bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Change Management on the Efficiency of Organizations: An Applied Study on the DAL Dairy Factory - Sudan 2019 - 2020
Authors: Hussain Malak S.
Published: July 2021

Objectives: This study aims to know the effect of change in culture and technology on efficiency in Dairy Factory - Sudan, 2019-2020 and to know the views of managers on the impact of change management on efficiency, to identify the positive aspects that help in improving this efficiency as well as to identify the negatives Which limit the company's efficiency in this field, by answering the following research questions: - Is there an impact of changing culture and technology on increasing the efficiency of institutions? To answer these questions on which the problem is centered around, the following scientific hypotheses were put forward: - There is a statistically significant relationship between changing the organization's culture and increasing the efficiency of organizations, as well as the existence of a statistically significant relationship between changing technology in the organization and increasing the efficiency of organizations. Methods: The descriptive and analytical approach was used to describe the phenomenon under study, and the questionnaire was used to collect various data. The questionnaire was distributed to the sample members who numbered (55) employees to conduct the statistical analysis for this study, through the program used for the statistical analysis of social sciences, the hypotheses were tested by Median and chi-square. Finding: inflating the culture of the departments and divisions of the company, the stagnation and inflexibility of the society's culture, and the inadequacy of that culture to the requirements of work within the community, which led to an overlap in the powers and responsibilities? The most important recommendations: The necessity of changing the organizational structure to comply with the requirements of work, after carefully studying the internal and external environment, and for the change to take place based on the recommendations of specialists in administrative sciences. So that it is not random and does not lead to an inflation of the organizational structure without success. Value: The importance of the study stems from the fact that it addresses an important topic in business administration, which is managing change in organizations, which is the only way for these organizations to develop and continue to exist. It also studies the reality of change management in the DAL Dairy Factory - Sudan.
A Qualitative Study of Psycho Social Impact on Multi Drug Resistant TB (MDRTB) Cases: Experience from Ahmedabad City, India
Authors: Sharma Rashmi , Bakshi Harsh , Prajapati Shailesh , Bhatt Gneyaa , Mehta Rajesh , Rami Kiran , Mehta Prakash , Shah Tejas , Dave Roshni , Pirzada Azbah
Published: July 2021

NA
Geocultural Aspects of the Security Policy of Contemporary Israel
Authors: Tarasiuk Renata
Published: July 2021

The article shows how the symbolism contained in the image of the Jewish state influenced, especially recently, the vectors of Israel’s security policy. Attention is paid to these aspects aimed at protecting national identity. The author tries to substantiate the influence of the cultural factor on Israel’s security policy. The research is based on historical analysis, source analysis, and descriptive narrative. The instruments and tools used by the state in the implementation of the aforementioned tasks are presented – from the basic laws and compatible legal acts regulating the social life of Israeli citizens to the policy of cultural and ethnic isolation and separation carried out by the armed forces. In the Middle East emphasizing one’s own individuality is a strategic goal, but the price of internal a conflicts can be high.
The Statistical Analysis of Criminality in Podkarpackie Voivodeship in the years 2010–2019
Authors: Żołyniak Krzysztof
Published: July 2021

There is no society free from a criminality. There is also no level of social and economic development, level of affluence or philosophical and ethical system which may ensure total elimination of criminality from the social life. The aim of this article is presentation of the scale of criminality phenomenon in Podkarpackie Voivodeship in the years 2010–2019 with the consideration of criminality among minors on the basis of data included in the reports of The Regional Police Headquarters based in Rzeszów and The Metropolitan Police in Warsaw concerning security situation as well as public order in Podkarpackie Voivodeship, taking into account the juvenile delinquency in this area. In this article the sociological theories explaining the reasons and factors that influence criminality are discussed.
Protective effects of curcumin against methotrexate-induced testicular damage in rats by suppression of the p38-MAPK and nuclear factor-kappa B pathways
Authors: Kilinc Leyla , Uz Yesim Hulya
Published: July 2021

