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Background: People with intellectual disabilities are known to have increased medical needs and are prescribed more medication than the general population. Understanding the reality of incorporating medication into their lives would help healthcare professionals provide care in more meaningful and personalised ways. Aim: A narrative review of the current literature relating to people with intellectual disabilities and their experience of medication/pharmaceutical care. Method: Electronic databases were searched for articles relating to intellectual disabilities and medication administration or pharmaceutical care. Other relevant papers identified from included article reference lists were also identified. A narrative literature was undertaken due to the heterogeneity of the identified papers. Results: A total of 29 studies from the literature searches were included alongside other relevant papers. Conclusions: The published literature noted some aspects of the medication‐related experiences of people with intellectual disabilities. However, a greater understanding of medication‐related experiences is still required. [ABSTRACT FROM AUTHOR]

There have been increasing calls for collaboration between Indigenous health practitioners (IHPs) and allopathic health practitioners (AHPs) in Africa. Despite this, very few successful systems exist to facilitate formal collaboration. Direct relationships between providers, and at a health systems level are crucial to successful collaboration, but the nature and extent of these relationships have yet to be adequately explored. To explore the relationship between IHPs and AHPs in Africa, and to discuss the implications of this for future collaboration. An interpretive qualitative synthesis approach, combining elements of thematic analysis, meta-ethnography, and grounded theory, was used to systematically bring together findings of qualitative studies addressing the topic of collaboration between Indigenous and allopathic health practitioners in Africa. A total of 1,765 papers were initially identified, 1,748 were excluded after abstract, full text and duplicate screening. Five additional studies were identified through references. Thus, 22 papers were included in the final analysis. We found that the relationship between Indigenous and allopathic health practitioners is defined by a power struggle which gives rise to lack of mutual understanding, rivalry, distrust, and disrespect. The power struggle which defines the relationship between IHPs and AHPs in Africa is a hindrance to their collaboration and as such could partly account for the limited success of efforts to foster collaboration to date. Future efforts to foster collaboration between IHPs and AHPs in Africa must aim to balance the power disparity between them if collaboration is to be successful. Since this would be a novel approach, decision-makers and organisations who trial this power balancing approach to facilitate collaboration should evaluate resultant policies and interventions to ascertain their feasibility and efficacy in fostering collaboration, and the lessons learnt should be shared. [ABSTRACT FROM AUTHOR]

Fuzzy logic is one of the precisely constructed and wellmotivated logical systems that find successful applications in various fields. They are especially suitable in cases when it is necessary to use approximate reasoning. In this paper, I present the main views on the application of fuzzy logic and fuzzy sets in the field of medicine and I express my attitude to them. [ABSTRACT FROM AUTHOR]

Background. Despite substantial progress in the treatment of hepatitis C through the use of direct-acting antivirals which have been shown to cure the disease, complementary and alternative medicines (CAM) are popular among patients as a substitute or complement of allopathic medicines. This study aimed to explore the perspectives of patients and CAM practitioners on the use of CAM for the treatment of hepatitis C in Pakistan. Methods. A cross-sectional design was adopted. Participants (CAM practitioners and patients) were recruited from the capital and two provinces: Khyber Pakhtunkhwa and Punjab of Pakistan. A survey using paper-based questionnaires, each specific for patients and CAM practitioners, was conducted to gather information pertaining to demography, disease status, treatment history, and participants' perspectives (about the disease, reasons to switch to CAM, and referring source). Results. A total of 417 respondents (n = 284 patients, n = 133 practitioners) were recruited. Of the total patients, 170 (59.9%) had started CAM during the previous three months. There were 168 (59.2%) of the total patients who had used allopathic treatments for hepatitis C prior to their use of CAM. The confidence in CAM (24.6%), high cost (19%), and unbearable side effects (52.1%) of allopathic medicines were the main reasons to switch to CAM treatment. Majority (49.3%) of the patients were referred to CAM on the recommendations of relatives or care givers (17.3%) whereas only 9.5% were referred by health care professionals. Out of 133 practitioners, 48 (36.1%) were practicing herbal medicines. From practitioners' perspectives, club-moss (Lycopodium clavatum) was the best treatment option for hepatitis C. The majority, 73 (54.9%), of the patients had chosen to use CAM because of the side effects of allopathic medicines. Patients who had previous "good experience" with CAM were the most common referral source (56.4%) for CAM use in hepatitis C. Conclusions. Patients' beliefs in CAM, side effects of allopathic therapy, high cost of allopathic medicines, and referrals from previous CAM users are key factors in the switching of hepatitis C patients to CAM. [ABSTRACT FROM AUTHOR]

