Ethics and genetics in Latin America

Genetic research in human beings poses deep ethical problems, one being the problem of distributive justice. If we suppose that genetic technologies are able to produce visible benefits for the well being of people, and that these benefits are affordable to only a favored portion of society, then the consequence is obvious. We are introducing a new source of inequality. In the first section of this paper, I attempt to justify some concern for the distributive consequences of applying genetics to human beings. This concern transcends a mere preoccupation for material equality. I argue that genetic inequality can undermine the very basis of social cooperation, at least regarding health care. The second section is more practical. My aim is to defend how, at least in some legal and cultural frameworks (such as those clearly apparent in some Latin American countries), the undesired distributive consequences of genetics are more likely to arise and more difficult to avoid.     

And How Are We Supposed to Pay for Health Care? Views of the Poor and the Near Poor on Welfare Reform

The welfare reform debate focuses on the characteristics of who gets government benefits and who pays for them. People perceive the welfare reform debate as the white middle class denying benefits to poor people of color. But larger questions regarding the U.S. lack of comprehensive social policy for health care, education, and child care lurk behind these concerns. Drawing on research with public assistance recipients and working- and middle-class people, in this paper I explore the ways that people interact with and perceive government social programs. I argue that both attitudes and proposed solutions toward welfare reflect different access to government programs and resources such as jobs, savings, and social supports among people who have and have not accessed welfare. Since economic disparity in the United States correlates highly with race, the debate over welfare reform also involves racial attitudes. Changing both the welfare debate and poverty in the United States must start by providing universal benefits, [ public policy, poverty, welfare reform, race, United States ]     

Social Psychological Dimensions of Bioenergy Development and Public Acceptance

The best technology does no good unless people use it. Thus, the future of biofuels depends not only on development of effective and efficient technologies but also on the social, economic, and political climate within which people decide to use or avoid these new fuel sources and technologies. On a social psychological level, individual behaviors are often guided by people’s attitudes toward the behavior or objects involved and by the norms established by others within the social setting. Therefore, understanding technology adoption requires an understanding of how public attitudes and beliefs are formed or changed, as well as the implications of these changes for social norms. We provide an overview of basic social psychology research connecting attitudes and norms to individual behavior, and we describe implications of these social factors for biofuel development and use.     

Bias,Discrimination, and Obesity

This article reviews information on discriminatory attitudes and behaviors against obese individuals, integrates this to show whether systematic discrimination occurs and why, and discusses needed work in the field. Clear and consistent stigmatization, and in some cases discrimination, can be documented in three important areas of living: employment, education, and health care. Among the findings are that 28% of teachers in one study said that becoming obese is the worst thing that can happen to a person; 24% of nurses said that they are “repulsed” by obese persons; and, controlling for income and grades, parents provide less college support for their overweight than for their thin children. There are also suggestions but not yet documentation of discrimination occurring in adoption proceedings, jury selection, housing, and other areas. Given the vast numbers of people potentially affected, it is important to consider the research‐related, educational, and social policy implications of these findings.     

Dietitians and Nutritionists: Stigma in the Context of Obesity. A Systematic Review

Aim

Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists.

Method

A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library.

Results

Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology.

Discussion

Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.     

Positive alcohol expectancies mediate associations between ADHD behaviors and alcohol-related problems among college students

