The discovery of dietetics -- Philosophy of the nature of man -- Therapy of body and soul -- The philosophical legacy of On regimen.

Hynek Bartos does the field of ancient philosophy a great service by detailing the influence of early Greek thinkers (such as Heraclitus, Empedocles, Anaxagoras, Democritus, and Diogenes of Apollonia) on the Hippocratic work On Regimen, and by demonstrating that work’s innovative engagement with contemporary scientific and philosophical concepts as well as its direct influence on Plato and Aristotle. His study usefully counteracts the lamentable tendency among ancient philosophers to ignore or downplay the influence of medical literature on philosophy in (...) general, and to heap scorn on this text in particular, which Kirk, Raven, and Schofield considered ‘an eclectic and very superficial quasi- philosophical treatise’ and Barnes famously called ‘a silly farrago of ill-digested Presocratic opinions’. (shrink)

Athenaeus of Attalia distinguishes two types of exercise or training (γυμνασία) that are required at each stage of life: training of the body and training of the soul. He says that training of the body includes activities like physical exercises, eating, drinking, bathing and sleep. Training of the soul, on the other hand, consists of thinking, education, and emotional regulation (in other words, 'philosophy'). The notion of 'training of the soul' and the contrast between 'bodily' and 'psychic' exercise is common (...) in the Academic and Stoic traditions Athenaeus is drawing from; however, he is the earliest extant medical author to distinguish these kinds of training and to treat them as equally important aspects of regimen. In this paper, I propose some reasons why he found this distinction useful, and I examine how he justified incorporating it into his writings on regimen, namely by attributing Plato's beliefs about regimen to Hippocrates, a strategy Galen would adopt well over a century later. (shrink)

The paper provides an innovative interpretation of the treatise De Victu, showing that, though Heraclitean, Anaxagorean and Empedoclean borrowings in the work are certainly pervasive, the author also develops a sophisticated and multi-purpose explanatory framework, which, being based on an original conception of the nature of man, the cosmos and the relationship between the two, provides an effective foundation for the medical enterprise, allowing him to propose his dietetics as a ‘way of life’. At the core of this enterprise is (...) the relationship between microcosm and macrocosm: in virtue of this relationship, I submit, the cosmos becomes both an active factor to be taken into account for the maintenance of individual physical well-being and the normative standard to which a dietician and whoever cares about health must refer in order to live the healthiest possible life. (shrink)

This study analyzes the dissemination and readership of two medieval medical works in Catalan. Combining the use of diverse sources such as the manuscripts themselves, post-mortem inventories, and the prologues written by the translators, the study shows how the diffusion of these works exemplifies the two main audiences to which vernacular texts were addressed. These were, on the one hand, literate but not Latinate surgeons and other practitioners interested in the new medicine emanating from the emerging universities; and on the (...) other, nobles and burghers interested in issues of health and disease and in natural philosophy in general. The framework for the study is the general process of consolidation of the new medical system which developed in late medieval Latin Europe. (shrink)

Relationships, jobs, and health behaviors-these are what New Year's resolutions are made of. Every year millions resolve to adopt a better diet, exercise more, become fit, or lose weight but few put into practice the health behaviors they aspire to. For those who successfully begin, the likelihood that they will maintain these habits is low. Healthcare professionals recognize the importance of these, and other, health behaviors but struggle to provide their patients with the tools necessary for successful (...) maintenance of their medical regimens. The thousands of research papers that exist on patient adherence and health behavior change can leave professionals overwhelmed. This book synthesizes the results from more than 50 years of empirical research, resulting in simple, powerful, and practical guidance for health professionals who want to know the most effective strategies for helping their clients to put long-term health-relevant behavior changes into practice. It advocates a straightforward 3-ingredient model: Before a person can change, they must know what change is necessary ; desire the change ; and then have the tools to achieve and maintain the change. This book is designed to be informative and compelling, but its numerous anecdotes and examples render it engaging and entertaining, as well. Written for a practitioners and students of medicine, chiropractic, osteopathy, nursing, health education, physician assistant programs, dentistry, clinical and health psychology, marriage and family counseling, social work, school psychology, and care administrators -- and for lay persons who wish to take an active role in their health, this book brings together major empirically-based findings within the field and provides succinct, evidence-based recommendations and strategies for using these findings to make real changes. (shrink)

Moshe ben Maimon, or Moses Maimonides, remains one of the most celebrated rabbis in this history of Judaism; his numerous writings include philosophical and medical treatises in Arabic, two of history's most important works on Jewish law, and, most notably, efforts to reconcile Aristotelian philosophy with biblical teaching. The _Complete Medical Works_, edited by Gerrit Bos of the Martin-Buber-Institut fur Judaistik at the University of Cologne, collects the entirety of Maimonides's medical writings. Notwithstanding its title, _On Asthma_ is in fact (...) a complete regimen of health, designed for the needs of a high-ranking patient whose identity is not stated. In true Galenic fashion, Maimonides stresses that a healthy lifestyle and diet are the most important preventative measures against chronic illness such as asthma. Good and bad foods are described in detail, and many recipes for beneficial dishes and drugs are included, with Maimonides adapting Galenic regimens to the needs of his Muslim patient. (shrink)

