Medical View Research Articles

INTER-RELATIONSHIP BETWEEN THE BRAIN-INTESTINE AXIS AND THE SEROTONERGIC MECHANISM IN OBESITY

The enteric nervous system (ENS), communicates with the central nervous system (CNS) in a dynamic and complex fashion, through different pathways forming a bidimensional axis. This balance depends on several factors, between these systems and serotonin synthesis (5 HT). The gut synthesizes about 90% of the serotonin in our body and participates in various functions such as physiological control of the energy balance and maintenance of intestinal homeostasis. However, does serotonin that is synthesized in the gut have any impact on the brain and gut? Knowledge of the relationship between the gut-brain axis and participation of the serotonin system in the control of food intake and satiety in obesity is of great interest and importance, a fascinating and growing field. Objective: To describe and analyze interactions between the Central Nervous System (CNS) and the Enteric Nervous System (ENS), related to the serotonergic mechanism in obesity. Method: A bibliographic review included data from 134 scientific articles published between 2014 and 2021 in the PubMed, SciELO, LILACS, PsycINFO and ISI Web of Knowledge databases. Results and Conclusions: Interactions between the CNS and the ENS show gastrointestinal sensory motor functions. The gut produces around 90% of serotonin in our body. However, serotonin exerts approximately 80% of its action within the gut and most of the body’s 5-HT is secreted into the bloodstream, where it is largely and rapidly eliminated by the liver and lungs. CNS serotonergic neurons are independent from ENS serotonergic neurons and enteroendocrine cells. In addition, the blood-brain barrier is impermeable to serotonin. Therefore, serotonin synthesis in the brain is one of the major mechanisms that control hunger and satiety as well as carbohydrate ingestion, some of the contributing factors in the development of obesity. Integrative medicine represents a change in paradigm from a medical view of hermetically closed compartments to an interdisciplinary view between the brain-gut axis and the serotonin mechanism in obesity.

Applying Bioethics Across Cultures

In our multicultural society, as well as when working internationally, emergency physicians (EPs) frequently see patients from cultures with communitarian or hierarchal structures. These groups may rely on traditional medical practices and view health care decisions through a lens other than patient autonomy. This leads to uncertainty about who can legitimately make decisions for patients and how to apply basic ethical principles. Because the commonly taught ethical principles (autonomy, beneficence, nonmaleficence, and distributive justice) are loosely defined, they provide little help to EPs when working with cultures that de-emphasize Western individualism. The case illustrates this complexity by detailing how visiting EPs dealt with leaders from a communitarian culture who demanded that a preteen be treated for a femur fracture by a traditional bone healer rather than with modern techniques. The Western-trained clinicians struggled with their ethical responsibility to protect the child's welfare within the social setting: What should beneficence look like in this situation and to whom did it apply? More broadly, this paper examines the bases on which health care professionals might justify overruling parental decisions. It also asks whether the lack of clarity of the most used Western ethical principles suggests the need to broaden clinical ethics education to include issues from other cultures and settings. Despite principlism's shortcomings, the ease of teaching ethics to health care providers by grouping basic philosophical ideas suggests that we continue to use its structure. As educators and practitioners, we should, however, expand the concept of principlism to better address ethical values and issues found across different cultures.

The use of Semi-Markov Model to determine the efficacy of CDC staging criterion in Nigeria (A case study of General Hospital Minna, Niger State)

Semi-Markov model in discrete state and time to study the trajection among the various defined HIV/AIDs stages has been presented in this paper. The model was used to determine the staging of HIV- infected clients reported at heart-to-heart clinic of General Hospital Minna, Niger State, Nigeria for a period of 10 years. The result shows that there is no transition from asymptomatic stage of HIV to late/advance AIDs such that φ14 (n) = 0; which led to gradual increment in the graphs of interval transition probabilities for all n ∈ N.The study shows that there are some increments in the transition probabilities from stages 2, 3 and 4 to stage 1 from about 0.05745, 0.01055 and 0.00379 in the first month (n = 1) to about 0.37163, 0.17821 and 0.05862 in the forty four months (n = 44) and in the forty five months (n = 45) respectively. From the virtual transition probabilities, the graph is gradually decreasing after forty-five (45) months. The result show that φ11 (n), φ22 (n), φ33 (n) and φ44 (n)attained the values of about 0.56516, 0.50353, 0.53343 and 0.65623 respectively for the first few months or years. The percentage decrease is about 37.1%, 17.8% for stages 2, 3 in forty-four months and 5.8% for stage 4 in forty-five month duration. However, client’s transitions dropped slowly and attain stability of stage at infinity. In compliance to the medical view, all HIV-naïve patients transit to AIDs stage especially when therapeutic intervention is lacking. The model established in this study could assist the Medical Personnels’ (MP), Health Care Providers (HCP), Epidemiologists, Medical Statisticians and other funding organizations to plan for the treatment, tracking and intervention for the ever increasing scourge of HIV/AIDs.

