The interaction of humans, cholera bacteria, the zooplankton host of the bacterium , and the environment in the case of cholera can be employed to make reasonable predictions about this climate-driven disease. The issues are truly international and represent those that comprise a global scientific enterprise and encompass many other infectious diseases.

Age rationing is a central issue in the health care priority‐setting literature, but it has become ever more salient in the light of the Covid‐19 outbreak, where health authorities in several countries have given higher priority to younger over older patients. But how is age rationing different under outbreak circumstances than under normal circumstances, and what does this difference imply for ethical theories? This is the topic of this paper. The paper argues that outbreaks such as that of (...) Covid‐19 involve special circumstances that change how age should influence our prioritization decisions, and that while this shift in circumstances poses a problem for consequentialist views such as utilitarianism and age‐weighted consequentialism, contractualism is better equipped to cope with it. The paper then offers a contractualist prudential account of age rationing under outbreak circumstances. (shrink)

John Beatty (1995) and Alexander Rosenberg (1994) have argued against the claim that there are laws in biology. Beatty's main reason is that evolution is a process full of contingency, but he also takes the existence of relative significance controversies in biology and the popularity of pluralistic approaches to a variety of evolutionary questions to be evidence for biology's lawlessness. Rosenberg's main argument appeals to the idea that biological properties supervene on large numbers of physical properties, but he also develops (...) case studies of biological controversies to defend his thesis that biology is best understood as an instrumental discipline. The present paper assesses their arguments. (shrink)

Research represents an essential component of the response to infectious disease outbreaks and to other public health emergencies, whether they are localised, of international concern, or global. Research conducted in such contexts also comes with particular ethics challenges, the awareness of which has significantly grown following the Ebola outbreak in West Africa, the Zika outbreak in Latin America and the COVID-19 pandemic. These challenges include the need for implementing meaningful community engagement with the researched communities, not just to (...) build unidirectional trust towards the research team, but to achieve a genuine and mutually respectful partnership before, during and after the research. Here, we describe the real-life experience of 10 well-established research clinics in Nairobi, where a successful experience of community engagement linking prevention and care to research was interrupted during the COVID19 pandemic. We contrast this experience with the concept and processes of community engagement as described in selected scientific manuscripts and guidelines, to formulate some conclusions and recommendations. We contend that more action is needed, from research ethics committees and other key-research stakeholders, to align policies and practices with ethics guidance and with evidence-based recommendations from the academic literature, to achieve meaningful community engagement during emergency research, irrespective of the scale and location of an outbreak or public health crisis. Failure to do so, will aggravate the (postcolonial) asymmetries of power in global health and local systems. (shrink)

Many ecological processes exhibit trajectories which can be suitably represented by stable equilibria or smooth limit cycles. However, a third kind of ecological process involves intermittent, abrupt, and drastic changes in densities, here termed outbreak dynamics, which require different modelling frameworks. One such framework, the cusp catastrophe, is used here in a modelling study of a particular outbreak insect, the forest tent caterpillar. This model is then generalized to cover a set of related ecological systems. The particular form (...) of the model for each system depends on whether the major controlling ecological variables are externally imposed, or are incorporated in the model equations. It is concluded that the simple cusp catastrophe is an appropriate metaphor for understanding outbreak dynamics. (shrink)

Infectious disease outbreaks in residential care are complex to manage and difficult to control. Research in this setting that includes individuals who lack capacity must conform to national legislation. We report here on our study that is investigating outbreaks of scabies, an itchy skin infection, in the residential care setting in the southeast of England. There appears to be a gap in legislative advice regarding the inclusion of people who lack capacity in research that takes place during time-limited acute scenarios (...) such as outbreaks. We received inconsistent advice from experts regarding, in particular, the role of nominated consultees. There is a potential inequality for vulnerable populations who cannot themselves provide informed consent in terms of their access to participation in a range of health-related research. (shrink)

The causes and the outbreak of the Corinthian war, as well as the events immediately preceding it, have often been discussed by modern historians. Since the Corinthian war is the first attempt at achieving a new settlement in Greece after the Peloponnesian war and since it brought about new political alliances and the revival of old imperial rivalries, it is not only an episode in the continual warfare among the Greek states, but may also be regarded as a key (...) to the understanding of a part, at least, of the pattern of Greek history in the fourth century B.C. (shrink)