During the last decade, there have been several publications highlighting the need for consistent terminology in breastfeeding research. Standard terms and definitions are essential for the comparison and interpretation of scientific studies that, in turn, support evidence‐based education, consistency of health care, and breastfeeding policy. Inconsistent advice is commonly reported by mothers to contribute to early weaning. A standard language is the fundamental starting point required for the provision of consistent advice. LactaPedia (www.lactapedia.com) is a comprehensive lactation glossary of over 500 terms and definitions created during the development of LactaMap (www.lactamap.com), an online lactation care support system. This paper describes the development of LactaPedia, a website that is accessible free of charge to anyone with access to the Internet. Multiple methodological frameworks were incorporated in LactaPedia's development in order to meet the needs of a glossary to support both consistent health care and scientific research. The resulting LactaPedia methodology is a six‐stage process that was developed inductively and includes framework to guide vetting and extension of its content using public feedback via discussion forums. The discussion forums support ongoing usability and refinement of the glossary. The development of LactaPedia provides a fundamental first step towards improving breastfeeding outcomes that are currently well below World Health Organisation recommendations globally. [ABSTRACT FROM AUTHOR]

There is increasing pressure on complementary and alternative medicine (CAM) to follow the evidence-based approach promoted in allied health and medicine, in which the randomised control trial represents the evidence gold standard. However, many CAM advocates see these methods as undermining the holism of CAM practice. This paper explores how such tensions are managed in CAM university departments – settings in which particular forms of knowledge and evidence are given 'official' imprimatur by CAM educators and researchers. By comparing two types of CAM, the paper also unpacks differences within this broad category, asking whether CAM academic disciplines comprise different 'epistemic cultures' (Knorr-Cetina, K. (1999). Epistemic cultures: How the sciences make knowledge. Cambridge, MA: Harvard University Press). Interviews were conducted with 20 lecturers in Chinese medicine and osteopathy, across five Australian universities, and augmented with observation in two degree programs. Findings reveal contrasting ontological and epistemological perspectives between the two academic fields. Chinese medicine lecturers had largely adopted bioscientific models of research, typically conducting laboratory work and trials, although teaching included traditional theories. Osteopathy academics were more critical of dominant approaches and were focused on reframing notions of evidence to account for experiences, with some advocating qualitative research. The study illustrates CAM's 'epistemic disunity' while also highlighting the particular challenges facing academic CAM. [ABSTRACT FROM AUTHOR]

By declaring biomedicine as its apolitical counter-discourse, social theory, including disability studies, experiences problems discussing bodies and their ailments. This paper explores possibilities to ‘bring bodies back in’ in politically relevant ways, while avoiding reducing bodies to singular, natural ‘givens’. This is done by exploring some of the practices in which people with severe Chronic Obstructive Pulmonary Disease (COPD) attempt to live with their chronic disease and together with others. It becomes clear that what they experience as important physico-social problems are the invisibility of their disease, combined with the visibility of the aids used to deal with its problems. This combination leads to behaviour that is incomprehensible to others. It is demonstrated that some form of presence of the disease is needed to create social positions that allow patients to live with others in an acceptable way. The paper continues by exploring ways in which bodies are made present in useful ways. These are found where the people with COPD: (1) create communities of shared bodies that allow for a multitude of visible and invisible presences of COPD; (2) develop ways to educate their bodies in different ways to create new presences; (3) use their bodies as sources of knowledge about living with breathlessness; and (4) create transportable bodies to take COPD presences elsewhere, by using the argument of ‘demonstration by numbers’, the workings of time and by playing out the exceptional characteristics of their bodies and situations. The paper concludes with a discussion of the relatively unexplored possibilities for creating and sharing ‘patient knowledge’ and the areas this opens up for a new politics of social inclusion. [ABSTRACT FROM AUTHOR]

