ObjectiveTo investigate the effects of cell phone dependence on mental health among undergraduates during the COVID-19 pandemic and further identify the determinants that may affect their mental health in China.MethodsThe data were collected from 602 students at a medical school in Shanghai via an online survey conducted from December 2021 to February 2022. The Mobile Phone Addiction Index and Depression Anxiety Stress Scale were applied to evaluate CPD and mental health, respectively. Independent sample t-test and one-way analysis of variance (...) were employed to compare the means of continuous variables among categorical groups. Correlations between continuous variables were detected using Pearson's correlation analysis. Univariable and multivariable logistic regressions were employed to identify the determinants of mental health.ResultsAmong the 402 eligible students, 73.88% were women with an average age of 20.19 ± 2.36 years. On average, the DASS score was 32.20 ± 11.07, the CPD score was 36.23 ± 11.89, and the cell phone use duration was 7.67 ± 3.61 h/day. CPD was found to have a negative effect on mental health among college students in Shanghai. Additionally, cell phone use duration, age, being senior students, faculty-student relationship, insomnia, tobacco use, obesity, and life satisfaction were clarified as contributing factors to mental health among college students.ConclusionHigh degree of CPD could have a negative effect on college students' mental health, which might lead to some psychological problems. Appropriate actions and effective interventions are highly needed to prevent severe psychological injuries among college students in China. (shrink)

Background: Only data of published study results are available to the scientific community for further use such as informing future research and synthesis of available evidence. If study results are reported selectively, reporting bias and distortion of summarised estimates of effect or harm of treatments can occur. The publication and citation of results of clinical research conducted in Germany was studied.Methods: The protocols of clinical research projects submitted to the research ethics committee of the University of Freiburg in 2000 were (...) analysed. Published full articles in several databases were searched and investigators contacted. Data on study and publication characteristics were extracted from protocols and corresponding publications.Results: 299 study protocols were included. The most frequent study design was randomised controlled trial , followed by uncontrolled studies , laboratory studies and non-randomised studies . 182 were multicentre studies including 97 international collaborations. 152 of 299 had commercial funding and 46 non-commercial funding. 109 of the 225 completed protocols corresponded to at least one full publication ; the publication rate was 48%. 168 of 210 identified publications were cited in articles indexed in the ISI Web of Science. The median was 11 citations per publication .Conclusions: Results of German clinical research projects conducted are largely underreported. Barriers to successful publication need to be identified and appropriate measures taken. Close monitoring of projects until publication and adequate support provided to investigators may help remedy the prevailing underreporting of research. (shrink)

BackgroundSocial networking sites (SNSs) have penetrated all aspects of health care professionals’ (HCPs’) professional and private lives. A new term, e-professionalism, has emerged, which describes the linking of traditional values with this new dynamic online environment for HCPs. The four aims of this study were: (1) to examine their SNS prevalence and usage habits, (2) to examine their perception of e-professionalism, (3) to develop an e-professionalism assessment compatibility index and (4) to investigate their tendencies and differences in values of (...) the e-professionalism assessment compatibility index (ePACI).MethodsA cross-sectional study was conducted among MDs and DMDs in Croatia via email using a questionnaire. The questionnaire was distributed to all MDs and DMDs who were members of their respective chambers. In addition to descriptive statistics, Chi-square or Fisher’s exact test when appropriate, t-test, ANOVA and Mann–Whitney U tests were used to determine differences between groups. A principal component analysis (PCA) with varimax rotation was used to investigate dimensionality. Results of the PCA were compared to the coding based on the Social Media e-Professionalism rubric in order to create the ePACI.ResultsOf the 1013 gathered responses, 753 were from valid SNS users and suitable for further analysis. Facebook (91.6%) and Instagram (63.1%) were the predominant SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly in the “conservative” direction in the cases of both, MDs (t506 = 19.033, p < 0.001) and DMDs (t245 = 12.991, p < 0.001). HCPs who are older (r = 0.308, p < 0.001), who have fewer SNS profiles (rs = −0.142, p < 0.001), and who access their profiles less frequently (r = −0.166, p < 0.001) have statistically significantly more conservative ePACI values.ConclusionsMDs and DMDs in Croatia are frequent SNS users, with Facebook and Instagram being the main SNSs used. Both groups have a good understanding of e-professionalism. The newly developed ePACI deviates slightly towards the conservative side regarding perception of the e-professionalism content for both groups. The development of the ePACI, and its subsequent usage in further research, will have a direct influence in its validation, gathering comparable data, and be able to direct efforts in oversight, regulation and education. (shrink)

