empregando técnicas para facilitar a obtenção do leite e para ascender a produtividade de cada vaca leiteira de sua região. O aumento do volume de leite produzido nos países em desenvolvimento deve-se principalmente ao crescimento da Índia (5,6%) e Paquistão (3%) na Ásia, do Quênia na África e do Brasil (0,8%) na América do Sul. Os países considerados desenvolvidos apresentaram um crescimento grande e pouco superior aos subdesenvolvidos, e os maiores responsáveis por esse crescimento nos últimos anos foram a Rússia com 32 bilhões de litros, os EUA com quase 100 bilhões de litros produzidos ou 1/5 da produção dos países desenvolvidos, a Alemanha com acréscimo em sua produção, bem como a França, a Inglaterra e o aumento de 4,4% da Nova Zelândia. A redução da produção de leite em alguns países da União Europeia como a Ucrânia e da China na Ásia pode ser parcialmente atribuída às reformas políticas que culminaram em diminuição gradativa de subsídios a desvalorização de produtos agrícolas e, consequentemente a baixa no preço do leite, e também por serem países com menor competitividade em custo de produção. Além disso, os países europeus estão entre os que apresentam maiores níveis de produtividade média do rebanho, indicando alto grau de incorporação de tecnologia e dificuldade de expansão da produção. A Rússia foi um país que mais contribuiu negativamente para a redução da participação europeia, com quedas de dois bilhões de litros em 5 anos como aconteceu entre 2002-2007, porém, a mesma está investindo potencialmente em seu rebanho e em mão-de-obra qualificada para transformar seu rebanho em altos potenciais genéticos para a produção leiteira e é o que visa aos dias de hoje quanto a participação do pais na produção leiteira atual. Sobre essa queda da produção russa, com o fim da URSS, o setor lácteo na Rússia passou por um processo de reorganização e competição capitalista primordialmente com os EUA. Todas as ineficiências anteriormente mascaradas pelo regime comunista apareceram, exigindo do setor privado melhorias de qualidade, investimento em máquinas, equipamentos e qualificação de mão-de-obra. O reflexo imediato foi a redução significativa do rebanho e queda da produção de leite. O mesmo movimento ocorreu na Ucrânia, que também contribuiu para a perda da participação europeia na oferta global desde os anos 2000 até os dias atuais. A produção de leite ocorre em todos os países do mundo, porém a heterogeneidade do processo produtivo e volume de produção entre os diferentes países é marcante. Na tabela 2, observam-se os dez principais países produtores de leite em 2017. -/- Tabela 2: Dez principais países produtores de leite em 2017. FONTE: Farmnews. A produção mundial em 2017 foi de 812 bilhões de litros e esses países corresponderam a 45% do volume mundial, quase a metade de toda produção. O Brasil, em 2017, ocupou a quarta colocação, com uma produção aproximada de 34,3 bilhões de litros anuais, que reapresentou 4,5% da produção total no mundo; em 2018 essa produção foi de mais de 36 bilhões de litros e uma queda na participação mundial, passando para 4,25%. Como conclusão, são infinitas as mudanças geográficas da produção de leite no mundo, o que ocasiona grandes diferenças nos sistemas produtivos e no volume produzido nos diversos países; consequentemente essas transformações causam mudanças na oferta do produto e o surgimento de países produtores de leite com maior competitividade, possibilidades de incorporação de tecnologia e estratégias definidas de inserção no mercado internacional. (shrink)

What is it to be mentally healthy? In the ongoing movement to promote mental health, to reduce stigma and to establish parity between mental and physical health, there is a clear enthusiasm about this concept and a recognition of its value in human life. However, it is often unclear what mental health means in all these efforts and whether there is a single concept underlying them. Sometimes the initiatives for the sake of mental health are aimed just at reducing mental (...) illness, thus implicitly identifying mental health with the absence of diagnosable psychiatric disease. More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall wellbeing. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of wellbeing is too demanding and potentially oppressive. As a compromise we sketch out a middle position. On this view mental health is a primary good, that is the psychological preconditions of pursuing any conception of the good life, including wellbeing, without being identical to wellbeing. (shrink)