This article is in response to Wurr and Cooney’s Case Discussion entitled ‘Ethical dilemmas in population-level treatment of lead poisoning in Zamfara State, Nigeria’. The Case Discussion draws attention to Médecins Sans Frontières’ (MSF’s) remarkable achievement of providing the world’s first population-level treatment for severe lead poisoning. Wurr and Cooney raise two key ethical issues: treatment in the face of ongoing exposure, and withdrawal from program. Having participated in the emergency response to the lead-poisoning outbreak, I reflect on the (...) Case Discussion and how the ethical issues fall within a troubling broader context. I offer a deeper analysis of the ethical issues by raising further substantive and philosophical considerations. I draw attention to social injustice and inequity at the root of the disaster, and link the disaster to neoliberal economic policies that impose public health austerity and then look to private non-governmental organizations for disaster response. A larger ethical concern is how the humanitarian response, in addressing immediate medical needs, can leave unjust political structures intact. Around the world, abject poverty, high gold prices and unviable traditional farming continue to drive families into dangerous artisanal mining. Meanwhile, the longer-term prospects for the severely lead-affected children of northern Nigeria remain grim. (shrink)

Current thinking on the development of molecular microbial characterisation techniques in public health focuses mainly on operational issues that need to be resolved before incorporation into daily practice can take place. Notwithstanding the importance of these operational challenges, it is also essential to formulate conditions under which such microbial characterisation methods can be used from an ethical perspective. The potential ability of molecular techniques to show relational patterns between individuals with more certainty brings a new sense of urgency to already (...) difficult ethical issues associated with privacy, consent and a moral obligation to avoid spreading a disease. It is therefore important that professionals reflect on the ethical implications of using these techniques in outbreak management, in order to be able to formulate the conditions under which they may be applied in public health practice. (shrink)

A return to Adorno, called for by Robert Hullot-Kentor twenty years ago in this journal,1 has materialized as a welcome scholarly development, and Adorno is now being considered increasingly on his own terms. As the editors of a recent collection of essays on Adorno point out, he has suffered the ill fate of being taken to the task, on the one hand, by Habermasians for allegedly abandoning the “project” of Enlightenment, and, on the other hand, by academic theorists subscribing to (...) cultural and post-colonial studies who view his critical theory as burdened with an untimely allegiance to a Eurocentric notion…. (shrink)

This article is about the cholera epidemic that occurred in the Benghazi Sanjak, a region under the rule of the Ottoman Empire, in the year 1858. The purpose of this study is to highlight the measures taken by both the central and local governments against the cholera epidemic that occurred in 1858 and to shed light on the management of the outbreak. In this context, the social health practices and the public's sensitivity towards health in the Benghazi Sanjak during (...) the Karamanli administration in Tripolitania in the early 1800s, as well as the period after it became directly connected to the Ottoman central government from 1835, will be examined, and the historical process leading up to the epidemic will be presented. The implementation of the quarantine measures introduced by the Ottoman Empire from the 1840s onwards, particularly in Benghazi, also holds a significant position in understanding the outbreak. The study is crucial in revealing the advancements in the health sector of the Benghazi Sanjak. The article emphasizes that the region of Berka, where the Benghazi Sanjak is located, was frequently afflicted by epidemics, but by the 1860s, there was noticeable improvement in the health sector. (shrink)

Guideline 20 of the updated International Ethics Guidelines for Health‐related Research Involving Humans (2016) by the Council for International Organizations of Medical Sciences (CIOMS) provides guidance on research in disasters and disease outbreaks against the background of the need to generate knowledge quickly, overcome practical impediments to implementing such research, and the need to maintain public trust. The guideline recommends that research ethics committees could pre‐screen study protocols to expedite ethical reviews in a situation of crisis, that pre‐arrangements be made (...) regarding data sharing and biomedical sample sharing, and that sponsors and research ethics committees seek to minimize risk to researchers conducting research during a disaster. This paper critiques these recommendations against the background of the findings of a survey of public health officials and chairs of research ethics committees in the Caribbean during 2016, which sought to determine the best template for the expeditious ethical review of research proposals in emergency and epidemic situations in the Caribbean, and whose findings can serve as a model for other low‐ and middle‐income countries. (shrink)