These essays, first presented at a conference, “Coping with Sickness,” held in Italy in 1997, address ethical and regulatory medical issues within a historical context. Many of the essays, while addressing interesting topics, combine policy analysis and critical cultural theory. Critical cultural theory can be intellectually engaging at times but is generally irrelevant to public officials concerned with specific policy issues.Coping with Sickness is the third and final volume derived from a series of conferences cosponsored by the European Science Foundation (...) and the Euroconferences Activity of the European Union. The eight essays are organized chronologically and cover a range of disparate topics: medical practitioners and the Spanish Inquisition , the history of autopsy legislation in German since 1800 , the history of “sadism” as a medical term in the nineteenth century , folk medicine in Holland in the late nineteenth century , abortion in Weimar Germany , drug testing in Africa in the early twentieth century , comparative policies toward STDs , and the debate over brain death in Germany . As might be expected in an anthology of this sort, the quality varies considerably. Nonetheless, the subjects addressed in this volume are engaging—much to the credit of the editors.Two pieces in particular represent the range of these collected essays. In “Vacher the Ripper and the Construction of the Nineteenth‐Century Sadist,” Angus McLaren, one of the best historians writing on the history of sexuality today, explores the “discovery” of sadism in the late nineteenth century by focusing on the dramatic trial of Joseph Vacher, who was charged in 1895 for the brutal sexual murder of a woman in Champuis. He later confessed to the murder and the sexual violation of another seven females and four males. Vacher had a long history of mental illness; indeed, he had been institutionalized in July 1893 following a failed attempt at suicide that left a bullet lodged in his head. At the trial the criminologist Alexandre Lacassagne was brought in as an expert witness to testify that Vacher was not insane but an antisocial sadist, as revealed by his dabbling in anarchism, vagabondism, and homosexuality. As a consequence, Vacher was found guilty and given a death sentence.McLaren finds in this trial an example of the social construction of a new medical concept, “sadism.” The emergence of the concept of sadism, he argues, reflected a “gendered notion” of defining appropriate male and female behavior; physicians at the turn of the century believed that “civilized men were most threatened, not by excess passion, but by the enervation spawned by urban life” . The concept of sadism was also employed by doctors to enhance their own authority and to alert the public to the dangers of a male manifesting “feminine traits” and to “beat back” homosexuality.There is much interesting conjecture to McLaren's study, but what policy lessons should be drawn from this remains unclear. If every concept is actually a social construction, reflecting the social anxieties of the age, then is the fashionable concept of social construction itself socially constructed to enhance the authority of the medical historian?More interesting methodologically is Claudia Wiesemann's absorbing essay on the historical debate in Germany over “brain death.” Relying on Ulrich Beck's social theory of simple and reflexive modernization, she shows that, when confronted with complex scientific questions, the public has to decide between competing plausible scientific claims; as a result, political groups make use of scientific expertise and counterexpertise to push their favorite practical and legal solutions. (shrink)

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two (...) historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

This essay reconsiders Paul Ramsey’s “medical indications” policy and argues that his reconstruction of the case of Joseph Saikewicz demonstrates that there is more room for caretakers to decline treatments for “voiceless dependents” than his interlocutors have sometimes thought. It furthermore draws on Ramsey’s earlier work to propose ways that Ramsey might have improved his policy, and argues that the shortcomings of Ramsey’s view arise from his bracketing of age in making determinations about what form of medical care is owed. (...) The reading of Ramsey set forth here suggests Cathleen Kaveny’s depiction of the ‘medical indications’ policy in Ethics at the Edges of Law is too rigid and inflexible, even while it affirms other aspects of her critique. (shrink)

Baker and McCullough (2007) criticize a 1979 article by this author for insufficiently appreciating how physicians have appropriated ideas from moral philosophy. This rejoinder argues that the two articles are complementary. The 1979 article summarized evidence that leading physicians in the nineteenth and twentieth centuries appropriated ideas from moral philosophy and related disciplines that reinforced their political goals of self-regulation and dominance of the allocation of resources for health. In retrospect the 1979 article also urged bioethicists to appropriate ideas from (...) other disciplines, including moral philosophy, which would contribute to improving the health of populations. (shrink)

The dilemma of incapacitated patients with acute medical problems who want or try to leave the hospital is a common problem in American clinical ethics. One need only listen to clinicians who work...