Analisis Bibliometrik Dari Istilah ‘Salutogenesis dalam Kebidanan’

AbstractBackground: The medical view of the entire maternal period calls into question the use of pathogenesis to frame maternity care services. Therefore, adopting a salutogenic model of maternal care can reduce care inequalities and improve the quality of maternity care provided. The concept of salutogenesis was first introduced in the late 1970s by Antonovsky, who focused on the origins of good health rather than the origins of disease. Salutogenesis is an alternative school of thought that encourages healthcare professionals to adopt a more positive and health focused approach in providing perinatal care to women. In the salutogenic approach, a woman's past experiences, both pleasant and unpleasant, are strongly believed to contribute to her perception of life, well-being, and ability to cope with stressful situations such as the perinatal period.Objective: This study explores the topic of salutogenesis in obstetrics through the Google Scholar databaseResearch Methods: This study uses bibliographic information from the Google Scholar article database between 2000 and 2020 using a total sampling technique. Data was extracted using Publih Or Parish, VOS Viewer and Mendeley Desktop Keywords: salutogenesis, obstetrics, bibliometric, Publish Or Parish, VOSViewer

The Political Economy of the Mental Health System: A Marxist Analysis.

The present paper analyses the functions of the mental health system in relation to the economic organisation of society, using concepts derived from Marx’s work on political economy and building on previous critiques. The analysis starts from the position that mental health problems are not equivalent to physical, medical conditions and are more fruitfully viewed as problems of communities or societies. Using the example of the United Kingdom, it traces how a public mental health system evolved alongside capitalism in order to manage the problems posed by people whose behaviour was too chaotic, disruptive or inefficient to participate in a labour market based on exploitation. The system provided a mixture of care and control, and under recent, Neoliberal regimes, these functions have been increasingly transferred to the private sector and provided in a capitalistic manner. Welfare payments are also part of the system and support those less seriously affected but unable to work productively enough to generate surplus value and profit. The increased intensity and precarity of work under Neoliberalism has driven up benefit claims at the same time as the Neoliberal state is trying to reduce them. These social responses are legitimised by the idea that mental disorders are medical conditions, and this idea also has a hegemonic function by construing the adverse consequences of social and economic structures as individual problems, an approach that has been particularly important during the rise of Neoliberalism. The concept of mental illness has a strategic role in modern societies, therefore, enabling certain contentious social activities by obscuring their political nature, and diverting attention from the failings of the underlying economic system. The analysis suggests the medical view is driven by political imperatives rather than science and reveals the need for a system that is more transparent and democratic. While the mental health system has some consistent functions across all modern societies, this account highlights one of the endemic contradictions of the capitalist system in the way that it marginalises large groups of people by narrowing the opportunities to make an economic contribution to society.

Knowledge of recent medical graduates and views of stakeholders and teachers regarding medical ethics and professionalism in Bangladesh

Medical education aims to produce competent medical professionals and gives emphasis on competency-based learning in Bangladesh. Medical ethics and professionalism are considered as a core competency. A competent physician can ensure patient-centered health care system. This was an effort to obtain data regarding the knowledge of recent medical graduates and the opinion of medical educational stakeholders and teachers about medical ethics and professionalism at undergraduate medical education in Bangladesh. This mixed-method study was conducted in two rounds. The Round I was conducted from January 2018 to June 2019 for assessing the knowledge of 308 recent medical graduates towards medical ethics and professionalism. In Round II, key informant interviews were conducted among 30 medical educational stakeholders and teachers from July 2020 to December 2020. Data were collected by pre-tested self administered semi-structured questionnaire and interview guidelines. The percentages of recent medical graduates who could give correct answers regarding autonomy, justice, presenting a subject to visual social media, breaching of confidentiality, organ donation and medical certificate were 19.8%, 54.9%, 73.1%, 37.3%, 91.6% and 74.4% respectively. Most of the medical educational stakeholders and teachers (80%) expressed their opinion related to curriculum. They also suggested for practicing ethics (20.0%) and training (20.0%). A gap was observed in the knowledge regarding medical ethics and professionalism of recent medical graduates. To improve practice of ethics and professionalism, enhancement of the knowledge by incorporating “medical ethics and professionalism” in curriculum might be considered. A separate compulsory module for training on medical ethics and professionalism can be added at pre-internship period for the recent medical graduates. Bangladesh Journal of Medical Education Vol.13(1) January 2022: 40-48

Fifth year medical students' education, confidence and learning needs related to healthcare provision for sexual and gender minority patients: a cross-sectional survey.