Seasonal outbreaks have several different periods that occur primarily during winter in temperate regions, while influenza may occur throughout the year in tropical regions, triggering outbreaks more irregularly. Similarly, dengue occurs in the star of the rainy season in early May and reaches its peak in late June. Dengue and flu brought an impact on various countries in the years 2017–2019 and streaming Twitter data reveals the status of dengue and flu outbreaks in the most affected regions. This research work (...) presents that Social Media Analysis can be used as a detector of the epidemic outbreak and to understand the sentiment of social media users regarding various diseases. Providing awareness about seasonal outbreaks through SMA is an effective approach for researchers and healthcare responders to detect the early outbreaks. The proposed model aims to find the sentiment about the disease in tweets, and the seasonal outbreaks-related tweets are classified into two classes as disease positive and disease negative. This work proposes a machine-learning-based approach to detect dengue and flu outbreaks in social media platform Twitter, using four machine learning algorithms: Random Forest, K-Nearest Neighbor, Support Vector Machine, and Decision Tree, with the help of Term Frequency and Inverse Document Frequency. For experimental analysis, two datasets are analyzed individually. The experimental results show that the RF classifier has outperformed the comparison models in terms of improved accuracy, precision, recall, F1-measure, and Receiver Operating Characteristic curve. The proposed work offers favorable performance with total precision, accuracy, recall, and F1-measure ranging from 84% to 88% for conventional machine learning techniques. (shrink)

The use of wireless sensor networks and the Internet of things to detect forest fire outbreaks may help to reduce the response time and avoid natural disasters. This work proposes the deployment of WSN to enhance the real-time monitoring of dynamic variables such as polluting gases, temperature or the presence of fire flames by infrared. In addition, the activation of forest fire alerts if environmental status may involve evidence of a recent fire outbreak. A fuzzy-based controller is implemented to (...) manage the uncertainty related to estimating forest fire occurrence and dynamic update of fuzzy sets is developed to distinguish usual and unusual environmental conditions of every monitored forest area. Merkle trees, AES and hash functions are considered to protect the integrity of environmental data. (shrink)

This study aims to investigate the relationship between job burnout and employee performance in the feed industry during the ASF outbreak. Further, the researchers employed a descriptive-correlational research design in order to analyze the acquired data and produce pertinent findings. Thus, the researchers gathered data from one hundred two (102) feed industry employees. The Maslach Burnout Inventory (MBI) and Individual Work Performance Questionnaire (IWPQ) were employed to ascertain the extent of job burnout experienced by the respondents and evaluate employee (...) performance, respectively. Based on the statistical analysis, there is a significant relationship between job burnout and employee performance. Moreover, the study's findings were thoroughly analyzed and discussed. (shrink)

Background During disease outbreaks, nurses express concerns regarding the organizational and social support required to manage role conflicts. Objectives The study examined concerns, threats, and attitudes relating to care provision during the COVID-19 outbreak among nurses in Israel. Design A 53-item questionnaire was designed for this research, including four open-ended questions. The article used a qualitative research to analyze the responses to the open-ended questions and their association with responses to the close-ended ones. Participants and research context In all, (...) 231 registered nurses and fourth-year nursing students throughout the whole country. The questionnaire was delivered in nursing Facebook and WhatsApp groups and through snowball sampling. Ethical considerations The research was pre-approved by the Ethics Committee at the researchers’ university. Results Nurses mostly referred to personal risk, followed by dilemmas regarding care provision. On average, 38.6% of quotations stated that during the pandemic, nurses are not asked to perform unfair duties. Nurses discussed activities and requirements that impact their personal and familial safety, their relationship with employer, organization or the state, and their duty to providing care. Other than fear of contraction, respondents’ most frequent themes of concerns were related to work condition and patients’ interests, inter-collegiate relationships, and uncertainty and worries about the future. Respondents’ ethical dilemmas mostly referred to clinical questions, providing care without adequate equipment or managerial support, and in conditions of uncertainty and increased risk. Discussion Nurses raise important issues concerning their relationships with employers and family members, and significant insights regarding the pandemic and their revised responsibilities and definition of work. They raise serious concerns regarding their rights at work and their standing for them. Conclusions Health managers should find ways to enhance the ethical climate and institutional support to enable a better work-life balance in times of pandemic and support nurses’ working needs and labor rights. (shrink)

