Alzheimer’s disease (AD) and associated dementia patient numbers continue to increase globally with associated economic costs to healthcare systems. Of note is the increase in numbers in lower and middle-income count...Alzheimer’s disease (AD) and associated dementia patient numbers continue to increase globally with associated economic costs to healthcare systems. Of note is the increase in numbers in lower and middle-income countries (LMICs) including Sub-Saharan African (SSA) countries, which already face challenges with their health budgets from communicable and non-communicable diseases. Ghana, an SSA country, faces the problem of healthcare budgetary difficulties and the additional impact of AD as a consequence of increasing population strata of old aged persons (OAPs) due to the demographic transition effect. This article uses examples of known patients’ illness courses to give a perspective on the lived experience of patients with dementia (PWD) in Ghana, living amongst a populace with a culture of stigmatization of PWD, and a relatively fragile public mental health system (PMHS) for those with mental illness, including AD. The lived experience of AD patients is characterised by stigmatisation, discrimination, non-inclusiveness, diminished dignity and human rights abuses in the face of their mental disability, and eventually death. This article is an advocacy article giving voice to the voiceless and all persons suffering from AD and other dementias in Ghana, whilst pleading for a call to action from healthcare professionals and responsible state agencies.展开更多
This paper highlights the increasing problem of road traffic accident (RTA) related morbidity and mortality in Ghana, and the public health measures needed to control the problem. Descriptive data in the public domain...This paper highlights the increasing problem of road traffic accident (RTA) related morbidity and mortality in Ghana, and the public health measures needed to control the problem. Descriptive data in the public domain from statutory bodies and media houses reports on country RTA information, as well as academic papers on the problem, were used as source of information about the problem. The observed trend in Ghana indicates that RTA related fatalities and injuries continue to be increasing, as morbidity and mortality factors since the year 2000. Most of the remedial measures suggested in academic papers, and state agencies measures to curb the RTA trend in Ghana to date, have discussed the problem in terms of injury and safety issues/measures. This paper suggests that the increasing RTAs with associated morbidity and mortality in Ghana need to be looked at more as a public health problem and priority that requires prompt tackling using a public health problem orientated approach and measures, than just as a safety problem due to RTAs’, as is currently done.展开更多
This article provides a brief description of an epithelial ovarian cancer(EOC) case(stage Ⅳ) treated with the association of complete Cyto Reductive Surgery and hypertermic intra PEritoneal chemotherapy(HIPEC). Theus...This article provides a brief description of an epithelial ovarian cancer(EOC) case(stage Ⅳ) treated with the association of complete Cyto Reductive Surgery and hypertermic intra PEritoneal chemotherapy(HIPEC). Theuse of HIPEC in EOC makes theoretic sense in view of the high rates of recurrence following standard treatment, but there are no randomized clinical trial to date and HIPEC for these patients still represents a radical treatment where the choice of no treatment may be acceptable since definitive cure is unlikely. We reviewed the entire decision making process considering the risk/benefit of the procedure in term of mortality/morbidity, the quality of life and the psychological profile of the patient 1 year after surgery. The platform World Health Organization- International Classification of Functioning, Disability and Health that permits evaluation of the person in relation to the psycho-social context is presented. A person-centred approach and assessment of health-related quality-of-life and disability in EOC survivors are of central importance for decision making.展开更多
Police emergency commitment powers for detention of persons in the community perceived to be seriously mentally ill for further specialist examination in a designated facility have always raised interest in medical an...Police emergency commitment powers for detention of persons in the community perceived to be seriously mentally ill for further specialist examination in a designated facility have always raised interest in medical and legal circles on both sides of the Atlantic. The objective of this article is to detail the police commitment procedure in England and Wales, as dictated by the mental health act of 1983 (MHA 1983) amended in 2007 (MHA 2007);and compare this with similar legal provisions as prevails under current state mental health statutes in the United States of America (USA). The comparative review of the commitment processes in England and Wales to that of the USA reveals that the process in England and Wales seeks to primarily ensure that persons with mental disorder (PWMD) in crisis are directed to a specialist hospital for evaluation and appropriate specialist care. In the USA such persons in a good number of cases may end up in the criminal justice system due to application of the “dangerousness” standard. Additionally whereas in England and Wales the commitment law is uniform in law and application, the federal system in the USA is such that the commitment law may have minor variations depending on the individual states. The minor variation in state commitment laws may engender a situation where the commitment law in England and Wales may seem relatively equitable and just towards PWMD in crisis, compared to the state commitment laws in the USA.展开更多
The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appe...The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appear polarized.Some believe that the gut microbiome is at the core of human health and is related to every single disease.To the opposite,some people question the scientific basis of gut microbiome studies and criticize that many of them are farfetched;there is even a joke spreading in the biomedical research field—"keeping gut microbiome in mind,no mechanism is hard to find".展开更多
Recent years have witnessed an unprecedented explosion of scientific knowledge and advances in human microbiome research due to the emerging high-throughput molecular technologies. The term human microbiome refers to ...Recent years have witnessed an unprecedented explosion of scientific knowledge and advances in human microbiome research due to the emerging high-throughput molecular technologies. The term human microbiome refers to the population of microorganisms, including bacteria, viruses, fungi and protozoan, and their genetic material that live on and inside the human organisms （skin, mucous membranes, intestinal tract, etc.） （Honey, 2008）. A search of the literature at PubMed for the term ＂microbiome＂ in the title and abstract illustrates the fast progression of microbiome science. From 2006 to 2010 there were just 304 papers that used the word microbiome in their title and/or abstract, whereas the number has increased to 11,128 from 2011 to 2017.展开更多
文摘Alzheimer’s disease (AD) and associated dementia patient numbers continue to increase globally with associated economic costs to healthcare systems. Of note is the increase in numbers in lower and middle-income countries (LMICs) including Sub-Saharan African (SSA) countries, which already face challenges with their health budgets from communicable and non-communicable diseases. Ghana, an SSA country, faces the problem of healthcare budgetary difficulties and the additional impact of AD as a consequence of increasing population strata of old aged persons (OAPs) due to the demographic transition effect. This article uses examples of known patients’ illness courses to give a perspective on the lived experience of patients with dementia (PWD) in Ghana, living amongst a populace with a culture of stigmatization of PWD, and a relatively fragile public mental health system (PMHS) for those with mental illness, including AD. The lived experience of AD patients is characterised by stigmatisation, discrimination, non-inclusiveness, diminished dignity and human rights abuses in the face of their mental disability, and eventually death. This article is an advocacy article giving voice to the voiceless and all persons suffering from AD and other dementias in Ghana, whilst pleading for a call to action from healthcare professionals and responsible state agencies.
