Monitieteisi�� n��k��aloja itsemurhaan

Kirjallisuusarvostelu

The stigma and prejudice of leprosy: influence on the human condition

INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

A few philosophical ruminations on the human condition and choosing to live well

The notion that life is meaningful through choosing to live well has historically received substantive attention in various philosophical circles, notably the ancient Greek philosophers Socrates, Plato, and Aristotle, and more recently several of the existentialists. In some respects, the idea of choosing to live well is a ���thematization��� of two widely-recognized, independent components of a meaningful life: happiness and authenticity. I develop this notion of choosing to live well by exploring, developing, and relating these conceptions of happiness and authenticity. By appealing to a very basic account of human nature that has found favor among a great number of people, I show how happiness and authenticity complement each other as conditions for the possibility of living meaningfully.

The stigma and prejudice of leprosy: influence on the human condition

Introduction: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. Methods: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiaba, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. Results: The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. Conclusions: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

Development of a co-culture model of the human lungs for toxicity testing and identification of biomarkers of inhalation toxicity

The airway epithelium is the first point of contact in the lung for inhaled material, including infectious pathogens and particulate matter, and protects against toxicity from these substances by trapping and clearance via the mucociliary escalator, presence of a protective barrier with tight junctions and initiation of a local inflammatory response. The inflammatory response involves recruitment of phagocytic cells to neutralise and remove and invading materials and is oftern modelled using rodents. However, development of valid in vitro airway epithelial models is of great importance due to the restrictions on animal studies for cosmetic compound testing implicit in the 7th amendment to the European Union Cosmetics Directive. Further, rodent innate immune responses have fundamental differences to human. Pulmonary endothelial cells and leukocytes are also involved in the innate response initiated during pulmonary inflammation. Co-culture models of the airways, in particular where epithelial cells are cultured at air liquid interface with the presence of tight junctions and differentiated mucociliary cells, offer a solution to this problem. Ideally validated models will allow for detection of early biomarkers of response to exposure and investigation into inflammatory response during exposure. This thesis describes the approaches taken towards developing an in vitro epithelial/endothelial cell model of the human airways and identification biomarkers of response to exposure to xenobiotics. The model comprised normal human primary microvascular endothelial cells and the bronchial epithelial cell line BEAS-2B or normal human bronchial epithelial cells. BEAS-2B were chosen as their characterisation at air liquid interface is limited but they are robust in culture, thereby predicted to provide a more reliable test system. Proteomics analysis was undertaken on challenged cells to investigate biomarkers of exposure. BEAS-2B morphology was characterised at air liquid interface compared with normal human bronchial epithelial cells. The results indicate that BEAS-2B cells at an air liquid interface form tight junctions as shown by expression of the tight junction protein zonula occludens-1. To this author���s knowledge this is the first time this result has been reported. The inflammatory response of BEAS-2B (measured as secretion of the inflammatory mediators interleukin-8 and -6) air liquid interface mono-cultures to Escherichia coli lipopolysaccharide or particulate matter (fine and ultrafine titanium dioxide) was comparable to published data for epithelial cells. Cells were also exposed to polymers of ���commercial interest��� which were in the nanoparticle range (and referred to particles hereafter). BEAS-2B mono-cultures showed an increased secretion of inflammatory mediators after challenge. Inclusion of microvascular endothelial cells resulted in protection against LPS- and particle- induced epithelial toxicity, measured as cell viability and inflammatory response, indicating the importance of co-cultures for investigations into toxicity. Two-dimensional proteomic analysis of lysates from particle-challenged cells failed to identify biomarkers of toxicity due to assay interference and experimental variability. Separately, decreased plasma concentrations of serine protease inhibitors, and the negative acute phase proteins transthyretin, histidine-rich glycoprotein and alpha2-HS glycoprotein were identified as potential biomarkers of methyl methacrylate/ethyl methacrylate/butylacrylate treatment in rats.