The world in 2010 is a very different place to 1987 when Bhugra's paper on homophobia was published. Huge shifts have occurred in society's attitudes to gender, sex, sexuality and identity - notably by the internet, changes in HIV treatment, media representation of homosexuality and feminism and the role of women in society. This paper updates the literature review on homophobia revisiting society's assumptions about homosexuals. Changes are discussed in the context of definitions of homophobia, socio-cultural and politico-legal perspectives and homophobia and medicine. New current assumptions are drawn up and offered as a way of understanding both development and limitations - whilst there has been a reduction in the fear associated with gay men and women, discrimination remains. Newer issues such as internalised homophobia, globalisation and mainstream representations of homosexuality add complexity to this ongoing concern. [ABSTRACT FROM AUTHOR]

The empiricist logic of humanism insists that we can know the essence of something through observation. However, it is my aim in this paper to challenge this notion by asserting that empirical observation is never neutral, but always laden with cultural meanings, specificities and prejudices. I argue that medical science is founded in a humanist empiricism in order to make bodies intelligible as "normal" or "pathological", depending on a range of bodily markers. In designating a body as "normal", the clinician uses measures of "sameness" that are underpinned by a deeper concern for normalisation. In upholding the norm/pathology binary in medical discourse, what is effected is a neglect of a recognition of the socio-cultural function of the categories of "normal" and "pathological", and medical participation in the way these terms come to "mean" in lay society, and their sedimentation in pre-conscious practices of perception. The central task of this paper is to examine the "clinical gaze", and moreover the consultation between the paternalistic and rational figure of the doctor and the patient/subject, understood simply as a malfunctioning machine in need of restoration to normality. Drawing on the work of Linda Alcoff, I argue that what is ignored in medical discourse is the persistence and irrevocability of tacit bodily knowledges that construct us within every context, not least the privileged "objective" space of medical consultation and diagnostics. [ABSTRACT FROM AUTHOR]

In the business context, concern for the environment began to develop when pressure from the public administration and environmental awareness groups raised the specific requirements for companies. The Theory of Planned Behavior considers that people's conduct is determined by the intention of carrying out a certain behavior. Thus, the individual's intent is determined by three factors related to the desired outcome of the behavior: the Personal Attitude toward the Results, the Perceived Social Norms, and the Perceived Behavioral Control over the action. Therefore, the objectives of this paper are to clarify the attitudes of the managers of Canarian small and medium-sized companies about taking environmental measures, and try to demonstrate whether there is a relationship between the proposed factors and the intention to take these measures. [ABSTRACT FROM AUTHOR]

Early-modem Jesuit universities did not offer studies in medicine, and from 1586 onwards, the Jesuit Ratio studiorum prohibited digressions on medical topics in the Aristotelian curriculum. However, some sixteenth-century Jesuit text books used in philosophy classes provided detailed accounts on physiological issues such as sense perception and its organic location as discussed in Aristotle's De anima II, 7-11. This seeming contradiction needs to be explained. In this paper, I focus on the interst in medical topics manifested in a commentary by the Jesuits of Coimbra. Admittedly, the Coimbra commentary constituted an exception, as the Jesuit college that produced it was integrated in a royal university which had a strong interest in educating physicians. It will be claimed that the exclusion of medicine at Jesuit universities and colleges had its origin in rather incidental events in the course of the foundation of the first Jesuit university in Sicily. There, the lay professors of law and medicine intended to avoid subordination to the Jesuits and thereby provoked a conflict which finally led the Jesuit administration to refrain from including faculties of medicine and law in Jesuit universities. Towards the end of the sixteenth century, a veritable Jesuit animosity towards medicine emerged for philosophical and pedagogical reasons. This development reflects educational concerns within the Society as well as the role of commentaries on Aristotle for early-modern learning. [ABSTRACT FROM AUTHOR]

