Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure

Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.

Designing a medical ethics curriculum in ophthalmology

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional development.The four pillars of medical ethics are beneficence,non-maleficence,autonomy,and justice.In addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up sessions.Ethical considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training programs.The concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical discussions.This paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

Medical Ethics: Context Is the Key Word

Medical Ethics is no different to Ethics, but relates specifically to the doctor-patient relationship. This relationship is based on mutual trust—trust in the doctor’s expertise and knowledge and trust that the patient is consulting the doctor, for his/her/their own health, wellbeing and welfare, without agenda or bias. In other words, the basis of the doctor-patient relationship is one of mutual trust and confidence. Thus, what is imparted between them is held in the strictest confidence. The doctor must act within the law. No third party influence can be brought to bear on this relationship without the patient’s consent. In the case of minors the relationship is between the child’s guardians as well as the doctor who must act within the law. In the category of “elderly” or adult guardianship or advocacy, those appointed and in positions of trust must take the person’s wishes into account if the patient has capacity to make decisions or has indicated their wish prior to any such appointment. Capacity is defined as consistent belief or wish, awareness of what one does not wish for, satisfaction when wishes are respected and fulfilled and the opposite when they are not. Ethical practice is determined by taking context into account in decision-making and ensuring the sanctity of the patient’s rights and wishes. Abuse is just the opposite, where actions taken or not taken are against a person’s wishes. Personal wish determines best interest. Best interest may also be defined in terms of social functioning and psychological wellbeing. Discussion of ethics in terms of General Systems Theory is also addressed, and affects an action on the environment or others, i.e. ethics in the wider medical context may pertain if the person has a contagious disease and a period of quarantine or “isolation” or barrier” nursing is required, and where precedent is given to society’s best interest over the person’s wishes, as part of an educational process and as required for strategic disease management.

Patients＇ Responsibilities in Medical Ethics

There has been a shift from the general presumption that ＂doctor knows best＂ to a heightened respect for patient autonomy. Medical ethics remains one-sided, however. It tends （incorrectly） to interpret patient autonomy as mere participation in decisions, rather than a willingness to take the consequences. In this respect, medical ethics remains largely paternalistic, requiring doctors to protect patients from the consequences of their decisions. This is reflected in a one-sided account of duties in medical ethics. Medical ethics may exempt patients from obligations because they are the weaker or more vulnerable party in the doctor-patient relationship. We argue that vulnerability does not exclude obligation. We also look at others ways in which patients＇ responsibilities flow from general ethics： for instance, from responsibilities to others and to the self, from duties of citizens, and from the responsibilities of those who solicit advice. Finally, we argue that certain duties of patients counterbalance an otherwise unfair captivity of doctors as helpers.

Medicine as Profession： An Overlooked Approach to Medical Ethics

This article begins with three problems of ＂dual loyalties＂ in medicine, the supposed fact that military physicians are, as medical officers, sometimes required to do what violates ordinary medical ethics--for example, ignore medical need in order to treat their own wounded before civilians or wounded enemy, help make chemical or biological weapons more deadly, or assist at a rough interrogation. These problems are analyzed as special cases of a problem that could arise in any profession, a problem easily resolved using a theory of professional ethics （more or less） absent from medical ethics until now though common outside. Employing a physician--rather than an ordinary officer, some other kind of healer, or scientist--is to enter a sort of ＂Ulysses contract＂ requiring the physician＇s professional standards to preempt obligations otherwise applying to an employee. In this way, the article also illustrates the benefits that might accrue to medical ethics from drawing （more than is now common） on other fields of practical ethics.

Medical ethics w.s.r to ayurveda

With nearly 5,000,000 Indians dying due to medical negligence every year.there is a circular relationship between nature and humankind because human concepts are nature’s concepts. Human technological and economic inventiveness is no more than nature’s way of acting upon itself and shaping its own future. The outcome could be glorious success or disastrous failure - in either case, nature acting through humankind bears partial responsibility for the outcome. A basic knowledge of how judicial forums deal with the cases relating to medical negligence is of absolute necessity for doctors. The need for such knowledge is more now than before in light of higher premium being placed by the Indian forums on the value of human life and su ffering, and perhaps rightly so. Judicial forums, while seeking to identify delinquents and delinquency in the cases of medical negligence, actually aim at striking a careful balance between the autonomy of a doctor to make judgments and the rights of a patient to be dealt with fairly.Agadatantra one among eight branches of ayurveda has given good references in regard to medcal ethics and also how to overcome the burden of medical negligence merely by identifying the treating doctor.

