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Arnason V 《Medicine, health care, and philosophy》2000,3(1):17-23
In his seminal work, Truth and Method, theGerman philosopher Hans-Georg Gadamer distinguishesbetween three types of what he calls the experience ofthe `Thou'.
In this paper, Gadamer's analysis of thisexperience is explained in terms of his philosophicalhermeneutics and brought to
bear upon thepatient-professional relationship. It is argued thatwhile Gadamer's analysis implies fruitful insights fora dialogical
account of the patient-professionalinteraction, it harbours elements which are conduciveto paternalistic practice of medicine.
The strongattribution of value to tradition and the respect forauthority emphasized in his theory result in a lack ofsensitivity
for individual self-determination which isneeded for a successful account of thepatient-professional relationship. 相似文献
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Cancer incidence among 10,211 airline pilots: a Nordic study 总被引:5,自引:0,他引:5
Pukkala E Aspholm R Auvinen A Eliasch H Gundestrup M Haldorsen T Hammar N Hrafnkelsson J Kyyrönen P Linnersjö A Rafnsson V Storm H Tveten U 《Aviation, space, and environmental medicine》2003,74(7):699-706
BACKGROUND: Commercial airline pilots are exposed to cosmic radiation and other potentially carcinogenic elements during work and leisure activities. HYPOTHESIS: Work-related factors affect cancer pattern of the pilots. METHODS: A cohort of 10,051 male and 160 female airline pilots from Denmark, Finland, Iceland, Norway, and Sweden was followed for cancer incidence through the national cancer registries. There were 177,000 person-years at follow-up, 51,000 of them accumulated after 20 yr since the time of first employment. Standardized incidence ratios (SIRs) were defined as ratios of observed over expected numbers of cases based on national cancer incidence rates. Dose-response analyses were done with Poisson regression method. RESULTS: Among male pilots, there were 466 cases of cancer diagnosed vs. 456 expected. The only significantly increased SIRs concerned skin cancer: melanoma 2.3 (95% CI 1.7-3.0), squamous cell cancer 2.1 (1.7-2.8), and basal cell carcinoma 2.5 (1.9-3.2). The relative risk of skin cancers increased with the time since first employment, the number of flight hours, and the estimated radiation dose. There was an increase in the relative risk of prostate cancer with increasing number of flight hours in long-distance aircraft (p trend 0.01). No increased incidence was found for acute myeloid leukemia or brain cancer which were of interest a priori based on earlier studies. CONCLUSIONS: This large study, based on reliable cancer incidence data, showed an increased incidence of skin cancer. It did not indicate a marked increase in cancer risk attributable to cosmic radiation although some influence of cosmic radiation on skin cancer cannot be entirely excluded. 相似文献
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In the present paper, we focus on the role that the concept of geneticization has played in the discussion about health care,
bioethics and society. The concept is discussed and examples from the evolving discourse about geneticization are critically
analyzed. The relationship between geneticization, medicalization and biomedicalization is described, emphasizing how debates
about the latter concepts can inspire future research on geneticization. It is shown how recurrent themes from the media coverage
of genetics portray typical traits of geneticization and thus contribute to the process. We look at examples of small-scale
studies from the literature where geneticization of medical practice has been demonstrated. Methodological disputes about
the relevance of empirical evidence for the geneticization thesis and the normative status of the concept are discussed. We
consider arguments to the effect that ideas from mainstream bioethics have facilitated geneticization by emphasizing individualistic
notions of autonomy and responsibility while ignoring the role of genetics in the wider social context. It is shown how a
concept like geneticization, which can be used to draw the attention of philosophers, social scientists and others to challenges
that tend to be neglected by mainstream bioethics, also has the potential to move people’s attention away from other pertinent
issues. This may happen if researchers become preoccupied with the transformative effects of genetics, and we argue that a
wider reading of geneticization should inspire critical analysis of the sociocultural preconditions under which genetics is
currently evolving. 相似文献
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Zeeb H Blettner M Langner I Hammer GP Ballard TJ Santaquilani M Gundestrup M Storm H Haldorsen T Tveten U Hammar N Linnersjö A Velonakis E Tzonou A Auvinen A Pukkala E Rafnsson V Hrafnkelsson J 《American journal of epidemiology》2003,158(1):35-46
There is concern about the health effects of exposure to cosmic radiation during air travel. To study the potential health effects of this and occupational exposures, the authors investigated mortality patterns among more than 44,000 airline cabin crew members in Europe. A cohort study was performed in eight European countries, yielding approximately 655,000 person-years of follow-up. Observed numbers of deaths were compared with expected numbers based on national mortality rates. Among female cabin crew, overall mortality (standardized mortality ratio (SMR) = 0.80, 95% confidence interval (CI): 0.73, 0.88) and all-cancer mortality (SMR = 0.78, 95% CI: 0.66, 0.95) were slightly reduced, while breast cancer mortality was slightly but nonsignificantly increased (SMR = 1.11, 95% CI: 0.82, 1.48). In contrast, overall mortality (SMR = 1.09, 95% CI: 1.00, 1.18) and mortality from skin cancer (for malignant melanoma, SMR = 1.93, 95% CI: 0.70, 4.44) among male cabin crew were somewhat increased. The authors noted excess mortality from aircraft accidents and from acquired immunodeficiency syndrome in males. Among airline cabin crew in Europe, there was no increase in mortality that could be attributed to cosmic radiation or other occupational exposures to any substantial extent. The risk of skin cancer among male crew members requires further attention. 相似文献
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Torsteinsdóttir S Carlsdóttir HM Svansson V Matthíasdóttir S Martin AH Pétursson G 《Vaccine》2007,25(37-38):6713-6720
In spite of intense efforts no vaccine is yet available that protects against lentiviral infections. Sheep were immunised eight times over a period of 2.5 years with the maedi-visna (MVV) gag gene on two different vectors, 2 sheep with VR1012-gag-CTE and 2 sheep with pcDNA3.1-gag-CTE. All sheep responded to some of the mature MVV Gag proteins in Western blot (WB). Three of them responded to the virus in lymphocyte proliferation test. The sheep received a boost with recombinant Gag protein resulting in elevated antibody response. However, when they were challenged intratracheally with MVV they all became immediately infected as judged by a strong rise in antibody titer and virus isolation from blood. It is therefore clear that the vaccination gave no protection. It is even possible that it facilitated infectivity since virus was isolated earlier from all the vaccinated sheep than from any of the unvaccinated sheep infected in the same way with the same dose. 相似文献
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