Medical treatment and the good death: an ethical analysis of euthanasia, physician assisted suicide, and the right to die

Frequent advances in medical technologies have brought fonh many innovative treatments that allow medical teams to treal many patients with grave illness and serious trauma who would have died only a few years earlier. These changes have given some patients a second chance at life, but for others. these new treatments have merely prolonged their dying. Instead of dying relatively painlessly, these unfortunate patients often suffer from painful tenninal illnesses or exist in a comatose state that robs them of their dignity, since they cannot survive without advanced and often dehumanizing forms of treatment. Due to many of these concerns, euthanasia has become a central issue in medical ethics. Additionally, the debate is impacted by those who believe that patients have the right make choices about the method and timing of their deaths. Euthanasia is defined as a deliberate act by a physician to hasten the death of a patient, whether through active methods such as an injection of morphine, or through the withdrawal of advanced forms of medical care, for reasons of mercy because of a medical condition that they have. This study explores the question of whether euthanasia is an ethical practice and, as determined by ethical theories and professional codes of ethics, whether the physician is allowed to provide the means to give the patient a path to a "good death," rather than one filled with physical and mental suffering. The paper also asks if there is a relevant moral difference between the active and passive forms of euthanasia and seeks to define requirements to ensure fully voluntary decision making through an evaluation of the factors necessary to produce fully informed consent. Additionally, the proper treatments for patients who suffer from painful terminal illnesses, those who exist in persistent vegetative states and infants born with many diverse medical problems are examined. The ultimate conclusions that are reached in the paper are that euthanasia is an ethical practice in certain specific circumstances for patients who have a very low quality of life due to pain, illness or serious mental deficits as a result of irreversible coma, persistent vegetative state or end-stage clinical dementia. This is defended by the fact that the rights of the patient to determine his or her own fate and to autonomously decide the way that he or she dies are paramount to all other factors in decisions of life and death. There are also circumstances where decisions can be made by health care teams in conjunction with the family to hasten the deaths of incompetent patients when continued existence is clearly not in their best interest, as is the case of infants who are born with serious physical anomalies, who are either 'born dying' or have no prospect for a life that is of a reasonable quality. I have rejected the distinction between active and passive methods of euthanasia and have instead chosen to focus on the intentions of the treating physician and the voluntary nature of the patient's request. When applied in equivalent circumstances, active and passive methods of euthanasia produce the same effects, and if the choice to hasten the death of the patient is ethical, then the use of either method can be accepted. The use of active methods of euthanasia and active forms of withdrawal of life support, such as the removal of a respirator are both conscious decisions to end the life of the patient and both bring death within a short period of time. It is false to maintain a distinction that believes that one is active killing. whereas the other form only allows nature to take it's course. Both are conscious choices to hasten the patient's death and should be evaluated as such. Additionally, through an examination of the Hippocratic Oath, and statements made by the American Medical Association and the American College of physicians, it can be shown that the ideals that the medical profession maintains and the respect for the interests of the patient that it holds allows the physician to give aid to patients who wish to choose death as an alternative to continued suffering. The physician is also allowed to and in some circumstances, is morally required, to help dying patients whether through active or passive forms of euthanasia or through assisted suicide. Euthanasia is a difficult topic to think about, but in the end, we should support the choice that respects the patient's autonomous choice or clear best interest and the respect that we have for their dignity and personal worth.