A recent study by Olivieri et al, published in PLOS ONE, reports that between 2009 and 2015 a third of patients with thalassaemia in Canada’s largest hospital were switched from first-line licensed drugs to regimens of deferiprone, an unlicensed drug of unproven safety and efficacy. Based on retrospective data from patient records, the PLOS Study reports that patients treated with deferiprone, either as monotherapy or in combination with first-line drugs, suffered serious adverse effects. The data reported by Olivieri et al (...) give rise to a number of ethical issues. These ethical issues are identified, placed in historical context and analysed. For purposes of this analysis, reliance is placed on two core principles of research ethics, harm minimisation and informed consent, and also on the hospital’s mission statement. Then a mystery is explored: How and why did it happen that Toronto’s University Health Network treated large numbers of patients with an unlicensed drug over a period of many years? ‘Institutional conflict of interest’ is considered as a possible explanatory hypothesis. (shrink)

A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we—as embodied beings—engage with health-promoting behaviours. It specifically considers (...) how we engage with oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint. (shrink)

ABSTRACT Public health communication campaigns have been credited with helping raise awareness of risk from chronic illness and new infectious diseases and with helping promote the adoption of recommended treatment regimens. Yet many aspects of public health communication interventions have escaped the scrutiny of ethical discussions. With the transference of successful commercial marketing communication tactics to the realm of public health, consideration of ethical issues becomes an essential component in the development and application of public health (...) strategies. Ethical issues in public health communication are explored as they relate to eight topics: ‘targeting’ and ‘tailoring’ public health messages to particular population segments; obtaining the equivalence of informed consent; the use of persuasive communication tactics; messages on responsibility and culpability; messages that apply to harm reduction; and three types of unintended adverse effects associated with public health communication activities that may label and stigmatise, expand social gaps, and promote health as a value. We suggest that an ethical analysis should be applied to each phase of the public health communication process in order to identify ethical dilemmas that may appear subtle, yet reflect important concerns regarding potential effects of public health communication interventions on individuals and society as a whole. (shrink)

Moshe ben Maimon, or Moses Maimonides (1135-1204), remains one of the most celebrated rabbis in this history of Judaism; his numerous writings include philosophical and medical treatises in Arabic, two of history's most important works on Jewish law, and, most notably, efforts to reconcile Aristotelian philosophy with biblical teaching. The Complete Medical Works, edited by Gerrit Bos of the Martin-Buber-Institut fur Judaistik at the University of Cologne, collects the entirety of Maimonides's medical writings. Notwithstanding its title, On Asthma is in (...) fact a complete regimen of health, designed for the needs of a high-ranking patient whose identity is not stated. In true Galenic fashion, Maimonides stresses that a healthy lifestyle and diet are the most important preventative measures against chronic illness such as asthma. Good and bad foods are described in detail, and many recipes for beneficial dishes and drugs are included, with Maimonides adapting Galenic regimens to the needs of his Muslim patient. Volume Two offers Gerrit Bos’s critical editions of all three surviving medieval Hebrew translations of Maimonides’ work: one allegedly prepared by the fourteenth-century physician Samuel Benveniste, who served Don Manuel, brother of King Pedro IV of Aragon; a second by Joshua Shatibi from Játiva (Xátiva) between the years 1379 and 1390, for the referendary Fernán Díaz of Toledo at the court of King Juan II of Castile; and a third by an anonymous translator, perhaps in the thirteenth century. The volume also contains critical editions by Michael R. McVaugh of the two medieval Latin translations of Maimonides’ treatise, one probably made by Giovanni da Capua at Rome c. 1300 and the other begun by Armengaud Blaise in Montpellier in 1294 but completed eight years later. It concludes with a section of addenda and corrigenda to the first volume. (shrink)

