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Jun 2021 DOI 10.14302/issn.2641-4538.jphi-21-3861
Dieb Miziara IvanCorresponding author
Associate Professor – Head of Department – Department of Legal Medicine, Ethics and Social Medicine São Paulo University School of Medicine (São Paulo – Brazil) – Orcid Id: 0000-0001-7180-8873.
Based on two fictitious cases of disregard for the rules to prevent the spread of Sars-Cov-2 in which individuals claim that their autonomy has been disrespected, in Brazil, the authors ask to what extent individual autonomy must be strictly respected and propose a new approach to the bioethics principles, so that they are applied with a view to public health and the common good.
Jul 2016 DOI 10.14302/issn.2381-862X.jwrh-16-1060
Regassa NigatuCorresponding author
Visiting research scholar, University of Saskatchewan, SK, Saskatoon, Canada.
The low level of women autonomy and the key pre disposing factors affecting household decision makings among many population groups in Ethiopia is not well understood among scholars, and is less investigated. This study examined the status and the micro level factors associated with women autonomy in Sidama, the most populous zone in Southern Ethiopia. A simple random sampling technique (using the available complete listing of households) was used to select the 231 sample households from one of the districts of the zone. Sidama zone was selected due to its historically strong customs of patriarchal family system. Quantitative and qualitative data were obtained using structured questionnaire and focus group discussions. Household, women and husband characteristics were used as explanatory variables while women autonomy index, developed from a set of questions, served as the dependent variable. The study revealed that women’s decision makings on core household and personal issues were very low in the study population. The predicted probability, using Ordinary Least Square Regression shows that women’s education, alcohol intake by husbands, household size and land size were the main determinants of autonomy in decision makings in the study area. The study recommended that concerned bodies should capitalize on educating women and girls through both formal and informal learning platforms, promote income generation activities through entrepreneurship, increased access to property and economic assets, training, microfinance and markets.
Jan 2024 DOI 10.14302/issn.2474-7785.jarh-24-4890
Marks RayCorresponding author
Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.
Feb 2019 DOI 10.14302/issn.2643-6655.jcap-18-2570
Emanuela ZappellaCorresponding author
Department of Human and Social Sciences, University of Bergamo, Italy
Self-determination is a key concept to promote greater self-awareness in the subjects with disability, to build appropriate educational or professional projects and to evaluate the already active programs. Using PRISMA checklist, I selected articles from different databases (CINAHL, Medline, Psych INFO, Cochrane Library, ERIC, Scholar. The 9 evaluation measures identified are analyzed with respect to: choice of the points of view to be collected, domains, items and data collection methods. The results show that while some scales focus on autonomy, empowerment, self-realisation and self-regulation and others focus on knowledge, skills and abilities, attitudes and beliefs. Two instruments added also: opportunities and support. With respect to the choice of the points of view to be collected: in some cases the student’s opinion is collected but in other cases their point of view is integrated or replaced with that of teachers and parents. Only one tool is designed for all children and starts from the belief that self-determination is important for all people, including those with a disability. A third element of the analysis is the possibility of answering the questions posed by the various evaluation tools. A typical form is Likert scale while in other cases open questions are used. The analysis highlights two critical issues. The variety of definitions of self-determination is inevitably reflected in the choice of domains and items and therefore self-determination is only partially investigated. Secondly the opinion and people with disabilities are sometimes completed or replaced by that of third persons as parents and teachers. Starting from the analysis of existing instruments. the article closes with a reflection on the possibility of constructing a scale that considers all the aspects of self-determination offered in the literature (at the individual and environmental level) and collects the opinion of all the subjects involved in self-determination projects. This synthesis represents a first step in the construction of a possible universal scale starting from the analysis of the literature. A comparison would then be necessary with the students with intellectual disabilities, the family members and the other actors involved to understand which domains are really meaningful to them and to build indicators that correspond to the elements that are important to them. In this way we would have a tool capable of combining the point of view of literature with that of the people directly involved.
Feb 2019 DOI 10.14302/issn.2641-4538.jphi-19-2589
Ahmadou Diallo AlphaCorresponding author
Ministry of Health
Several studies show that policies to improve maternal and infant health must be contextualised within broader questions and commitments concerning women’s empowerment. There are, however, two-way linkages between women’s empowerment and reproductive services. Certain institutional approaches that support women’s reproductive health can themselves be experienced as empowering whereas others, however well-meaning, can be experienced as disempowering, undermining health and broader goals. It is thus important to discern and support those elements of reproductive services that might have empowerment outcomes, and to avoid others that undermine them. This paper is premised on the hypothesis that approaches to reproductive health that are rooted in women’s life worlds, that support women’s social networks and which enhance women’s confidence and control will have very different empowerment effect from those that subordinate women and their networks to external expertise and (often male) authority and undermine women’s preferences or autonomy. We (a) conduct an audit of positive practices concerning maternal and child health and (b) examine how current support to maternal and infant health articulates with this. Analysis seeks to reposition indigenous knowledge, community wisdom and their secular practices in a way that promotes better health provision that is integrated with these existing practices and that is empowering.
Nov 2017 DOI 10.14302/issn.2641-4538.jphi-17-1839
Mango LucioCorresponding author
Nuclear Medicine, S. Camillo-Forlanini General Hospital, Rome – Italy
A perspective on public health ethics discusses fairness, autonomy, and solidarity in policy making. It illustrates dilemmas in resource allocation and risk communication.
Mar 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1161
Johansson GunnarCorresponding author
Professor of Health Sciences, School of Health and Welfare, Halmstad University
There Is A Gap Between What We Know And What We Do, Such As Knowing What We Should Eat And What We Actually Eat, A So-Called “Attitude/Behavior Gap”. It Is Not Necessary To Go From A Change In Attitude To A Change In Behavior. It Is Possible To Do The Opposite; In Other Words, It Is Possible To Go From A Change In Behavior To A Change In Attitude. The Objective Of This Paper Is To Describe And Explain The Concept Of Dietary Advice On Prescription (DAP) And Present The Reasons And Evidences For The DAP Messages. Dietary Advice On Prescription (DAP) Starts With Discussing Behaviors Related To Dietary Habits And Then Goes From Behaviors Towards Attitudes. DAP Is A Theory-Based Pedagogical Model That Deals With Behaviors Related To Why, How And When We Eat, Rather Then What We Eat. The DAP Model Is A Method That Quickly Leads The Client Onto A Track That Yields Autonomy, Respects The Client’s Integrity, Gives Confirmation, Emphasizes The Delight And Pleasure Of Eating, Stimulates Discussions And Gives The Client The Initiative In These Discussions. In A Clinical Situation, The Counsellor Lays Out The DAP Postcards On A Table And The Client Picks One Card (Or Several) That Feels Relevant And Interesting For The Client To Discuss. Together They Make An Agenda For The Discussion Such As, For Instance, In What Order To Discuss The DAP Postcards. The Counsellor Asks In An Open Manner With A Motivational Interview (MI) Spirit Why The Client Has Chosen The Particular Card(S). The Client Explains, Elaborates, Turns And Twist About The Choices He/She Has Made. The Results Of The First Published Qualitative Study Of This Two-Year Randomized Controlled Trial Demonstrate That The Participants Found The Concept Valuable.