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1.
Nature ; 590(7846): 392-394, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33526901
2.
Medicina (Kaunas) ; 57(1)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429930

RESUMO

Background and objectives: To explore the ethical and legal complexities arising from the controversial issue of surrogacy, particularly in terms of how they affect fundamental rights of children and parents. Surrogacy is a form of medically-assisted procreation (MAP) in which a woman "lends" her uterus to carry out a pregnancy on behalf of a third party. There are pathological conditions, such as uterine agenesis or hysterectomy outcomes, that may prevent prospective mothers from becoming pregnant or carry a pregnancy to term; such patients may consider finding a surrogate mother. Many issues relating to surrogacy remain unresolved, with significant disagreements and controversy within the scientific community and public opinion. There are several factors called into play and multiple parties and stakeholders whose objectives and interests need to somehow be reconciled. First and foremost, the authors contend, it is essential to prioritize and uphold the rights of children born through surrogacy and heterologous MAP. Materials and methods: To draw a parallel between Italy and the rest of the world, the legislation in force in twelve European countries was analyzed, eleven of which are part of the European Union (France, Germany, Italy, Spain, Greece, Netherlands, Belgium, Denmark, Lithuania, Czech Republic and Portugal) and three non-members of the same (United Kingdom, Ukraine and Russia), as well as that of twelve non-European countries considered exemplary (United States, Canada, Australia, India, China, Thailand, Israel, Nigeria and South Africa); in particular, legislative sources and legal databases were drawn upon, in order to draw a comparison with the Italian legislation currently in force and map out the evolution of the Italian case law on the basis of the judgments issued by Italian courts, including the Constitutional and Supreme Courts and the European Court of Human Rights (ECHR); search engines such as PubMed and Google Scholar were also used, by entering the keywords "surrogacy" and "surrogate motherhood", to find scientific articles concerning assisted reproduction techniques with a close focus on surrogacy. Results: SM is a prohibited and sanctioned practice in Italy; on the other hand, it is allowed in other countries of the world, which leads Italian couples, or couples from other countries where it is banned, to often contact foreign centers in order to undertake a MAP pathway which includes surrogacy; in addition, challenges may arise from the legal status of children born through surrogacy abroad: to date, in most countries, there is no specific legislation aimed at regulating their legal registration and parental status. Conclusion: With reference to the Italian context, despite the scientific and legal evolution on the subject, a legislative intervention aimed at filling the regulatory gaps in terms of heterologous MAP and surrogacy has not yet come to fruition. Considering the possibility of "fertility tourism", i.e., traveling to countries where the practice is legal, as indeed already happens in a relatively significant number of cases, the current legislation, although integrated by the legal interpretation, does not appear to be effective in avoiding the phenomenon of procreative tourism. Moreover, to overcome some contradictions currently present between law 40 and law 194, it would be appropriate to outline an organic and exhaustive framework of rules, which should take into account the multiplicity of interests at stake, in keeping with a fair and sustainable balance when regulating such practices.


Assuntos
Política Pública/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Mães Substitutas/legislação & jurisprudência , Altruísmo , Austrália , Criança , Bem-Estar da Criança/ética , Bem-Estar da Criança/legislação & jurisprudência , Comércio , Europa (Continente) , Feminino , Humanos , Israel , Itália , Japão , Turismo Médico/ética , Turismo Médico/legislação & jurisprudência , Gravidez , Técnicas de Reprodução Assistida/ética , Federação Russa , Problemas Sociais , Tailândia , Ucrânia , Estados Unidos
3.
Epidemiol Psychiatr Sci ; 30: e5, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33413736