This article re-exams the old tension between the philosopher and the city. Reading Ibn Bājja’s Governance of the Solitary and Nietzsche’s Thus Spoke Zarathustra against the background of Plato’s Republic, I argue that they both embrace several key aspects of Platonic political philosophy: the assumption that philosophical natures can grow spontaneously in sick cities, the ideal of the philosopher legislator and the correlative project of founding a virtuous new regime. Yet in preparation for this final task, each prescribes a (...) class='Hi'>regimen of solitude for philosophers, so that they might preserve their own health and autonomy. While this spiritual exercise at first appears merely temporary and provisional—aimed at the cultivation of a philosopher ruler and the eventual establishment of a healthy political regime —I argue that both Ibn Bājja and Zarathustra ultimately abandon their Platonic ambitions and opt instead for the apolitical contemplative life. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Meeting of Minds: Intellectual and Religious Interaction in East Asian Traditions of ThoughtDeborah SommerMeeting of Minds: Intellectual and Religious Interaction in East Asian Traditions of Thought. Edited by Irene Bloom and Joshua A. Fogel. New York: Columbia University Press, 1997. Pp. 391.Meeting of Minds: Intellectual and Religious Interaction in East Asian Traditions of Thought, a volume of eleven essays written in honor of Wing-tsit Chan and William Theodore (...) de Bary, proposes to explore how Confucian and Neo-Confucian traditions have responded to and have influenced other traditions (Buddhist, Taoist, folk, Japanese nativist, and so on) in China and Japan. The essays are arranged first geographically (seven articles on China precede four on Japan) and then roughly chronologically. All essays, save one, describe Sung or post-Sung developments. A few sentences per essay must suffice in this review.Irene Bloom's "Three Visions of Jen" is the only essay on the classical period. Informed especially by Wing-tsit Chan's work on jen and shaped by Sung and later notions of the transmission of the way, the essay examines the notion of jen in the Analects, the Mencius, and Chu Hsi's "Jen shuo" (Discussion of jen), succinctly [End Page 318] emphasizing the significant differences of perspective therein. Nodding to the book's larger intent of examining intellectual interactions with other traditions, some attention is given in the conclusion to comparisons with the Mohist, Yangist, and Ch'an traditions. Rodney Taylor's "Chu Hsi on Meditation" is also deeply indebted to Wing-tsit Chan and starts by resurveying much terrain already explored in Chan's 1989 "Chu Hsi and Quiet-Sitting" (in Chu Hsi: New Studies, published by University of Hawai'i Press). Taylor enlarges upon Chan's work especially in his discussion of Chu Hsi's practices of breath-control techniques to improve health. In keeping with the larger direction of the book, Taylor contrasts Chu's emphasis on quiet sitting as a support for study with the different spiritual goals of Ch'an Buddhism.Patricia Ebrey's "Sung Neo-Confucian Views on Geomancy" examines a topic that is seldom encountered in American scholarship: the attitudes of such figures as Ssu-ma Kuang, Ch'eng I, Chu Hsi, and Ts'ai Yan-ting toward popular practices governing the placement of graves. Ebrey outlines the views of those who, as it were, are "for" or "against" geomancy (Chu and Ts'ai took geomancy seriously, although Ssu-ma and Ch'eng viewed it with apprehension) but also provides textual evidence that allows one to see the grayer areas between support for, and condemnation of, feng shui and other arts. Julia Ching's "Chu Hsi and Taoism" considers Chu's interpretations of such classical texts as the I ching, Lao Tzu, Chuang Tzu, and Ch'u tzu and also assays his commentaries on such later texts as the Ts'an-t'ung-ch'i (an alchemical text Chu commented on with the assistance of Ts'ai Yan-ting) and the Yin-fu-ching (a commentary that Ching concludes is most likely not Chu's work). She also explores in some detail the specifics of Chu's regimen of breathing practices.Moving from specific thinkers of the Sung to general developments in the Ming and Ch'ing dynasties, Chn-fang Y's "The Cult of Kuan-yin in Ming-Ch'ing China: A Case of Confucianization of Buddhism?" describes how the cult of Kuan-yin served the aims of Confucian family values and facilitated the realization of women's domestic expectations of filiality and fertility. Y explores the little-studied practice of ke-ku, or the cutting off of one's flesh to feed another, and relates Kuan-yin's role as a protector of those who engage in such filial excisions.Koichi Shinohara's "Ta-hui's Instructions to Tseng K'ai: Buddhist 'Freedom' in the Neo-Confucian Context" returns to the Sung but continues the focus on Buddhism, finding an example of Buddhist-Confucian interaction in the religious instruction given by the monk Ta-hui to a vice minister of rites. But what is particularly Confucian about minister Tseng K'ai's interest in Buddhism? The... (shrink)

Your Essential How-To Guide for Self-Healing The greatest medical breakthrough in recent years isn’t the creation of a new drug or treatment—it’s the discovery of how much your mind affects your health. With Your Power to Heal, Dr. Henry Grayson offers a treasury of techniques and insights to help you harness the mindbody connection. “When we can identify and change the inner voices that keep us feeling powerless,” writes Dr. Grayson, “we can go beyond treating just symptoms or relying (...) on doctors to fix us. We have far greater potential to heal than we realize.” In this practical guidebook, Dr. Grayson presents life-changing insights and effective tools anyone can use, including: • The new physics of healing—the ever-expanding body of research that reveals our untapped capacity for self-healing • Simple tips to nip many symptoms in the bud as they start • Self-assessment questionnaires to help you locate and change subconscious beliefs and disturbances • The Emotional Freedom Technique for resolving trauma and restoring your vitality • Thought Field Therapy to clear the blockages in your body’s energy system that are impeding health • Why therapy, diets, and exercise regimens often fail—and how to make them succeed You don’t need years of meditation practice to use your mind to improve your health. Your Power to Heal is an invaluable resource to help you harness the power of your own thoughts, transform illness at its source instead of just alleviating symptoms, and start taking charge of your health today. (shrink)