Objective: Methotrexate (MTX), is a commonly used chemotherapeutic agent. This study aimed to investigate the possibility that curcumin (CMN) protects against MTX-induced testicular damage by affecting the phospho (p)-p38 mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-kB) signaling pathways. Methods: Male Wistar albino rats were subdivided into three groups. The control group was given an intragastric (ig) administration of dimethyl sulfoxide (DMSO) daily for 14 days, the MTX group was given a single intraperitoneal (ip) dose of MTX (20 mg/kg) on the 11th day, and the MTX+CMN group was given ig CMN (100 mg/kg/day, dissolved in DMSO) for 14 days and a single ip dose of MTX (20 mg/kg) on the 11th day. Results: The animal weights, the seminiferous tubule diameter, and germinal epithelium height significantly decreased in the MTX group compared to the control group. The testes weight and the ratio of the testes to body weight did not change, whereas the number of seminiferous tubules and the interstitial space width increased significantly in the MTX group. The number of phospho-p38 (p-p38) MAPK immunopositive cells and the immunoreactivity of NF-kB also increased in the MTX group compared to the control group. Conclusion: CMN prevented the MTX-induced decreases in the body weight, seminiferous tubule diameter, and the germinal epithelium height, while significantly reducing the number of histologically damaged seminiferous tubules and the interstitial space width changes due to MTX. CMN also reduced the number of p-p38 MAPK immunopositive cells and the NF-kB immunoreactivity.
Appraising Research on Positive Mental Health for Person Centered Medicine
Authors: Schmolke Margit
Published: July 2021

The author appraises studies on positive mental health relevant to person centered medicine, with an emphasis on qualitative research designs dealing with personal and social resources, resilience and individual recovery processes of psychiatric patients. These studies and developments may have an enriching and stimulating impact on a person-centred medicine since they deal with patients’ inner subjective experiences and healthy aspects in midst of mental illness processes. Also the recent service user involvement in mental health research – a main component of the recovery movement – can be seen as an innovative step towards a new culture of research on subjective illness experience. Furthermore, the convergence of recovery orientation and person-centred care perspectives are delineated.
Research Supporting Health Policy Development: Contextualizing Evidence for People-Centred Care in Low and Middle Income Countries
Authors: Rajan Dheepa
Published: July 2021

The three areas of research, policy, and practice seem to work and interact within silos, or independent niches.  Especially for the complex task of reorienting health care and indeed, a health system, towards people-centredness, these niches at both global and country level must be broken down.  Since health policy-making is complex and non-linear, context is crucial for making research for health policies and implementation of health policies (practice) relevant.  The real measure of success is whether the evidence-informed policy has worked and produced results at ground level.  When context is so important, however, evidence (research) is only one piece of the puzzle.  Stakeholder’s views, or simply put, their opinion, is just as decisive.  This paper documents some promising examples in research and practice of bringing together evidence and stakeholder opinion, particularly highlighting a case study on Brazil as well as WHO tools for communities of practice.
Strengthening research ethics review systems
Authors: Bouesseau Marie-Charlotte
Published: July 2021

Concerns about the ethical conduct of research involving human participants includes a number a very complex issues such as the optimization of the risk-benefit ratio for the potential participants to the research, the equitable access to the benefits of the research for the populations, the need to focus research on health priorities addressing what is known as the “10/90 gap”. Over the last decades, norms and standards have been developed and regularly up dated in order to provide regulation at national and international level. Many initiatives have been also taken to strengthen capacity in research ethics; however it is now crucial to put in place person centered research ethics review systems, coordinating the different stakeholders and ensuring that the rights of the research participants and their communities are respected. To strengthen research ethics review systems, WHO promotes an holistic approach based on principles of good governance such as inclusiveness, transparency and enforcement of fair normative framework.
Exploring the interactional sphere of a systemic self-management intervention for chronic obstructive pulmonary disease (COPD)
Authors: Farver-Vestergaard Ingeborg , Early Frances , Fuld Jonathan , Pedersen Christina Gundgaard
Published: July 2021

Patients with chronic obstructive pulmonary disease (COPD) face challenges in managing the physical and psychological consequences of the condition. Systemic self-management interventions based on the Wagner chronic care model seek to facilitate change in patient, healthcare professional (HCP) and healthcare system in order to support patients to self-manage their condition. Few studies have investigated the interactional sphere between patients and HCPs in the context of a systemic self-management intervention. The aim of the present study was to evaluate such an intervention and explore the discursive implications for self-management in COPD. Data were collected via interviews with patients and HCPs, observations of patient-provider interaction and document analysis of documents given to the patients to support self-management. An illustrative analytical model was developed on the basis of Willig’s discourse analysis guidelines. The findings suggested two different ways of talking about self-management – biomedical and patient-centred – that seemed to have implications for what speakers drawing on these discursive repertoires could say, do and experience in relation to self-management support and practice. Whilst the analytical method does not pass judgement on which discourse is ‘best’, results of this study show how the two identified discourses are oriented to different actions and positions, and highlight their relative strengths and limitations. The findings of the present study are relevant to the issue of how the ‘healthcare institution’, and evidence-based medicine as we know it, should be manifested – empirically and practically – in the future.
The Protection of the Person is Central in CIOMS International Ethical Guidelines
Authors: Vallotton Michel , Fluss Sian , Sjolin Forsberg Gian
Published: July 2021