Taiwan was affected by an outbreak of severe acute respiratory syndrome (SARS) in early 2003. A questionnaire survey was conducted to determine (1) the perceptions of risk of SARS infection in nurses; (2) the proportion of nurses considering leaving their job; and (3) work as well as non-work factors related to nurses' consideration of leaving their job because of the SARS outbreak. Nearly three quarters (71.9%) of the participants believed they were 'at great risk of exposure to SARS', (...) 49.9% felt'an increase in workload', and 32.4% thought that people avoided them because of their job; 7.6% of the nurses not only considered that they should not care for SARS patients but were looking for another job or considering resignation. The main predictors of nurses' consideration of leaving their job were shorter tenure, increased work stress, perceived risk of fatality from SARS, and affected social relationships. The findings are important in view of potential impending threats of pandemics such as avian influenza. (shrink)

After initially emerging in China, the coronavirus (COVID-19) outbreak has advanced rapidly. The World Health Organization (WHO) has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with (...) remote chances, and this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians. (shrink)

Prior to the outbreak of the coronavirus disease 2019 pandemic, the churches in Nigeria contended with Bokoharam insurgency which mainly affected the churches in Northern Nigeria. However, COVID-19 affected various churches in all the nooks and crannies of the country. It brought about obvious changes in numerous practices of churches in Nigeria. Long-standing traditions of churches such as solemnisation of Holy Matrimony, Holy Communion, baptism, prayer and sharing of peace have been modified or suspended. Whilst this article appreciates the (...) efforts of the federal and state governments, it investigates the implications of COVID-19 outbreak on traditional religious practices of churches in Nigeria. It also examines the responses of churches towards controlling the pandemic. The phenomenological method is used to analyse the data collected from both primary and secondary sources. Findings from this work indicate that COVID-19 outbreak is a challenge to the purpose of the institution 'church'.CONTRIBUTION: The article investigated and examined the changes which churches made in their doctrine and liturgy with respect to the outbreak of COVID-19 in Nigeria. It discovered that many traditions of the church have been modified or suspended as a way of curtailing the spread of the virus. (shrink)

A public health emergency, as the COVID-19 pandemic, may lead to shortages of potentially life-saving treatments. In this situation, it is necessary, justifiable and proportionate to have decision tools in place to enable healthcare professionals to triage and prioritise access to those resources. An ethically sound framework should consider the principles of beneficence and fair allocation. Scientific Societies across Europe were concerned with this problem early in the pandemic and published guidelines to support their professionals and institutions. This article aims (...) to compare triage policies from medical bodies across Europe, to characterise the process of triage and the ethical values, principles and theories that were proposed in different countries during the first outbreak of COVID-19. (shrink)

This article explores Vietnam’s response to the COVID-19 pandemic as an example of good ethical practice in dealing with the COVID-19 outbreak. Vietnam’s response to the pandemic is in accordance with the ethics of care which emphasizes solidarity and responsibility. Vietnam’s approach to the COVID-19 pandemic is also in accordance with the third generation of human rights that promote solidarity and responsibilities towards the community. A full implementation of human rights requires more emphasis on responsibilities, especially in the time (...) of crisis. (shrink)

IntroductionDuring the COVID-19 outbreak, many citizens were asked to stay at home in self-quarantine, which can pose a significant challenge with respect to remaining physically active and maintaining mental health. This study aimed to evaluate the prevalence of inadequate physical activity, anxiety, and depression and to explore the relationship of physical activity with anxiety and depression symptoms among Chinese college students during quarantine.MethodUsing a web-based cross-sectional survey, we collected data from 1,396 Chinese college students. Anxiety and depression were assessed (...) with the Self-Rating Anxiety Scale and the Self-Rating Depression Scale, respectively. The data on physical activity were collected by types of physical activity and the International Physical Activity Questionnaire.ResultsDuring the COVID-19 outbreak, about 52.3% of Chinese college students had inadequate physical activity. The rates of anxiety and depression symptoms were 31.0 and 41.8%, respectively. A high level of physical activity was significantly closely associated with low anxiety, while a moderate, or high level of physical activity was significantly closely associated with reduced depression after adjusting confounding demographic factors. Moreover, specific types of physical activity, such as stretching and resistance training, were negatively correlated with both anxiety and depression; doing household chores was negatively correlated with depression.ConclusionOur findings highlight specific levels and types of home-based physical activities that need to be taken into consideration to protect the mental health of college students during the COVID-19 epidemic. (shrink)