IntroductionWith the normalization of COVID-19 prevention and control, a large number of intergenerational audiences with different cognition preferences and value orientations have started to pour into non-acquaintance virtual communities to address their social needs by disclosing their own thoughts, feelings and experiences toward certain topics. To avoid the negative impacts of self-disclosure, this study introduced the concept of social integration into cyber society among non-acquaintance VCs, such as the topic-based VCs. Our theoretical model considers both the psychological antecedents and consequences (...) of VC audiences’ social integration and our findings have implications for public online social life. Moreover, this research could play a guiding role in improving VC audiences’ social integration status in future online learning and telecommuting scenarios.MethodTo assess the theoretical model constructed in this manuscript, we conducted an online survey in two different topic-based VCs among Microblog and yielded 472 useable responses from intergenerational audiences, among which 28.81% were born before 1985, 26.67% were born from 1985 to 1995, and 48.52% were born after 1995. Our sample consisted of 208 individuals from Health Regimen VC and 264 individuals from Star Chasing VC, 200 were men and 272 were women.ResultsOur structural equation model indicated that individuals’ self-disclosure in topic-based VCs might not directly guide them to acquire social integration. However, intimacy and cognitive communion derived from VC audiences’ self-disclosure might not only enhance their social integration, but also improve their psychological well-being. In addition, VC audiences’ social integration mediated the relationship between intimacy and psychological well-being, and the relationship between cognitive communion and psychological well-being. Moreover, VC audiences’ intimacy was found to have a direct influence on their cognitive communion.ConclusionIn the context of topic-based VCs, audiences’ self-disclosure could significantly foster their intimacy and cognitive communion with others, and both intimacy and cognitive communion are conductive to VC audiences’ social integration. Thus, audiences in topic-based VCs who wish to improve their psychological well-being need to disclose themselves and build corresponding psychological foundations to enhance their social integration. Meanwhile, topic-based VCs should pay attention to the cultivation of intimacy and cognitive communion among audiences while encouraging them to reveal themselves. (shrink)

Published data show that new HIV prevention strategies including treatment-as-prevention and pre-exposure prophylaxis (PrEP) using oral antiretroviral drugs (ARVs) are highly, but not completely, effective if regimens are taken as directed. Consequently, their implementation may challenge norms around HIV prevention. Specific concerns include the potential for ARV-based prevention to reframe responsibility, erode beneficial sexual norms and waste resources. This paper explores what rights claims uninfected people can make for access to ARVs for prevention, and whether moral claims justify the provision (...) of ARV therapy to those who do not yet clinically require treatment as a way of reducing HIV transmission risk. An ethical analysis was conducted of the two strategies, PrEP and treatment-as-prevention, using a public health stewardship model developed by the Nuffield Bioethics Council to consider and compare the application of PrEP and treatment-as-prevention strategies. We found that treating the person with HIV rather than the uninfected person offers advantages in settings where there are limited opportunities to access care. A treatment-as-prevention strategy that places all the emphasis upon the positive person's adherence however carries a disproportionate burden of responsibility. PrEP remains an important option for receptive partners who face increased biological vulnerability. We conclude that the use of ARV for prevention is ethically justified, despite imperfect global to drugs for those in clinical need. The determination of which ARV-based HIV prevention strategy is ethically preferable is complex and must take into account both public health and interpersonal considerations. (shrink)

In _Regimens of the Mind_, Sorana Corneanu proposes a new approach to the epistemological and methodological doctrines of the leading experimental philosophers of seventeenth-century England, an approach that considers their often overlooked moral, psychological, and theological elements. Corneanu focuses on the views about the pursuit of knowledge in the writings of Robert Boyle and John Locke, as well as in those of several of their influences, including Francis Bacon and the early Royal Society virtuosi. She argues that their experimental programs (...) of inquiry fulfill the role of regimens for curing, ordering, and educating the mind toward an ethical purpose, an idea she tracks back to the ancient tradition of _cultura animi_. Corneanu traces this idea through its early modern revival and illustrates how it organizes the experimental philosophers’ reflections on the discipline of judgment, the study of nature, and the study of Scripture. _ _ _ _ It is through this lens, the author suggests, that the core features of the early modern English experimental philosophy—including its defense of experience, its epistemic modesty, its communal nature, and its pursuit of “objectivity”—are best understood. (shrink)

Background: Recent research demonstrates that people sometimes make different medical decisions for others than they would make for themselves. This finding is particularly relevant to end-of-life decisions, which are often made by surrogates and require a trade-off between prolonging life and maintaining quality of life. We examine the impact of decision role, patient age, decision maker age and multiple individual differences on these treatment decisions. Methods: Participants read a scenario about a terminally ill cancer patient faced with a choice between (...) an aggressive chemotherapy regimen that will extend life by two years and palliative treatments to control discomfort for one remaining month. Participants were randomly assigned to one of three decision roles (patient, physician, or an abstract other) and the scenario randomly varied whether the patient was described as 25 or 65-years old. Results: When deciding for a 65-year old patient, approximately 60% of participants selected aggressive chemotherapy regardless of decision role. When deciding for a 25-year old patient, however, participants were more likely to select chemotherapy for a patient (physician role) or another person (abstract other) than for themselves (70%, 67%, and 59%, respectively). In addition, confidence that powerful others (eg, physicians) control one’s health, as well as respondents’ age and race, consistently predicted treatment choices. Conclusions: Patient age appears to influence medical decisions made for others but not those that we make for ourselves. These findings may help to explain the discord that often occurs when younger cancer patients refuse life-extending treatments. (shrink)

