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Orsini D, Bianucci R, Galassi FM, Lippi D, Martini M. Vaccine hesitancy, misinformation in the era of Covid-19: Lessons from the past. ETHICS, MEDICINE, AND PUBLIC HEALTH 2022; 24:100812. [PMID: 35721377 PMCID: PMC9189098 DOI: 10.1016/j.jemep.2022.100812] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/01/2022] [Indexed: 11/20/2022]
Abstract
Background As the world has challenged/argued with the Covid-19 pandemic over the last two years, there has been an increase in vaccine misinformation. Although immunity against Covid-19 infection is limited to 4-6 months and requires at least three doses of vaccine to be maximally effective, the current vaccination campaign in industrialized countries shows that vaccinated citizens experience greater immunological protection against severe forms of the disease than unvaccinated citizens. Methodology A perusal of the literature was performed in order to reconstruct the communication methods applied in the managing of the Covid-19 pandemic; the management of the current pandemic was compared with the management of another scourge of the past: poliomyelitis. Results/Discussion In order to raise public awareness on public health issues, it is essential that governments and institutions communicate scientific data to all sections of the population in an unambiguous way. In this sense, it is essential to apply "prebunking", which is a layered defense system available to society that prevents misinformation before it is spread. This is to avoid the subsequent debunking of false information, which generates insecurity and fuels fears. Belief in medical misinformation represents a meaningful problem for public health efforts to fight Covid-19 through vaccination. Conclusion/Perspectives In this sense an example of proper management of one of the many epidemics of the recent past, poliomyelitis, should make us reflect on the effectiveness of past approaches. This testimony from the past can provide us with food for thought regarding how to face the present Covid-19 pandemic and to prepare for the future. Certainly, it shows us how the awful pandemics/epidemics from the past was handled and finally overcome, despite perceived risk and vaccine hesitancy.
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Affiliation(s)
- D Orsini
- University Museum System of Siena (SIMUS), History of Medicine, University of Siena, Siena, Italy
| | - R Bianucci
- Department of Cultures and Societies, University of Palermo, Palermo, Italy
- The Ronin Institute, Montclair, New Jersey, USA
| | - F M Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia
| | - D Lippi
- Department of Experimental and Clinical Medicine, School of Sciences of Human Health, University of Florence, 50134 Florence, Italy
| | - M Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Bhattarai S, Adhikari A, Rayamajhee B, Dhungana J, Singh M, Koirala S, Shakya DR. Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal. Front Public Health 2022; 10:873881. [PMID: 35832276 PMCID: PMC9272001 DOI: 10.3389/fpubh.2022.873881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.
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Affiliation(s)
- Suraj Bhattarai
- Department of Global Health, Global Institute for Interdisciplinary Studies (GIIS), Kathmandu, Nepal
| | - Anurag Adhikari
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Binod Rayamajhee
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia
| | - Jaya Dhungana
- Department of Global Health, Global Institute for Interdisciplinary Studies (GIIS), Kathmandu, Nepal
| | - Minu Singh
- Department of Infection and Immunology, Kathmandu Research Institute for Biological Sciences (KRIBS), Lalitpur, Nepal
| | - Sarun Koirala
- Department of Anatomy, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
- Nepali Unit of International Chair in Bioethics, Dharan, Nepal
| | - Dhana Ratna Shakya
- Nepali Unit of International Chair in Bioethics, Dharan, Nepal
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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Lippi D, Varotto E, Boccalini S, Bechini A, Galassi FM. In Search of a Lost Father: Adrien Proust (1834–1903), An Almost Forgotten Public Health Pioneer. Vaccines (Basel) 2022; 10:vaccines10050644. [PMID: 35632400 PMCID: PMC9146741 DOI: 10.3390/vaccines10050644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: In this communication, we wish to remember the important historical role played by Marcel Proust’s father, the now mostly forgotten Achille-Adrien Proust (1834–1903). Study Design and Methods: His career, scientific interests and, above all, his brilliant intuitions and suggestions in the fight against cholera in the 19th century are recalled. Results and Conclusions: His role in the promotion of a globally effective vision of public hygiene and health is stressed as a bright example for modern physicians fighting contemporary epidemics.
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Affiliation(s)
- Donatella Lippi
- Department of Experimental and Clinical Medicine, School of Sciences of Human Health, University of Florence, 50134 Florence, Italy;
| | - Elena Varotto
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide 5001, Australia; (E.V.); (F.M.G.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy;
| | - Angela Bechini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy;
- Correspondence:
| | - Francesco Maria Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide 5001, Australia; (E.V.); (F.M.G.)
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Lippi D, Varotto E, Donell S, Galassi FM. Dino Buzzati's 50th death anniversary: an appraisal of medicine and infectivology's influence on his literary production. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022261. [PMID: 36300223 PMCID: PMC9686148 DOI: 10.23750/abm.v93i5.13340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/20/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIM This paper, in the 50th anniversary of the author's death, examines the overall impact and influence of medicine, in particular of infectious diseases, on the literary production of Italian writer and novelist Dino Buzzati (1906-1972). METHODS Analysis of literary sources and historical study. RESULTS AND CONCLUSIONS Buzzati's literary world is great fun for the reader, being both intriguing and anxiety forming at the same time. One finishes reading his books only to discover the one truth which overturns everything that seemed to be true. In particular, in his short stories, which stem mostly from episodes taken from everyday life, the plot suddenly comes to life. The atmosphere becomes surreal, and in a moment the incredible happens. Behind the apparent lightness of the fairytale narrative there lies hidden the important issues addressed by the author. He uses the hospital as a metaphor for a categorised life, in which we are at risk of no longer being masters of ourselves, in which we suffer a continuous steady drip that makes us head downwards day after day, floor after floor. We will come back up, but not today, tomorrow perhaps, or at the latest, the day after tomorrow. Corte on the second floor hopes, and screams to give strength to his hope, that he will soon return to the top, towards the seventh floor.