The objective of this paper is to assess the attitude of Malaysian stakeholders to genetically modified (GM) salmon and to identify the factors that influence their acceptance of GM salmon using a structural equation model. A survey was carried out on 434 representatives from various stakeholder groups in the Klang Valley region of Malaysia. Public attitude towards GM salmon was measured using self-developed questionnaires with seven-point Likert scales. The findings of this study have confirmed that public attitudes towards GM salmon is a complex issue and should be seen as a multi-faceted process. The most important direct predictors for the encouragement of GM salmon are the specific application-linked perceptions about religious acceptability of GM salmon followed by perceived risks and benefits, familiarity, and general promise of modern biotechnology. Encouragement of GM salmon also involves the interplay among other factors such as general concerns of biotechnology, threatening the natural order of things, the need for labeling, the need for patenting, confidence in regulation, and societal values. The research findings can serve as a database that will be useful for understanding the social construct of public attitude towards GM foods in a developing country. [ABSTRACT FROM AUTHOR]

Aims: This study analysed whether beliefs about medicines mediated the relationship between illness representations and medication adherence. Background: Adherence to medication is required in diabetes treatment, contributing to decreased blood glycaemic levels. The knowledge and perception of patients about diabetes as well as the beliefs about medicines are considered to be key factors for medication adherence. Design The study used a cross‐sectional design that included 387 patients recently diagnosed with type 2 diabetes. Methods: Participants were assessed, between 2010 and 2013, and answered the Medication Adherence Scale, the Beliefs about Medicines Questionnaire, and the Brief Illness Perception Questionnaire. Results: The results of the path analysis showed that beliefs about medicines had a mediating role on self‐report medication adherence with the exception of beliefs about specific concerns with medicines. Therefore, both general beliefs and specific needs about medicines mediated the relationship between diabetes consequences and self‐report medication adherence as well as between treatment control and self‐report medication adherence. Needs about medicines mediated the relationship between personal control and self‐report medication adherence. Conclusion: Health professionals should target beliefs about medicines besides illness representations regarding medication adherence. The current study may help optimize adherence to medication in early‐diagnosed type 2 diabetes patients. SUMMARY STATEMENT: What is already known about this topic? Adherence to medication is a required self‐care behaviour in type 2 diabetes treatment regimen to decrease blood glycaemic levels.The Extended Common‐Sense Model proposes beliefs about medicines as mediators between illness representations and adherence, and they have been tested in several chronic disease samples.The mediator role of medication beliefs between illness representations regarding diabetes and medication adherence has never been studied in patients recently diagnosed with type 2 diabetes. What this paper adds? Both general beliefs and specific needs about medicines mediated the relationship between diabetes consequences/treatment control and self‐report medication adherence.Needs about medicines mediated the relationship between personal control and self‐report medication adherence. The implications of this paper: Health professionals should target beliefs about medicines besides illness representations regarding medication adherence.The current study may help optimize intervention regarding adherence to medication in early‐diagnosed type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Borrett joins other phenomenologists in using phenomenological ideas on temporality to explain how illness affects the individual's experience of time. Unlike others, he attempts to synthesize this use of phenomenology with a biomedical understanding of the relation between time and illness. My paper expands on Borrett's ideas by reviewing current medical scholarship on time and illness perception, including Heidegger's ideas on temporality. The first section considers questions and suggestions emerging from contemporary medicine. After a short review of theories of time perception, I describe and critique how Borrett and others use phenomenological temporality in a medical context. My conclusion suggests how Heideggerian temporality might help with the questions and recommendations emerging within diverse medical fields. [ABSTRACT FROM AUTHOR]

In the era of an aging population and escalating healthcare costs, the futility debate has become the object of extended critical attention. The issue has divided experts in relevant fields into two camps. The proponents of medical futility defend the physician's exclusive right to determine the futility of treatment and decide whether treatment should be withheld or withdrawn. On the other hand, opponents believe that a discourse of power lies at the heart of the futility debate. They believe that medical futility was constructed, in part, as a means of enhancing the physician's domination in a context wherein medical authority was threatened. This paper presents some current approaches to the futility debate and highlights positions taken by physicians and bioethicists. It concludes that establishing an operational guideline, either at hospital or national level, is a critical requirement for resolving problems posed by futility. It suggests that policies should not be based on either excessive patient's autonomy or physician's paternalism. [ABSTRACT FROM AUTHOR]