This essay illustrates what the Chinese family-based and harmony-oriented model of medical decision making is like as well as how it differs from the modern Western individual-based and autonomy-oriented model in health care practice. The essay discloses the roots of the Chinese model in the Confucian account of the family and the Confucian view of harmony. By responding to a series of questions posed to the Chinese model by modern Western scholars in terms of the basic individualist concerns and values (...) embedded in the modern Western model, we conclude that the Chinese people have justifiable reasons to continue to apply the Chinese model to their contemporary health care and medical practice. (shrink)

Abortion has been legal in the United States since the Supreme Court's landmark 1973 ruling in Jane Roe, et al. v. Henry Wade, District Attorney of Dallas County. Over the past forty years, however, access to abortion has diminished as states have devised creative ways to regulate and restrict the abortion procedure. In the first half of 2011, state legislators introduced a record number of antiabortion bills. In 19 states alone, 80 laws ranging from mandatory counseling and waiting periods to (...) gestational laws and bans on insurance coverage were passed, a legislative testimony to the incremental successes of the antiabortion campaign. Since 2011, the rapid increase in restrictive... (shrink)

Medical errors are all too common. Ever since a report issued by the Institute of Medicine raised awareness of this unfortunate reality, an emerging theme has gained prominence in the literature on medical error. Fears of blame and punishment, it is often claimed, allow errors to remain undisclosed. Accordingly, modern healthcare must shift away from blame towards a culture of safety in order to effectively reduce the occurrence of error. Against this shift, I argue that it would serve the medical (...) community well to retain notions of individual responsibility and blame in healthcare settings. In particular, expressions of moral emotions—such as guilt, regret and remorse—appear to play an important role in the process of disclosing harmful errors to patients and families. While such self-blaming responses can have negative psychological effects on the individual practitioner, those who take the blame are in the best position to offer apologies and show that mistakes are being taken seriously, thereby allowing harmed patients and families to move forward in the wake of medical error. (shrink)

This paper explores how organizational members use documents to share their knowledge within and across work settings. I suggest that organizational studies of distributed knowledge sharing and information systems would greatly benefit from the linguistic analysis of communicative practices. Specifically, the paper highlights the notion of indexical centering as formulated by the linguistic anthropologist William Hanks and demonstrates its analytical power in studying documenting as a communicative practice. Drawing on a 15-month, multi-sited ethnographic study in several pediatric healthcare settings, the (...) paper focuses on how two doctors compose and use two medical histories found in two distinct medical information systems. The analysis suggests that the doctors use documents to index the temporal, spatial, and participatory dimensions of their knowledge sharing. They do so by indexing, on the one hand, the participants, times and places for their communicative practices and, on the other hand, the participants, times and places of their general care practices. The indexical analysis allows us to perceive documents, as more than mere vessels for knowledge transfer among organizational members, but as an integrated part of how people structure their work practices and situate their knowledge sharing in complex distributed organizational settings. (shrink)

This paper examines the deployment of science studies within the field of medical ethics. For a short time, the discourse of medical ethics became a fertile ground for a dialogue between philosophically minded bioethicists and the philosophers of science who responded to Thomas Kuhn's challenge. In their discussion of the validity of Kuhn's work, these bioethicists suggested a distinct interpretation of Kuhn, emphasizing the elements in his account that had been independently developed by Michael Polanyi, and propelling a view of (...) science that retreated from idealizations of scientific method without sacrificing philosophical realism. Appropriating Polanyi, they extended his account of science to biology and medicine. The contribution of Karl Popper to the debate on the applicability of philosophy of science to the issues of medical ethics provides the opportunity to discuss the ways in which political agendas of different epistemologies of science intertwined with questions of concern to medical ethics. (shrink)

Is it ethical to perform a surgery whose purpose is to make a male look like a female or a female to appear male? Is it medically appropriate? Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. (1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, “first, do no harm.” (2) Candidates for SRS may believe (...) that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion. SRS, therefore, is a “category mistake”—it offers a surgical solution for psychological problems such as a failure to accept the goodness of one’s masculinity or femininity, lack of secure attachment relationships in childhood with same-sex peers or a parent, self-rejection, untreated gender identity disorder, addiction to masturbation and fantasy, poor body image, excessive anger, and severe psychopathology in a parent. (3) SRS does not accomplish what it claims to accomplish. It does not change a person’s sex; therefore, it provides no true benefit. (4) SRS is a “permanent,” effectively unchangeable, and often unsatisfying surgical attempt to change what may be only a temporary (i.e., psychotherapeutically changeable) psychological/psychiatric condition. National Catholic Bioethics Quarterly 9.1 (Spring2009): 97–125. (shrink)

