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Patients/consumers are end user of medicines and should play important role in reporting the Adverse Drug Reactions (ADRs) to pharmacovigilance system. Consumers can provide detailed first-hand in formation about their experiences with medicines and how these medicines have affected their life. Direct consumer reporting leads to earlier identification and accumulation of signals and may provide neglected details related to psychiatric feelings and quality of life. Consumers may report ADRs due to “over the counter” (OTC) medicines, herbal medicines, and ADRs related to excipients and potential interactions. Direct patient/ consumer reporting will also rectify the under-reporting by patients to physician and will change the attitude related to importance of patient’s experience. NCC-PvPI (National Coordination Centre-Pharmacovigilance Programme of India), IPC (Indian Pharmacopoeia Commission) had launched “Medicines Side Effect Reporting form for Consumer” (blue form) at the National level conference on “Participation of patient/consumer organization in PvPI” on 1st August, 2014, which encourages patient or his/her representative (relative) to report ADRs directly either by submitting the form to the NCC-PvPI or to the nearest AMC (Adverse Drug Reaction Monitoring Centres) under PvPI. Consumers can also reports through toll free helpline number: 1800-180-3024 or email id: pvpi.compat@gmail.com to NCC-PvPI.

This paper reflects a personal conclusions on person-centred care practice, based on my own research in strabismus field. Theoretical and practical considerations of the person-centred approach are discussed. Health services struggle to ensure health care in a “person-centered” way, but the general concept also called personcentered care is an ethical one: patients should be treated as “persons.” Person-centred practice needs to be well facilitated in order to flourish the healthcare framework. However, the literature is sometimes unclear about the nature of these person-centred actions and questions remain about how to provide and measure clinical outcomes of personcentred care while being engaged with others in real health practice contexts.

A point estimate study was conducted at a general teaching hospital in Britain that measured the availability of patients' paper medication administration records (also known as MARs or drug charts) in five surgical and two medical units. The five surgical units kept MARs at patients' bedsides, whereas each of the two medical units kept all MARs at two designated drug trolleys. MARs were readily available 76% (84 of 111 patients) of the time in the surgical units, compared to 94% (45 of 48 patients) of the time in the medical units. The difference in availability was statistically significant (p

Clinical guidelines, defined as ‘systematically developed statements to assist both practitioner and patient decisions in specific circumstances, have become an increasingly familiar part of clinical care. A central challenge in Primary Care is the question of how do we act in the field of atypical courses of diseases or clinical symptoms beside the spectrum of EBM and how could this gap be measured in scientific literature. Main purpose of this paper is a brief analysis of the actual role and evidence of clinical case reports and case series in primary care as a basis for a scientific discussion. According to the scientific-accepted Oxford levels of evidence case reports and case series belong to the level 4 of evidence. At present a significant majority of published case reports deal with descriptions of physician’s care following their clinical intuition beside the pathways of randomized controlled trials (RCT) or guidelines. Clinical symptoms of many cases will add up to what we would recognize as a ‘medical’ condition, but in up to 19% they are vague, non-specific and/or contradictory and the management of patients with such undefined symptoms can pose a daunting challenge. Even randomized controlled trials are the gold standard in clinical research and systematic reviews and meta-analysis have the highest level of evidence, there is still a need for well-prepared case reports; for instance to describe rare adverse drug effects.

Adaptive clinical trials attract great attention from academia, industry and regulatory authorities. Both the European Medicines Agency and the US FDA have clarified their positions in recently issued (final or draft) guidance documents. With this background, current trends and issues were analyzed in a panel discussion at the International Society for Biopharmaceutical Statistics (ISBS) meeting in March 2011. In this article, members of the panel summarize their thoughts based on this discussion.

Brad Spellberg is an Associate Professor of Medicine at the University of California, Los Angeles and is based at the Division of General Internal Medicine at the Los Angeles Biomedical Research Institute at Harbor- University of California, Los Angeles Medical Center. His research is diverse, ranging from NIH-funded basic immunology and vaccinology to pure clinical and outcomes research. He is the co-founder and Medical Director of Clinical Research Solutions, a clinical trial unit at his research institute. He is also a Fellow in the Infectious Diseases Society of America (IDSA) and is a member of the IDSA’s Antimicrobial Availability Task Force, formed to bring attention to the problems of increasing drug resistance and decreasing new antibiotics. His research regarding new drug development has been a cornerstone of the IDSA’s white paper, ‘Bad Bugs, No Drugs’, and has been cited extensively in medical literature and on Capitol Hill. He has lead authored numerous IDSA position papers and review article...

The study was undertaken to evaluate various aspects of self-medication in medical students. A prospective, cross-sectional, questionnaire-based study was carried out among 488 medical students selected by simple random sampling from January 2013 to June 2013. Data was collected and analyzed for counts and percentage. Students reported self-medication in the preceding one year was 71.7 % and the prevalence was more in final year students. Fever and headache were the most frequently reported illnesses, commonly used drugs were antipyretics and analgesics, obtained information through reading material, and reasons quoted were minor ailments and quick relief. Majority students agreed that medical knowledge is necessary for administration of medicine by self. Self-medication is highly prevalent in medical students, which is quite alarming.