While vaccination rates in the United States are high — generally over 90 percent — rates of exemptions have been going up, and preventable diseases coming back. Aside from their human cost and the financial cost of treatment imposed on those who become ill, outbreaks impose financial costs on an already burdened public health system, diverting resources from other areas. This article examines the financial costs of non-vaccination, showing how high they can be and what they include. It makes a (...) case for requiring those who do not vaccinate to cover the costs of outbreak caused by their choice. Such recouping is justified because the choice not to vaccinate can easily be seen as negligent. But even if it is not, that choice involves imposing costs on others, and there are good reasons to require the actors to internalize those costs. The article proposes alternative statutory and regulatory schemes to cover the costs imposed on the public purse, focusing on no-fault mechanisms. We consider both ex ante mechanisms like a tax or a fee that will go into a no-fault fund to cover the costs and ex post mechanisms like a statutory authorization for recoupment of those costs by health officials. (shrink)

Ensuring that countries have adequate research capacities is essential for an effective and efficient response to infectious disease outbreaks. The need for ethical principles and values embodied in international research ethics guidelines to be upheld during public health emergencies is widely recognized. Public health officials, researchers and other concerned stakeholders also have to carefully balance time and resources allocated to immediate treatment and control activities, with an approach that integrates research as part of the outbreak response. Under such circumstances, (...) research “ethics preparedness” constitutes an important foundation for an effective response to infectious disease outbreaks and other health emergencies. A two-day workshop was convened in March 2018 by the World Health Organisation Global Health Ethics Team and the African coaLition for Epidemic Research, Response and Training, with representatives of National Ethics Committees, to identify practical processes and procedures related to ethics review preparedness. The workshop considered five areas where work might be undertaken to facilitate rapid and sound ethics review: preparing national ethics committees for outbreak response; pre-review of protocols; multi-country review; coordination between national ethics committees and other key stakeholders; data and benefit sharing; and export of samples to third countries. In this paper, we present the recommendations that resulted from the workshop. In particular, the participants recommended that Ethics Committees would develop a formal national standard operating procedure for emergency response ethical review; that there is a need to clarify the terminology and expectations of pre-review of generic protocols and agree upon specific terminology; that there is a need to explore mechanisms for multi-country emergency ethical consultation, and to establish procedures for communication between national ethics committees and other oversight bodies and public health authorities. In addition, it was suggested that ethics committees should request from researchers, at a minimum, a preliminary data sharing and sample sharing plan that outlines the benefit to the population from which data and samples are to be drawn. This should be followed in due time by a full plan. It is hoped that the national ethics committees, supported by the WHO, relevant collaborative research consortia and external funding agencies, will work towards bringing these recommendations into practice, for supporting the conduct of effective research during outbreaks. (shrink)

Background: Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. Objective: The objective of this study was to explore emergency nurses’ ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome–coronavirus in Korea. Design (...) and sample: For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome–coronavirus patients in the capital area. Methods: Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. Results: The findings of this study suggest that during the Middle East respiratory syndrome–coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses’ ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. Conclusion: Through this study, we obtained information on emergency nurses’ ethical problems during the Middle East respiratory syndrome–coronavirus outbreak and identified the factors that influence them. As found in this study, nurses’ ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers. (shrink)

Thresholds for disease extinction provide essential information for the prevention and control of diseases. In this paper, a stochastic epidemic model, a continuous-time Markov chain, for the transmission dynamics of West Nile virus in birds is developed based on the assumptions of its analogous deterministic model. The branching process is applied to derive the extinction threshold for the stochastic model and conditions for disease extinction or persistence. The probability of disease extinction computed from the branching process is shown to be (...) in good agreement with the probability approximated from numerical simulations. The disease dynamics of both models are compared to ascertain the effect of demographic stochasticity on West Nile virus dynamics. Analytical and numerical results show differences in model predictions and asymptotic dynamics between stochastic and deterministic models that are crucial for the prevention of disease outbreaks. It is found that there is a high probability of disease extinction if the disease emerges from exposed mosquitoes unlike if it emerges from infectious mosquitoes and birds. Finite-time to disease extinction is estimated using sample paths and it is shown that the epidemic duration is shortest if the disease is introduced by exposed mosquitoes. (shrink)

