Language in Bioethics: Beyond the Representational View.

Though assumptions about language underlie all bioethical work, the field has rarely partaken of theories of language. This article encourages a more linguistically engaged bioethics. We describe the tacit conception of language that is frequently upheld in bioethics-what we call the representational view, which sees language essentially as a means of description. We examine how this view has routed the field's theories and interventions down certain paths. We present an alternative model of language-the pragmatic view-and explore how it expands and clarifies traditional bioethical concerns. To lend concreteness, we apply the pragmatic view to a pervasive concept in bioethics and adjacent fields: decision making. We suggest that problems of the decision-making approach to bioethical issues are grounded in adherence to the representational view. Drawing on empirical work in surgery and critical care, we show how the pragmatic view productively reframes bioethical questions about how medical treatments are pursued.

Molecular architecture of the actin cytoskeleton: From single cells to whole organisms using cryo-electron tomography.

Cryo-electron tomography (cryo-ET) has begun to provide intricate views of cellular architecture at unprecedented resolutions. Considerable efforts are being made to further optimize and automate the cryo-ET workflow, from sample preparation to data acquisition and analysis, to enable visual proteomics inside of cells. Here, we will discuss the latest advances in cryo-ET that go hand in hand with their application to the actin cytoskeleton. The development of deep learning tools for automated annotation of tomographic reconstructions and the serial lift-out sample preparation procedure will soon make it possible to perform high-resolution structural biology in a whole new range of samples, from multicellular organisms to organoids and tissues.

Social network centrality predicts dietary decisions in a wild bird population.

How individuals balance costs and benefits of group living remains central to understanding sociality. In relation to diet, social foraging provides many advantages but also increases competition. Nevertheless, social individuals may offset increased competition by broadening their diet and consuming novel foods. Despite the expected relationships between social behavior and dietary decisions, how sociality shapes individuals' novel food consumption remains largely untested in natural populations. Here, we use wild great tits to experimentally test how sociality predicts dietary decisions. We show that individuals with more social connections have higher propensity to use novel foods compared to socially peripheral individuals, and this is unrelated to neophobia, observations, and demographic factors. These findings indicate sociable individuals may offset potential costs of competition by foraging more broadly. We discuss how social environments may drive behavioral change in natural populations, and the implications for the causes and consequences of social strategies and dietary decisions.

Interdisciplinary co-teaching as a sustainable model for health humanities pedagogy.

Academics and students from marginalised identities encounter challenges and barriers at all levels of participation in the settler colonial university, in both practices of teaching and learning. While this observation holds true for courses in the health humanities, their unique interdisciplinary position and context creates space for challenging dominant norms in society and in academia. In this paper, we describe our experiences as two black and queer graduate students developing and co-teaching an online interdisciplinary course, 'Race and Medicine'. The idea for co-teaching originated as a means of ensuring continuity and sustainability in the course (AvB was expecting her first child and contending with the possibility of unplanned preterm birth) and emerged into what we suggest, in line with the transformative pedagogical theory of bell hooks, was a micro-scale transgressive learning community. We argue that our co-teaching partnership facilitated practices of revealing, mitigating and disrupting oppressive structures in the white heteropatriarchal academy, in addition to offering unique learning opportunities for students. The intersections of difference and similarity between our disciplinary, professional and social identities transformed and enhanced the types of conversations and learning activities we held with the class and were a feature of the course which was rated highly in evaluations. We conclude by suggesting co-teaching as a possible model of sustainable pedagogy for the health humanities, one that is especially valuable for racialised graduate students who are developing professional identities as instructors and exploring careers in the health humanities. In addition to facilitating interdisciplinary student learning, co-teaching and the subsequent formation of micro-scale transgressive learning communities challenges the dominant power structures of the academy by making space for teaching and learning in the contexts of solidarity, care and sustainability.

[The sociological approach to vasectomized patient trajectories at the Buenos Aires University Clinical Hospital "José de San Martín"].