文摘This paper highlights the increasing problem of road traffic accident (RTA) related morbidity and mortality in Ghana, and the public health measures needed to control the problem. Descriptive data in the public domain from statutory bodies and media houses reports on country RTA information, as well as academic papers on the problem, were used as source of information about the problem. The observed trend in Ghana indicates that RTA related fatalities and injuries continue to be increasing, as morbidity and mortality factors since the year 2000. Most of the remedial measures suggested in academic papers, and state agencies measures to curb the RTA trend in Ghana to date, have discussed the problem in terms of injury and safety issues/measures. This paper suggests that the increasing RTAs with associated morbidity and mortality in Ghana need to be looked at more as a public health problem and priority that requires prompt tackling using a public health problem orientated approach and measures, than just as a safety problem due to RTAs’, as is currently done.
文摘This article provides a brief description of an epithelial ovarian cancer(EOC) case(stage Ⅳ) treated with the association of complete Cyto Reductive Surgery and hypertermic intra PEritoneal chemotherapy(HIPEC). Theuse of HIPEC in EOC makes theoretic sense in view of the high rates of recurrence following standard treatment, but there are no randomized clinical trial to date and HIPEC for these patients still represents a radical treatment where the choice of no treatment may be acceptable since definitive cure is unlikely. We reviewed the entire decision making process considering the risk/benefit of the procedure in term of mortality/morbidity, the quality of life and the psychological profile of the patient 1 year after surgery. The platform World Health Organization- International Classification of Functioning, Disability and Health that permits evaluation of the person in relation to the psycho-social context is presented. A person-centred approach and assessment of health-related quality-of-life and disability in EOC survivors are of central importance for decision making.
文摘Police emergency commitment powers for detention of persons in the community perceived to be seriously mentally ill for further specialist examination in a designated facility have always raised interest in medical and legal circles on both sides of the Atlantic. The objective of this article is to detail the police commitment procedure in England and Wales, as dictated by the mental health act of 1983 (MHA 1983) amended in 2007 (MHA 2007);and compare this with similar legal provisions as prevails under current state mental health statutes in the United States of America (USA). The comparative review of the commitment processes in England and Wales to that of the USA reveals that the process in England and Wales seeks to primarily ensure that persons with mental disorder (PWMD) in crisis are directed to a specialist hospital for evaluation and appropriate specialist care. In the USA such persons in a good number of cases may end up in the criminal justice system due to application of the “dangerousness” standard. Additionally whereas in England and Wales the commitment law is uniform in law and application, the federal system in the USA is such that the commitment law may have minor variations depending on the individual states. The minor variation in state commitment laws may engender a situation where the commitment law in England and Wales may seem relatively equitable and just towards PWMD in crisis, compared to the state commitment laws in the USA.
基金This work was supported by National Key Research and Development Program of China(2018YFC2000500)the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB29020000)+1 种基金the National Natural Science Foundation of China(31771481,91857101)the National Social Science Foundation of China(16CZX064).We thank Prof.Liping Zhao from Shanghai Jiao Tong University for insightful advice and the many researchers,clinicians and industry specialists who participated in the discussion and provided valuable suggestions.
文摘The gut microbiome has attracted increasing attention over the past 15 years.Along with the fast-growing body of research literature and media reports,the public's opinions on the gut microbiome have begun to appear polarized.Some believe that the gut microbiome is at the core of human health and is related to every single disease.To the opposite,some people question the scientific basis of gut microbiome studies and criticize that many of them are farfetched;there is even a joke spreading in the biomedical research field—"keeping gut microbiome in mind,no mechanism is hard to find".
基金This study was supported by project ＂Ethical, legal, and social implications of human microbiome research＂ funded by China National Social Science Foundation （16CZX064）. We are very grateful for the insights from anonymous reviewers.
文摘Recent years have witnessed an unprecedented explosion of scientific knowledge and advances in human microbiome research due to the emerging high-throughput molecular technologies. The term human microbiome refers to the population of microorganisms, including bacteria, viruses, fungi and protozoan, and their genetic material that live on and inside the human organisms （skin, mucous membranes, intestinal tract, etc.） （Honey, 2008）. A search of the literature at PubMed for the term ＂microbiome＂ in the title and abstract illustrates the fast progression of microbiome science. From 2006 to 2010 there were just 304 papers that used the word microbiome in their title and/or abstract, whereas the number has increased to 11,128 from 2011 to 2017.