Diabetes mellitus (DM) is a colossal burden in global health, its prevalence increases steadily throughout the world. This systematic review explores the pathophysiology and epidemiology of diabetes, which describes the interactions that implicate that is the result of the play between genetic, environmental, and lifestyle factors in the development and progression of the disease. The review also describes a plethora of pharmacological treatments available to manage diabetes, with the oral agent, insulin regimens, and new approaches to therapy. Integrating the (...) wisdom of the best clinical guidelines, those are from American diabetes association (ADA), European association for the study of diabetes (EASD), and International Diabetes Federation (IDF). Since these reviews are consistent with normative standards for evidence-based recommendations of optimal care of diabetes. The review goes further to cover technological advances in the management of diabetes. They include Continuous Glucose Monitoring, advanced insulin delivery systems, and Artificial Pancreas Systems. Such technologies hold more promising routes to better glucose control and patient quality of life. All this comes along with challenges that their deployment and maintenance that run through economic, adherence issues, and unequal access to healthcare. The future research and innovation in the battle against DM will include the application of personalized medicine and the development of advanced digital health solutions. This article will become a treasure for health professionals, researchers, and policymakers who have dedicated themselves to battling the adversities of diabetes mellitus. (shrink)

This paper describes how body regimes are effectuated in the prevailing treatment strategy of physiotherapy. The process of self‐mastering in the context of sports‐related injuries is highlighted. Through a Foucauldian perspective on body regimes the aim is to shed light on the process of individualization and self‐mastery in rehabilitation. The treatment of illness in the physiotherapy clinic does not characterize the patient as sick, and exempt the patient from daily duties and expectations. The empirical data include 17 qualitative illness narratives (...) and several years of fieldwork observing patients with anterior cruciate ligament (ACL) injuries in a physiotherapy clinic. The study demonstrates how the expectation that the patients be active and self‐mastering permeates the total process of treatment. The individual responsibility for personal well‐being is a recurrent phenomenon in public health services in general, and specifically prominent in the rehabilitation of sports injuries. (shrink)

Academic procrastination – habitually delaying work with academic tasks to the extent that the delays become detrimental to performance, wellbeing, and health – represents a substantial personal, systemic, and societal problem. Still, efforts to prevent and reduce it are surprisingly scarce and often offered as treatment regimens rather than preventive efforts. Based on the principles of functional analysis and a broad examination of factors that are important for academic procrastinatory behaviors, this paper aims to describe a strategy for analyzing (...) individual controlling conditions for procrastination and give parallel advice on how to change those controlling conditions. Both are ideographic, allowing for individual and dynamic analyses of factors responsible for instigating and maintaining procrastination, as well as tailor-made remedies that address controlling conditions in preventive and curative efforts to reduce procrastination. Although functional analysis integrates well with important research findings in the procrastination field, this approach suggests new criteria for identifying procrastinatory behaviors and an alternative model for analyzing their control conditions. We conclude that a functional approach may supplement procrastination research and efforts to prevent and alleviate this detrimental habit. (shrink)

The problem of non-compliance with treatment and its repercussions on the clinical evolution of different conditions has been widely investigated.1–4 Non-compliance has also been shown to have significant economic implications, not only as a result of product loss but also indirectly through the complication of disease management and its subsequent healthcare and social costs.5–7Non-compliance as a health problemThe term “non-compliance” might be taken to refer both to the failure to follow a drug regimen and to the failure to (...) adopt other measures that contribute to improvement in health—for example, changes in lifestyle or diet. This letter focuses on the former.Non-compliance with a drug regimen can be the result of a number of different factors9–11 and a variety of techniques have been developed in an attempt to control it.12,13 Of these, the few techniques that have been shown to be effective have only managed to solve the problem in specific situations over short periods of time. The use of such techniques to control non-compliance, particularly where these are effective, raises interesting ethical questions about the extent to which their application constitutes an infringement of the patient’s right to decide on how to manage their own health.8 Here we suggest that in some cases one factor that leads to non-compliance is the tendency to provide extensive and exhaustive information on side effects in …. (shrink)