The COVID-19 outbreak required diverse strategies, such as social distancing and self-isolation, to avoid a healthcare system crisis. However, these measures have been associated with the onset or increase of anxiety and depression symptoms in the population. Music listening was previously shown to regulate emotion, consequently reducing depression symptoms. Since previous studies with Brazilian samples have already shown a high prevalence of depressive symptoms during the first confinement period, the aim of this study was threefold: (i) to compare groups (...) with severe depression symptoms and no depression in what concerns to demographic and socio-economic factors as well as symptoms of anxiety and resilience levels, (ii) to explore changes in music listening daily routine during the confinement measures by both groups (no depression and severe depression), and (iii) to investigate which were the main factors influencing both two groups to music listening during the COVID-19 pandemic. This cross-sectional study included 494 Brazilian respondents aged 18 years and above. Our online survey comprised demographics, socio-economic, and COVID-19 related questionnaires, with questions regarding music listening used during social distancing measures on which the participants rated how much each of the 41 potential reasons for listening to music changed in importance compared to the situation before the pandemic and also the evaluation of anxiety, depression, and resilience levels. The respondents with severe depression were younger and showed higher levels of anxiety symptoms and lower resilience level. Furthermore, they were increasingly likely to listen to music to feel emotionally better with the situation, to feel comfort, to forget problems, to be energetic, to decrease sad feelings, to relax, to cheer up, to forget concerns, to express feelings, to reduce anxiety, to remember better times, to relieve boredom, to mentally stimulate themselves, and to ward off stressful thoughts compared to the participants with no depression. The exploratory factor analysis (FA) identified four types of music listening functions during social distancing measures: negative mood management, cognitive functioning, positive mood management, and physical involvement, in which the participants with severe depression revealed significant differences compared to non-depressed participants for the negative mood management factor, which shows the importance of music listening to regulate their negative emotions. As a conclusion, we can argue that most of our respondents used music listening to cope with and regulate their moods during confinement, especially those who presented with severe depression symptoms. (shrink)

This article outlines aconceptual framework for examining recentoutbreaks of E. coli O157:H7 infectionassociated with the consumption of beef in theUnited States. We argue that beef produced inthis country is generally safer frombacteriological contamination than in the past.Paradoxically, increasing intensification andconcentration in the meat subsector since theearly 1980s has (a) altered agro-food ecology,including characteristics of foodborne bacteriaand human physiology; (b) created conditionsfavorable for the rapid amplification of lowconcentrations of pathogens; and (c) reducedthe beef industry's flexibility to introducechanges necessary to preclude and/or (...) controlthe rapid spread of pathogens in meat and meatproducts. As a result, beef industry currentlyis capable of producing large quantities ofbacteriologically safe meat whilesimultaneously becoming more vulnerable to foodcontaminations that can be fatal in some cases.The limitations and effectiveness of a newregulatory regime, the HACCP (Hazard Analysisand Critical Control Points) system as well asother efforts to decontaminate the beef supplyare discussed. (shrink)

A One Health approach holds great promise for attenuating the risk and burdens of emerging infectious diseases (EIDs) in both human and animal populations. Because the course and costs of EID outbreaks are difficult to predict, One Health policies must deal with scientific uncertainty, whilst addressing the political, economic and ethical dimensions of communication and intervention strategies. Drawing on the outcomes of parallel Delphi surveys conducted with policymakers in Singapore and Australia, we explore the normative dimensions of two different precautionary (...) approaches to EID decision-making—which we call regimes of risk management and organizing uncertainty, respectively. The imperative to act cautiously can be seen as either an epistemic rule or as a decision rule, which has implications for how EID uncertainty is managed. The normative features of each regime, and their implications for One Health approaches to infectious disease risks and outbreaks, are described. As One Health attempts to move upstream to prevent rather than react to emergence of EIDs in humans, we show how the approaches to uncertainty, taken by experts and decision-makers, and their choices about the content and quality of evidence, have implications for who pays the price of precaution, and, thereby, social and global justice. (shrink)