Detection of surfactant proteins A and D in human tear fluid and the human lacrimal system

PURPOSE: To evaluate the expression and presence of surfactant protein (SP) A and SP-D in the lacrimal apparatus, at the ocular surface, and in tears in healthy and pathologic states. METHODS: Expression of mRNA for SP-A and SP-D was analyzed by RT-PCR in healthy lacrimal gland, conjunctiva, cornea, and nasolacrimal ducts as well as in a spontaneously immortalized conjunctival epithelial cell line (HCjE; IOBA-NHC) and a SV40-transfected cornea epithelial cell line (HCE). Deposition of SP-A and SP-D was determined by Western blot, dot blot, and immunohistochemistry in healthy tissues, in tears, aqueous humor, and in sections of different corneal abnormalities (keratoconus, herpetic keratitis, and Staphylococcus aureus-based ulceration). Cell lines were stimulated with different cytokines and bacterial components and were analyzed for the production of SP-A and SP-D by immunohistochemistry. RESULTS: The presence of SP-A and SP-D on mRNA and protein levels was evidenced in healthy lacrimal gland, conjunctiva, cornea, and nasolacrimal duct samples. Moreover, both proteins were present in tears but were absent in aqueous humor. Immunohistochemistry revealed the production of both peptides by acinar epithelial cells of the lacrimal gland and epithelial cells of the conjunctiva and nasolacrimal ducts, whereas goblet cells revealed no reactivity. Healthy cornea revealed weak reactivity on epithelial surface cells only. In contrast, SP-A and SP-D revealed strong reactivity in patients with herpetic keratitis and corneal ulceration surrounding lesions and in several immigrated defense cells. Reactivity in corneal epithelium and endothelium was also seen in patients with keratoconus. Cell culture experiments revealed that SP-A and SP-D are produced by both epithelial cell lines without and after stimulation with cytokines and bacterial components. CONCLUSIONS: These results show that SP-A, in addition to SP-D, is a peptide of the tear film. Based on the known direct and indirect antimicrobial effects of collectins, the surfactant-associated proteins A and D seem to be involved in several ocular surface diseases.

Conscious recollection and the human hippocampal formation: evidence from positron emission tomography.

We used positron emission tomography (PET) to examine the role of the hippocampal formation in implicit and explicit memory. Human volunteers studied a list of familiar words, and then they either provided the first word that came to mind in response to three-letter cues (implicit memory) or tried to recall studied words in response to the same cues (explicit memory). There was no evidence of hippocampal activation in association with implicit memory. However, priming effects on the implicit memory test were associated with decreased activity in extrastriate visual cortex. On the explicit memory test, subjects recalled many target words in one condition and recalled few words in a second condition, despite trying to remember them. Comparisons between the two conditions showed that blood-flow increases in the hippocampal formation are specifically associated with the conscious recollection of studied words, whereas blood-flow increases in frontal regions are associated with efforts to retrieve target words. Our results help to clarify some puzzles concerning the role of the hippocampal formation in human memory.

A qualitative analysis of the congruency of Jungian psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development role of instructor/facilitator

The purpose of this ethnographic study was to describe and explain the congruency of psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development (HRD) role of instructor/facilitator. This investigation was conducted with 23 HRD professionals who worked in the Miami, Florida area as instructors/facilitators with adult learners in job-related contexts.^ The study was conducted using qualitative strategies of data collection and analysis. The research participants were selected through a purposive sampling strategy. Data collection strategies included: (a) administration and scoring of the MBTI, Form G, (b) open-ended and semi-structured interviews, (c) participant observations of the research subjects at their respective work sites and while conducting training sessions, (d) field notes, and (e) contact summary sheets to record field research encounters. Data analysis was conducted with the use of a computer program for qualitative analysis called FolioViews 3.1 for Windows. This included: (a) coding of transcribed interviews and field notes, (b) theme analysis, (c) memoing, and (d) cross-case analysis.^ The three major themes that emerged in relation to the congruency of psychological preferences and the role of instructor/facilitator were: (1) designing and preparing instruction/facilitation, (2) conducting training and managing group process, and (3) interpersonal relations and perspectives among instructors/facilitators.^ The first two themes were analyzed through the combination of the four Jungian personality functions. These combinations are: sensing-thinking (ST), sensing-feeling (SF), intuition-thinking (NT), and intuition-feeling (NF). The third theme was analyzed through the combination of the attitudes or energy focus and the judgment function. These combinations are: extraversion-thinking (ET), extraversion-feeling (EF), introversion-thinking (IT), and introversion-feeling (IF).^ A last area uncovered by this ethnographic study was the influence exerted by a training and development culture on the instructor/facilitator role. This professional culture is described and explained in terms of the shared values and expectations reported by the study respondents. ^