An increasing percentage of college students report being affected by ADHD behaviors, and this population is at increased risk of experiencing negative consequences associated with alcohol consumption. However, specific factors motivating alcohol consumption and contributing to negative outcomes among these individuals are not well understood. Recent work suggests alcohol expectancies may interact with ADHD behaviors to influence negative drinking-related outcomes among those with elevated inattention and/or hyperactivity-impulsivity. Seven-hundred-forty emerging adults (M age = 19.13 [SD = 2.25] years; 72.1% female; 85.8% Caucasian) enrolled in two public universities in the Southeast and Midwest USA completed the Brief Comprehensive Effects of Alcohol Survey (B-CEOA) and provided self-reports of ADHD symptoms and drinking-related outcomes. Multiple mediation analyses were conducted to evaluate effects of ADHD behaviors (i.e., hyperactivity-impulsivity, and inattention) and related impairment in major life domains (e.g., social interactions, occupational and educational activities, fulfillment of daily responsibilities) on drinking-related outcomes via positive and negative alcohol expectancies, controlling for sex, age, co-occurring oppositional behaviors, and data collection site. Inattention, hyperactivity-impulsivity, and impairment directly predicted both personal and social problems consequent to alcohol use. Effects of ADHD behaviors and impairment on drinking-related personal and social problems were partially mediated by positive expectancies. Findings are consistent with and extend prior work supporting a role of positive alcohol expectancies in alcohol-related negative outcomes among college students experiencing mild to moderate symptoms of ADHD.     

Science, Stewardship, and Spirituality: The Human Body as a Model for Ecological Restoration

Ecological restoration is practiced by people of diverse backgrounds working at many different levels in a variety of settings. Portraying the human body as a metaphor of a natural ecosystem can be useful in identifying the breadth of strategies used to restore the natural environment. A technical approach, environmental stewardship, and more spiritual traditional attitudes to ecological restoration can be viewed as analogous to restoring health to the human body through an operation in a hospital, administering remedies to oneself from the medicine cabinet, and taking a broader holistic/preventative approach to cultivate the mind–body connection through, e.g., yoga.     

Consequentialism, reasons, value and justice

Over the past 10 years, John Harris has made important contributions to thinking about distributive justice in health care. In his latest work, Harris controversially argues that clinicians should stop prioritising patients according to prognosis. He argues that the good or benefit of health care is providing each individual with an opportunity to live the best and longest life possible for him or her. I call this thesis, opportunism. For the purpose of distribution of resources in health care, Harris rejects welfarism (the thesis that the good of health care is well-being) and argues that utilitarianism in general may lead to de facto discrimination against groups of people needing health care. I argue that well-being is a superior theory of the good of health care to Harris' opportunism. Harris' concerns about utilitarianism can be better addressed by: (i) relating justice more closely to reasons for action; (ii) by conceptualising the relationship between reasons for action and the value of the consequences of those actions as a plateau rather than scalar relationship. Justice can be understood as satisfying as many equally rational claims on resources as possible. The rationality of a person's claim on health resources turns on the strength of that person's reasons to promote certain health-related states of affairs. I argue that the strength of that reason does not track the expected value of that state of affairs in a fully scalar fashion. Rather a person can have most reason to promote some state of affairs, even though he or she could promote other more valuable states of affairs. Thus there can be equal reason for a distributor of public resources to save either of two people, even though one will have a better and more valuable life. This approach, while addressing many of Harris' concerns about utilitarianism, does not imply that doctors should give up prioritising patients according to prognosis altogether, but it does allow that patients with lower but reasonable prognosis should have a share of public resources.     

Question of Mutual Security: Exploring Interactions between the Health of Coral Reef Ecosystems and Coastal Communities

Coral reefs are the worlds most celebrated indicators of ocean health. While the global trajectory of coral reef degradation is now well documented, and the accompanying loss of economic benefits increasingly demonstrated, the consequences in terms of human health have been largely ignored. Reefs provide a wide array of benefits to humans, contributing most directly to the health of subsistence fishing communities located on adjacent coasts and islands. Interactions between human and marine ecosystem health are complex, bidirectional and nonlinear. We draw on a broad range of data and experience to identify key links in the ecological chain from the coral polyp to the human society. Our conclusions are that humans are components of coral reef ecosystems, few studies of reef health incorporate human health, few data are available to quantify the health services reefs provide to people, and human health security is essential to the preservation of coral reef ecosystems.     

Indonesia ergonomics roadmap: where we are going?

