The Unspeakable Nature of Death & Dying During Childhood: A Silenced Phenomenon in Pediatric Care

In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research.

Smart Electrically Assisted Bicycles as Health Monitoring Systems: A Review

This paper aims to provide a review of the electrically assisted bicycles (also known as e-bikes) used for recovery of the rider’s physical and physiological information, monitoring of their health state, and adjusting the “medical” assistance accordingly. E-bikes have proven to be an excellent way to do physical activity while commuting, thus improving the user’s health and reducing air pollutant emissions. Such devices can also be seen as the first step to help unhealthy sedentary people to start exercising with reduced strain. Based on this analysis, the need to have e-bikes with artificial intelligence (AI) systems that recover and processe a large amount of data is discussed in depth. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to complete the relevant papers’ search and selection in this systematic review.

Haiti: The Development of “Seamless” Assistance from Disaster Relief to UNPKOs

In this chapter, we will examine Japan’s response to a complex crisis in Haiti, in which a natural disaster and civil unrest were compounded. Persistent insecurity and confusion in Haiti, albeit under the presence of an ongoing United Nations Peacekeeping Operation (UNPKO), further deteriorated after the great earthquake in 2010. This challenge unexpectedly propelled Japan’s move toward closer “integration,” since several layers of civil-military cooperation rapidly developed to cope with the complicated emergency in post-earthquake Haiti. First, the Government of Japan (GoJ) deployed a civilian medical team and the Self-Defense Forces (SDF) emergency medical assistance unit (hereafter, the SDF medical unit) under the Japan Disaster Relief (JDR) Act. Following the SDF medical unit’s JDR work, the Japanese Red Cross Society (JRCS) carried on with medical assistance. Second, once emergency medical support ended, an SDF contingent was dispatched under the Peacekeeping Operations (PKO) Act. The Japan Engineering Groups’ (JEG’s) engagement in reconstruction served as a useful opportunity for the GoJ to refine the “All Japan” approach, further encouraging Japan’s inclination toward “integration.” Meanwhile, the experience in Haiti shed light on the gap in the legal assumptions between the JDR Act and the PKO Act, since neither of them anticipated the protection of civil JDR teams in insecurity.

“Dying with a Smile, Just Knowing that Somebody’s Listened to Me”: End-Of-Life Care and Medical Assistance in Dying in Canadian Prisons

Medical assistance in dying (MAiD) has been legal in Canada since 2016 and some incarcerated patients who are at the end of their lives are eligible for the procedure. Interviews with nine incarcerated men at a federal penitentiary in Canada provide insight into some of the ways that people who are navigating aging and end-of-life in prison think about MAiD. Interview themes are organized around: experience with death and dying; possibilities and barriers related to applications for release from prison at end-of-life; experiences of peer-caregiving in a prison palliative care program; support for MAiD and the expansion of eligibility criteria; what a good death looks like. Themes are contextualized alongside federal guidelines related to end-of-life care (EOLC) and MAiD for prisoners, highlighting that sound policy requires both generalizable principles and attention to nuance. MAiD rests on patient voluntariness, and thus autonomy over EOLC decisions is paramount for prisoners.

Telemedicine and Teleconsulting in the Era of COVID-19 Pandemic: A Useful Tool from Screening to Intensive Care Monitoring

The COVID-19 global pandemic has had striking effects on clinical practice and medical assistance and the progressive evolution of telemedicine and telehealth systems has allowed healthcare professionals to connect with patients yet respecting the striking need for social distancing. This article aims to review the possible ways to use telehealth and teleconsulting systems to guarantee an adequate level of clinical assistance starting from screening procedures up to support the management of patients admitted to intensive care units area, thus balancing the need to ensure continuity of care and at the same time limiting the possible sources of contagion expansion. Telemedicine may be a useful tool to improve clinical assistance and reduce the financial burden on the health system in a long-term view. Although it cannot completely replace patient-physician interactions, it would be desirable to implement this field and made it accessible to the largest part of the population.

Assessment of the relationship of exacerbations of diseases of the cardiovascular system with the meteorological situation

Introduction. The impact of weather factors on the occurrence of exacerbations of diseases in meteodependent people is currently one of the actively studied problems of medicine. The aim of the study was to identify the relationship between exacerbations of diseases of the cardiovascular system with the meteorological situation to substantiate the need for preventive and informational work with meteodependent patients. Material and research methods. The study used daily data on the number of patients with cardiovascular diseases seeking medical care at Voronezh City Polyclinic No. 18 and daily information on weather conditions for 2018. The ratio of the average number of cases of medical assistance requests on days unfavourable for meteorological factors to the average number of cases of medical assistance requests per day during the year was calculated. Using software (Statistica Base V6.1), a correlation analysis of the relationship between the number of medical requests and meteorological factors was carried out. Results. It has been established that the appealability of patients with cardiovascular diseases for medical care on days unfavourable for meteorological factors is 1.1-2.0 times higher than the average annual indicator. The most informative characteristic of the six meteorological indicators taken into account in the study (average daily, minimum, maximum ambient air temperature; temperature drops by more than eight °C per day; atmospheric pressure; atmospheric pressure drops by 12 mm Hg per day or more) is a sharp drop in atmospheric pressure during the day, with which statistically significant (p <0.05) correlates the number of cases of patients with cardiovascular diseases seeking medical help. Conclusion. In medical institutions providing primary health care, it is advisable to single out separate groups of patients with meteorological dependence for dynamic observation and conduct information work with them to mitigate the severity of the course of diseases of the cardiovascular system on days unfavourable according to meteorological indicators.

Canadian Undergraduates’ Perspectives on Medical Assistance in Dying (MAiD): A Quantitative Study

Background and Objectives: In 2016, Medical Assistance in Dying (MAiD) became legal in Canada for those suffering a grievous and untreatable medical condition. Currently, it is not available to minors or to those with an untreatable mental illness, although it is likely the scope of MAiD will be widened to include persons with severe and untreatable mental illnesses. However, little is known about the factors predicting acceptance or rejection of MAiD for persons with either a grievous medical condition or an untreatable mental illness. Methods: A survey was administered to 438 undergraduate students to examine factors associated with their acceptance or rejection of MAiD. The survey included four different scenarios: a young or old person with an untreatable medical condition, and a young or old person with an untreatable mental illness. Demographic questions (age, sex, religion, etc), personality measures, and an attitude towards euthanasia scale were also administered, as well as questions assessing participants’ general understanding of MAiD and their life experiences with death and suicide. Results/Conclusion: Overall, most of the Canadian undergraduate participants accepted MAiD for both terminally ill and mentally ill patients; however, different variables, such as age, religion, and ethnicity, predicted the acceptance or rejection of MAiD for each scenario.