Discussing parenthood with gay men diagnosed with HIV: a qualitative study of patient and healthcare practitioner perspectives

Background Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate. Methods Qualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20–45, who did not have children, and 16 HIV clinicians. A thematic analysis identified potential reasons why parenthood was rarely discussed with gay men in HIV care. Results Two sets of ideas contributed to a lack of conversations about parenthood: clinicians’ ideas about what matters to gay men and men’s ideas about what it means to be HIV-positive. Both sets of ideas largely excluded having children, with patients and practitioners similarly unlikely to raise the topic of parenthood in the clinic. Contrary to what clinician commonly assumed, many men expressed interest in receiving more information, highlighting the importance of reassuring people upon diagnosis that it is possible to become parents while living with HIV. Conclusions Parenting desires and intentions were rarely discussed with men in HIV care. Our findings illuminate the potentially beneficial effects of emphasising that having children is a possibility at diagnosis, regardless of patients’ gender or sexuality. Conveying this information seems meaningful, not only to men who want to become parents in the future but also to others, as it appears to alleviate fears about mortality and ill health.

Low back pain prevalence, beliefs, and treatment seeking behaviour in multi-ethnic Suriname

Objectives To determine LBP prevalence in urban and rural communities and to assess back beliefs and treatment seeking behaviour for the first time in Suriname, a multi-ethnic country in the Caribbean community. Methods A cross-sectional community-based survey using the Community Oriented Program for the Control of Rheumatic Diseases methodology was performed between April 2016 and July 2017. Information on LBP prevalence and LBP-related treatment seeking, beliefs about LBP (Back Beliefs Questionnaire (BBQ)), level of disability (Oswestry Disability Index), and the risk of developing persistent disabling pain (Start Back Screening Tool) was collected. Results A total of 541 out of 2902 individuals reported current acute or chronic LBP. It was more prevalent in urban (20.2%) than in rural (13.7%) communities, especially in females and older adults (>55 years). Individuals from rural areas (median BBQ = 18.00 (14.00–22.00)) had significantly more negative beliefs than the urban population (median BBQ = 25.00 (19.00–31.00)) (p < 0.001). Maroons displayed more negative beliefs than Creole (p = 0.040), Hindustani (p < 0.001), Javanese (p < 0.001) and Mixed ethnicity (p < 0.001). At least 75% of the LBP population sought care, especially from a western healthcare practitioner. Seeking treatment and having a higher risk to develop persistent disabling pain was significantly associated with more disability (p < 0.001). Age ≥45 years (p < 0.001), Indigenous ethnicity (p < 0.05), and functional disability (p < 0.001) were factors influencing treatment seeking. Conclusions LBP is a prevalent health problem in the Surinamese urban community, especially in older adults and among females. Most individuals experiencing LBP visited a western healthcare practitioner and had more negative beliefs compared with other communities.

Acts and distance—a commentary on Brummett's ‘when conscientious objection runs amok’

In his ‘When conscientious objection runs amok: A physician refusing human immunodeficiency virus (HIV) preventative to a bisexual patient’, Brummett has argued that Catholic physicians (or indeed any other healthcare practitioner) should not be able to raise conscientious objections to HIV pre-exposure prophylaxis for bisexual patients, as this constitutes discrimination. Brummett argues that such a conscientious objection represents an instance of conscience creep, which he argues is undesirable. Here I re-analyse the case presented by Brummett using a teleological framework and making reference to Catholic teaching on cooperation with evil. While I agree with Brummett that in this case the physician should not have had the right to conscientiously object, I argue that the teleological framework offers advantages over the argument Brummett has presented. I also comment on why only considering empirically measurable harm as a publicly defensible reason for one to hold a conscientious objection is problematic, as well as on the difficulties associated with cases of discrimination in a pluralistic society.

NARRATIVE-BASED MEDICAL WRITING: AN EMP CASE STUDY

The article discusses a case study employing medical writing for the development of skills, attitudes and values that are essential for the healthcare worker’s identity. The emphasis is made on empathy, communication skills and communicative tolerance. The authors argue that these attitudes can be enhanced in the academic curriculum of medical universities. The possible way to improve personal qualities essential for the future career of a medical worker is through narrative-based medical writing, which can be implemented in the course of the English for Specific (Medical) Purposes (ES(M)P) course. The 13-week course ‘Narrative-based medical writing’ designed and performed at Voronezh Medical University involved 60 undergraduate students. The participants had to complete 10 to 13 writing assignments describing patients’ experience of a disease. The key findings of the study have demonstrated a more competent usage of reflective writing techniques, a higher level of empathy manifestation and communicative tolerance comparing to the baseline measurements. These results support the idea that EMP with a narrative-based writing module can make an essential contribution to the development of communicative tolerance and empathic manifestation, thereby enabling the development of the crucial professional attitudes of a healthcare practitioner.

Legislation and ethics of physician-assisted suicide and euthanasia in psychiatric patients

Euthanasia is the act by which a third party (a physician or qualified healthcare practitioner) intentionally terminated a patient’s life by the patient’s request—the doctor administers the prescription. Physician-assisted suicide is where a physician or healthcare practitioner provide the means to a patient under the patient’s request, which will intentionally terminate the patient’s life—the individual then self-administers the prescription. Assisted suicide is where a physician or a healthcare practitioner is not directly involved and usually another third member or organization would assist in providing the patient with the means for self-administered suicide. This text presents the available data from the Benelux region on euthanasia and physician-assisted suicide requests that are grounded in psychiatric disorders. From a psychiatrist’s point of view, clinical and ethical questions are raised by such practices, since suicide prevention is a primary purpose of psychiatric care and a key focus of training.

Coronavirus - Past and Present

Coronavirus infectious disease 2019 (COVID-19) caused by a new mutant strain of coronavirus (SARS-CoV-2) which is an ongoing global health pandemic. However, you'll have first become conversant in the term coronavirus during the severe acute respiratory syndrome (SARS) outbreak in 2002. Here we summarize important distinguishing characteristics concerning both SARS-CoV and SARS-CoV2. SARS-Cov2, which is caused by the new novel coronavirus, has been highlighting the news lately. The virus that causes SARS is entitled as SARS-CoV, while the virus that causes COVID-19 is entitled as SARS-CoV-2. SARS was declared a global pandemic in late 2002 in China, when a healthcare practitioner got infected with a virus and unknowingly travelled to Hong Kong, with rapid spread to other nearby countries by international travelling of people. But due to many other factors, SARS was restrained in around 30 countries with an estimated mortality rate of 10% by the end of the pandemic in mid-2003. The focal point of this current novel coronavirus outbreak is within Wuhan city of China. Animal host act as a reservoir for novel coronavirus and it can infect human by crossing this barrier. Hence, a seafood wholesale market in the city was thought to be one among the places from where the transmission of COVID-19 initiated. As we go further in this article, we will come across the differences in genomic structure, pathogenicity, clinical features and lab investigations among SARS-CoV2 and SARS-CoV.