Peer review process helps in evaluating and validating of research that is published in the journals. U.S. Office of Research Integrity reported that data fraudulence was found to be involved in 94% cases of misconduct from 228 identified articles between 1994–2012. If fraud in published article are significantly as high as reported, the question arise in mind, were these articles peer reviewed? Another report said that the reviewers failed to detect 16 cases of fabricated article of Jan Hendrick Schon. Superficial (...) peer reviewing process does not reveals suspicion of misconduct. Lack of knowledge of systemic review process not only demolish the academic integrity in publication but also loss the trust of the people of the institution, the nation, and the world. The aim of this review article is to aware stakeholders specially novice reviewers about the peer review system. Beginners will understand how to review an article and they can justify better action choices in dealing with reviewing an article. (shrink)

In many countries, there are health care initiatives to make smokers give up smoking in the peri-operative setting. There is empirical evidence that this may improve some, but not all, operative outcomes. However, it may be feared that some support for such policies stems from ethically questionable opinions, such as paternalism or anti-smoker sentiments. This study aimed at investigating the support for a policy of smoking cessation prior to surgery among Swedish physicians and members of the general public, as well (...) as the reasons provided for this. A random sample of general practitioners and orthopaedic surgeons as well as members of the general public received a mail questionnaire. It contained a vignette case with a smoking 57-year old male farmer with hip osteoarthritis. The patient had been recommended hip replacement therapy, but told that in order to qualify for surgery he needed to give up smoking four weeks prior to and after surgery. The respondents were asked whether making such qualifying demands is acceptable, and asked to rate their agreement with pre-set arguments for and against this policy. Response rates were 58.2% among physicians and 53.8% among the general public. Of these, 83.9% and 86.6%, respectively, agreed that surgery should be made conditional upon smoking cessation. Reference to the peri-operative risks associated with smoking was the most common argument given. However, there was also strong support for the argument that such a policy is mandated in order to achieve long term health gains. There is strong support for a policy of smoking cessation prior to surgery in Sweden. This support is based on considerations of peri-operative risks as well as the general long term risks of smoking. This study indicates that paternalistic attitudes may inform some of the support for peri-operative smoking cessation policies and that at least some respondents seem to favour a “recommendation strategy” vis-à-vis smoking cessation prior to surgery rather than a “requirement strategy”. The normative reasons speak in favour of the “recommendation strategy”. (shrink)

This paper aims to fill the gap in literature concerning community gardens in post-communist countries by focusing on the situation in Prague, Czechia. It introduces Prague′s newly emerged community gardens and presents the results of a first representative survey of these gardens. Information was gathered about eleven of the sixteen larger community gardens and the data were collected by semi-structured interviews with the managers of the particular gardens. The paper compares the Czech community gardens as representatives of civic agriculture forms (...) in post-communist countries with their counterparts and stresses their similarities and differences. The results show that the new community gardens reflect much of what can be seen elsewhere in terms of spatial and organizational design, as well as reasons for starting them, motivations for participation and some of the challenges experienced. However, in contrast to many community gardens in the USA, Canada and UK that focus on food and nutrition provision, in Prague the community is more of a priority than food and the other mentioned benefits. The paper shows that different activities, events and functions make gardens important hubs of their communities and potential tools of further community involvement and social change. (shrink)

The specific objects are to know the source of income and employment status of the children at work, to investigate the types of injury that affect the working child of the child laborer and to explore the hazardous work places and abuse of the working children. The study conducted with the secondary data of Bangladesh Labor Force Survey (ILO), 2013. SPSS software were used for finding the result. It is found that the predominating income source of the working child was (...) service sector and child labor mostly were self-employed. 18.5% child were engaged with hazardous work, 2.3% working child had experienced various types of injuries and almost 8.5% had subjected to insult, physically or sexually abuse. Most of the child don’t like their work and working environment that have adverse physical and emotional effects on children’s health. Public and private sectors should maintain child labor rules and regulations, arrange awareness program for child safety. (shrink)

This article is about a new definition of health and how this relates to transition processes. It focuses on the practical translation of the new concepts into challenges for mental health nurses. To that aim the Engagement Model is examined and operationalized. We did so as nurse researcher and lecturer involved in training nurse practitioners.