A descriptive cross-sectional study was conducted to assess quality of dispensing and knowledge of dispensers in 206 private retail pharmacies. The study was conducted in Dar es Salaam, Tanzania between September 2011 and April 2012. Patient simulation (mystery shopper) approach was used to assess dispensing skills of drug dispensers for prescription only medicines. In assessing dispensing skills, a 7-days course of metronidazole tablets was bought from each pharmacy. The knowledge of drug dispenser's regarding dispensing of prescription only medicines was assessed through focus group discussions and interviews. Majority (70.4%) of drug dispensers were not trained pharmaceutical personnel. The level of dispensing skills ranged from low (25.7%) to medium (70.4%). Majority of drug dispensers had low (11.4%) to medium (83.2%) levels of knowledge about dispensing of ‘prescription only’ medicines. From these findings, it is recommended that the national Pharmacy Council should ensure that prescription only medicines are dispensed by trained pharmaceutical personnel. On job training and continuing professional development should also be emphasized to build capacity of drug dispensers.

Health record management is an important and challenging task. Utilization of technologies in health care, particularly the use of Electronic Health Records (EHR) offers a wide variety of benefits. Better healthcare is provided by EHR by improving all aspects of health care. This paper aims to do an extensive review of existing literature on the issues and expectations concerning consumers and physicians in the development of EHR. In this paper, based on the issues, recommendations are made, and future directions explored.

Management of sickle cell disease is key to improved quality of life of people living with the disease in Nigeria. This paper examined management strategies utilized by health workers in managing sickle cell patients in Obafemi Awolowo University health centre, in Ile-Ife, Nigeria. The specific objectives were to explore health workers definition of the disease, the observed symptoms by the health workers, drugs and non-drug strategies employed by these health workers in the management of the patients and the adequacy of health facilities for managing sickle cell patients. With structured in-depth interview schedule, fifteen health workers including nurses and doctors were interviewed. It was indicated that unanimously, health workers defined the disease as an inherited blood disorder which is highly symptomatic with a lot pains all over the body especially in joints and chest and that the sufferers are often admitted in the hospital. Also, the health workers use antibiotics, folic acid, analgesics, anti-malaria drugs, intravenous fluids and blood transfusion as drug regimens for managing the sufferers. The non- drug strategies employed by the health workers were counselling, education for self-care and psychotherapy. Furthermore, the health workers indicated that inadequate health facilities hamper their capacity to deliver effective management to people living with the disease. The paper concludes that health workers employ both drug and non-drug management strategies that promise improved quality of life for sickle cell patients in Nigeria but are constrained by inadequate health facilities and consumables.

This paper examines the milestones in the process of building interventions in mental health to alleviate human suffering in Uganda. The objectives of the paper are to trace the kind of mental health services provided in Uganda at different periods, identify the different activities that have influenced the building of the counselling industry in Uganda, analyze the challenges facing the counselling industry in Uganda, and develop coping strategies to address existing challenges in the counselling field of in the country. Initially professional mental health services were provided to people described by society as ‘mad’ persons. However, the perception has gone on changing from time to time as the need to research deeper into counselling and mental health issues arise. Counselling services that are restricted to normal persons are a recent occurrence in Uganda. It is just recently that counselling is taking on a different twist in society but with great challenges.

The paper argues by way of an international comparison that U.S. research publications as well as public health media provide inadequate information on contraceptive methods. To support this argument, the paper analyses the most salient publications as well as websites of public health agencies and compares them to European publications. It concludes that U.S. research has to intensify efforts to strive for accuracy and completeness to enable women to exert their autonomy as fully informed patients.

Introduction: Females genital mutilation/Cutting is a harmful traditional procedure disturbing the health of girls and women. It has a continuing sexual, physiological and psychological influence on women health life. The objective of current study was to visualize and analyze the global scientific activities in the field of female genital mutilation/Cutting during a period of 15 years through 2001-2015. Methodology: A Scientometric analysis was carried out to depict the global activities towards scientific production in the field of female genital mutilation/cutting during a period of 15 years. The Core Collection of Web of Science database was employed to extract all papers indexed as a topic of female genital mutilation/cutting through 2001-2015. The Science of Science Tool was used to map the co-authorship network of papers in the field. Results: Analysis of data showed that, although the number of papers in the field of female genital mutilation/cutting was not remarkable, but it steady increased through the period of study, so that the number of papers in 2015 was two times greater than those in 2006. English consisting 94% of total publication was the language of publications. The vast majority of publication type was in the form of journal articles (65%). Based on the Bradford Scatterings law the journal of “International of Gynecology Obstetrics” was the most productive journal. USA, England and Australia were the most productive countries in the field. Conclusion: The study concluded that the research activities in the field of FGM/C regarding to the number of circumcised women in the world was very small and insufficient. The psychological aspects of FGM/C have been neglected by the scientists as well as the women health organizations.