According to the Argentinian Ministry of Health records the number of patients requesting vasectomy increased twelve times in public hospitals in 2015-2019. The physicians and specialists account for this change in recent years, arguing, among other reasons, cultural change when male assumes active position in contraceptive methods. The article addresses vasectomized patient trajectory at the Buenos Aires University Clinical Hospital "José de San Martín". The purpose of the study was to define from sociological point of view if we are actually witnessing cultural change. While considering last ten years (2012-2022), through diachronic analysis of patient demand at the Male Fertility Laboratory (n=1136) it was found that although main motivation is fertility, minority (6%) consulting to confirm absence of sperm in the ejaculate following vasectomy increased significantly in 2022 (Pearson's chi-squared test p<0.0001). After qualitative/quantitative interviews of former patient group (n=36) two sub-populations were distinguished: childless (42%; Median age: 30 years old; range: 24-35) and those having a family (58%; Median age: 39 years old; range: 35-54). Most of them had University degree (67%) and learned about this anti-contraceptive method by the Internet. It is remarkable that 94% of them were not aware of the the Argentinian Law № 236139 of 2006 that grants their right to vasectomy. Among all patients randomly interviewed in 2022 (n=200) condom anti-contraceptive method was the best known (67%). The conclusion was made that in the meantime developed New Trend that comprises high educational level segment of population of Argentina that in the future can become the germ of Cultural Change encompassing the whole society.

[The long 1992 year in medicinal (non-)security of Russia. Report I. Market trial].

The year 1992 is an important landmark in the history of Russian pharmaceutical market. It began not in January, but in December 1991, when orders of the President and the Government to open free market of medications were promulgated. The Yeltsin advisers conceived that market economy was infallible means to combat medication shortages, corruption and bureaucratic monopoly. However, panacea did not work. Moreover, it gave rise to completely new problems. The human and state security implies protection from threats of dependence. The unprepared dive into market plunged Russians and the country into deep dependence on imported medications and foreign pharmaceutical companies. The proposed study proceeds our publications in this journal and in journal "Pharmacia" in 2022. At that time, analysis of medication "famine" was implemented on basis of published sources and relied on journalistic evidences. The current study was carried out on the basis of archive documents of the Ministry of Health of the Russian Federation and authors interviews of representatives of the regulator. The first report reveals administrative mechanism that engendered crisis of medication supply in the first post-Soviet year of our country.

Epidemic intelligence in Europe: a user needs perspective to foster innovation in digital health surveillance.

BACKGROUND: European epidemic intelligence (EI) systems receive vast amounts of information and data on disease outbreaks and potential health threats. The quantity and variety of available data sources for EI, as well as the available methods to manage and analyse these data sources, are constantly increasing. Our aim was to identify the difficulties encountered in this context and which innovations, according to EI practitioners, could improve the detection, monitoring and analysis of disease outbreaks and the emergence of new pathogens. METHODS: We conducted a qualitative study to identify the need for innovation expressed by 33 EI practitioners of national public health and animal health agencies in five European countries and at the European Centre for Disease Prevention and Control (ECDC). We adopted a stepwise approach to identify the EI stakeholders, to understand the problems they faced concerning their EI activities, and to validate and further define with practitioners the problems to address and the most adapted solutions to their work conditions. We characterized their EI activities, professional logics, and desired changes in their activities using NvivoⓇ software. RESULTS: Our analysis highlights that EI practitioners wished to collectively review their EI strategy to enhance their preparedness for emerging infectious diseases, adapt their routines to manage an increasing amount of data and have methodological support for cross-sectoral analysis. Practitioners were in demand of timely, validated and standardized data acquisition processes by text mining of various sources; better validated dataflows respecting the data protection rules; and more interoperable data with homogeneous quality levels and standardized covariate sets for epidemiological assessments of national EI. The set of solutions identified to facilitate risk detection and risk assessment included visualization, text mining, and predefined analytical tools combined with methodological guidance. Practitioners also highlighted their preference for partial rather than full automation of analyses to maintain control over the data and inputs and to adapt parameters to versatile objectives and characteristics. CONCLUSIONS: The study showed that the set of solutions needed by practitioners had to be based on holistic and integrated approaches for monitoring zoonosis and antimicrobial resistance and on harmonization between agencies and sectors while maintaining flexibility in the choice of tools and methods. The technical requirements should be defined in detail by iterative exchanges with EI practitioners and decision-makers.

