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Wardrope A, Reuber M. Seizure disorders and climate change: Everyone's problem. Seizure 2023; 106:164-165. [PMID: 36963356 DOI: 10.1016/j.seizure.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Affiliation(s)
- Alistair Wardrope
- Academic Neurology Unit, University of Sheffield, United Kingdom; Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom.
| | - Markus Reuber
- Academic Neurology Unit, University of Sheffield, United Kingdom; Department of Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom
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van Gils-Schmidt HJ, Salloch S. Taking a moral holiday? Physicians' practical identities at the margins of professional ethics. JOURNAL OF MEDICAL ETHICS 2022:jme-2022-108500. [PMID: 36175125 DOI: 10.1136/jme-2022-108500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Physicians frequently encounter situations in which their professional practice is intermingled with moral affordances stemming from other domains of the physician's lifeworld, such as family and friends, or from general morality pertaining to all humans. This article offers a typology of moral conflicts 'at the margins of professionalism' as well as a new theoretical framework for dealing with them. We start out by arguing that established theories of professional ethics do not offer sufficient guidance in situations where professional ethics overlaps with moral duties of other origins. Therefore, we introduce the moral theory developed by Christine M. Korsgaard, that centres around the concept of practical identity. We show how Korsgaard's account offers a framework for interpreting different types of moral conflicts 'at the margins of professionalism' to provide either orientation for solving the conflict or an explanation for the emotional and moral burden involved in moral dilemmas.
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Affiliation(s)
| | - Sabine Salloch
- Institute of Ethics, History and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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Trevino A, Cardinal C, Douglas CC. Altered health knowledge and attitudes among health sciences students following media exposure. Nurs Health Sci 2020; 22:967-976. [PMID: 32623789 DOI: 10.1111/nhs.12754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/10/2020] [Accepted: 07/03/2020] [Indexed: 11/27/2022]
Abstract
Communications media that fails to present information supported by evidence-based practice has the potential to adversely influence knowledge and, ultimately, behaviors. We assessed the immediate effect of a health science documentary on knowledge, attitude, and beliefs among collegiate health sciences students enrolled in an entry-level nutrition course using surveys administered online. Participants (n = 160) completed the pre-survey, watched the documentary What the Health, and immediately completed the post-survey in one setting. Compared with pre-survey scores, participants reported a significant decrease in knowledge, change in attitude to health toward regulation of animal products, and increased agreement with all seven, pre-selected contradictory health claims presented in the documentary. Post-documentary, most participants reported they were planning to make a change in their dietary habits to reflect a plant-based diet. Documentaries providing health information contradictory to the current body of scientific literature are persuasive and can potentially increase negative health behaviors. Inclusion of practices within the health curriculum that encourage, and ultimately, improve health literacy among students before entering the health care workforce is essential.
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Affiliation(s)
- Amanda Trevino
- Sam Houston State University, College of Health Sciences, Family and Consumer Sciences, Huntsville, Texas, USA
| | - Christine Cardinal
- Sam Houston State University, College of Health Sciences, Population Health, Huntsville, Texas, USA
| | - Crystal C Douglas
- Sam Houston State University, College of Health Sciences, Family and Consumer Sciences, Huntsville, Texas, USA.,The University of Texas Medical Branch, School of Health Professions, Nutrition & Metabolism, Galveston, Texas, USA
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Abstract
The expansion of new forms of public media, including social media, exposes clinicians to more illness experiences/narratives than ever before and increases the range of ways to interact with the people depicted. Existing professional regulations and ethics codes offer very limited guidance for such situations. We discuss the ethics of responding to such scenarios through presenting three cases of clinicians encountering television or social media stories involving potential unmet healthcare needs. We offer a structured framework for health workers to think through their responses to such situations, based around four key questions for the clinician to deliberate upon: who is vulnerable to harm; what can be done; who is best placed to do it; and what could go wrong? We illustrate the application of this framework to our three cases.