RESUMO

AIMS: When the Interagency Standing Committee (IASC) adopted the composite term mental health and psychosocial support (MHPSS) and published its guidelines for MHPSS in emergency settings in 2007, it aimed to build consensus and strengthen coordination among relevant humanitarian actors. The term MHPSS offered an inclusive tent by welcoming the different terminologies, explanatory models and intervention methods of diverse actors across several humanitarian sectors (e.g., health, protection, education, nutrition). Since its introduction, the term has become well-established within the global humanitarian system. However, it has also been critiqued for papering over substantive differences in the intervention priorities and conceptual frameworks that inform the wide range of interventions described as MHPSS. Our aims are to clarify those conceptual frameworks, to argue for their essential complementarity and to illustrate the perils of failing to adequately consider the causal models and theories of change that underlie our interventions. METHODS: We describe the historical backdrop against which the term MHPSS and the IASC guidelines were developed, as well as their impact on improving relations and coordination among different aid sectors. We consider the conceptual fuzziness in the field of MHPSS and the lack of clear articulation of the different conceptual frameworks that guide interventions. We describe the explanatory models and intervention approaches of two primary frameworks within MHPSS, which we label clinical and social-environmental. Using the examples of intimate partner violence and compromised parenting in humanitarian settings, we illustrate the complementarity of these two frameworks, as well as the challenges that can arise when either framework is inappropriately applied. RESULTS: Clinical interventions prioritise the role of intrapersonal variables, biological and/or psychological, as mediators of change in the treatment of distress. Social-environmental interventions emphasise the role of social determinants of distress and target factors in the social and material environments in order to lower distress and increase resilience in the face of adversity. Both approaches play a critical role in humanitarian settings; however, the rationale for adopting one or the other approach is commonly insufficiently articulated and should be based on a thorough assessment of causal processes at multiple levels of the social ecology. CONCLUSIONS: Greater attention to the 'why' of our intervention choices and more explicit articulation of the causal models and theories of change that underlie those decisions (i.e., the 'how'), may strengthen intervention effects and minimise the risk of applying the inappropriate framework and actions to a particular problem.


Assuntos
Altruísmo , Conflitos Armados , Saúde Mental , Sistemas de Apoio Psicossocial , Meio Social , Humanos , Refugiados
6.
Environ Health Prev Med ; 26(1): 3, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413099

RESUMO

BACKGROUND: Previous studies have suggested that screen time (ST) has a negative effect on children's emotional and behavioral health, but there are few longitudinal studies that have been conducted with infants and toddlers. This study sought to examine the effect of ST in early childhood on emotional and behavioral problems in children aged 4 years, based on a birth cohort study in China. METHODS: A total of 2492 children aged 4 years were enrolled in this study. The parents and guardians of each child completed a questionnaire that included items eliciting information on children's birth information, socio-demographic information at baseline, and ST at each follow-up. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ) at 4 years of age. Multivariate logistic analysis was used to explore the effects of ST on emotional and behavioral problems. RESULTS: The percentages of children with ST > 0 h/day at age 0.5 years, ST > 2 h/day at age 2.5 years, and ST > 2 h/day at age 4 years were 45.7, 55.5, and 34.5% respectively. The prevalence of emotional and behavioral problems was 10.8%. ST at 6 months was a risk factor for emotional symptoms and hyperactivity at the age of 4 years. ST at age 2.5 years was a risk factor for hyperactivity at the age of 4 years. However, ST at age 4 years was a risk factor for total difficulties, conduct problems, peer problems, hyperactivity, and prosocial behavior. CONCLUSIONS: Higher ST exposure at early childhood is associated with later emotional and behavioral problems. In particular, sustained high ST exposure is a risk factor for behavioral problems. These findings suggested the importance of controlling ST to prevent the occurrence of emotional and behavioral problems in the early years.


Assuntos
Altruísmo , Emoções , Comportamento Problema/psicologia , Agitação Psicomotora/epidemiologia , Tempo de Tela , Pré-Escolar , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Agitação Psicomotora/psicologia
7.
BMJ Glob Health ; 6(1)2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33408191

RESUMO

BACKGROUND: Many countries aiming to suppress SARS-CoV-2 recommend the use of face masks by the general public. The social meanings attached to masks may influence their use, but remain underinvestigated. METHODS: We systematically searched eight databases for studies containing qualitative data on public mask use during past epidemics, and used meta-ethnography to explore their social meanings. We compared key concepts within and across studies, then jointly wrote a critical synthesis. RESULTS: We found nine studies from China (n=5), Japan (n=1), Mexico (n=1), South Africa (n=1) and the USA (n=1). All studies describing routine mask use during epidemics were from East Asia. Participants identified masks as symbols of solidarity, civic responsibility and an allegiance to science. This effect was amplified by heightened risk perception (eg, during SARS in 2003), and by seeing masks on political leaders and in outdoor public spaces. Masks also acted as containment devices to manage threats to identity at personal and collective levels. In China and Japan, public and corporate campaigns framed routine mask use as individual responsibility for disease prevention in return for state- or corporate-sponsored healthcare access. In most studies, mask use waned as risk perception fell. In contexts where masks were mostly worn by patients with specific diseases (eg, for patients with tuberculosis in South Africa), or when trust in government was low (eg, during H1N1 in Mexico), participants described masks as stigmatising, uncomfortable or oppressive. CONCLUSION: Face masks can take on positive social meanings linked to solidarity and altruism during epidemics. Unfortunately, these positive meanings can fail to take hold when risk perception falls, rules are seen as complex or unfair, and trust in government is low. At such times, ensuring continued use is likely to require additional efforts to promote locally appropriate positive social meanings, simplifying rules for use and ensuring fair enforcement.