There are so many definitions for ergonomics terms such as human factors, human factors engineering, human engineering, human factors psychology, engineering psychology, applied ergonomics, occupational ergonomics, industrial ergonomics and industrial engineering. The most inclusive terms are ergonomics and human factors. Both represent the study of work and the interaction between people and their work environmental systems. The main objective is especially fitting with the need to design, develop, implement and evaluate human-machine and environment systems that are productive, comfortable, safe and satisfying to use. The work of the ergonomists in Indonesia--most of them are academicians--have one thing in common, i.e. with the appropriate type of ergonomic approaches to interventions; there would be improvements in productivity, quality of working conditions, occupational safety and health (OSH), costs reduction, better environment, and increase in profits. So many researches, training, seminars and socialization about ergonomics and OSH have been done concerning micro-to-macro themes; but it seems that we are practically still running at the same place up to now. In facts, workers are still working using their traditional or obsolete methods in poor working conditions. Accidents are still happening inside and outside industry with the main root-cause being human "unsafe behavior" and errors. Industrial products cannot compete in the global market, and so many manufacturing industries collapsed or relocated to foreign countries. This paper discusses such a roadmap and review what we ergonomists in Indonesia have done and where we are going to? This review will be treated in the field of ergonomics and OSH to take care the future Indonesia challenges. Some of the challenges faced are care for the workers, care for the people, care for the quality and productivity of work, care for the new advanced technologies, care for the environment, and last but not least care for the nation.     

The Effect of Conservation Knowledge on Attitudes and Stated Behaviors toward Arthropods of Urban and Suburban Elementary School Students

Arthropods provide ecosystem services upon which humans depend, yet are declining across the globe. Arthropods are neglected from conservation efforts due to many factors that include a lack of understanding of their roles and conservation need. Knowledge gain of arthropod roles could therefore increase support for their conservation, albeit indirectly through attitude changes. Evidence suggests knowledge and attitudes are more highly correlated in children and that environmental attitudes are shaped before age 12 years. Differences in the connection between knowledge, attitudes, and behaviors toward arthropods may also be different in children from different cultures or from urban versus rural locations due to varying experiences with arthropods. We sought to understand if different types of knowledge increased positive attitudes and stated conservation-based behaviors toward insects in children in both urban and suburban schools. We conducted either a basic biology lesson or a conservation lesson on ecosystem services in both urban and suburban 4th and 5th grade classes, and used pre- and post-questionnaires to detect changes in knowledge, attitudes, and stated behavior toward arthropods. We found that urban students had significantly lower knowledge of, less positive attitudes toward, and fewer stated conservation behaviors toward arthropods but also exhibited the greatest positive changes when presented the conservation-based lesson. In addition, we found that being able to identify the type of arthropod correctly was related to more positive attitudes and stated behaviors. Finally, we found that while attitudes did not change toward some species, stated conservation behaviors did increase with knowledge of the arthropod’s role in the ecosystem. Education in urban schools, with a focus on both distinguishing arthropods as well as ecosystem services, provides the most change per effort for conservation. Arthropod lessons could be done by local professors and undergraduate students in urban classrooms or local green spaces.     

Disordered eating attitudes and behaviors in overweight youth

Disordered eating attitudes and behaviors appear to be quite common in youth, and overweight youth have been identified as a subset of the population at particularly high risk for endorsing such symptoms. Overweight and eating disorder (ED) symptomatology independently confer significant threats to one's physical and psychosocial health, showing strong links with body weight gain and risk for ED development. When concurrent, the risk for negative health outcomes may be compounded. The purpose of this article is to review the current state of the literature as it concerns disordered eating and its correlates in overweight children and adolescents. Extant literature on the prevalence, distribution, correlates, and etiology of disordered eating attitudes and behaviors (i.e., negative attitudes toward shape and weight, unhealthy weight control behaviors, and binge eating) in overweight youth is reviewed and consolidated in order to make assessment and treatment recommendations for healthcare providers. The current literature suggests that early detection of disordered eating in overweight youth should be a priority to provide appropriate intervention, thereby helping to slow the trajectory of weight gain and prevent or reduce the long-term negative consequences associated with both conditions. Future research should focus on explicating developmental pathways, and on developing novel prevention and treatment interventions for overweight youth exhibiting disordered eating patterns.     