Social Factors Influencing Utilization of Old Age Homes by Elderly in Urban Area of South Chennai, Tamil Nadu.

Background: Currently, most old age homes in India are completely occupied. Nowadays, nuclear families are more than joint families, and due to various factors such as urbanization, the elderly are deprived of essential care at home and are moved from their own homes to old-age homes. With the increasing geriatric population, this study explored the various social factors influencing the elderly to reside in old age homes. Material and Methods: The study was conducted among 330 elderly in old age homes using simple random sampling. The study population included elderly above the age of 60 years and residing in old age homes, who were willing to participate. A pretested structured questionnaire with data on sociodemographic characteristics, family, financial support, and various other social factors was collected. Data were analyzed using SPSS. Results: Among the respondents, 20.6% were supported by children financially and 18.5% had a pension. Almost 70% of the elderly were left unattended by friends and family. Care and support through means of calls, letters, and visits when analyzed showed that 27.3% were provided care and support through children and 33.6% were left unattended. Conclusion: Family members, friends, and relatives should be encouraged to give regular visits and spend time with the elderly so that the bonding will have a positive effect on their mental health. Aging and geriatric health should be considered sensitively and should be made mandatory for schools and colleges to arrange visits to old age homes, thereby keeping the younger generation aware of the issues.

Mpox Illness Narratives: Stigmatising Care and Recovery During and After an Emergency Outbreak.

In May 2022, a global outbreak of mpox (formerly monkeypox virus) affected thousands of mainly gay and bisexual men. Mpox is usually a time-limited illness that can involve fever, pain, and skin lesions, but may require hospitalisation. There is scant research into the firsthand experiences of people affected by mpox, including experiences of symptoms, healthcare, and recovery. This study considers the different illness narratives of people who experienced mpox in Australia in 2022. In-depth interviews and 6-month follow-up interviews were conducted with 16 people, including 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay or bisexual men living in Australia. Participants' accounts described minor to severe periods of sickness, negative and stigmatising experiences engaging with healthcare, and some participants experienced long-term effects on their sexual well-being and complications from mpox. The emergency outbreak context meant that mpox was highly distressing, making it difficult to manage and producing varying forms of disruption to everyday life. Mpox was narrated as disruptive in different ways: as a minor interruption to holiday plans, a prolonged period of poor health, or a biographically disruptive event prompting a re-evaluation of sexual values and health. This analysis demonstrates that an unfamiliar emergent disease outbreak related to sexual practices and sociality can reconfigure personal life and sexual well-being, suggesting a need to focus on providing quality patient care in outbreaks of mpox and other infectious diseases.

Organization and quality of care in childbirth in private for-profit maternity units in France: Risks of the deprofessionalization of midwives.

OBJECTIVE: In France, in 2007-2009, the risk of peripartum maternal mortality, especially the one due to hemorrhage, was higher in the private for-profit maternity units than in university maternity units. Our research, a component of the MATORG project, aimed to characterize the organization of care around childbirth in these private clinics to analyze how it might influence the quality and safety of care. MATERIAL AND METHODS: We conducted a qualitative survey in 2018 in the maternity units of two private for-profit clinics in the Paris region, interviewing 33 staff members (midwives, obstetricians, anesthesiologists, childcare assistants and managers) and observing in the delivery room for 20 days. The perspective of the sociology of organizations guided our data analysis. FINDINGS/RESULTS: Our study distinguished three principal risk factors for the safety of care in maternity clinics. The division of labor among healthcare professionals threatens the maintenance of midwives' competencies and makes it difficult for these clinics to keep midwives on staff. The mode of remuneration of both midwives and obstetricians incentivizes overwork by both, inducing fatigue and decreasing vigilance. Finally the clinical decision-making of some obstetricians is not collegial and creates conflicts with midwives, who criticize the technicization of childbirth. Some demotivated midwives no longer consider themselves responsible for patients' safety. CONCLUSIONS: The organization of work in private maternity units can put the safety of care around childbirth at risk. The division of labor, staff scheduling/planning, and a lack of collegiality in decision-making increase the risk of deprofessionalizing midwives.