The Sts’ailes community is a First Nation close to Chilliwack in British Columbia, Canada where a mental wellness clinic was launched in January 2015. Presented here, in addition to description of the development and structure of the clinic are the sources of referral, demographics, diagnoses and other characteristics of all patients seen over a 15 month period (January 2015 to April 2016). By way of context, the paper begins with an overview of the cultural and historical background of Sts’ailes. It then describes the health services that were in existence at Sts’ailes prior to the mental wellness clinic as well as the values that were held to be important for the mental wellness clinic to embody. Emphasized in this paper too is the fact that a significant time period of consultation and relation-building as well as organizational commitment between First Nations representatives as well as representatives of the local health authority preceded the inception of the clinic.

Purpose: This paper aims to discuss the micro process of care delivery between the home care workers and the older person, with the aim of examining what aspects of the care delivery process improve or impinge on the on the care delivery. In addition to this the paper will consider whether any discernible differences were established between the two models of care delivery. Design/methodology/approach: This study followed eight homecare workers delivering time and task homecare and an alternative outcome-focused care model. Participant observations were undertaking with the workers who were followed delivering care to 16 older people with 8 older people were selected from each intervention group. In addition to the participant observations 4 follow up interviews were conducted with the homecare workers and 16 follow up interviews were conducted with the participants. Findings: The key findings were that the model and manner in which homecare is delivered have a profound impact upon the homecare workers and the older person’s ability to form a mutually satisfactory caring relationship. Originality/value: This paper helps to provide insight into how the micro delivery of care process impacts upon the quality of homecare an older person receives.

Objective: Alcohol consumption has been linked with increased risk and worse outcomes in multiple sclerosis (MS). However, the results are not uniform and conflicting data on the matter have been published. This systematic review addresses the association of alcohol with increased risk and worse outcomes in MS. Method: Systematic review of the literature, searching for the terms "Alcohol" AND "Multiple Sclerosis" OR "MS" in the Medline, PubMed, Lilacs, SciELO and Google Scholar databases. References from selected articles were used to identify studies that might not previously have been recognized as pertinent to this review. The period established for searching for articles started in 1983, after publication of Poser’s criteria for diagnosing MS and finished on July 31, 2016. Results: The initial search identified 1399 potential papers from the search terms selected. After exclusion of duplications and articles that did not fulfil the criteria of the review, 30 papers were selected for full-text discussion. Eleven research articles published between 2004 and 2016 were included in this review. Alcohol consumption was considered to be a risk factor for development of MS by some authors but not by others. Some studies even reported that drinking small amounts of alcohol had a protective effect against developing MS. Alcohol seemed to have a negative effect on disability progression in MS. Data from different countries and cultures may have played a role in the results from the studies. Conclusion: It has been suggested that alcohol use might be related both to bad and to good outcomes in MS. There are no recommendations on doses that might be acceptable.

This paper focuses on the introduction of the mental capacity legislation and in particular its application to care and family proceedings in the UK. It reviews challenges with regards to its implementation, noting serious shortfalls in its use even a decade after the mental capacity act was introduced. Guidance is provided within the paper with regard to maximizing capacity and involvement of individuals in care proceedings where these issues have been raised. Case examples are also used to clarify and to contextualize these matters.

Background: In the US, more than 1.2 million adults are living with human immunodeficiency virus (HIV); gay and bisexual men account for 82% of new diagnoses annually. Young men of color account for 67% of this total. Despite advances in disease control, lack of retention in care itself remains a barrier and how outpatient staff members impact this has not been investigated. The palliative approach is patient-centered care targeting "relief of suffering" and "quality of life." This paper describes the original protocol for the Care and Support Access Study (CASA) where outpatient HIV staff members are challenged to improve outcomes for young men who have sex with men (yMSM) by integrating the palliative approach early (ePA) with HIV care delivery. Methods: The hypothesis is that ePA can favorably impact outcomes for yMSM in one HIV clinic compared with treatment as usual (TAU) at a second clinic. In the era of HIVdisease control, we use a quasi-experimental design with mixed methods to compare patient-level outcomes at 2 HIV clinics. The intervention fosters incorporation of the ePA with care provision using didactic and iterative education. We survey HIV staff members with regard to stress of care-giving. Qualitative interviews will highlight impact of the experience. Objectives: This paper reviews the aims of the study including: 1) compare outcomes of yMSM receiving care from staff using the ePA to those receiving TAU; 2) compare work-related staff stress at a clinic receiving the ePA with staff providing standard HIV outpatient care; and 3) refine, deliver and determine the acceptability and applicability of interdisciplinary professional education to deliver the ePA in HIV management. Discussion: We will measure the impact of the ePA on care delivery relative to patientcentered benefits. Lessons learned can contribute to a model for working with diverse patients facing challenging life transitions.

Nursing education has direct relationship with quality based clinical practice and standardized care; however, private versus public education makes a difference among the graduates. Unfortunately, in Pakistan, nursing education has been facing numerous challenges with respect of lack of unified policies, absence of strategic planning, and constraint resources. This paper describes comparison between private and public (government) nursing academic institution in Karachi, Pakistan. This paper comprises similarities, differences, strengths, limitations, and challenges of both institutions including their bases and recommendation for possible solution particularly with reference of regulatory body Pakistan Nursing Council (PNC) and World Health Organization (WHO) guidelines.