Introduction Education on health care for patients with diverse sexual orientation, sex characteristics and gender identities is lacking in Aotearoa's medical schools. Aim This study surveyed fifth-year medical students at the University of Otago Wellington (UOW) about confidence in providing health care to lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) patients to identify learning needs. Methods This anonymous cross-sectional survey was designed with input from an advisory group (community members, education, research and subject matter experts). It was administered on paper during class, using Likert scales (level of agreement) and open-ended questions. All fifth-year medical students at the UOW campus were invited to participate in May 2021. Data were analysed in Microsoft Excel (Microsoft Corporation) and free-text comments were analysed using template analysis. Results In total, 74.7% (71/95) of students completed a survey. Participants lacked knowledge and confidence in their consultation skills with LGBTQIA+ patients and did not feel they had enough teaching in this area. Most (≥78.8%) were comfortable with common terms, but half or fewer could explain intersex, gender affirmation and Takatāpui. Free-text comments revealed learning needs relating to consultation skills, ways to approach this topic with sensitivity, and a desire to learn more about the cultural context. Discussion Medical students view LGBTQIA+ health care as an important topic and want opportunities to improve knowledge and confidence in this area. Students lack confidence in consulting with LGBTQIA+ patients, suggesting that more education focused on practical experience and interactions with real patients would be of benefit.

Views, facilitators, barriers and strategies associated with detoxification in patients with opioid use disorder: A qualitative study on primary care general practitioners

IntroductionOpioid Use Disorder (OUD) affects 16 million people worldwide and stems from the repeated use of opioids. Although standard care for OUD is based on harm reduction policy and relies on Opioid Maintenance Treatment, opioid detoxification still has some advantages over OMT. However, little is known about the medical community's views on this specific topic of the current advantages of detoxification. ObjectiveThe objective of this study is to collect the views of GPs on detoxification and identify the facilitators, barriers and strategies associated with detoxification. MethodsWe conducted a qualitative study using semi-structured in-person interviews with fifteen French GPs. After a triple-blind thematic analysis, main themes and sub-themes were selected after consensual agreement. We conducted an in-depth analysis of the discourse favouring an interdisciplinary approach. ResultsThe main themes are: GPs' views on detoxification, facilitators, barriers and strategies associated with detoxification. Detoxification is seen through OMT tapering or inpatient detoxification. Facilitators of detoxification include a steady environment, sufficient motivation and trust. Barriers to detoxification include abuse of OMT, polydrug use, long periods of drug use and pregnancy. Alleged obstacles include lack of availability/knowledge and difficulty having access to specialised care. Strategies facilitating detoxification include a coordinated healthcare circuit involving multiple providers in a dedicated healthcare facility and the practice of physical activity. ConclusionDetoxification is perceived through OMT tapering or inpatient detoxification. The conditions of practice influence the implementation of detoxification. This study shows that detoxification is possible in primary care in dedicated outpatient practices coordinated by GPs.

When law and science part ways: the criminalization of breastfeeding by women living with HIV.

Stigma and discrimination are a constant reality for the 37.7 million people living with human immunodeficiency virus (HIV) around the globe. Fear over vertical transmission has fuelled HIV criminalization: laws that target people living with HIV for acts deemed to be a transmission risk. Research has now shown that many of these behaviours, including breastfeeding, pose an extremely low risk of transmission when people have proper medical care, access to treatment and open relationships with medical professionals. Yet, we are witnessing a wave of criminal cases against women living with HIV for breastfeeding, an act which is actively promoted worldwide as the best infant feeding strategy. In this review, we will place the criminalization of breastfeeding within the context of current medical recommendations and cultural views of breastfeeding. We will highlight the criminal cases against women living with HIV for breastfeeding around the globe and the criteria for justifiable criminalization. Finally, we will provide recommendations for moving towards decriminalization, removing this barrier to HIV prevention, treatment and care.