Grieving for the Past and Hoping for the Future: Balancing Polarizing Perspectives in Conservation and Restoration

I consider the possibility that people engaged in conservation and management of species and ecosystems are experiencing grief related to ongoing loss of species, assemblages, ecosystem integrity, and so on. In human psychology, five stages of the grieving process have been identified, namely denial, anger, bargaining, depression, and acceptance. Although presented as a series of stages, it is recognized that the progression through them is not linear and people can move quickly among them or experience more than one at any one time. I then consider whether current polarized debates in conservation and restoration, for instance in relation to non‐native species and novel ecosystems, result in part from people operating from different places in the grief spectrum. Throughout the grieving process, hope remains a constant feature, and it is important to recognize the place of hope in motivating and sustaining people engaged in conservation and restoration. Although restoration provides great hope that losses can be minimized and, in some cases, reversed, this hope needs to be grounded in a realistic assessment of what is possible in a rapidly changing world.     

Depending on care: recognition of vulnerability and the social contribution of care provision

People who are paid to provide basic care for others are frequently undervalued, exploited and expected to reach often unrealistic standards of care. I argue that appropriate social recognition, support and fair pay for people who provide care for those who are disabled, frail and aged, or suffering ill health that impedes their capacity to negotiate daily activities without support, depends on a reconsideration of the paradigm of the citizen or and moral agent. I argue that by drawing on the ideas of human vulnerability and dependency as central to our personhood, a more realistic conception of selves, citizens and persons can be developed that better recognises the inevitability of human dependency and the social value of care work. I also indicate the significance of this vulnerability-focussed view for ethical evaluation of the emotional aspects of care relationships.     

Ecosystem Perspective of Groundwater Arsenic Contamination in India and Relevance in Policy

Millions of people living in India are at risk by consuming arsenic contaminated groundwater. Several technological solutions have failed to address the problem due to segmental approaches, resulting in human suffering for a period of three decades. The article is based on an analysis of arsenic-related health problems from an ecosystem perspective through a primary survey conducted in five arsenic affected villages in the state of West Bengal and review of existing research and policy documents. Although modern agricultural practices and drinking water policies have resulted in arsenic contamination of groundwater, current mitigation policy is essentially confined to biomedical approaches, which includes potable water supply and medical care. The study also shows that existing disparity, difficulty in coping, inaccessibility to health service and potable water supply and lack of participation in decision making have resulted in more suffering among the poor. On the other hand, spreading of arsenic contamination in the ecosystem remains unabated. Foods grown in the affected area have emerged as additional sources of exposure to humans. There is lack of evidence of any perceivable benefits due to sustainable agriculture, as present nature of agriculture practice is essentially driven by crop yield only. Further research is needed to generate credible evidence of alternative agriculture paradigms that may eventually reduce body burden of arsenic through reduced dependency on groundwater.     

Ecosystem services and management options as blanket indicators of ecosystem health

A pragmatic and integrative approach to evaluation of the environment combines ecosystem sciences, health sciences, and social sciences. Each has a crucial role to play: the ecosystem sciences provide information on the complex dynamics of ecosystems as they are influenced by stress and disturbance; the health sciences provide a methodology for systematic diagnosis of pathology, taxonomy of ills, and models for preventive as well as rehabilitative modes; the social sciences bring to the fore the importance of human values which are part and parcel of any health evaluation. The complexity of stress-response systems precludes anything approximating a complete understanding of mechanisms underpinning ecosystem transformations. However, the loss of ecosystem services and management options appears to be a general phenomenon that permits an overall evaluation of ecosystem health in both aquatic and terrestrial systems. Such blanket indicators take into account both the impairment of ecosystem function and societal values. This is illustrated by the history of ecosystem transformation in the Laurentian Lower Great Lakes and in the overharvested forest ecosystems of Eastern Canada. In both cases, cultural stress resulted in losses in highly valued ecosystem services and management options. These losses have been partially compensated for by new technologies that have permitted commercial use of the remaining lower quality resources. This process itself, however, may be pathological, reinforcing a degradation sequence rather than serving to restore ecosystem health.     