Assuntos
/etnologia , Máscaras , Altruísmo , Humanos , Pesquisa Qualitativa , Normas Sociais
8.
J Clin Ethics ; 32(1): 13-19, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33416515

RESUMO

Pandemic can prompt a variety of human motives, ranging from a desire for security to altruism. In our current perilous times, some patients have voiced a desire to help others. Such action can result in self-peril, and, as a result, their motives may be questioned. One health system now has a pandemic-based advance directive that queries patients about their value preferences regarding care that is directed toward others. Some object to this action because it may evoke patients to altruism. We examine both remote and recent examples of altruism, in which coercion could have played a major role. We next consider concerns based on aspects of the process of "inquiry versus evocation," slippery-slope claims, and inherent manipulation, and conclude that patients should be allowed to be asked about their preferences and values regarding altruism.


Assuntos
Altruísmo , Pandemias , Pacientes/psicologia , Coerção , Humanos , Motivação
9.
PLoS One ; 15(12): e0243796, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320873

RESUMO

OBJECTIVES: To examine the mediating effect of general self-efficacy on the relationship between the source of meaning in life (SML) and prosocial behaviours in vocational college nursing students. METHODS: Between March and June 2019, a cross-sectional descriptive study was conducted, and 799 nursing students from three vocational colleges completed the Source of Meaning in Life Scale, General Self-Efficacy Scale and Prosocial Behaviours Scale. Data were analyzed using structural equation modelling and statistical analysis by SPSS (version 23.0, IBM). RESULTS: The average SML, general self-efficacy and prosocial behaviours scores of the 799 nursing students were 6.43±0.83, 2.48±0.59 and 3.69±0.62, respectively. Correlation analysis showed that SML, general self-efficacy and prosocial behaviours were positively correlated (P<0.01). General self-efficacy partially mediated the relationship between SML and prosocial behaviours (P<0.01); this mediating effect contributed 22.97% of the total effect and explained 17.6% of the variance in the dependent variable. CONCLUSIONS: Educators should focus on cultivating nursing students' cognition and experience of meaning in life and their efficacy in life, study and work, which can improve students' "people-oriented" service and prosocial behaviour and the quality of nursing services.


Assuntos
Autoeficácia , Comportamento Social , Estudantes de Enfermagem/psicologia , Universidades/estatística & dados numéricos , Adolescente , Adulto , Altruísmo , Estudos Transversais , Feminino , Humanos , Masculino , Adulto Jovem
10.
Proc Biol Sci ; 287(1941): 20202250, 2020 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-33323079

RESUMO

Societies rely on individual contributions to sustain public goods that benefit the entire community. Several mechanisms, that specify how individuals change their decisions based on past experiences, have been proposed to explain how altruists are not outcompeted by selfish counterparts. A key aspect of such strategy updates involves a comparison of an individual's latest payoff with that of a random neighbour. In reality, both the economic and social milieu often shapes cooperative behaviour. We propose a new decision heuristic, where the propensity of an individual to cooperate depends on the local strategy environment in which she is embedded as well as her wealth relative to that of her neighbours. Our decision-making model allows cooperation to be sustained and also explains the results of recent experiments on social dilemmas in dynamic networks. Final cooperation levels depend only on the extent to which the strategy environment influences altruistic behaviour but are largely unaffected by network restructuring. However, the extent of wealth inequality in the community is affected by a subtle interplay between the environmental influence on a person's decision to contribute and the likelihood of reshaping social ties, with wealth-inequality levels rising with increasing likelihood of network restructuring in some situations.