Developing a scale measuring the doctor-patient relationship in China from the perspective of doctors.

The doctor-patient relationship is usually measured in line with patient needs and demands. This study aimed to develop a scale measuring such a relationship from the perspective of doctors. A draft scale was developed and adapted to the hospital context of China based on several existing scales, with an intention to measure how medical doctors view and manage their relationship with patients beyond episodic clinical encounters. Two rounds of Delphi consultations involving 14 experts were conducted to seek their consensus on the inclusion and descriptions of items. This resulted in a 19-item scale measuring four domains of the relationship. The scale was validated through a survey of 1,712 medical doctors selected from 27 public hospitals in Heilongjiang province of China. The internal consistency of the scale was assessed using Cronbach's α coefficients of the four domains. Confirmatory factor analyses were performed to test the construct validity of the scale. Linear regression analyses were performed to assess the known-group validity of the scale. The scale measures four domains. The Cronbach's α of the scale reached an acceptable level, ranging from 0.61 to 0.78 for its four domains. Good fitness of data into the four-domain structure of the scale was confirmed by the confirmatory factor analysis. Known-group differences were demonstrated in the regression analyses. The doctor-patient relationship scale developed in this study is a psychometrically valid tool assessing how medical doctors view and manage their relationship with patients in the hospital setting in China.

Sex-Positivity, Medical Mistrust, and PrEP Conspiracy Beliefs Among HIV-Negative Cisgender Black Sexual Minority Men in Atlanta, Georgia.

Because the public health response to the disproportionate HIV burden faced by Black sexual minority men (BSMMM) has focused on sexual risk reduction and disease prevention, other vital components of sexual health (e.g., intimacy, pleasure, benefits of sex) have been often overlooked. Sex-positive describes a more open, holistic approach toward sex and sexuality that prioritizes these other components, though such an approach is rarely applied to BSMM's sexual health. For sex-positive BSMM, risk/preventive discourse may foster or exacerbate medical mistrust as a reaction to the dissonance between how these men view sexual health and how the medical establishment views it, which may discourage sexual healthcare-seeking. We assessed sex-positivity and its association with medical mistrust and PrEP conspiracy beliefs among 206 HIV-negative cisgender BSMM in Atlanta, Georgia. We performed exploratory factor analytic procedures on responses to a sex-positivity scale, followed by multivariable linear regressions to determine sex-positivity's associations with medical mistrust and PrEP conspiracy beliefs. We extracted two sex-positivity factors: sexual freedom (α = 0.90), reflecting openness toward casual sex and rejection of sexual mores, and essence of sex (α = 0.77), reflecting the intimate, relational, and pleasurable qualities of sex. Sexual freedom was independently associated with perceived provider deception (β = 0.19, CI = 0.04, 0.34). Essence of sex was independently associated with PrEP conspiracy beliefs (β = 0.16, CI = 0.02, 0.31) and marginally associated with perceived provider deception (β = 0.14, CI = - 0.00, 0.29). Healthcare providers and public health practitioners may cultivate greater trust with BSMM by incorporating a sex-positive approach into patient/participant interactions, clinical decision-making, and interventions. Improving access to sexual pleasure acknowledges BSMM's right to optimal, holistic sexual health.

CONTENT ANALYSIS OF TYPES OF RATIONALITY IN THE CONCEPTS OF MEDICINE OF THE FUTURE

Abstract. In this article content analysis is used to examine medical students' views on the standards of rationality in medicine of the past, present, and future. The study involved 229 residents of 32 specialties. A quantitative analysis of keywords in views of the future of medicine revealed indicators of all types of rationality. Postmodern ideals of superhealth and immortality became trends in medical futurology even though a tenth of respondents considered them illusory. Young doctors placed the basic tenet of the Hippocratic Oath, "Healing," back among the top keywords for medicine of the future. Faith, authority, dialogue, consent, and self-treatment have lost much of their appeal.

Social injustices and public health Barry S. Levy Oxford University Press, 2019. ISBN‐13: 978‐0190914646.

