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.

Exploring the intersection of the medical metaverse and healthcare ethics:future considerations and caveats

The medical metaverse and digital twin are set to revolutionise healthcare.Like all emerging technologies their benefits must be weighed against their ethical and social,impacts.If we consider the advances of medical technology as an expression of our values,such as the pursuit of knowledge,cures and healing,an ethical study allows us to align our values and steer the technology towards an agreed goal.However,to appreciate the long-term consequents of a technology,those consequences must be considered in the context of a society already shaped by that technology.This paper identifies the technologies currently shaping society and considers the ethical,and social consequences of the medical metaverse and digital twin in that future society.

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.

Are medical ethics universal or culture specific

In our society and culture where family is of utmost importance,sometimes I wonder how much of a doctor's duty is to the patient and how much is to the whole family.As a medical student,I remember being told by my professors that we should treat the patient as a whole and not focus on just one problem or organ system.Similarly when practicing medicine in Pakistan,one cannot treat the patient alone and ignore the family.How much should relatives' wishes be taken into account when dealing with a patient? Don't patients have a right to their medical information? When,how,and by whom can that right be waived? What role does culture play when debating medical ethics?

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.

The Ethics of Veracity and It Is Importance in the Medical Ethics

The goals of this overview is to discuss the ethics of telling the patient the truth, with some historical backgrounds and it is importance in medical practice, Justifying Less than Full Disclosure in some situations in which the truth may have a terrible impact on the occasional patient, and the influence of the culture on the health care professionals attitudes towards telling the patient the truth. Conclusion: The health care professionals need more awareness, and training in ethics of veracity and also in the communication skills especially in the context of breaking bad news in telling the patient the truth about diagnosis, treatment outcomes, and prognosis of any serious illness.

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.

Congruent Feature Selection Method to Improve the Efficacy of Machine Learning-Based Classification in Medical Image Processing

Machine learning(ML)is increasingly applied for medical image processing with appropriate learning paradigms.These applications include analyzing images of various organs,such as the brain,lung,eye,etc.,to identify specific flaws/diseases for diagnosis.The primary concern of ML applications is the precise selection of flexible image features for pattern detection and region classification.Most of the extracted image features are irrelevant and lead to an increase in computation time.Therefore,this article uses an analytical learning paradigm to design a Congruent Feature Selection Method to select the most relevant image features.This process trains the learning paradigm using similarity and correlation-based features over different textural intensities and pixel distributions.The similarity between the pixels over the various distribution patterns with high indexes is recommended for disease diagnosis.Later,the correlation based on intensity and distribution is analyzed to improve the feature selection congruency.Therefore,the more congruent pixels are sorted in the descending order of the selection,which identifies better regions than the distribution.Now,the learning paradigm is trained using intensity and region-based similarity to maximize the chances of selection.Therefore,the probability of feature selection,regardless of the textures and medical image patterns,is improved.This process enhances the performance of ML applications for different medical image processing.The proposed method improves the accuracy,precision,and training rate by 13.19%,10.69%,and 11.06%,respectively,compared to other models for the selected dataset.The mean error and selection time is also reduced by 12.56%and 13.56%,respectively,compared to the same models and dataset.

Relationship between the use of smart medical services and mental health status

In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.

Navigating the ethical terrain:Off-label and experimental treatments in medical case reports

This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and pediatrics.It emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical knowledge.The discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and transparency.Challenges such as negative outcome reporting,commercial interests,and the balance between innovation and caution are examined.Recommendations for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific integrity.The article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.

Getting physical with medical education:Exercise based virtual anatomy review classes for medical students

The benefits of regular physical activity are well known.Yet,few studies have examined the effectiveness of integrating physical activity(PA)into curricula within a post-secondary setting.To investigate the incorporation of PA into medical curriculum,we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal(MSK)anatomy course material.These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor.The fitness instructor would lead students through both strength and yoga style exercises,while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered.After the sessions,participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge,PA levels,and mental wellbeing.Thirty participants completed surveys;a majority agreed that the classes increased understanding of MSK concepts(90.0%)and activity levels(97.7%).Many(70.0%)felt that the classes helped reduce stress.The majority of respondents(90.0%)agreed that the classes contributed to increased feelings of social connectedness.Overall,medical students saw benefit in PA based interventions to supplement MSK course concepts.Along with increasing activity levels and promoting health behaviours,integrating PA into medical curriculum may improve comprehension of learning material,alleviate stress and foster social connectivity among medical students.