Dying under the bird's shadow: narrative representations of degedege and child survival among the Zaramo of Tanzania

In this article, I examine the cultural interpretations of degedege, an indigenous illness commonly recognized by the Zaramo people of coastal Tanzania as life threatening. Drawing on the narratives of three bereaved parents who lost a child to degedege, I analyze the contextual and circumstantial factors involved in these parents' negotiation of the identity of an illness and in their subsequent therapy seeking behavior. I show that even though cultural knowledge and etiological beliefs about degedege may be shared locally, there is significant variation in the therapeutic pathways that parents follow to deal with an actual episode of the illness. I emphasize the need for more contextualized data on health-seeking behaviors, and argue that it is necessary to pay attention to the micropolitics of health care decision making at the household level. Finally, I also call attention to the politics of provider-patient communication at public health facilities as a means to improve public health interventions to increase child survival.     

Improving the dialogue between public health and ecosystem science on antimicrobial resistance

The concept of health has evolved markedly from a bio-medical, mechanistic model to include an interdisciplinary perspective where human, animal and ecosystem health are integrated. One Health, EcoHealth and Planetary Health are examples of approaches to health advocating collaboration and interdisciplinarity at multiple levels. In practice, successful integration has been challenging and in particular, understanding of the ecosystem component of health lags behind the human and animal components. Antimicrobial resistance is an important threat to human health, which develops, is maintained and transmitted at the human–animal–environment interface. While the human and livestock components of resistance are well understood, this is not the case for the ecosystem component. This gap in knowledge leads to a poor representation of the environmental dimension of antimicrobial resistance in key policy documents and in interdisciplinary work around this issue. We interviewed a group of leading researchers in public health and ecology to explore their perceptions on the integration of ecosystem and public health research in the context of antimicrobial resistance. Experts from both fields considered that research on antimicrobial resistance is only beginning to consider ecosystems. They highlighted various barriers that have contributed to limited integration, such as conceptual barriers, and a lack of knowledge translators as facilitators. Better interdisciplinary integration is needed to address the challenge of antimicrobial resistance. Improving the dialogues between the disciplines is a necessary first step in this process. Greater engagement of ecologists is needed to build a more complete understanding of the role of ecosystems in human health, and identify how human interactions with ecosystems can both contribute to, and restrict, the development of antimicrobial resistance.     

滨海湿地生态系统服务及其价值评估研究进展

滨海湿地是介于海陆之间的过渡地带,具有丰富的生物多样性和很高的生产力,能为人类提供诸多生态系统服务,但它又是对人类活动极为敏感的生态脆弱区。沿海经济的发展使湿地资源的有限性与人类需求的无限性之间的矛盾日益突出,导致湿地多样性丧失、服务功能退化等。在阐述滨海湿地特征及其服务产生机理的基础上,介绍了运用经济学方法对生态系统服务进行评价的进展,分析了各方法的优缺点及应用情况,最后对滨海湿地生态系统服务价值评估中存在的问题进行了总结归纳,评估所面临的困难一方面来自生态系统本身的复杂性;另一方面来自经济学方法的局限性。因此今后的研究应从生态系统服务的形成机制入手,注重生态学及经济学理论的结合,改善评估方法,提高评估结果的有效性和可信度,为湿地资源管理及生态补偿机制制定提供有力支持。