World Medical & Health PolicyEarly View BOOK REVIEW Social injustices and public health Barry S. Levy Oxford University Press, 2019. ISBN-13: 978-0190914646. Brenda A. Leath, Brenda A. Leath orcid.org/0000-0001-5005-1920 Leath & Associates, Inc. Health Informatics Information Technology Section, American Public Health Association (APHA)Search for more papers by this author Brenda A. Leath, Brenda A. Leath orcid.org/0000-0001-5005-1920 Leath & Associates, Inc. Health Informatics Information Technology Section, American Public Health Association (APHA)Search for more papers by this author First published: 06 November 2021 https://doi.org/10.1002/wmh3.481Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

A Bibliometric Analysis of Academic Publications About Intoxication in the Period from 1975 to 2020: A Global and Medical View

Intoxication is still the major cause of morbidity and mortality worldwide. Despite the growing number of global studies about intoxication, comprehensive bibliometric studies are not available in the literature. This study aims to analyze scientific articles about intoxication/poisoning and to evaluate this subject matter from a holistic point of view. Studies about intoxication that were published in the years between 1975 and 2020 were downloaded from the Web of Science (WoS) database and analyzed by bibliometric methods. Spearman’s correlation coefficient was used for correlation analyses. Regression analysis was used to estimate publication trends in the coming years. A total of 32,320 publications about medical research were obtained. Of these publications, 17,508 (54%) were articles. A non-linear growth trend was observed for the number of intoxication articles that have been published in recent years. The most active three institutions were the University of California San Francisco (137), Harvard University (133), and Oxford University (96). Clinical Toxicology was the journal that has published the highest number of articles (683). The most active author was Michael Eddleston (92). The most common subject matters were carbon monoxide, suicide, overdose, organophosphates, toxicology, alcohol, pesticides, epidemiology, children, paraquat, and lead poisoning. In this comprehensive bibliometric study about intoxication, which is a subject matter studied with a growing trend in the literature, we have presented a summary of 17,508 articles. This study can be a beneficial resource for clinicians and scientists by presenting global outputs about intoxication and future prospects and novel subject matters for research

Shaken brain: The science, care, and treatment of concussion ElisabethSandel Harvard University Press, 2020. pp. 368. Hardcover. ISBN: 9780674987418.

World Medical & Health PolicyEarly View BOOK REVIEW Shaken brain: The science, care, and treatment of concussion Elisabeth Sandel Harvard University Press, 2020. pp. 368. Hardcover. ISBN: 9780674987418. Mason Bennett, Mason Bennett orcid.org/0000-0002-0625-0647 Search for more papers by this author Mason Bennett, Mason Bennett orcid.org/0000-0002-0625-0647 Search for more papers by this author First published: 27 October 2021 https://doi.org/10.1002/wmh3.478Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

All creatures safe and sound: The social landscape of pets in disastersSarah E.DeYoung and Ashley K.FarmerPhiladelphia, PA: Temple University Press, 2021. pp. 210. Kindle Edition. LCCN: 2020045466.

World Medical & Health PolicyEarly View BOOK REVIEW All creatures safe and sound: The social landscape of pets in disasters , Sarah E. DeYoung and Ashley K. Farmer Philadelphia, PA: Temple University Press, 2021. pp. 210. Kindle Edition. LCCN: 2020045466. Mitchell Berger, Mitchell Berger orcid.org/0000-0002-0221-5334 Department of Health & Human Services, Washington, D.C., USASearch for more papers by this author Mitchell Berger, Mitchell Berger orcid.org/0000-0002-0221-5334 Department of Health & Human Services, Washington, D.C., USASearch for more papers by this author First published: 25 October 2021 https://doi.org/10.1002/wmh3.480Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

PENGURUSAN JENAZAH COVID-19 DALAM PANDANGAN MEDIS DAN ISLAM

The Covid-19 issue is a dangerous global disease that cannot be avoided, including deaths from the outbreak. However, in this study, he wants to explain how his death should get a decent position like death in general. This research is a qualitative research. The formulation of this research is: (1) How to take care of the corpse in general according to Islam (2) How to manage the COVID-19 body according to the medical (3) How to manage the COVID-19 body according to Islam. This research method uses content analysis research methods. for collecting data, researchers used the method of interview, observation, based on exposure to data on research findings coded by the management of the bodies of COVID-19 in Islamic and medical viewpoints, it can be concluded that the management of the corpse is Fardu Kifayah by bathing, kafaning, tithing, and burying, according to Islamic and medical views. the method prescribed by Islamic law. Thus, handling the bodies of Muslims infected with COVID-19, must pay attention to the provisions of the shari'ah and the implementation of handling the bodies must meet the provisions in the Standard Operating Procedures (SOP) of the medical party.