Developmental Dysplasia of the Hip (DDH) captures a range of hip disorders which requires early identification and management and as such is a significant public health and primary care issue. The incidence of late diagnosis is higher in Ireland that other countries. Hip ultrasound is not widely practiced in Ireland. After birth, Public Health Nurses (PHNs) practitioners in Ireland may be the first health professional to be alerted to a missed case of DDH. The aim of this paper is to use a case study to illustrate the complexities of public health nursing practice with parents to screen, intervene and manage DDH. The paper highlights the way in which PHNs fulfil their public health role by implementing interventions, at the level of individuals, communities and systems, to address public health issues, informed by the Public Health intervention Wheel (The Wheel). Implications for education and practice are also discussed.

Sad news is defined as a situation where there is feeling of no hope, a threat to person’s mental or physical wellbeing, or where a message is given which may result in fewer choices to individuals’ lives. This issue creates ethical controversies among health care professional that who should decide and to whom health personnel will disclose this sad news. The aim of this paper is to explain and analyze this concept in the light of ethical principles. The paper will discuss the role of health care professionals in the disclosure of sad news integrating an explicit ethical decision making process.

Aim: Technology is essential for nursing care and is seen as support that puts a transforming action into practice. Methods: Integrative review consulting 97 issues of the Revista Brasileira de Enfermagem published from 2000 to 2015. Results: A total of 2,163 papers were identified, 15 of which were included in the corpus of analysis: 40% of these referred to technologies aimed to aid direct care provided to patients, 33% addressed education in nursing; and 27% addressed the management of services. The largest number (three) of papers was published between 2010 and 2011, followed by two papers published in 2009. The remaining years together totalled 46%. Conclusion: Given the daily practice of nurses, they are able to identify needs that can be met by the production of technology of their own authorship or in partnership with other professionals. Nonetheless, the papers do not present a discussion from this perspective or regarding intellectual property and do not present a taxonomy regarding technology and technological production in the nursing field.

The issue of end of life among the elderly is understudied by researchers and practitioners especially medical social workers. The end-of-life period is a period of when the body systems are shutting down and death is imminent, typically lasts from a matter of days to a couple of weeks among the elderly. The paper explored the emerging issue in caring for the elderly at the end of life stage. The paper x-rayed the emerging roles of the medical social workers. The paper recommends that, developing capacity of individuals (informal caregivers) networks will bridges the gap in absence of the primary caregiver to provision of comprehensive care planning for the elderly at the end of life stage.

Objective: The scope of this paper is to present the main aspects related to the causative agent of visceral leishmaniasis and implications of this interaction with the human host, allowing the improvement of health care actions. Methods: The paper was put together based on a literature review with a defined search strategy. To obtain the articles we consulted the Scientific Electronic Library Online (SciELO) and the U. S. National Library of Medicine (PubMed). Results: The leishmaniases are a group of diseases that pose a serious public health problem in at least 88 countries, and are included among the six priority endemic diseases in the world, according to the World Health Organization (WHO). In this scenario the visceral form stands out kala-azar (visceral leishmaniasis) which, despite its endemic nature, has been reported in different areas of Latin America associated with the process of expansion and urbanization, as well as the unchecked deforestation. Conclusion: The importance of this discussion of the clinical and diagnostic aspects of VL relates particularly to delayed diagnosis of cases by professionals unfamiliar with the disease – which is becoming quite common due to the intense flow of people in the world resulting in the delayed initiation of therapy.

The role and strength of primary health care (PHC) varies considerably between countries although it has been on the global health-policy agenda for almost three decades since the Conference of Alma-Ata in 1978. A rapid international overview suggests the hypothesis that state-run or tax-borne health system tend to face less difficulties to implement strong primary care compared to those where non-state actor play a more important or even predominant role. This paper aims at contributing to empirical evidence and system understanding of the underlying causes for countries’ difficulties to strengthen PHC. Germany is an example for a healthcare system with long tradition and universal coverage of quality health services that has not yet managed to strengthen PHC. For assessing the reasons why, the paper starts with a general overview of relevant features and the rather complex structure of stakeholders in the German healthcare system, including medical training. It follows an analysis of potential system obstacles on the way towards strengthening PHC and particularly towards reforming medical training in order to better prepare future physicians for general practice and rural health. Finally, the paper briefly presents an innovative approach launched by the medical faculty of Magdeburg for promoting the recruitment of rural health professionals and upcoming system obstacles.

Background: “Early detection save lives” is a common and almost universal slogan for promoting cancer screening world-wide. Doubtlessly, early detection of cancer can save lives when the detection is followed with appropriate interventions. Conversely, when early detection is not followed with appropriate intervention(s), then it becomes effort in futility. Therefore, we are advocating that the slogan should change from early detection save lives to early intervention save lives, particularly, for resource- constraints settings where we have evidence that early detection might not be followed with appropriate interventions as exemplified by this case report. The paper sets out to x-ray challenges of oncology care in resource-constraint environment and to emphasise the fact that cancer prevention goes beyond detection. Materials and Methods: Using the case report of a breast cancer patient that was detected relatively early without appropriate intervention, we did a critical analysis of state of oncology care from prevention services to palliative care in a resources-constraint environment, drawing heavily from local experiences in cancer management. Results: The paper revealed the challenges of oncology care from preventive services to palliative care in a resource-constraint environment. Locally applicable recommendations aimed at optimizing the available resources and simultaneously, reducing cancer related morbidity and mortality should be strongly considered. Conclusion: A cancer prevention and control service is a comprehensive package in which early detection is a major component. For early detection of cancer to save lives, it has to be followed by appropriate interventions. In recognition of this fact, we are advocating a change in the slogan from “early detection save lives” to “early intervention save lives” based on our local experience which is seen in most developing countries that are hugely challenged by resource-constraints.