BackgroundSocial support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is (...) related to survival. Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals.MethodsIn Study 1, we conducted a retrospective chart review of alloHCT patients and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge.ResultsPatients with a dedicated caregiver had a higher probability of surviving to 100 days than patients without a caregiver, OR = 2.84, p = 0.042. Study 2 demonstrated the importance of post-transplant support due to patients’ emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients’ daily lives, including support for attending doctor’s appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support.ConclusionThe findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients’ adherence to recommended self-care and survival. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dying is DifficultClarice DouilleHayden had been a constant in my life since I was eight, as our families were close. He was a single dad who loved to talk and always had a smile on his face. He was obsessed with anything related to his kids and attended every school activity or sporting event.In 2015, Hayden was diagnosed with stage III colon cancer. He was adamant that he didn't (...) want to share any information about his condition with his kids, waiting several months until the eve of his first surgery before breaking the news to them. Hayden made the operation seem trivial and underplayed the severity of the chemotherapy treatments that would follow. Despite whatever he was feeling, he seemed committed to maintaining his happy demeanor, which was probably an effort to convince himself and others to feel better about the situation.Hayden survived his first operation and rounds of chemotherapy. And, over the next several years, he chose to undergo a regimen of additional aggressive treatments, submitting to surgery after surgery, as well as several more rounds of chemotherapy, followed by radiation treatments. I was already working as a home care aide, and because of the close relationship between our families, Hayden asked me to help as his caregiver, including running errands and babysitting for his younger kids. Hayden made it clear that he wanted his kids to remain ignorant of the progression of his condition so that they wouldn't worry and become anxious. It seemed he was motivated by his desire to preserve his young kids' happiness and innocence. In hindsight, I think this prevented his kids from being able to fully savor moments with their dad or prepare for the possibility of his death. I also think Hayden was trying to shelter himself from his own fear of mortality. And it was this fear that made Hayden a "difficult patient."Hayden suffered both physically and mentally, not only from his disease and treatment but also from his fear of mortality. I noticed how he tried to hide his suffering by shutting himself in his bedroom and making excuses when he wasn't eating. He often forgot to take his medications; he refused to use pill boxes and objected to reminders from others. The consequences often meant additional hospitalizations. I wish more palliative options had been introduced to him earlier in his disease course. I believe a palliative care team would have encouraged Hayden to think about and discuss death, helped him change his outlook for treatment and living with cancer, and most importantly, enabled him to better enjoy the remainder of his life with his kids.Nevertheless, I understood why Hayden was worried about his kids, and I could see how his recent personal experiences since his initial diagnosis might have contributed to his choice for the most aggressive treatments: his sister and both his parents had died, leaving no other relatives to care for his kids. He wanted to be there for his kids, yet the side effects of treatment made him so sick that he couldn't leave his bed. He couldn't even do the very activities that made him want to live.Hayden was an extremely social person, but when he found out his cancer was terminal, he [End Page E6] isolated himself from his loved ones for nearly six weeks. Even though I was likely the only person he was communicating with, as the person who helped him and his family, I often didn't see him for weeks at a time. He would text me requests, leave money on the front table, and ask me to drop off the items I purchased and then leave. Hayden's kids continued their daily routines, despite comments from them about his absence.In early August 2020, Hayden was admitted to the hospital. His doctor called the kids at home and told them that their dad would immediately be enrolled in hospice care. They were, as one might expect, shocked at this news. They knew their dad was sick and had been dealing with his cancer for years. But Hayden's health deteriorated slowly, and the kids hadn't known... (shrink)

A recent article published in Nursing Ethics, written by Professor Bridgit Dimond, highlighted the topic of noncompliance by patients and attention was drawn to a number of issues relevant to health care professionals. In this response, some specific challenges facing nurses are considered in the light of Professor Dimond’s arguments. In doing so, the notion of compliance as an appropriate concept in modern nursing practice is questioned. The recommendations to emerge include strategies to consider patient response to treatment regimens (...) in the form of adherence to health care advice through negotiated therapy. The claimed benefits of health care recommendations are considered and caution about iatrogenesis is advised. (shrink)

Distribution of sufficient health care resources to the maximum number of people in LIC is the central theme of the book. Bangladesh is taken as a representative of low income countries (LIe. In LIC, there is scarcity of health care resources like other resources but the deserving persons are numerous. Therefore, it requires an efficient distribution of resources. Considering 'Inequality to get access to health care' as the basic problem in LIC, John Rawls' principle of fair equality (...) of opportunity is proposed to apply to give people access to health care resources. In this book it is critically analyzed how the principle fails to return a good result in LIC. Instead the principle of maximizing utility is proposed for the purpose. It is argued that maximum number of people can be provided sufficient health care by applying the principle. The principle has also been justified theoretically in concerned low income country and a fruitful result has been achieved from the test. It is claimed that applying principle of utility to provide sufficient health care to the maximum number of people is the most efficient way of health care resources distribution in LIC. (shrink)