Assuntos
Altruísmo , Comportamento Cooperativo , Modelos Teóricos , Teoria do Jogo , Características de Residência
12.
BMC Health Serv Res ; 20(1): 1031, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33176771

RESUMO

BACKGROUND: Extensive measures to reduce person-to-person transmission of COVID-19 are required to control the current outbreak. Special attention is directed at healthcare professionals as reducing the risk of infection in healthcare is essential. The purpose of this study was to explore healthcare professionals' experiences of awaiting a test result for a potential COVID-19 infection. METHODS: Qualitative interviews with 15 healthcare professionals were performed, underpinned by a phenomenological hermeneutical analytical framework. RESULTS: The participating healthcare professionals' experiences of awaiting a COVID-19 test result were found to be associated with a stoic and altruistic orientation towards their work. These healthcare professionals presented a strong professional identity overriding most concerns about their own health. The result of the coronavirus test was a decisive parameter for whether healthcare professionals could return to work. The healthcare professionals were aware that their family and friends were having a hard time knowing that the COVID-19 infection risk was part of their jobs. This concern did not, however, cause the healthcare professionals to falter in their belief that they were doing the right thing by focusing on their core area. The threat to own health ran through the minds of the healthcare professionals occasionally, which makes access to testing particularly important. CONCLUSION: The participating healthcare professionals had a strong professional identity. However, a discrepancy between an altruistic role as a healthcare professional and the expectations that come from the community was illuminated. A mental health coronavirus hotline for healthcare professionals is suggested.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Adulto , Altruísmo , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/psicologia , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Filosofia , Pesquisa Qualitativa , Adulto Jovem
13.
PLoS One ; 15(10): e0239747, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33052914

RESUMO

This study provides an exploration of the meanings of leisure for humanitarian migrants in regional Australia and these meanings' implications for health. It uses mixed-methods to explore leisure-time physical activity participation and day-to-day experiences of leisure and health. A sample representing approximately one third of the Coffs Coast adult humanitarian migrant population completed the survey, as well as 32 individuals who participated in interviews and focus groups. Findings were organised into three themes and explored issues around mental health and time for leisure, cultural differences in experiencing leisure, and the connections with experiences of other disadvantaged groups. We conclude by arguing that leisure needs to be brought to the fore of discussions around service provision and policy making concerned with the wellbeing of the refugee migrant population, particularly focusing on support for the (re)development of a vocabulary for recreation, as a step forward in the journey to healing and belonging.


Assuntos
Altruísmo , Exercício Físico/fisiologia , Atividades de Lazer/psicologia , Recreação/fisiologia , Recreação/psicologia , Adulto , Austrália , Feminino , Grupos Focais , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Refugiados/psicologia , Migrantes/psicologia , Vocabulário , Adulto Jovem
14.
Public Health ; 188: 51-53, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120232

RESUMO

OBJECTIVES: The purpose of this study is to show that social distancing is a public good under the COVID-19 pandemic. STUDY DESIGN: We apply economic theory to analyse a cross-sectional survey. METHODS: Economic theory is complemented with empirical evidence. An online survey of those aged 30-49 years in Japan (n = 2177) was conducted between April 28 and May 7. Respondents were selected by quota sampling with regard to age group, gender and prefecture of residence. Our main figure shows the proportion of people who increased/did not change/decreased social distancing, relative to the level of altruism and sensitivity to public shaming. The results of OLS and logit models are shown in Supplementary Materials. RESULTS: Social distancing is a public good under the COVID-19 pandemic for which the free-rider problem is particularly severe. Altruism and social norms are crucial factors in overcoming this problem. Using an original survey, we show that people with higher altruistic concerns and sensitivity to shaming are more likely to follow social distancing measures. CONCLUSIONS: Altruism and social norms are important for reducing the economic cost of the pandemic.