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.

Hierarchical Media Ethics in the Digital Age: An Analysis of the “Primary School Student Lost Homework in Paris” Incident

In the digital age,traditional media ethics norms lack sufficient explanatory power and binding force in practice.This paper uses the“Primary School Student Lost Homework in Paris”incident as a case study to explore the ethical controversies surrounding the dissemination of this event.By adopting a hierarchical media ethics perspective,the paper dynamically examines the ethical conduct of various communicators,elucidates the ethical responsibilities of each party involved,and reveals the complexity of communication ethics in the digital age.

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.

Curved Spine:The Shape of Spine in Taoist Body Diagrams and Its Influence on Medical Body Diagrams

From the early Taoist diagrams of the human body to the end of the Qing dynasty and the beginning of the Republic of China,Taoists exaggerated and deformed the human spine in a shape-shifting manner.It is likely that medical practitioners were influenced by this style of representation,and there are also numerous diagrams of the human body with the curved spine in the lateral-view diagrams of viscera and Ming Tang Tu(明堂图Acupuncture and Moxibustion Chart),which constantly show the human torso in an elliptical“egg shape”.No later than the Ming dynasty,medical practitioners began to depict the actual physiological spinal curve of the human body.By the Qing dynasty,the depiction of the spinal curve in medical diagrams of the human figure showed a tendency to part ways with the Taoist freehand style of the previous generation.Although the representation of the curve of the spine was very crude,later medical images of the human body at least gradually straightened the spine and no longer depicted it in a shape-shifting manner.However,the curved spine in Taoist diagrams of the human body continued to exist,and the presentation of the curved spine never changed.This way of depicting its appearance,which is very different from reality,is shaped by Taoism's special way of perceiving and viewing the body,and may also contain another form of truth.

Medical Ethics in the Context of the Teachings of V.I.Vernadsky About the Earth’s Biosphere and Living Matter

The subject of medical ethics is usually considered within the binary doctor-patient relationship.In the context of V.I.Vernadsky’s teaching about the Earth’s biosphere and living matter,this relationship turns into a tripartite relationship.The third party is the natural environment around us,primarily the Earth’s biosphere.Thus,the problem of developing and improving medical ethics is connected with entropy-ecological issues.Against the background of this issue,the article draws attention to three issues:the issue of maintaining the chiral purity of living matter,the issue of coexistence and the fight against the world of viruses,and the issue of the danger of degradation of human intelligence under the influence of digitalization and robotization.All three questions relate to the physical and mental health of a person and correspond to what is included in the content of the concept of medical ethics.

Associative Tasks Computing Offloading Scheme in Internet of Medical Things with Deep Reinforcement Learning

The Internet of Medical Things(Io MT) is regarded as a critical technology for intelligent healthcare in the foreseeable 6G era. Nevertheless, due to the limited computing power capability of edge devices and task-related coupling relationships, Io MT faces unprecedented challenges. Considering the associative connections among tasks, this paper proposes a computing offloading policy for multiple-user devices(UDs) considering device-to-device(D2D) communication and a multi-access edge computing(MEC)technique under the scenario of Io MT. Specifically,to minimize the total delay and energy consumption concerning the requirement of Io MT, we first analyze and model the detailed local execution, MEC execution, D2D execution, and associated tasks offloading exchange model. Consequently, the associated tasks’ offloading scheme of multi-UDs is formulated as a mixed-integer nonconvex optimization problem. Considering the advantages of deep reinforcement learning(DRL) in processing tasks related to coupling relationships, a Double DQN based associative tasks computing offloading(DDATO) algorithm is then proposed to obtain the optimal solution, which can make the best offloading decision under the condition that tasks of UDs are associative. Furthermore, to reduce the complexity of the DDATO algorithm, the cacheaided procedure is intentionally introduced before the data training process. This avoids redundant offloading and computing procedures concerning tasks that previously have already been cached by other UDs. In addition, we use a dynamic ε-greedy strategy in the action selection section of the algorithm, thus preventing the algorithm from falling into a locally optimal solution. Simulation results demonstrate that compared with other existing methods for associative task models concerning different structures in the Io MT network, the proposed algorithm can lower the total cost more effectively and efficiently while also providing a tradeoff between delay and energy consumption tolerance.