Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy-makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable ...answers. In such cases, policy-making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds-a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought to have on lockdown decision-making, including how policy-makers ought to handle misinformed or morally suspect viewpoints, and how policy-makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision-making, will be central to the field of bioethics as it increasingly focuses on policy and population-level issues and therefore ought to be priorities for future work.
Many philosophers of science have argued that social and ethical values have a significant role to play in core parts of the scientific process. This naturally suggests the following question: when ...such value choices need to be made, which or whose values should be used? A common answer to this question turns to democratic values—the values of the public or its representatives. I argue that this imposes amorally significant burden on certain scientists, effectively requiring them to advocate for policy positions they strongly disagree with. I conclude by discussing under what conditions this burden might be justified.
Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I ...propose that we can arrive at a set of ethical guidelines to govern scientists' presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists' political advocacy rights, but argue that the benefits of adopting it-promoting democratic governance-justify the restriction.
Many urban projects have shown that there is a lack of exchanges between the different communal actors. Inhabitants are poorly informed about urban development and are not included in it. In managing ...current challenges in urban development, a balance must be struck between common sense approaches and local needs. Therefore, the active participation of target groups is an important prerequisite for the success and sustainability of projects and programs. To address this gap in urban development in the city of Piura, Peru, an urban vision was developed along with many Piurans. A discursive space was created that invites to formulate ideas about urban development with which it is possible to collect, value and promote local knowledge of the citizen about places, challenges and opportunities of urban planning as well as their creativity to achieve the empowerment of the population and boost new bottom-up activities. Based on 600 ideas, a first version of the urban vision was developed. The vision is meant to serve as a participatory counterpart to the official plans of the city: a constructive contribution to the discussion, which reveals the weaknesses of public programs and shows the power in the ideas of citizens.
When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, ...or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don't discount the value of future health, there is a sense in which the choice of calculation method is a mere question of accounting. Such questions can be important, but they don't raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen.
OBJECTIVE In tuberculum sellae meningioma (TSM) surgery, endonasal approaches are claimed to have a superior visual outcome compared with transcranial approaches. The authors question whether this is ...always true and analyze their series of cases of endoscope-assisted transcranial TSM surgery with special regard to the postoperative visual outcome in order to explore this issue. METHODS All surgical procedures for TSM performed between 2003 and 2015 in the Department of Neurosurgery, University Medicine Greifswald, were retrospectively analyzed. Special attention was paid to the postoperative visual outcome. RESULTS During the study period, 15 patients (12 female and 3 male) underwent surgery for TSM. Gross-total resection was achieved in 14 cases (93.3%) and near-total resection in 1. One patient suffered from a major stroke during surgery and had to be excluded from further analyses. No other complications occurred. Preoperatively, visual acuity was disturbed in 12 patients (80%) and visual field deficits were present in 11 patients (73.3%). In 3 patients (20%), the TSM was an incidental finding. Postoperatively, ophthalmological examination revealed an improvement of visual acuity in 10 (90.9%) of 11 patients and improvement of visual field deficits in 9 (90%) of 10 patients; no deterioration of visual acuity or visual field was seen in any patient. Visual acuity and visual field improvement was observed in all patients who had surgery within 3 years after the onset of visual disturbances. No tumor recurrence was observed during follow-up (mean 32 months, range 3-134 months). TSMs were approached via a frontolateral craniotomy in 7 patients and via a supraorbital craniotomy in 8. The use of the endoscope as an assistive device led to improved tumor visualization and consequent removal in areas that were hidden in the microscopic view in 6 patients (40%). CONCLUSIONS The present series confirms a favorable visual outcome after TSM surgery via supraorbital or frontolateral endoscope-assisted approaches. With endoscopic visualization, major manipulation of the optic apparatus could be avoided, perhaps affecting the favorable visual outcome.
Many economic measures are structured to reflect ethical values. I describe three attitudes towards this: maximalism, according to which we should aim to build all relevant values into measures; ...minimalism, according to which we should aim to keep values out of measures; and an intermediate view. I argue the intermediate view is likely correct, but existing versions are inadequate. In particular, economists have strong reason to structure measures to reflect fixed, as opposed to user-assessable, values. This implies that, despite disagreement about precisely how to do so, economists should standardly adjust QALYs and DALYs to reflect egalitarian values.
Introduction
High-intensity interval training (HIIT) is an appropriate training modality to improve endurance and therefore contributes to physical performance. This review investigates the effect of ...HIIT on functional performance in cancer patients. We reviewed the relative peak oxygen uptake (relV̇O
2PEAK
) and meta-analytical compared HIIT with moderate intensity continuous training (MICT). Furthermore, we took various training parameters under consideration.
Methods
A systematic literature search was conducted in Scopus, PubMed, and Cochrane Library databases. For the review, we included randomized controlled trials containing HIIT with cancer patients. From this, we filtered interventions with additional MICT for the meta-analysis. Outcomes of interest were various functional performance assessments and V̇O
2MAX
.
Results
The research yielded 584 records which fit the inclusion criteria, of which 31 studies with
n
=1555 patients (57.4±8.6 years) could be included in the overall review and 8 studies in the meta-analysis (
n
=268, 59.11±5.11 years) regarding relV̇O
2PEAK
. Different functional outcomes were found, of which walking distance (+8.63±6.91% meters in 6-min walk test) and mobility (+2.7cm in sit and reach test) improved significantly due to HIIT. In terms of relV̇O
2PEAK
, the performance of cancer patients was improved by HIIT (10.68±6.48%) and MICT (7.4±4.29%). HIIT can be favored to increase relV̇O
2PEAK
(SMD 0.37; 95% CI 0.09–0.65;
I
2
=0%;
p
=0.009). Effect sizes for relV̇O
2PEAK
improvements correlate moderately with total training volume (Spearman’s ρ=0.49;
p
=0.03), whereas percentage increases do not (Spearman’s ρ=0.24;
p
=0.14).
Conclusion
Functional and physical outcomes were positively altered by different HIIT protocols and forms of implementation, whereas a tendency toward more effectiveness of HIIT vs. MICT was found for relV̇O
2PEAK
. Future studies should include functional parameters more often, to finally allow a comparison between both training protocols in this regard.
Is consistency overrated? Schroeder, S Andrew
Journal of medical ethics,
03/2018, Letnik:
44, Številka:
3
Journal Article
Recenzirano
If the API captures these dual goals and weights them in a way that reflects the relative importance we place on them, it serves its purpose and is an effective tool. i I think something similar is ...happening with the DALY. ii With respect to any individual, it seems natural to describe us as having two health-related goals: to help her avoid undesirable morbidities and to keep her alive (or, to keep her from 'dropping out' of the population). Comprehensive systematic analysis of global epidemiology: definitions, methods, simplification of DALYs, and Comparative Results from the Global Burden of Disease Study 2010. In 2012, the Global Burden of Disease Study adopted the hybrid prevalence-incidence calculation method that I prefer, suggesting its authors agree. 3 iii: Murray alternately describes DALYs as true measures of health loss, or of the burden of disease. 2 3 There are independent reasons to reject the former view, and the latter strikes me as vague enough to be interpretable in many ways, including as an index. iv:
PDF