Chest pain is the pain felt in the chest by infants, children and adolescents. In most cases the pain is not associated with the heart. It is mainly recognized by the observance or report of pain by the infant, child or adolescent by reports of distress by parents or care givers. Chest pain is not unusual in children. Lots of children are seen in ambulatory clinics, emergency rooms and hospitals and cardiology clinics. Usually there is a benign cause for the (...) pain for utmost children. Certain patients have conditions that are serious and perhaps life-threatening. Chest pain in pediatric patients needs careful physical examination and a detailed history that would point to the possibility of a serious cause. Researches of pediatric chest pain are scarce. It has been difficult to create evidence-based guidelines for evaluation. In this paper we propose an expert system to help doctors and parents, and care giver in diagnosing chest pain in infants and children. This expert System is design and implemented in SL5 Object language. (shrink)

Background: With the coming of the Industrial Revolution, the levels of pollution grow significantly. This Technological development contributed to the worsening of shortness breath problems in great shape. especially in infants and children. There are many shortness breath diseases that infants and children face in their lives. Shortness of breath is one of a very serious symptom in children and infants and should never be ignored. Objectives: Along these lines, the main goal of this expert system is to help physician (...) in diagnosing and describe some common causes of shortness of breath in infants and children by diagnosing their cases through our expert system. Moreover, this system which we are presenting will give patient the appropriate diagnosis of disease and the treatment required. Methods: In this paper the strategy of the expert system for diagnosing a number of the existed shortness of breath in infants and children diseases such as (Asthma , Bronchiolitis, Viral Pneumonia, cough, Shortness of breath' dyspnea ', Epiglottitis, Croup, ABSCESS in the tonsil 'peritonsillar abscess', Bronchitis, Viral Bronchitis, Wheezing, sudden infant death syndrome 'SIDS' ) is introduced, an overview about the shortness of breath in children and infants diseases are delineated, the cause of diseases are sketched and the treatment of disease whenever conceivable is given . SL5 Object Expert System language was utilized for designing and implementing the proposed expert system. Results: The proposed shortness of breath in children and infants diseases diagnosis expert system was estimated by Medical students and they were satisfied with its result. Conclusions: The Proposed expert system is very useful for Respiratory physician, pediatrician, recently graduated physician, and for children's parents with shortness of breath problem. (shrink)

Review of the book Feral: Rewilding the Land, Sea, and Human Life by George Monbiot, Penguin Books, London 2014.

We argue that successful participatory mental health organisations should be seen as ‘engines of alternative objectivity’ rather than as the subjective ‘other’ to objective science. With the term ‘alternative objectivity’, we point to collectivisations of experience that are different to biomedical science but are nonetheless forms of objectivity. Taking inspiration from feminist theory, science studies and sociology of culture, we argue that participatory mental health organisations generate their own forms of objectivity through novel modes of collectivising experience. Through two case (...) studies, the Hearing Voices Movement and Stepping Out Theatre Company, we demonstrate how successful participatory organisations can be seen as ‘engines of alternative objectivity’ rather than as the subjective other to objective, biomedical science. The Hearing Voices Movement cultivates an ‘activist science’ that generates an alternative objective knowledge through a commitment to experimentation, controlling, testing, recording and sharing experience. Stepping Out distinguishes itself from drama therapy by cultivating an alternative objective culture through its embrace of high production values, material culture, aesthetic standards and critical review processes. A crucial aspect of participatory practice is overcoming alienation, enabling people to get outside of themselves, encounter material worlds and join forces with others. (shrink)