There has been an explosion of literature on the attitudes of a variety of health care providers, particularly physicians, to the growing utilization of complementary and alternative medicines and modalities (CAM). What is most seriously lacking is a conceptual framework that helps to distill this mountain of literature into a manageable and more understandable amount. In this paper, we address these important issues by examining the literature that surveys the attitudes and behaviour of providers regarding CAM comparatively across the professions of medicine and nursing and across settings. We do so by drawing upon existing, more general theoretical contributions to the area of CAM in order to propose a comparative conceptual framework with which to interpret the diverse and at times discrepant results of this body of research. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to study possible relationships between traditional Chinese health beliefs and health practices in adult Chinese in a modernized society. The study populations comprised 398 35-44-yr-old and 559 65-74-yr-old Hong Kong Chinese. The respondents were categorized into three groups with weak, moderate, or strong Chinese beliefs on the basis of interview questions on the causes of gum disease. Chinese preventive practices and Chinese pain practices were defined according to respondents' reported use of recommended traditional cures. Questions on generally accepted oral practices were phrased in terms of frequency of daily brushing of teeth, use of toothpicks the previous day, and whether or not teeth were flossed the previous day. Around one-third of the respondents had weak, almost one-half had moderate, and around one-quarter expressed strong Chinese health beliefs. No significant differences in Chinese health beliefs were found between men and women in either age group, or between the age groups. In the 35-44 age group, more of those with a higher education were in the "weak" Chinese health belief category, whereas, conversely, more of those with a lower education expressed stronger Chinese health beliefs (P<0.05). Women in both age groups reported significantly more frequent brushing. Toothpicks were used by around three-quarters of both age groups, but flossing was extremely rare. Chinese preventive practices were reported significantly more frequently by those in the older group who held strong Chinese health beliefs than those with moderate or weak beliefs, whereas the trend in the younger group was not significant. Chinese pain practices were reported very infrequently. Chinese health beliefs did not correlate with use variables. In the older group, Chinese health beliefs correlated strongly with preventive practices and with knowledge. [ABSTRACT FROM AUTHOR]

In this paper, I will explore the concept that healing activities shape the objects of therapy and seek to construct those objects through therapeutic activities. Objects of therapy are the persons, patients, human bodies, diseases, physiological processes and personal suffering—that which clinical medicine constructs through its distinctive formative processes, practices and knowledge. The rationale for choice of philosophical sources namely, Cassirer, Foucault, the anthropological perspective of Good and the sociological account of Frank will be discussed. The claim articulated by Good will be examined and its relationship to culture, illness, medical knowledge, practice, truth, and science. I then focus on Frank's concepts of the patient and the body and how medical knowledge and practices affects it. The concept that the medicalization of the illness narrative silences the patient's voice requiring an ethic of listening will be emphasized, described and further supported by Charon's (2006, Narrative medicine: Honoring the stories of illness. New York, NY: Oxford University Press) and Cassell's (2015, The nature of suffering and the goals of medicine. New York, NY: Oxford University Press) thoughts on narrative of illness in clinical medicine. My position concludes that healing activities construct the objects of therapy: as the medical culture's way of seeking truth; as medicine's way of mediating and organizing forms of reality through culture and symbolic forms; and, as medicine's way of entering the body and constructing the disease. Lastly, I suggest that in spite of the remarkable progress in the control of disease, the failure to address the interpretation of illness meanings is a fundamental flaw in the work of "doctoring." The experience and meanings of illness are at the centre of clinical practice and is a moral, political, ethical and professional obligation. The person is a cultural construct, a complex and culturally shaped way of experiencing self and other, and cultural "work" is required to constitute the person who is the object of medical attention and it also necessitates the ethic of listening. [ABSTRACT FROM AUTHOR]