Males are consistently reported as more physically active than females regardless of age or measure. Often, this difference results in females identified as under active and at risk of longterm poor health outcomes. In this paper a different perspective drawing on evidence from many sources is offered. Males and females gain different health benefits according to the level, mode and intensity of the physical activity. Some potential ramifications of these gender differences in health benefits are evident in the prevalence of hypokinetic diseases across the life span and the interpretation of measured physical activity levels and intensities. By focusing on these differences, this papers highlights the need to take a more divergent view of what exercise really means, and how it provides health needs differently for males and females. We identified important implications for public policy and physical activity guidelines.

Aim: To provide a narrative review of the literature and discussion addressing the issue of young university undergraduate students, patterns of disordered eating and the relationship between stress and stress coping. Background: The term disordered eating reflects the spectrum of disturbed eating patterns, including anorexia nervosa and bulimic nervosa. In the last three decades a significant amount of research has been undertaken internationally in relation to this area, with increasing concern as disordered eating impacts upon the individual’s long-term health prospects, but also their ability to function and achieve as undergraduate students. Methods: A narrative review and discussion of the literature from 1980, against 7 databases with assessment of the papers applying a quality criteria scale. 35 papers were finally included for consideration in this review. Conclusion: There are a large number of young undergraduate students probably struggling with or at risk from disordered eating. A significant proportion of this may be undisclosed and presents sub-clinically. There may be issues relating to mental health in some of the cases, but the literature suggests at least a proportion of the students are perhaps struggling with stress/distress and poorly developed coping resources. The emergence of or exacerbation of disordered eating may present as a negative coping response. The discussion and review suggests a need for greater qualitative enquiry to expose more of the student’s voice in terms of eating and their stress/distress experience. Such deeper enquiry might better inform support for young students in managing stress in the early years at University.

Introduction: Psychotherapy is governed by an interplay of various patient, therapist and process variables. The patients’ engagement and their level of insight play a significant role in guiding the therapeutic journey. Methodology: Integrating concepts borrowed from client centred, metacognitive and insight-oriented therapies, this paper theoretically explores the role of insight as a confounding variable within the process of a cognitive-behavioural therapy setting, using qualitative findings derived from clinical case observations long-term therapy for a patient with mood disorder. Discussion: Active involvement of patients within the formulation and progression of therapy has been hypothesized to improve the outcomes, as greater insight aids patients in the identification and regulation of their emotions, and relapse prevention. Conclusion: This paper reiterates the importance of transcending the structured models of cognitive-behaviour therapy to explore the establishment of an insight-based alliance between the patient and the therapist, to achieve greater therapeutic outcomes both in terms of coping and resilience building.

Duty to care is the first oath that each nurse must take while entering in nursing profession. It’s not only mean to provide care but also protect the patient from potential harm in term of giving infection from himself/herself. This commentary paper is based on a scenario, addressing an ethical conflict between a duty nurse and management, where administration wants a sick nurse to give care to an organ transplant patient. This paper also aimed to give critical review and identify the possible solution for such a routine ethical issues.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. "The literature states that maltreatment in childhood and youth make up a problem on a global scale that exceeds ethnicities, religions, cultures, social and economic classes. It is also said that more than half of the injuries from maltreatment occur in the head and face. Assuming the particular relevance of orofacial structures, the dentist must know how to observe and recognize the indicators and properly diagnose the injury by maltreatment. This scientific review aimed to understand what types of intraoral lesions, signs or external lesions of the head or neck can be associated with child maltreatment. One primary database was searched so that systematic review articles and meta-analysis, case reports or case series of intraoral lesions, signs or external lesions of the head or neck by child maltreatment could be acquired. The references in the works acquired by electronic search were manually researched and the authors of all possibly relevant papers were contacted. In all searches inclusion and exclusion criteria were applied. Of the twenty two papers included two were systematic reviews and twenty were case reports or case series. The twenty articles of case reports or case series exposed information from thirty-five clinical cases included. Despite the limitations of scientific evidence it can be concluded that oral cavity, head and neck regions are home to multiple and diverse injuries by maltreatment of children and youngsters."

An important framework for understanding a social problem is to examine it through the lens of hybrid policy analysis model. Doing so will help an analyst, a policy developer, or reformer to not only appreciate the background but also understand the condition and direction of an existing policy for the purpose of reformation. This paper utilizes a hybrid policy model to analyse Nigerian mental health Lunacy Act (1958) that still governs the treatment of mental illness in Nigeria today. The paper also provides some recommendations that can be adopted to enhance the treatment of mental illness and mental health policy in Nigeria.