Lifelines

There is an imbalance across design disciplines in how the user is theorised, represented and ultimately configured. It is suggested that normative user-centred design, as practiced in product design and human-computer interaction (HCI), can lead to a lack-based approach which, when applied in a health and wellbeing context, tends to align unreflexively with a medicalised view of the person. In contrast, the use of self in research is a concept well-developed in health care ethics and care professions, while the interpersonal relationship is valued and analysed in psychotherapy and counselling research and practice. Inspired by these, this article presents a discussion on the sometimes deeply relational nature of doing design with users when viewed through the lens of the Person-Centred Approach (PCA) (Rogers 1961/1967). A case study is used to illustrate an encounter of relational depth as experienced by students working directly with individuals to design prosthetics. Lifelines is a creative project brief developed by Jivan Astfalck (2008; 2011), which asks students to represent ten significant moments in their own lives through the creative use of materials and found objects. In this case, the brief was altered so that another person (the ‘user’) would be represented. The aim was that the student designers would experience moving beyond implicit conceptions of the user as defined by a need or perceived (dis)ability, and that the intimate and personal nature of identifying and representing significant moments would raise questions about expectations of objectivity in design and research. The case study demonstrates that working in this way can be experienced as profoundly moving, with powerful moments of personal transformation and interpersonal growth. In discussion, it is suggested that through such moments of encounter, it becomes possible to examine the qualities of the relational in action, and to analyse not only problematic processes of othering, but also their converse - meetings at relational depth. The Lifelines brief is proposed as a transformative way for designers to re-engage with the whole person, as both substantial (self-realising) and relational (in time, with others and the world), and as one creative exercise in a potential suite of tools for the strengthening of the “ethical reflex” necessary in Design and HCI (Vandenberghe and Slegers 2016, 514).

Non-Therapeutic Circumcision of Boys: Medical, Sociocultural and Ethical View

There is no medical or ethical consensus over the necessity and the ethical statue of nontherapeutic circumcision of boys. From the medical aspect, there are some potential medical benefits like decreased UTI contracture and Human Immunodeficiency Virus (HIV). transmission rates. However, it is an intervention to the child’s bodily integrity and has some surgical complications like bleeding, pain, postoperative infection and inadequate skin removal. Complication rates are low when the surgery is done according to medical standards. When considering the ethical aspects of circumcision, the most important question to be asked is ‘What is the best interest of the child?’ In order to answer this question, all medical, cultural and psychosocial aspects of the circumcision need to be evaluated. It is an important part of sociocultural life especially in Islamic and Jewish societies. Therefore, it is necessary for the child to be integrated to society and to socialize in that environment. Since it is not a fact whether the medical benefits outweigh the risk or vice versa, the right of the parents to raise a child according to their sociocultural and religious beliefs and the right of the child to be a part of the society should not be eliminated.

Medical Student Attitudes and Perceptions on the Relevance of Neuroscience to Psychiatry: a Mixed Methods Study.

Many psychiatry residency programs are actively incorporating neuroscience training into their curricula; however, relatively little scholarship exploring neuroscience and psychiatry integration in undergraduate medical education has been conducted. This study investigated second-year, pre-clerkship medical students' perceptions on the relationship between neuroscience and psychiatry following foundational neuroscience and behavior instruction to identify their views before they enter clerkships. A mixed methods design combined qualitative analysis of medical students' essays in response to the prompt: "What is the relationship between neuroscience and psychiatry?" with quantitative analysis of survey responses on a 7-point scale. Ninety-three percent of the class participated in the study (n = 77). Learners rated neuroscience as important for understanding and treating psychiatric disorders, albeit less important for psychiatric compared to neurological disorders. Using applied thematic analysis, the authors identified qualitative themes. Specifically, participants recognized neuroscience as a foundational science for psychiatry, but some emphasized that factors other than neuroscience are needed to explain psychiatric disorders. Some students perceived neuroscience and psychiatry as complementary approaches to understanding the brain and behavior. Others identified a role for neuroscience in reducing the stigma of psychiatric disorders and thereby improving access to psychiatric care. The quantitative and qualitative findings reinforced each other and provided novel insight to pre-clerkship medical students' views on the relevance of neuroscience for psychiatry. Educating all medical students, not just psychiatry residents, on the neuroscience of psychiatric disorders may better equip the next generation of physicians, regardless of specialty, to care for their patients with psychiatric conditions.