Assuntos
Altruísmo , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/economia , Pneumonia Viral/epidemiologia , Normas Sociais , Inquéritos e Questionários , Adulto Jovem
15.
PLoS One ; 15(10): e0240349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027308

RESUMO

Adolescence is a formative phase for social development. The COVID-19 pandemic and associated regulations have led to many changes in adolescents' lives, including limited opportunities for social interactions. The current exploratory study investigated the effect of the first weeks of COVID-19 pandemic lockdown on Dutch adolescents' (N = 53 with attrition, N = 36 without attrition) mood, empathy, and prosocial behavior. Longitudinal analyses comparing pre-pandemic measures to a three-week peri-pandemic daily diary study showed (i) decreases in empathic concern, opportunities for prosocial actions, and tension, (ii) stable levels of social value orientation, altruism, and dire prosociality, and (iii) increased levels of perspective-taking and vigor during the first weeks of lockdown. Second, this study investigated peri-pandemic effects of familiarity, need, and deservedness on giving behavior. To this end, we utilized novel hypothetical Dictator Games with ecologically valid targets associated with the COVID-19 pandemic. Adolescents showed higher levels of giving to a friend (a familiar other, about 51% of the total share), a doctor in a hospital (deserving target, 78%), and individuals with COVID-19 or a poor immune system (targets in need, 69 and 63%, respectively) compared to an unfamiliar peer (39%) This suggests that during the pandemic need and deservedness had a greater influence on adolescent giving than familiarity. Overall, this study demonstrates detrimental effects of the first weeks of lockdown on adolescents' empathic concern and opportunities for prosocial actions, which are important predictors of healthy socio-emotional development. However, adolescents also showed marked resilience and a willingness to benefit others as a result of the lockdown, as evidenced by improved perspective-taking and mood, and high sensitivity to need and deservedness in giving to others.


Assuntos
Comportamento do Adolescente/psicologia , Afeto , Altruísmo , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Empatia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adolescente , Criança , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Diários como Assunto , Feminino , Amigos , Humanos , Relações Interpessoais , Estudos Longitudinais , Masculino , Países Baixos/epidemiologia , Pandemias/prevenção & controle , Grupo Associado , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Quarentena/métodos , Adulto Jovem
16.
BMJ Glob Health ; 5(10)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33028701

RESUMO

In health outcomes terms, the poorest countries stand to lose the most from these disruptions. In this paper, we make the case for a rational approach to public sector health spending and decision making during and in the early recovery phase of the COVID-19 pandemic. Based on ethics and equity principles, it is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue to be resourced. We present a list of 120 essential non-COVID-19 health interventions that were adapted from the model health benefit packages developed by the Disease Control Priorities project.


Assuntos
Altruísmo , Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pandemias , Pneumonia Viral , Betacoronavirus , Países em Desenvolvimento , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Pobreza , Saúde Pública
19.
J Law Med ; 27(4): 914-927, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32880409

RESUMO

Draft legislation has been approved by the Union Cabinet in India seeking to limit surrogacy to altruistic arrangements with intended parents who are either Indian citizens or couples residing outside the country but of Indian origin. This follows longstanding debates as to whether commercial surrogacy should be permitted. The primary argument against such arrangements has been the potential to exploit and cause harm to surrogate women. There is considerable literature on the exploitation debate, but little has been written about whether these transactions cause harm to surrogate women. Our article addresses this gap in the literature and develops a three-step framework using Mill's harm principle through which to assess whether harm has occurred. We apply this framework to a sample of women who provided surrogacy services in India between 2006 and 2015, the period just before the government moved to ban overseas couples from accessing commercial surrogacy.


Assuntos
Altruísmo , Dissidências e Disputas , Feminino , Humanos , Índia , Mães Substitutas
20.
S Afr Med J ; 110(6): 450-452, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32880548

RESUMO

It is likely that the SARS-CoV-2 pandemic will affect a large part of the world's population and will last for several years. Many critical ethical issues have arisen in the healthcare context. While response from healthcare professionals to participating in the care of patients in the era of COVID-19 has generally been positive, there have also been disturbing experiences on the ground. The practice of medicine is a social contract with humanity. Challenges have arisen because the patient is both a victim and a vector of the coronavirus. All humans should have a natural instinct to care for those in need. Ethically and legally, healthcare professionals cannot be expected to assume a significant and unreasonable risk of harm. While fear is understandable, altruism and interest in serving the sick exemplify the value of solidarity. Social harms like stigmatisation and discrimination can occur. Concerns have been raised regarding protection of privacy and respect for rights of infected individuals. In the era of COVID-19, fear, misinformation and a detachment from one's calling put professionalism strongly to the test.


Assuntos
Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Pneumonia Viral/terapia , Altruísmo , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/ética , Pessoal de Saúde/ética , Humanos , Pandemias/ética , Pneumonia Viral/epidemiologia , Profissionalismo
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