With technological advancement, health care is becoming complex for the individuals and meeting individual expectations have become a great challenge for Health Care Providers (HCP). Health care providers face ethical dilemma in everyday situation for taking decision for patient’ better health outcomes. The aim of this paper is to highlight the controversy between giving patients’ autonomy in taking independent decisions and health care professionals’ expertise to breach patient autonomy in order to save a patient’s life and to provide maximum benefits to the patient. Moreover, this paper also highlights the significance of culturally sensitive care in health care setting. Research shows that in most of the situations, HCPs take decision in view of their expertise in the medical field. However, on many occasions, both HCP and patients are not satisfied with the decisions that are taken in the best interest of the patient.

Indian medicinal plants have potent effects in treating diseases such as hypercholesterolemia. This review was performed on published Indian articles on hypocholesterolemic effect of Indian medicinal plants through literature search using Cochrane Library Database, Embase, Sci-finder, Pubmed with MeSH keywords and abstracts of Medicinal and Aromatic plants. All databases were searched from their respective inception until April 2011. About 15,620 papers were obtained using related titles and keywords through the electronic databases as well as various other sources. Therefore, 110 papers were finalized on native and naturalized Indian medicinal plants (24) belonging to various families and were then reviewed. Hypocholesterolemic effect of Indian medicinal plants was furnished with available animal models and clinical trials, which contribute to design new strategies to manage hypercholesterolemia.

Background: In spite of the increase in the number of people testing for HIV, the virus that causes AIDS, stigma and discrimination against people living with HIV/AIDS (PLWH) remains one of the major obstacles in the fight against HIV/AIDS. This paper examines the factors that influence HIV testing in Zambia and looks into detail whether testing for HIV reduces stigma and discrimination against PLWH. Methods: The data used in this paper were drawn from the 2005 Zambia Sexual Behaviour Survey conducted by MEASURE Evaluation and the Central Statistical Office, Zambia. This is a nationally representative survey whose main objective is to obtain national estimates on a number of key indicators important for monitoring progress of the national HIV/AIDS/STDs programme. The study was conducted among women aged 15-49 years and among men aged 15-59. Our analysis is based on 3,982 men and women aged 15-49 years. Results: Results show that HIV testing is not the most significant factor in inculcating tolerant attitudes towards PLWH. The most influential factors are level of education and knowledge of HIV/AIDS. Multivariate results also show that respondents who are young, from Nyanja-speaking ethnic groups, with low HIV/AIDS knowledge levels, less than secondary education, and those with high risk sexual behaviour had lower odd-logs of having more than less tolerant attitudes towards PLWH. On the other hand, health workers and those from Region 1, and males who had ever tested for HIV had higher odd-logs of having more than less tolerant attitudes towards PLWH. Conclusions: This paper demonstrates that HIV testing alone is not the most influential factor towards achievement of positive attitudes towards PLWH. Ideally, apart from learning about one’s status, a person who has undergone the counselling process during testing should also have more tolerant attitudes towards people infected with HIV. Therefore, there is need to ensure that counselling is emphasised before and after testing for HIV in order to change attitudes towards PLWH.

This paper is concerned with ethical issues that have to be considered when conducting research with children in nonwestern cultures. It sets the discussion in the context of current debate about researching children with cancer and explores the extent to which these ethical issues are similar to, or different from Western countries. A number of culturally sensitive issues encountered with children in Jordan while investigating their psychological wellbeing is discussed. These issues are discussed with relation to obtaining informed consent from children for participation in the research; issues of assuring confidentiality; and assuring no harm. Concern with children’s rights has been extended to the question is it ethical to provide full information about the study for children who were not informed about their cancer diagnosis. Such issues are often overlooked and for future studies with children acknowledging these issues can help provide a basis for reasoning and direct actions. The ethical issues that are discussed in this paper exemplify that exploring children’s psychological distress in a culture where this is not recognized provides the researcher with a number of concerns; the communication approaches of illness diagnosis, the wisdom of their elders, and the importance of their family which may result in reluctance to show emotion or to question decisions made on their behalf. The necessity for researchers to take an ethical stance in such cases may encounter difficulty and a number of issues had to be addressed and sorted case by case.

Background: Health-related quality of life is a frequently assessed patient-reported outcome in the current literature on patients living with atrial fibrillation. Originally, quality of life is an abstract, complex concept, and there is no consensus on a final definition of it. Considering overall quality of life to be assessable using a standardized tool may lead to the loss of valuable knowledge about the patients’ individual lived experiences. Aim: To report how the concept of quality of life is being defined and which arguments are given for using the concept in scientific research papers on patients living with atrial fibrillation. Method: Systematic literature study based on analysis of 53 scientific research papers on patients living with atrial fibrillation and inspired by Leif Becker Jensen’s suggestions on how to perform text analysis on a hermeneutical process described by Hans Georg Gadamar. Findings: Three ways of defining the concept of quality of life and five preferred ways of giving reasons for using the concept were found. Thirteen of the papers offered no definition of the concept of quality of life, while 19 papers did not offer arguments for using the concept. Conclusion: Quality of life is seen reduced into assessable parameters like health status. This might lead to the loss of valuable insight into the patients’ subjective perception of their lives. To avoid this reduction in future, it is important to call for clear definitions and arguments for