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Affiliation(s)
| | - Markus Reuber
- University of Sheffield, Sheffield, UK
- Royal Hallamshire Hospital, Sheffield, UK
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Popkirov S, Nicholson TR, Bloem BR, Cock HR, Derry CP, Duncan R, Dworetzky BA, Edwards MJ, Espay AJ, Hallett M, Lang AE, Leach JP, Lehn A, McGonigal A, Morgante F, Perez DL, Reuber M, Richardson MP, Smith P, Stamelou M, Tijssen MAJ, Tinazzi M, Carson AJ, Stone J. Hiding in Plain Sight: Functional Neurological Disorders in the News. J Neuropsychiatry Clin Neurosci 2019; 31:361-367. [PMID: 31117907 PMCID: PMC7291360 DOI: 10.1176/appi.neuropsych.19010025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Functional movement and seizure disorders are still widely misunderstood and receive little public and academic attention. This is in stark contrast to their high prevalence and levels of associated disability. In an exploratory observational study, the authors examined whether the relative lack of media coverage of functional neurological disorders is in part due to misidentification in "human interest" news stories. METHODS Thirteen recent news stories from high-impact English-language media outlets that portrayed patients with complex symptoms either attributed to other diagnoses or presented as medical mysteries were identified using online keyword searches. All selected news stories contained video or still images displaying relevant symptoms. Cases were categorized into movement disorders or seizure disorders and were then independently assessed by 10 respective expert raters. For each category, one story of a patient whose symptoms were due to a well-recognized neurological disease was also included. Both the diagnostic category and the respective confidence level were reported by each rater for each case. The interrater agreement was calculated for each group of disorders. RESULTS The raters confirmed almost unanimously that all presented news stories except the negative control cases portrayed misidentified functional movement or seizure disorders. The interrater agreement and average diagnostic confidence were high. CONCLUSIONS Functional neurological disorders are often wrongly considered a rare medical curiosity of the past. However, these findings suggest that, while they are largely absent from public discourse, they often appear in the news incognito, hiding in plain sight.
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Affiliation(s)
- Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Timothy R. Nicholson
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
| | - Bastiaan R. Bloem
- Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition, and Behaviour, Nijmegen, the Netherlands
| | - Hannah R. Cock
- Institute of Medical and Biomedical Education, St. George’s University of London and Atkinson Morley Regional Neuroscience Centre, St. George’s University Hospitals NHS Foundation Trust, London
| | - Christopher P. Derry
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom
| | - Roderick Duncan
- Department of Neurology, University of Otago, Christchurch, New Zealand
| | - Barbara A. Dworetzky
- Department of Neurology, Edward B. Bromfield Epilepsy Program, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Mark J. Edwards
- Institute of Molecular and Clinical Sciences, St. George’s University of London
| | - Alberto J. Espay
- Department of Neurology, Gardner Family Center for Parkinson Disease and Movement Disorders, University of Cincinnati
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Md
| | - Anthony E. Lang
- Morton and Gloria Shulman Movement Disorders Clinic and Edmond J. Safra Program in Parkinson’s Disease, Toronto Western Hospital, Toronto
| | - John Paul Leach
- Queen Elizabeth University Hospital, University of Glasgow, Glasgow, United Kingdom
| | - Alexander Lehn
- Mater Centre for Neurosciences and School of Medicine, University of Queensland, Brisbane, Australia
| | - Aileen McGonigal
- Institut de Neurosciences des Systèmes, INSERM, Aix-Marseille Université, Marseille, France,Department of Clinical Neurophysiology, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Francesca Morgante
- Institute of Molecular and Clinical Sciences, St. George’s University of London,Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - David L. Perez
- Departments of Neurology and Psychiatry, Functional Neurology Research Group, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Markus Reuber
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, United Kingdom
| | - Mark P. Richardson
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London
| | - Philip Smith
- Department of Neurology, Alan Richens Epilepsy Unit, University Hospital of Wales, Cardiff, United Kingdom
| | - Maria Stamelou
- HYGEIA Hospital, Athens, Greece,Neurology Clinic, Philipps University Marburg, Marburg, Germany,University of Athens, Greece
| | - Marina A. J. Tijssen
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Michele Tinazzi
- Neurology Unit, Movement Disorders Division, University of Verona, Verona, Italy
| | - Alan J. Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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