Reading Toni Morrison’s Home From the Perspective of Medical Relationship Ethics

As the first black women Nobel laureate,Toni Morrison has drawn great attention with her fascinating and deep-thinking novels.Her 10th novel Home vividly shows the racial suffering and the post-war trauma of black veteran Frank,who has drawn critical attention from various perspectives.However,there is hardly any scholarly focus on another major character Cee,whose experience of medical and racial discrimination actually constitutes another important clue throughout the whole story.Therefore,this paper intends to analyze Home from the perspective of ethical relationship ethics,including doctor-patient relationship,doctor-society relationship,patient-society relationship,and patient-family relationship.The analysis indicates that Home not only reveals the history of medical racial discrimination and human experiment ethics problems under the rapid development of medical technology in the 1950s,but also inspire readers’thinking on the ethical problems and ethical dilemmas in the contemporary world.

Rhazes’concepts on medical ethics

Ethics in any industry and profession,especially in medicine,is a matter of great concern and debatable.Ancient Persian Muslim doctors also did not neglect this issue,as they mentioned some points regarding the observance of medical ethics in most of their books.Rhazes'"Akhlaq al-Tabib"treatise is one of the most important manuscripts on medical ethics.Abu Bakr Muhammad ibn Zakariyya Razi,known in the west as Rhazes,was a great Persian scientist and physician who lived in the 9th and 10th centuries AD.In the"Akhlaq al-Tabib"treatise,he wrote a collection of his guidelines and ideas about medical ethics.In this manuscript,Rhazes first mentioned the ethical qualities that the physician must admire,and then pointed out the ethical standards regarding treatment and patient's rights.The study found that the principles of tenth-century medical ethics are very similar to what is being said today.

Study on the Integration of Professional Ethics in Medical Interpretation Course Based on Situational Simulation Teaching Method and Virtual Reality Technology

Based on the theory of situational simulation,the article explores the approach to building the medical interpretation course from three aspects,which are the objective,design,and teaching model.The course aims to cultivate high-quality medical interpreting talents and enhance students’practical interpretation skills,as well as to integrate professional ethics into teaching.Thus,it is necessary for lecturers to change their teaching philosophy,apply information technology,and improve teaching design.Through rich medical interpretation course,lecturers can promote the integration of professional ethics in medical interpretation.

Application and Development of 3D Printing in Medical Field

Different from reduction manufacturing and equal manufacturing, 3D printing is an additive manufacturing method, which transforms 3D model into 2D cross-section data to form entity layer by layer. This makes its processing not limited by complexity of the design model and number of the manufacturing products. It is very suitable for the medical field with high customization requirements. In fact, application of 3D printing technology in the medical field is particularly noticeable. In this paper, application and development of 3D printing technology are reviewed in medical model, rehabilitation equipment, tissue engineering, medical hygiene materials, lab-on-chip. Its applications include medical education, surgical planning, prosthesis customization, tissue culture and biosensor manufacturing and so on. Its wide application is due to its digital model, which makes the whole manufacturing process easier to digitize, so it is more conductive to updating and customization of products via 3D printing.

Text duplication of papers in four medical related fields

Purpose:To reveal the typical features of text duplication in papers from four medical fields:basic medicine,health management,pharmacology and pharmacy,and public health and preventive medicine.To analyze the reasons for duplication and provide suggestions for the management of medical academic misconduct.Design/methodology/approach:In total,2,469 representative Chinese journal papers were included in our research,which were submitted by researchers in 2020 and 2021.A plagiarism check was carried out using the Academic Misconduct Literature Check System(AMLC).We generated a corrected similarity index based on the AMLC general similarity index for further analysis.We compared the similarity indices of papers in four medical fields and revealed their trends over time;differences in similarity index between review and research articles were also analyzed according to the different fields.Further analysis of 143 papers suspected of plagiarism was also performed from the perspective of sections containing duplication and according to the field of research.Findings:Papers in the field of pharmacology and pharmacy had the highest similarity index(8.67±5.92%),which was significantly higher than that in other fields,except health management.The similarity index of review articles(9.77±10.28%)was significantly higher than that of research articles(7.41±6.26%).In total,143 papers were suspected of plagiarism(5.80%)with similarity indices≥15%;most were papers on health management(78,54.55%),followed by public health and preventive medicine(38,26.58%);90.21%of the 143 papers had duplication in multiple sections,while only 9.79%had duplication in a single section.The distribution of sections with duplication varied among different fields;papers in pharmacology and pharmacy were more likely to have duplication in the data/methods and introduction/background sections,however,papers in health management were more likely to contain duplication in the introduction/background or results/discussion sections.Different structures for papers in different fields may have caused these differences.Research limitations:There were three limitations to our research.Firstly,we observed that a small number of papers have been checked early.It is unknown who conducted the plagiarism check as this can be included in other evaluations,such as applications for Science and technology projects or awards.If the authors carried out the check,text with high similarity indices may have been excluded before submission,meaning the similarity index in our research may have been lower than the original value.Secondly,there were only four medical fields included in our research.Additional analysis on a wider scale is required in the future.Thirdly,only a general similarity index was calculated in our study;other similarity indices were not tested.Practical implications:A comprehensive analysis of similarity indices in four medical fields was performed.We made several recommendations for the supervision of medical academic misconduct and the formation of criteria for defining suspected plagiarism for medical papers,as well as for the improved accuracy of text duplication checks.Originality/value:We quantified the differences between the AMLC general similarity index and the corrected index,described the situation around text duplication and plagiarism in papers from four medical fields,and revealed differences in similarity indices between different article types.We also revealed differences in the sections containing duplication for papers with suspected plagiarism among different fields.