Human error can occur in any profession. Medical errors are most commonly occurring errors in a health care system, which are responsible to delay patient’s recovery and produce harm to patient. However, being as a health care professional, it is the requirement of professional code of ethics to do well and not to harm our patients. Historically, many of these errors were not disclosed to patients but the trend is emerging for more open disclosure of medical errors to patients and their families. The aim of this paper is to explain medical error and analyze this concept in the light of ethical principles. The paper will discuss the role of medical professionals in the disclosure of medical errors integrating an explicit ethical decision making process named MORAL. Citation: Ghazal L, Saleem Z, Amlani G (2014) A Medical Error: To Disclose or Not to Disclose. J Clin Res Bioeth 5: 174. doi:10.4172/21559627.1000174

The purpose of this paper is to outline the academic and medical evidence for Tai Chi and Qigong impact on pain, and describe the hypothesized mechanism that enables Tai chi and Qigong to work so well at relieving pain - often better than opioid pain medication, and with fewer side effects. This paper also describes a paradigm for research which will increase the likelihood that researchers doing projects in this field can synergize their efforts and start building a foundational body of knowledge rather than continue to do independent and disconnected studies on the phenomenon that enables Tai Chi and Qigong to work.

This paper analyzes multiple articles that demonstrate the effects of poor nutrition on school-age children. The research shows that having a healthy, balanced diet improves brain capacity, maximizes cognitive capabilities, and improves academic performance in school-age children. Alternatively, the research also shows that having too much junk food and an unhealthy diet decreases academic performance by limiting the amount of information to the brain. The brain is able to both retain and recall on demand. The literature also shows the danger of not having enough nutrition and the effects of food insufficiency, which can lead to malnutrition as well as poor academic performance. Overall, this research illustrates the need to aid children in maintaining a nutritious lifestyle. Whether at home or at school, there is a responsibility of the community; locally, regionally or governmentally, to afford each child an equal chance to succeed academically. Socioeconomic status has been shown to have an effect on a child academically, and this paper shows that coming from a poorer neighborhood should not decrease that child’s chances of being a well-adjusted, healthy student.

This paper reports research which identified a number of mental health help-seeking responses in a rural region of Australia. It describes the characteristics of services and of individual health professionals, as well as some Australian government initiatives that may promote help seeking behaviours. Focus group and individual interviews were undertaken. Participants included those who had personally experienced mental ill health, family and professional careers of individuals with mental ill health and individuals from rural culturally and linguistically diverse (CALD) communities. The researchers found that while many previously reported factors, such as stigma, limited confidentiality, cost factors, and previous negative experiences with mental health care continue to inhibit help-seeking, a number of responses and initiatives may actively promote help-seeking behaviours. These include: mental health literacy; targeted government schemes; accessible information; continuity of care and affordable services. The paper concludes that promoting these help-seeking enablers may support more desirable outcomes for those experiencing mental-ill healths in rural areas of Australia.

Phase I clinical trials raise ethical challenges, particularly the Phase I trials that involve a novel therapy being tested in humans for the first time, usually termed first-in-human (FIH) trials. The ethical appropriateness of clinical research requires having a favorable risk-to-benefit ratio and protecting patients from excessive risk, but both of these standards may be difficult to assess and to achieve in Phase I trials. There are no widely accepted standards for judgments concerning risk, benefit, and value in Phase I trials. Also the question of how to conceptualize and compute benefit has been a subject of ethical debate, particularly for Phase I trials where the likelihood of therapeutic benefit to participants is very slight. Specifically, should regulators and institutional review boards approve Phase I trials in the absence of likely benefit to participants when these subjects are being exposed to an uncertain and potentially high level of risk. Then there is the question as to how to communicate accurate and meaningful information about the uncertainty, risk of adverse events, and the very limited, if any, prospect of therapeutic benefit to potential trial participants in order to promote a meaningful informed consent process. That FIH trials involving highly novel agents often enroll participants with serious unmet needs further complicates the process. Very serious adverse reactions that occurred in the first-in-human trial of the monoclonal antipody TGN412 in Britain led to the issuing of several reports on first-in-human studies and the European Medicines Agency published a guideline on first-in-human trials shortly thereafter. In the past two years the (United States) Food and Drug Administration (FDA) has approved Investigational New Drug applications for three Phase I first-in-human clinical trials of candidate therapeutics derived from human embryonic stem cells (hESCs). Neither the FDA nor the National Institutes of Health have developed their own guidelines for the safety and ethics of first-in-human trials or guidelines for first-in-human trials with hESC derivatives. The analysis in this paper highlights the need for more focused attention to the ethical issues that first-in-human, trials raise. The paper proposes identifying prerequisites for beginning trials with a novel and potentially high-risk intervention. Preferably, there should be clear-cut guidelines and/or review by a central body.