Spread of awareness of COVID-19 between December 2019 and March 2020 in France.

During the early phase of outbreaks, awareness of the presence of the disease plays an important role in transmission dynamics. To investigate the processes of how people become aware of a disease, we conducted two complementary investigations. First, we surveyed 868 academic researchers in France, on the time and circumstances when they became aware of COVID-19 as an important event. We found that 25% did so before February 18th (first death in France), 50% did so before March 10th (first presidential allocution) and 75% did so before March 16th (announcement of the lockdown). Awareness came from nine categories of circumstances: (1) decisions taken by the government (elicited by 35.7% participants); (2) information from media or social media (24.7%); (3) conversation with friends (22.4%); (4) observed changes in their personal lives (14.0%); (5) decisions taken by the employer (9.2%); (6) observed changes at work (9.9%); (7) suspected case of COVID-19 in their entourage (3.1%); (8) fear for oneself or their entourage (2.8%) and (9) self-appraisal of scientific reports (2.8%). Second, we appraised three general media in France (a television news show, a radio news show, and a newspaper) and showed that COVID-19 became a preeminent topic only after March 1st 2020 when the epidemic is present on national soil. Our results show that multiple intricated factors prompt the awareness of an emerging infectious disease. Awareness is not solely driven by general media as they begin to focus on the topic late.

Innovation in sport medicine and science: a global social network analysis of stakeholder collaboration in rugby union.

Objectives: To investigate the network of stakeholders involved in rugby union research across the globe. Methods: Using author affiliations listed on scientific publications, we identified the organisations that contributed to rugby union research from 1977 to 2022 and examine collaboration through coauthorship indicators. We determined the locations and sectors of identified organisations and constructed a collaboration network. Network metrics, including degree centrality and betweenness centrality, are computed to identify influential organisations and measure intersector collaboration. Results: There is an increase in scientific knowledge creation and collaboration between organisations for rugby union research over time. Among the sectors, the university, professional sports team and sports governing body sectors exhibit the highest intersectoral and intrasectoral density. Predominantly, influential actors are located in England, Australia, France, New Zealand, Ireland and South Africa. Australian Catholic University, Leeds Beckett University, Stellenbosch University, Swansea University, University College London and the University of Cape Town emerge as influential actors between 2016 and 2022. Conclusions: Our study underscores the ongoing growth of scientific knowledge generation in rugby union, primarily led by organisations in tier 1 rugby-playing nations within the university sector. Intersectoral collaboration with sports governing bodies plays a crucial role, acting as a broker between sectors. However, the overall collaboration landscape between and within sectors is low. These results highlight an opportunity for improved collaboration opportunities, as the organisations driving knowledge creation have been identified.

Mental health, gender, and higher education attainment.

We compared the mental health of higher education students with that of nonstudents. Moreover, we examined whether the mental health of students predicts their probability of obtaining a higher education degree, and whether the extent to which mental health affects educational attainment varies by gender. Drawing on a risk and resilience framework, we considered five facets of mental health that may be implicated in distinct ways in the educational attainment process: positive attitude towards life, self-esteem, self-efficacy, negative affectivity, and perceived stress. We used data from a nationally representative panel study from Switzerland (Nstudents = 2070, 42.8% male; Nnonstudents = 3755, 45.9% male). The findings suggest that overall, the mental health of higher education students was relatively similar to that of nonstudents, although students exhibited slightly higher self-esteem, slightly weaker self-efficacy, greater negative affectivity, and higher levels of perceived stress. The effects of different facets of mental health on higher education degree attainment were mostly statistically and/or practically insignificant. However, positive attitudes towards life had a substantial positive effect on the probability of being awarded a higher education degree. Mental health was equally important for male and female students' educational attainment. Supplementary Information: The online version of this article (10.1007/s11618-023-01187-3) contains supplementary material, which is available to authorized users.

Impact of a university teaching of integrative medicine on the social representations of undergraduate medical students.