The Role of Artificial Intelligence in the Medical Field

The Artificial Intelligence in the medical field has revolutionized the industry. Recently, A. I. has interested medical practitioners in applying innovation to healthcare systems. A. I. has еmеrgеd as a transformative forcе, revolutionizing the industry by leveraging advanced algorithms and computing powеr to еnhancе various aspects of hеalthcarе dеlivеry. The background highlights that artificial intelligence as innovation promises to transform how medical staffs manage patients and treat and diagnose patients. This comprehensive literature review to identify the relevant sources of information on A. I implementation in healthcare, focusing on the advantages and disadvantages. The obtained results from the materials provided valuable insights into the various means A. I. is used in the medical industry and its effects on patient care and recovery. The findings indicated that;A. I. streamlines Tedious Tasks since it is accurate and gives speedy services enabling early detection of illnesses and leading to positive patient outcomes. A. I. provides Real-Time Data which is essential in addressing patients’ conditions with clear objectives;the use of A. I. improves helps to reduce Burnout in medical practitioners. The use of A. I. helps provide Precision Medicine since it can obtain and analyze large amounts of information. The future directions encompass the implementation of the legal framework, enhancing transparency and accountability, and addressing challenges related to data standardization.

Consideration of Postgraduate Training under the Cross Field of Medical Information and Engineering

The slogan of“Combination of medicine and engineering”proposed in“Made in China 2025”has aroused great attention to higher engineering education.However,it is a difficult problem and challenge for schools and educators to effectively adapt to the economic and social development,train new medical and engineering talents,and explore and cultivate new subject growth points.In order to deal with engineering change and a new round of scientific and technological revolution,facing the challenge of new engineering construction.This paper will combine the reality and characteristics of colleges and universities,analyze the problems existing in the current medical engineering cross-graduate training,and put forward countermeasures and suggestions to promote the progress and development of science and technology in colleges and universities.

A New Method for Medical Image Retrieval Based on Markov Random Field

The development of medical images acquisition and storage technology has led to the rapid growth of the relevant data.Retrieval of similar medical images can effectively help doctors to diagnose diseases more accurately.But because of the particularity of medical images,traditional contentbased image retrieval(CBIR)method such as bag-of-words(BOW)cannot be applied to medical images.For example,when retrieving a diseased image,we should not only consider the similar characteristics but also need to consider the type of lesion.And for medical images,images with the same lesion may have different image features,similar images may have different types of lesions.In this paper,a Markov random field(MRF)is structured,and an approximate belief propagation algorithm is used to retrieval images.An adjust-ranking step after initial retrieval is incorporated to further improve the retrieval performance.This paper uses the real brain CT images.The experimental results show that the proposed method can significantly improve the retrieval accuracy and has good efficiency.

Medical Knowledge Extraction and Analysis from Electronic Medical Records Using Deep Learning

Objectives Medical knowledge extraction (MKE) plays a key role in natural language processing (NLP) research in electronic medical records (EMR),which are the important digital carriers for recording medical activities of patients.Named entity recognition (NER) and medical relation extraction (MRE) are two basic tasks of MKE.This study aims to improve the recognition accuracy of these two tasks by exploring deep learning methods.Methods This study discussed and built two application scenes of bidirectional long short-term memory combined conditional random field (BiLSTM-CRF) model for NER and MRE tasks.In the data preprocessing of both tasks,a GloVe word embedding model was used to vectorize words.In the NER task,a sequence labeling strategy was used to classify each word tag by the joint probability distribution through the CRF layer.In the MRE task,the medical entity relation category was predicted by transforming the classification problem of a single entity into a sequence classification problem and linking the feature combinations between entities also through the CRF layer.Results Through the validation on the I2B2 2010 public dataset,the BiLSTM-CRF models built in this study got much better results than the baseline methods in the two tasks,where the F1-measure was up to 0.88 in NER task and 0.78 in MRE task.Moreover,the model converged faster and avoided problems such as overfitting.Conclusion This study proved the good performance of deep learning on medical knowledge extraction.It also verified the feasibility of the BiLSTM-CRF model in different application scenarios,laying the foundation for the subsequent work in the EMR field.