Objective: The global outbreak of COVID-19 has greatly affected individual's lives around the world and resulted in various negative psychological consequences. During the pandemic, reflection on and attention to COVID-19 may help in dealing with its symptomology but frequent and persistent thoughts about the situation can be unhealthy. The present study examined the direct and indirect associations between obsession concerning COVID-19, psychological distress, life satisfaction, and meaning in life.Design: This mediation study presents a primary analysis of normative data collected (...) after the initial outbreak of COVID-19 in Pakistan. Parametric bootstrapping was used to test the mediation models of subjective well-being, the extent of the effect, and meaning in life as parallel and serial mediators concerning the associations between COVID-19 obsession and psychological distress measures.Setting: A sample of 1,002 adults were recruited utilizing an online survey between April to May 2020. They were aged between 19 and 45 years and normalized on population characteristics.Results: Two out of three mediators in parallel mediation fully mediated the relationship between obsession and psychological distress illustrating that high-level obsessions were associated with low levels of satisfaction with life and presence of meaning in life and search for meaning in life. Psychological distress is likely to decrease in the presence of a high level of satisfaction with life and meaning. Moreover, satisfaction with life and search for meaning in life significantly mediated the association between COVID-19 obsession.Conclusion: The present study showed that life satisfaction and search for meaning in life may play a significant role in decreasing psychological distress during the COVID-19 pandemic. (shrink)

After the COVID-19 outbreak, the health status of the general population has suffered a huge threat, and the health system has also encountered great challenges. As critical members of human capital in the health sector, medical students with specialized knowledge and skills have positively fought against the epidemic by providing volunteer services that boosted the resilience of the health system. Although volunteer behavior is associated with individual internal motivation, there is sparse evidence on this relationship among medical students, especially (...) regarding potential mechanisms. Therefore, this study had two main objectives: to examine the influence of prosocial motivation of medical students on their VB; and to verify the chain-mediating role of calling and vocation as well as social responsibility in the relationship between PM and VB. Study I: a total of 2454 Chinese full-time medical students were invited to complete an online survey. Data analysis was performed using descriptive statistics, Pearson’s correlation coefficient, and multiple linear regression analysis. The results demonstrated that PM significantly affected VB in medical students ; CV as well as SR chain-mediated the relationship between PM and VB. PM promoted the formation of SR by positively evoking CV of medical students, further resulting in increased VB. Study II: A 28 person qualitative interview was conducted. Qualitative data are added to reduce the limitations of online questionnaires. At the same time, we can also critically study the VB of Chinese medical students during COVID-19. The results showed that there were various reasons for medical students to volunteer in the process of fighting against COVID-19, and the experience of volunteer service and the impact on their future life were different. Lastly, the current findings suggest that fostering volunteerism among medical students requires the joint effort of the government, non-profit organizations, and medical colleges. (shrink)

Aim of the study was to analyze the posttraumatic stress disorder risk nurses, detecting the relationship between distress experience and personality dimensions in Italian COVID-19 outbreak. A cross-sectional study was conducted based on 2 data detection. Mental evaluation was carried out in Laboratory of Clinical Psychology on n.69 nurses in range age 22–64 years old. Measurement was focused on symptoms anxiety, personality traits, peritraumatic dissociation and post-traumatic stress for all participants. No online screening was applied. Comparisons within the various (...) demographic characteristics demonstrated few significant differences between groups on DASS-21, PDEQ, and ISE-R scores. Correlation analysis was performed among PDEQ, DASS-21, BFI-10 and IES-R and confirmed between anxiety and peritraumatic dissociation and post-traumatic stress; then anxiety is positively correlated to agreeableness variable of BFI-10 test. The emotional distress was protracted overtime but in long-term personality traits resulted mediator facing subjective stress. Our finding drew details for protective and predictive risk factors as well as mental health issues of nurses dealing with pandemic: healthcare workers faced the protracted challenge caring COVID-19 patients over and over again: in short time the impact was relevant, and the prolonged exposition to the stressor was tackled by personal resources such as personality traits. (shrink)

Human encroachment on the habitats of wild animals and the dense living conditions of farmed animals increase spill-over risk of emerging infectious diseases from animals to humans (such as COVID-19). In this article, we defend two claims: First, we argue that in order to limit the risk of emerging infectious disease outbreaks in the future, a One Health approach is needed, which focuses on human, animal, and environmental health. Second, we claim that One Health should not solely be grounded in (...) collaborations between veterinary, medical, and environmental scientists, but should also involve more dialogue with animal and environmental ethicists. Such an interdisciplinary approach would result in epidemiology-driven measures that are ethically legitimate. (shrink)