In the 1970’s when the substance abuse treatment field was still developing as a discipline, there was a great deal of workers needed to help with the large amount of substance abusers wanting help. And since specific credentials were not yet established for the field of addictions, individuals with sobriety were hired on and given on the job training. The literature has described many barriers that the counselor in recovery has been faced with over the decades. A common theme throughout the literature is that these individuals usually enter the field at an older age and have less formal education than the non-recovering counsellor. The role of the counsellor in recovery is often distorted within the field by the second-class citizen status to which they are sometimes subjected. By writing this paper we hope to resurrect topics that might be perceived as barriers by counsellors in recovery that were briefly discussed in the literature decades ago. To begin this process of reform, this paper reviews the literature in an attempt to examine the perceived barriers associated with the recovering addict working in the addiction field. It also addresses the limitations of the studies conducted to date, provides recommendations for further research and proposes that this topic be explored using a qualitative approach, so that this unique group of counsellors can construct their own narratives.

With the arrival of advancements in modern medicine, most of the aging related diseases have attained great attention in the era. The disease of the elderly may affect their related activities, and even cause serious threat to the life. Demographic transitions have occurred in the field of geriatrics in China. The senile diseases have also showed a rising trend. In this paper, health effects and different intervention strategies on cardiovascular disease and its risk factors were analysed. The results show that taking the necessary intervention strategies can further ensure the prevention of cardiovascular disease in the elderly population.

The aim herein is to show the need for reconsidering our approach to the use of psychopharmacology as a standard treatment for mental health. Although the most recent scientific research supports abandoning it altogether, this paper presents arguments using pure logic. Using one of the simplest valid propositional forms, Modus Tollens, the argument will flow as follows: if a method is successful, it must meet specific criteria; the method does not meet the required criteria; therefore, the method is unsuccessful. &nbsp

Personalized medicine becomes an area of great interest following the recent development in human genetics, proteomics and metabolomics. There is an increasing need to embed the scientific discoveries from basic medical research into real life clinical practices, such that a patient's biological traits can be used to facilitate treatment. Those individualized biological traits, termed as biomarkers, are actively involved in developing personalized medicine and therefore bring out challenges to clinical trial designs. The necessity of biomarker validation and patient subgroup selection make the trial design more complex. This paper will first introduce different types of biomarkers and then review the challenges of clinical trial design with biomarkers from the clinical, statistical and regulatory perspectives.

Background: Drug use is a complex subject involving the prescriber, the dispenser, the patient and pharmaceutical institutions. It is influenced by factors such as drug availability, prescriber’s experience, and knowledge of dispensers, health budget, cultural factors and many more. Inappropriate drug use is the problem of the whole world; however the degree of the problem is higher in developing countries like Ethiopia. Objective: To assess drug use pattern by using who core drug use indicators at public hospitals in Gamo Gofa Zone, Southern Ethiopia September 2013. Methods: Retrospective and prospective cross sectional study were used to collect data from prescriptions dispensed through the general outpatient pharmacies and Information for patients respectively. A pretested structured questionnaire was employed to collect information from prescription papers and respondents after obtaining a verbal consent. Data was entered, cleaned, edited and analysed using SPSS Version 16.0 statistical software package. Results: The average number of drugs per prescription was 1.77 in Arba Minch General Hospital and 1.95 in Chencha District hospital ranging from 1-5. Percentage of encounter with antibiotics was 292 (48.67%) and 360 (60.20%) respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 100%. The mean consultation time spent between the prescriber and patient was 3.82 minutes and 3.66 minutes respectively and the mean pharmacy dispensing time was 1.18 minutes and 1.33 minutes respectively. More than half Patients had knowledge on drug dispensed to them 60.0% and 52.0% respectively and none of drugs dispensed were adequately labelled. Conclusion: In our study the labelling status of prescribed medicines was very poor and needs special attention. Dispensing time is very short and it could have influenced patient’s knowledge on dispensed drugs. Furthermore designing strategies to improve availability of key essential drugs; establishing antimicrobial stewardship committee in both hospitals and improving drug and therapeutics committee by responsible bodies.

This perspective paper is aimed to describe an Italian experience related to the empirical implementation of Congenital Heart Disease (CHD) transition care models, highlighting the most significant author’s perspectives. The CHD transition care models implementation strategy adopted at Policlinico San Donato (Italy) is closely linked to the clinical practice and to the research activity at national and international level. This strategy could be an efficient start-up to boost the understanding of the adolescent patients’ needs, also giving more evidence to the effectiveness of the transition care models.

A call center is a central place where Customer Care Associates (CCA) handles queries of customers over the telephone. Over the past two decades, the rapid escalation in access to new information technologies that is computers and mobile phones in particular has increased the demand of creative methods to connecting these tools to address reproductive health challenges [1]. This paper will highlight the importance of the role of telehealth call centers in providing sexual and reproductive health services to attain woman reproductive health. It will also cover significance, purpose, and questions of the present study. This chapter intends to provide a comprehensive review of the literature around the topic of interest: telehealth call centre and its significance to women sexual and reproductive health. The purpose of the chapter, literature review is to write an in-depth analysis and synthesis of current literature to understand the advancement of information and communication technology (ICT) in providing health care through call centres and its significance for women reproductive health. In addition, barriers to approach women reproductive health will also be explored which will justify the need for conducting this present study.