Artificial Intelligence in Healthcare and Medicine:Promises,Ethical Challenges and Governance

Artificial intelligence (AI) is rapidly being applied to a wide range of fields,including medicine,and has been considered as an approach that may augment or substitute human professionals in primary healthcare.However,AI also raises several challenges and ethical concerns.In this article,the author investigates and discusses three aspects of AI in medicine and healthcare:the application and promises of AI,special ethical concerns pertaining to AI in some frontier fields,and suggestive ethical governance systems.Despite great potentials of frontier AI research and development in the field of medical care,the ethical challenges induced by its applications has put forward new requirements for governance.To ensure “trustworthy” AI applications in healthcare and medicine,the creation of an ethical global governance framework and system as well as special guidelines for frontier AI applications in medicine are suggested.The most important aspects include the roles of governments in ethical auditing and the responsibilities of stakeholders in the ethical governance system.

Improved Medical Image Segmentation Model Based on 3D U-Net

With the widespread application of deep learning in the field of computer vision,gradually allowing medical image technology to assist doctors in making diagnoses has great practical and research significance.Aiming at the shortcomings of the traditional U-Net model in 3D spatial information extraction,model over-fitting,and low degree of semantic information fusion,an improved medical image segmentation model has been used to achieve more accurate segmentation of medical images.In this model,we make full use of the residual network(ResNet)to solve the over-fitting problem.In order to process and aggregate data at different scales,the inception network is used instead of the traditional convolutional layer,and the dilated convolution is used to increase the receptive field.The conditional random field(CRF)can complete the contour refinement work.Compared with the traditional 3D U-Net network,the segmentation accuracy of the improved liver and tumor images increases by 2.89%and 7.66%,respectively.As a part of the image processing process,the method in this paper not only can be used for medical image segmentation,but also can lay the foundation for subsequent image 3D reconstruction work.

A Systematic Review of Cultural Preferences for Receiving Medical “Bad News” in the United States

According to the dominant models of medical ethics in the United States and many Western countries, physician disclosure of information such as diagnosis, treatment options, and prognosis is considered an essential precondition for patient informed consent. While being consistent with the principle of patient autonomy stressed in many Western healthcare systems, full disclosure—particularly of life-threatening diagnoses and poor prognoses—is inconsistent with the cultural values of many ethnic communities within the United States. A systematic review of research examining cultural preferences for disclosure of medical “bad news” was conducted. Results suggested that cultural preferences are more heterogeneous than has often been portrayed. Particularly when communicating with patients and families from culturally and ethnically diverse backgrounds, health care professionals should ask about preferences for receiving medical information and making treatment decisions.

The complicated life of a physician-soldier: Medical readiness training exercises &the problem of dual loyalties

While physicians are generally understood as owing moral obligation to the health and well being of their individual patients, military health professionals can face ethical tensions between responsibilities to individual patients and responsibilities to the military mission. The conflicting obligations of the two roles held by the physician-soldier are often referred to as the problem of dual loyalties and have long been a topic of debate. This paper seeks to enrich the dualloyalties debate by examining the embedded case study of medical civilian assistance programs. These programs represent the use of medicine within the military for strategic goals. Thus, a physician is expected to meet his obligation to his role as a soldier while also practicing medicine. These programs involve obligations inherent in both roles of the physician-soldier and thusly they serve as excellent exemplars for the problem of dual loyalties at an institutional level. This paper focuses on Medical Readiness Training Exercises (MEDRETEs). These programs are short-term, generally taking place in low-income nations in order to accomplish strategic goals including training opportunities for military medical professionals that are not possible on the home front. This form of temporary program raises ethical concerns regarding the exploitation of vulnerable populations and the value of what is termed “parachute medicine”. The short-term nature of these interventions makes long-term treatment and follow-up impossible, begging the question as to whether this peak and trough approach to foreign civilian aid is of any use. Physicians are generally understood as having obligations towards the well being of the patient, which these programs do not necessarily prioritize. Rather, the programmatic intent is military, with political and strategic aims of furthering international relations, increasing US military global presence and providing austere and tropical training opportunities for military healthcare providers. This can be morally problematic for the physician-soldier.

The Health Care Ethics: Overview of the Basics

In this overview we answers certain Questions in order to increase the awareness towards the basic of the health care ethics: what is ethics, what are the several fields of ethics connected to medical activities, what are the types of Ethical approaches in relation to the medical practice. Conclusion: Through understanding the basics of the ethics, the awareness of the medical ethics in the health care can be increased.