Reductionism and the human duplication thought-experiment

The human duplication thought-experiment is examined, and basic positions concerning the possible outcomes of the experiment are spelled out. A first position sustains supervenience, either from a reductionist or an emergentist perspective, and such views are contrasted. Certain moral aspects of the thought-experiment are then considered, especially in relation to the idea of death. Taking reductionism as a working hypothesis, two possibilities are suggested for investigating the hard problem of qualia: the postulation of some novel sort of physical interaction, and the postulation of a counter-intuitive law of scaling. One possibility for the latter would lead to a violation of supervenience.

The trouble with suicide. Mental health, suicide and the Northern Ireland conflict: a review of the evidence.

Section 1: The Social Basis of Mental Well-being Section 2: Mental Illness, Conflicts and Disasters Section 3: Northern Ireland, Conflict and Mental Health Section 4: Mental Health and Suicide Section 5: Suicide: Patterns and Trends Section 6: The Social Characteristics of Suicides in Northern Ireland Section 7: Explaining Suicide Trends Section 8: Suicide and Transition to Peace Section 9: ConclusionThis resource was contributed by The National Documentation Centre on Drug Use.

Finitude, hope and the human community

UANL

"Judicial Activism in the ""Eye of the Beholder"" : the Israeli High Court of Justice and the Human Rights of the Palestinians in the Occupied Territories"

Il est mondialement reconnu que les institutions judiciaires jouent un r��le central dans le processus de prise de d��cisions politiques, �� la fois au niveau national et international. C���est d���ailleurs le cas �� la Haute Cour de justice d���Isra��l. L�����tendue de son succ��s (ou de son ��chec) dans la tentative de trouver une solution aux violations des droits humains dans les territoires occup��s est un probl��me qui continue de faire l���objet de bien des d��bats et de recherches acad��miques. �� cet ��gard, il a ��t�� sugg��r�� que, malgr�� l���absence de constitution ��crite et l���existence d���un ��tat d���urgence prolong�� en Isra��l, la Haute Cour de justice a r��ussi �� adopter une approche �� judiciairement active �� quant �� la protection et la promotion des droits de l���homme de mani��re g��n��rale, y compris ceux des Palestiniens dans les territoires occup��s. Dans cette perspective, le d��bat sur le processus d���examen judiciaire de la Haute Cour de Justice tient pour acquise la notion qu���Isra��l est une d��mocratie. Ainsi, cet article cherche �� examiner cette hypoth��se. Premi��rement, en adoptant la position que le processus de r��vision judiciaire est compatible avec la d��mocratie et la r��gle de loi. Deuxi��mement, il examine l���approche �� judiciairement active �� de la Cour et soumet un bref aper��u du processus, des outils et des principes l��gaux que la Cour adopte pour examiner les actions des autorit��s isra��liennes, y compris l���arm��e, et imposer une loi commune de protection des droits de la personne, donc ceux des Palestiniens dans les territoires occup��s. L���article argumente ��galement que le contr��le prolong�� des territoires occup��s par Isra��l a eu des cons��quences significatives, car tout effort fourni par la Cour pour garantir le respect des droits humains de la population civile palestinienne doit se faire sans compromettre la s��curit�� du pouvoir isra��lien. La conclusion �� laquelle on arrive ici d��pend de la fa��on dont on qualifie ce contr��le: une occupation �� long terme ou une annexion (ce qui n���est pas r��glementaire par rapport �� loi internationale), ce qui n���est pas sans cons��quence sur le r��le que la Haute Cour de justice peut effectivement jouer pour faire respecter les droits de la personne dans les territoires occup��s.