ObjectiveTo explore the relations among perceived stress, fatigue, sleepiness, and the pathway of their effects on the ambulatory arterial stiffness index among medical staff.MethodsThis cross-sectional study was conducted at a tertiary hospital in Wuhan, China. Perceived stress, fatigue, and sleepiness were measured using the perceived stress scale, Fatigue assessment scale, and Epworth Sleepiness Scale, respectively. AASI was obtained from 24-h ambulatory blood pressure monitoring. Path analysis was used to clarify the relations among the PSS, FAS, and ESS scores, and (...) their relations to AASI values.ResultsA total of 153 participants were included herein. The PSS and FAS correlated with the ESS, and the PSS correlated with the FAS. In addition, the ESS correlated with the AASI. According to the path analysis results, the PSS and FAS had no direct effect on the AASI, but did have an indirect effect on this index by influencing the ESS.ConclusionSleepiness was a mediator of the effects of perceived stress and fatigue on AASI. (shrink)

I argue that not all context dependent expressions are alike. Pure (or ordinary) indexicals behave more or less as Kaplan thought. But quasi indexicals behave in some ways like indexicals and in other ways not like indexicals. A quasi indexical sentence φ allows for cases in which one party utters φ and the other its negation, and neither party’s claim has to be false. In this sense, quasi indexicals are like pure indexicals (think: “I am a doctor”/“I am not a (...) doctor” as uttered by different individuals). In such cases involving a pure indexical sentence, it is not appropriate for the two parties to reject each other’s claims by saying, “No.” However, in such cases involving a quasi indexical sentence, it is appropriate for the par- ties to reject each other’s claims. In this sense, quasi indexicals are not like pure indexicals. Drawing on experimental evidence, I argue that gradable adjectives like “rich” are quasi indexicals in this sense. e existence of quasi indexicals raises trouble for many existing theories of context dependence, including standard contextualist and relativist theories. I propose an alternative semantic and pragmatic theory of quasi indexicals, negotiated contextualism, that combines insights from Kaplan 1989 and Lewis 1979. On my theory, rejection is licensed with quasi indexicals (even when neither of the claims involved has to be false) because the two utterances involve conflicting proposals about how to update the conversational score. I also adduce evidence that conflicting truth value assessments of a single quasi indexical utterance exhibit the same behavior. I argue that negotiated contextualism can account for this puzzling property of quasi indexicals as well. (shrink)

Eighteenth-century Epicureanism is often viewed as radical, anti-religious, and politically dangerous. But to what extent does this simplify the ancient philosophy and underestimate its significance to the Enlightenment? Through a pan-European analysis of Enlightenment centres from Scotland to Russia via the Netherlands, France and Germany, contributors argue that elements of classical Epicureanism were appropriated by radical and conservative writers alike. They move beyond literature and political theory to examine the application of Epicurean ideas in domains as diverse as physics, natural (...) law, and the philosophy of language, drawing on the work of both major figures (Diderot, Helvétius, Smith and Hume) and of lesser-known but important thinkers (Johann Jacob Schmauss and Dmitrii Anichkov). -/- Table of Contents -/- Neven Leddy and Avi S. Lifschitz, Epicurus in the Enlightenment: an introduction -/- Elodie Argaud, Bayle’s defence of Epicurus: the use and abuse of Malebranche’s Méditations chrétiennes -/- Hans W. Blom, The Epicurean motif in Dutch notions of sociability in the seventeenth century -/- Thomas Ahnert, Epicureanism and the transformation of natural law in the early German Enlightenment -/- Charles T. Wolfe, A happiness fit for organic bodies: La Mettrie’s medical Epicureanism -/- Natania Meeker, Sexing Epicurean materialism in Diderot -/- Pierre Force, Helvétius as an Epicurean political theorist -/- Andrew Kahn, Epicureanism in the Russian Enlightenment: Dmitrii Anichkov and atomic theory -/- Matthew Niblett, Man, morals and matter: Epicurus and materialist thought in England from John Toland to Joseph Priestley -/- James A. Harris, The Epicurean in Hume -/- Neven Leddy, Adam Smith’s critique of Enlightenment Epicureanism -/- Avi S. Lifschitz, The Enlightenment revival of the Epicurean history of language and civilisation -/- Bibliography -/- Index. (shrink)