This article explores how cross-sector partnerships (CSPs) operating in a development context built resilience during the outbreak of the COVID-19 pandemic. Based on a qualitative analysis of eight partnerships operating in East-Africa, Central America, and Indonesia, I show how CSPs engaged in three practices of resilience building (i.e., forming unconventional alliances, mobilizing digital technologies, and building subnetworks), which allowed them to remain functional despite facing adversity. In addition to fostering their resilience, my findings show how engaging in these practices (...) enabled the CSPs to develop new capabilities (i.e., improved abilities to engage with beneficiaries) that benefit them in the long run. Based on these insights, I advance our understanding of resilience building by unpacking this concept on a CSP level. Furthermore, by unfolding the relevance of incidental learning in a cross-sectoral setting, I widen our knowledge of learning processes in CSPs. (shrink)

The first domestic death from Ebola in the United States occurred in Texas in October 2014. Family members who were potentially exposed to the infected individual were legally and involuntarily quarantined. Quarantine may not be a recent normal practice in the United States, but it was used extensively during the influenza pandemic in the early 20th century. However, health care ethics comes into play when we quarantine someone whose infection status is unknown versus active. To prevent the spread of a (...) pathogen, one person may be held against his or her will and that person’s freedom is terminated. Quarantine may be acceptable in the case of Ebola, as it is particularly virulent and there have been more and more potential cases in the United States . As a result, the general population may understand how isolation and quarantine may help prevent the spread of Ebola. We must use this epidemic as an opportunity to educate the general population on ways to prevent the sprea .. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. Study (...) data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

The pathogen-prevalence hypothesis postulates that collectivism would be strengthened in the long term in tandem with recurrent attacks of infectious diseases. However, it is unclear whether a one-time pathogen epidemic would elevate collectivism. The outbreak of COVID-19 and the widespread prevalence of online social networks have provided researchers an opportunity to explore this issue. This study sampled and analyzed the posts of 126,165 active users on Weibo, a leading Chinese online social network. It used independent-sample t-tests to examine whether (...) COVID-19 had an impact on Chinese collectivistic value-related behaviors by comparing the usage frequency of personal pronouns, group-related words, and relationship-related words before and after the outbreak. Overall, most collectivist words exhibited a significant upward trend after the outbreak. In turn, this tendency pointed to a rising sense of collectivism. Hence, this study confirmed the pathogen-prevalence hypothesis in real settings, finding that an outbreak of an infectious disease such as COVID-19 could exert an impact on collectivism and may deliver a theoretical basis for psychological protection against the threat of COVID-19. However, further evaluation is required to ascertain whether this trend is universal or culture-specific. (shrink)

BackgroundHow do the police officers perceive health risk, psychological distress, and work stress during the COVID-19 outbreak in China? This study explores the health risk perception, work stress, and psychological distress of police officers who worked at the front line to implement lockdown measures.Materials and MethodsWe conducted a large-scale field survey with police officers sample in the northwestern part of China from February 29 to March 7, 2020. Independent-sample T-test and ANOVA were used to analyze whether there are differences (...) in health risk perception, work stress, and psychological distress between different groups. The regression analysis was employed to figure out the factors that influence police officers’ psychological distress.ResultsResults showed a gender difference in perceiving work stress among police officers. Also, police officers with chronic disease perceived higher health risks, more psychological distress, and higher work stress. Additionally, police officers above 45 years old significantly perceived higher health risks than young officers did. It also revealed that working hours contribute to police officers’ health risk perception, psychological distress, and work stress. Finally, our results highlight that age, working hours, chronic disease, health risk perception, and work stress significantly contribute to police officers’ psychological distress.ConclusionOur research verifies that there is a gender difference in perceiving work stress among police officers. Police officers with ongoing medical issues and above 45 years old suffer more during the COVID-19 outbreak in China. Our research suggests that the government should pay more attention to their physical health and mental health. The heavy workload containing the COVID-19 extends police officers’ working hours, causing higher health risks, work stress, and psychological distress. This study contributes to the psychological distress literature and provides a way forward to other countries struggling to contain the COVID-19. (shrink)

During the outbreak of COVID-19, information on the epidemic inundated people’s lives and led to negative emotions in many people. This study aims to explore the effect of various emotions on prosocial tendencies during the COVID-19 outbreak and the moderating effect of the severity of the epidemic. We explore these effects by conducting a text analysis of the content of posts by 387,730 Weibo users. The results show that the severity of the epidemic promotes prosocial tendencies; anger motivates (...) prosocial tendencies significantly; and the severity of the epidemic moderates the effects of three emotions—anger, sadness, and surprise—on prosocial tendencies. These findings provide a reference for exploring the positive significance of major disasters. (shrink)