Integrative medicine, need to be inoffensive, effective, and of quality (World Health Organization). In 2010, the American Society of Teachers of Family Medicine approved 19 competencies for teaching integrative medicine to residents. In 2018, the University of Rennes created a course: "Integrative Medicine and Complementary Therapies". Up until then, the only feedback from the courses was the students' opinions. We investigated the impact on medical students' social representation.We performed a sociological analysis of students' social representations before and after the course. The social representation is based on the way an individual creates his or her universe of beliefs and ideas. After hearing, "What word or group of words comes to mind when you hear people speak of integrative medicine and complementary therapies?", students were asked to provide 5 words/phrases, rank their importance, and show their attitude towards these words/phrases. The frequency and importance of these words/phrases were used to construct social representations (with central cores, and primary and secondary peripheries) before and after the course.Among the 101 students registered, 59 provided complete responses before and 63 after the course. Before, the central core comprised "hypnosis" and "alternative medicine", while after: "complementary care" and "global care". We only identified first periphery before the course: "acupuncture" and "homeopathy". 4 new contrasting elements: "integration with conventional treatment", "patient's choice", "personalisation of care", and "caring relationship of trust".This teaching course positively affected students' social representation of integrative medicine, and might promote their use during future practices.

"Getting Moving" and Being "Active Fit": Class Differences and Similarities in Health-promoting Parenting through Children's Organized Athletic Activities.

Parents are held increasingly responsible for acting intensively to protect their children's health through everyday decisions and practices. We add to this scholarship by considering how organized athletic activities, an important part of the lives of many children, help parents fulfill their responsibility to protect their children's health. Through qualitative analysis of 92 in-depth interviews with parents, we attend to how parents' class shapes their articulation of the relationship between their children's health and their extracurricular involvement, considering literature on the ubiquity of intensive parenting expectations and the possibility that health behaviors and understandings constitute health-related cultural capital. Contrary to previous research, overall, we find similarities across class in parents' understandings of the health benefits of organized athletic activities. We find that parents believe organized athletic activities protect their children's health from inactivity, excess technology usage, and fatness. We do find some class distinctions. Middle-class parents, and not working-class parents, believe that their children's athletic activities will instill a passion for exercise and staying in shape and give children the experience and knowledge to control their body size and promote their well-being through their lives. This may signal a transformation in the relationship between health-related parenting and class that could maintain middle-class children's advantage if it contributes to differences in health beliefs, narratives, or practices that are differentially rewarded by important institutions such as schools, the workplace, or the medical system.

Hospital Environment and Medical Sociology: User-Centered Environmental Sociology Model Based on a Systematic Review.

PURPOSE: This study investigates the relationship between environmental quality and medical sociology in hospitals and suggests a conceptual framework for understanding their interrelation. BACKGROUND: Despite the importance of environmental properties in the sociological approach to users' health and the role of medical sociology research in the design of hospital environments, few studies have been conducted in the field of hospital environments and medical sociology interrelation. Therefore, this article attempts to fill this gap in our knowledge. METHODS: A systematic review was carried out in five databases (Scopus, Web of Science, Google Scholar, MEDLINE, and ScienceDirect) based on PRISMA guidelines to survey how environmental quality and medical sociology factors are related in the medical/environmental sociology research and the hospital design. RESULTS: The search yielded the final 17 potentially relevant articles after finding 3,840 records, screening 1,295 nonduplicate articles, and reviewing 158 full-text articles. The findings revealed that four main aspects of medical sociology (physical-biological, psychological, social, and economic) and hospital environmental quality (physical, social, and psychological dimensions) influence users' health and disease status. The hospital environment includes various social issues in medical sociology (like interactions, behavior patterns, lifestyle, work motivation, and culture). The physical and psychosocial factors of the hospital environment (such as spatial configuration, aesthetics, scale, privacy, and collective spaces) are associated with psychosocial aspects of medical sociology (like social class, behavior patterns, culture, and lifestyle). CONCLUSION: Environmental features and psychosocial issues should be considered to improve users' health and experience in hospitals and to create a user-centered health-promoting environment.