For individuals pursuing medically assisted gender transition, gender-affirming surgical treatments, such as oophorectomy (removal of the ovaries) and orchiectomy (removal of the testicles), cause sterility, and gender-affirming hormone treatment with medications (i.e., testosterone and estrogen) may negatively impact infertility. The major United States (US) medical associations already endorse fertility preservation (FP) through cryopreservation (i.e., “freezing” egg and sperm) for transgender individuals. Despite these endorsements from the relevant medical societies, medical insurance coverage for FP remains very limited in the US. Given (...) the high out-of-pocket costs for FP services, fertility preservation remains financially out of reach for many transgender individuals who may desire it. We present an ethical justification for universal FP coverage for all transgender and gender diverse (TGD) individuals who request this option during medically assisted gender transition. First, we argue that gender-affirming medical care is analogous to other medical interventions and treatment regimens that compromise fertility, such as cancer care, and that both types of interventions need to be afforded the same medical benefits and assistance in pursuing fertility goals. Second, we argue that the lack of FP for transgender individuals contributes to the ongoing and profound transphobia and anti-trans bias that has been exacerbated in the past several years across the healthcare landscape in the United States. We argue that the provision of FP coverage for transgender individuals is necessary for clinicians and third-party payers to state their unequivocal support for TGD patients and their healthcare needs. (shrink)

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the (...) education of medical students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

Ideal for students in the philosophy of medicine, healthcare and public health, this book offers an introduction to the philosophical debates around health justice. It presents clear conceptual definitions of health, disease and illness and the various theories of justice, developing a specific normative argument in the debate on health justice.

The author reviews various conceptions of autonomy to show that humans are actually not autonomous, strictly speaking. He argues for a need to rethink the personal autonomy approaches to HIV testing in sub-Saharan Africa (SSA) countries. HIV/AIDS has remained a leading cause of disease burden in SSA. It is important to bring this disease burden under control, especially given the availability of current effective antiretroviral regimens in low- and middle-income countries. In most SSA countries the ethic or value of personal (...) autonomy or self-determination is promoted as primary in HIV testing decision-making. SSA policymakers have an ontological and moral duty to adopt HIV testing policies that reflect human and medical realities, relationships, local contexts, and respect human rights for both individuals and others who are affected by HIV in society. Without rethinking the value of autonomy in HIV testing decision-making, the article cautions that attainment of the Sustainable Development Goal (SDG) 3 and the UNAIDS fast-track strategy that explicitly call to end the epidemic by 2030 will not be feasible for SSA. (shrink)

This book is aimed at providing the reader with a systematic overview of the concepts of health and disease as utilized in various areas of the health sciences. It attempts to provide some historical background to modern models of health and disease. Special attention is given to controversial topics such as the notion of "mental health." the volume contains a number of new papers on health and disease by physicians, philosophers and others.

In 2008 New Zealand's pharmaceutical management agency, PHARMAC, made its final decision on the funding of trastuzumab (Herceptin) for HER2-positive early stage breast cancer. PHARMAC declined to fund the 12-month Herceptin regimen requested by the drug's manufacturer, funding instead a 9-week treatment regimen. The decision was justified on the grounds that there was insufficient evidence of additional long-term health benefits from the longer treatment course, which, coupled with the high cost of the drug, did not make the (...) 12-month regimen sufficiently cost-effective. This paper examines the criticism of PHARMAC's decision that ultimately led to the government's decision to expand the health budget in order to fund the 12-month regimen. It defends PHARMAC's decision against the charge of unfairness, arguing that for high-cost drugs with limited proven effectiveness it is not unfair to deny funding on grounds of cost-effectiveness, since although some moral priority must be given to helping those with serious diseases like breast cancer, the capacity of such drugs to swamp health care budgets is itself a significant moral issue. It concludes that the decision to expand the health budget to pay for Herceptin exacerbates rather than solves the political and moral problems involved in prioritizing health care resources. (shrink)

This is Warrior Yoga, New York Times bestselling author and retired Navy SEAL Commander Mark Divine's latest contribution to mental and physical achievement exercises started with 8 Weeks to SEALFIT and Unbeatable Mind. This is not your average yoga book. Using Coach Divine's signature integrated training curriculum, Warrior Yoga is an intense physical workout designed for both the nation's elite special ops soldiers, and the regular athlete with the heart and mind of a warrior. His tried and true warrior sequences (...) are designed to be simple and flexible. These short, powerful drills can be done from home or on the road to enhance existing workout regimens and cultivate new ones. The sequences are targeted and focused to adapt to any athlete's physical and mental capabilities including those rehabilitating from injuries and suffering from PTSD. Mark's decades of experience with amateur and professional athletes, active and aspiring Navy SEALS, and wounded warriors uniquely qualify him as an expert motivator and teacher. To be a SEALFITTM Yoga Warrior requires a harmonious balance between mental and physical toughness, strength, and agility. Mark's short digestible exercises will help any athlete hone their fitness routine to reach their fullest potential, combining the physical, emotional and spiritual aspects of an unbeatable mind and body program. (shrink)

The application of machine learning in health care holds great promise for improving care. Indeed, our own team is collaborating with experts in machine learning and statistical modeling to bu...

Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervized weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean (...) body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervized weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization. (shrink)

This book is a collection of articles about communication and ethics in the field of medicine and health care. Common to all the articles is that they are not directly based on empirical investigations. The discussions refer to research, but this is research that has already been carried out and documented in existing literature. In this sense the articles belong to what is often called applied philosophy. All the articles address communicative and ethical challenges in patient interaction on the (...) basis of assumptions in modern moral philosophy and philosophy of language. There is a great need for literature that deals more comprehensively with the themes in this book than many introductory books do. It is particularly difficult to find suitable reading material that can be used in teaching at graduate and master levels. This book is designed to meet this need. It is suitable for use in all higher-level courses where the aim is to give students a theoretical understanding of ethical dilemmas and communicative challenges in health care. (shrink)

El artículo tiene como objetivo exponer los fundamentos en que se sustenta la metodología de evaluación de impacto social de un programa de salud con vistas a mejorar la calidad de los servicios en el sector. El producto científico presentado muestra el análisis y síntesis de documentos a partir de la bibliografía actualizada publicada en revistas digitales como Salud Pública Cubana; libros y materiales de autores de reconocido prestigio. La propuesta contempla cuatro etapas fundamentales, cuyas bases teóricas fueron asumidas de (...) investigaciones con este objeto de estudio en el contexto nacional e internacional. This article aims at setting out the fundamentals that support the assessment methodology of social impact of a health program in order to improve the quality of health care services provided in the sector. The scientific product presented shows the analysis and synthesis of documents starting from updated bibliography published in digital journals such as Cuban Public Health; books and materials from prestigious authors. The proposal has four main stages which theoretical basis were taken from researches with the same object of study in a national and international context. (shrink)

In a new era of regulatory oversight, the US Supreme Court upended traditional Chevron deference to agency interpretations of ambiguous Congressional provisions in Loper in June 2024. Federal courts were instructed to make their own assessments of statutory authorities amid an onslaught of public health agency challenges surfacing nationally. Even so, SCOTUS may be eyeing further limits on agency powers despite clear and substantial repercussions for the health of the nation.

The ethical dimensions of health communicators' interventions and campaigns are brought into question in this thought-provoking book. Examining the efforts to effect behavior change, the author questions how far health communication can and should go in changing people's values. The author broadens the current analysis of interventions and presents conceptual frameworks that help identify values and justifications that are embedded in health communication goals, strategies, and evaluation criteria. This critical approach helps explain how and why choices are (...) made in design and implementation, and provides constructs and frameworks to examine them. It also widens the criteria for program evaluation and policymaking, and provides practitioners, planners, policy-makers, researchers, and students with practice-oriented questions. (shrink)

Is positive thinking really so healthy that, as Martin Seligman (2000) and Mihaly Csikszentmihalyi passionately thus argued, "we believe that a psychology of positive human functioning will arise, which achieves a scientific understanding and effective interventions to build thriving individuals, families, and communities"? This optimistic view on positive thinking for health can be contrasted with an opposing view by Barbara Ehrenreich (2009), who "extensively critiqued 'positive psychology'" and showed "how obsessive positive thinking impedes productive action, causes delusional assessments of (...) situations, and people are then blamed for not visualising hard enough and thus 'attracting' failure even in situations when 'masses of lives were lost'." (WK 2013; R Byrne 2006) Contrary to these opposing views (and other ones as will be discussed in the book), health care (in relation to mental health and physical health in the context of mind and body) are neither possible (or impossible) nor desirable (or undesirable) to the extent that the respective ideologues (on different sides) would like us to believe. Surely, this questioning of the opposing views on health care does not suggest that the study of health care is worthless, or that those fields (related to health care) like medicine, chiropractic, health system, dentistry, health info tech, nursing, psychiatrics, clinical psychology, occupational therapy, pharmacy, allied health, and so on are unimportant. Needless to say, neither of these extreme views is reasonable. Instead, this book offers an alternative (better) way to understand the future of health care, especially in the dialectic relationships between mental health and physical health in the context of mind and body -- while learning from different approaches in the literature but without favouring any one of them (nor integrating them, since they are not necessarily compatible with each other). More specifically, this book offers a new theory (that is, the interconnected theory of health care) to go beyond the existing approaches in a novel way and is organised in four chapters. (shrink)

Many of the demands being voiced for a "humanizing" of health care center on the public's concern that they have some say In determining what happens to the individual in health care institutions. The essays in this volume address fundamental questions of conflicts of rights and autonomy as they affect four selected, controversial areas in health care ethics: the Limits of Professional Autonomy, Refusing! Withdrawing from Treatment, Electing "Heroic" Measures, and Advancing Reproductive Technology. Each of the topics (...) is addressed in such a way that it includes an examination of the locus of responsibility for ethical decision making. The topics are not intended to exhaustively review those areas of health care provision where conflicts of rights might be said to be an issue. Rather they constitute an examination of the difficulties so often encountered in these specific contexts that we hope will illuminate similar conflicts in other problem areas by raising the level of the reader's moral awareness. Many books in bioethics appeal only to a limited audience in spite of the fact that their subject matter is of deep personal concern to everyone. In part, this is true because they are frequently written from the perspective of a single discipline or a single profession. As a result, one is often left with the impression that such a book views the philosophical, historical, and! or theological problems as essentially indifferent to clinical, legal, and! or policy-making problems. (shrink)