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Affiliation(s)
- Donatella Lippi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Elena Varotto
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia
| | - Simon Donell
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Francesco M. Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia
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Daher-Nashif S. Doctors' Challenges During Infectious Disease Outbreaks: Medical Education Insights from Realistic Fiction Movies. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:265-272. [PMID: 33776502 PMCID: PMC7987262 DOI: 10.2147/amep.s297427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Movies have a strong influence on public perceptions due to their popularity and accessibility. Hence, movies on healthcare providers in general and medical doctors in particular can affect public opinions, expectations, and attitudes toward these professions. AIM This paper aims to present how realistic fiction movies reflect doctors' roles and challenges during infectious disease outbreaks and describe how some of this content can be used in medical education settings. METHODS Two sources were used to select the movies for inclusion in the study. First, the IMDB.com movie database was searched using the words "virus," "pandemic," "endemic," "epidemic," "outbreak," and "infectious disease." Second, Google was used to search the terms "movies on pandemics," "movies on epidemics," "movies on outbreaks," "movies on endemics," "movies on virus," and "movies on infectious diseases." Inclusion criteria were English language movies, realistic fiction movies, doctors as main actors, and a movie focus on community experiences. Exclusion criteria were non-English movies, zombie and apocalypse movies, doctors in secondary roles, and movies about individual experiences. RESULTS Eight movies met the inclusion criteria. Content analysis was conducted on all movies, and the main categories identified were doctors' roles, doctors' vulnerability, potential biases, potential conflicts, female doctors' power, and doctors bringing salvation. CONCLUSION Realistic movies on infectious disease outbreaks can be excellent tools for teaching medical students about doctors' roles and challenges when fighting an outbreak.
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Affiliation(s)
- Suhad Daher-Nashif
- Population Medicine Department, College of Medicine, QU-Health, Qatar University, Doha, 2713, Qatar
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Death Comes Calling: When the Physician Becomes the Patient. Ann Surg 2021; 273:e44-e45. [PMID: 33214460 DOI: 10.1097/sla.0000000000004618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hu X, Liu S, Wang B, Xiong H, Wang P. Management practices of emergency departments in general hospitals based on blockage of chain of infection during a COVID-19 epidemic. Intern Emerg Med 2020; 15:1545-1552. [PMID: 32948990 PMCID: PMC7500495 DOI: 10.1007/s11739-020-02499-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/05/2020] [Indexed: 10/29/2022]
Abstract
In a Coronavirus disease 2019 (COVID-19) epidemic, management of the emergency department is a difficult task in terms of prevention and control of the disease in general hospitals. On top of meeting urgent needs of patients for medical treatment, the emergency department also has to devote resources into investigation and prevention of COVID-19. At the beginning of the epidemic, with the strategy to intercept the chain of infection, Peking University First Hospital (PKUFH) focused on three important aspects: controlling the source of infection, cutting off the route of transmission, and protecting vulnerable populations, to expeditiously draft scientific and proper management measures for the emergency department, followed by real-time dynamic adjustments based on the development trend of the epidemic. These measures effectively ensured a smooth, orderly and safe operation of the emergency department. As of the writing of this manuscript, there has been no active COVID-19 infection in patients and medical staff in the emergency department, and no infection in patients admitted to PKUFH through the emergency department. This study describes the prevention and control measures in the emergency department of PKUFH during the outbreak of COVID-19, aiming to provide some reference for domestic and international medical institutions.
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Affiliation(s)
- Xiaojing Hu
- grid.411472.50000 0004 1764 1621Medical Affairs Department, Peking University First Hospital, Beijing, China
| | - Si Liu
- grid.411472.50000 0004 1764 1621Medical Affairs Department, Peking University First Hospital, Beijing, China
| | - Bo Wang
- grid.411472.50000 0004 1764 1621Emergency Department, Peking University First Hospital, Beijing, China
| | - Hui Xiong
- grid.411472.50000 0004 1764 1621Emergency Department, Peking University First Hospital, Beijing, China
| | - Ping Wang
- grid.411472.50000 0004 1764 1621Medical Affairs Department, Peking University First Hospital, Beijing, China
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Polosa R, Spinicci M, Prisco D. "COVID-19: diagnosis, management and prognosis": a new topical collection of Internal and Emergency Medicine. Intern Emerg Med 2020; 15:747-750. [PMID: 32734430 PMCID: PMC7391015 DOI: 10.1007/s11739-020-02461-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Riccardo Polosa
- Dipartimento Di Medicina Clinica E Sperimentale (MEDCLIN), University of Catania, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
| | - Michele Spinicci
- Dipartimento Di Medicina Sperimentale E Clinica (DMSC), Università Di Firenze, Florence, Italy
- SOD Malattie Infettive E Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Domenico Prisco
- Dipartimento Di Medicina Sperimentale E Clinica (DMSC), Università Di Firenze, Florence, Italy
- SOD Medicina Interna Interdisciplinare, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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