In this brief article the authors report on the objectives of this nongovernmental organization and, most particularly, on the protection of the person in its International Ethical Guidelines for the fields of clinical trials and epidemiological studies. They emphasize the terminology used to describe the subjects or the populations involved in these studies. They discuss the possibility and nature of harm to persons involved in such studies, and justify the requirement for informed consent also for the persons involved in epidemiological studies. Finally, they consider the roles of such trials and studies as the basis for evidence-based medicine, including cases when their results are pooled in meta-analysis. This methodology is the subject of examination by a CIOMS Working Group of  problems concerning identification and selection criteria, analysis and interpretation of results (including unpublished results), and storage of data.
Person-centered medicine in Croatia: Analyzing past successes and creating future goals
Authors: Bras Marijana , Đorđević Veljko , Komnenić Nadja
Published: July 2021

The promotion of person-centered medicine and people-centered healthcare has been occurring in Croatia for decades. Professor Andrija Štampar, considered by many as the father of public health, pioneered various public health projects in Croatia and abroad. Croatia is a country with a long history of patient associations, as well as one with an array of public health projects recognized worldwide. Recently, a group of enthusiasts gathered here to undertake the creation of a variety of projects related to the development of person-centered medicine. The International College on Person Centered Medicine (ICPCM) emerged from the ongoing annual Geneva Conferences and from the aspiration to promote medicine of the person, for the person, by the person, and with the person. The main theme of the First International Congress of the ICPCM in Zagreb in November 2013 was the Whole Person in Health Education and Training. The Zagreb statement on the appraisal and prospects for person-centered medicine in Croatia was formulated and adopted, wherein it was concluded that Croatia could contribute significantly to the development of person-centered medicine and people-centered healthcare, within Croatia and abroad.
A view of Evidence-based Medicine from Karl Popper.
Authors: Walsh Brian
Published: July 2021

Background: Popper has argued that knowledge is insecure, and moved the emphasis to conjecture and refutation. Science, Popper avers, does not build up universal laws from singular statements (representing events), since the principle of induction is non-existent. He would see many instances of confirmation of EBM methods, but EBM theory is too vague for refutation. Methods: I consider whether EBM has a theory, or whether it is heuristic, a method. I examine EBM's use of inductivism and falsificationism. I look at Popper's approach to knowledge (conjecture and refutation) and I relate this to EBM. Results: Popper writes about how to evaluate whether theories are scientific. But this scarcely applies to EBM. This is because EBM has left theory to the academics while it proceeds to develop and promulgate a method of practising medicine. Contra Popper, EBM does not put forward a theory for scholarly debate or empirical testing. By contrast, it promulgates a strict, detailed method whose merits are self-evident. (Who will argue against the evidence?) Conclusions: While EBM makes extensive use of falsification in evaluating tests and treatments, as a whole it fails to reach scientific status, as judged by Popper. It scarcely puts forward a risky theory to be challenged, and such theory as can be spider-webbed together is too diffuse to be precisely defined then falsified. Even so, I have provided a guide towards evaluating such EBM theory as there is.
Development and Implications of the Zagreb Declaration on Person-centered Health Professional Education
Authors: Appleyard James , Mezzich Juan , Ghebrehiwet Tesfamicael
Published: July 2021

The aim of this paper is to describe the development of the 2013 Zagreb Declaration on Person-centered Education and Training and to provide additional information on the action point areas identified during the Declaration’s development process. It is a living document and further suggestions for refinement at our annual Geneva Conferences are welcome.The current health profession educational system, including educators and professional role models, is dominated by professionals trained and practiced in a biomedical system of care focused on the diseases of individuals. There is less emphasis on their personal values and choices within a holistic care paradigm. There is a need for reorienting the education of medical and other health professionals towards person centered approach.Main areas of action include: enhancement of the conceptual bases of professional training and public education; analysis and optimization of the organization and culture of educational institutions; selection of educators and students who are suited to the goals and responsibilities required of health professionals; and promoting curricular developments that have person-centered guiding principles’.
Medicine as a Model for Aristotle’s Ethics and his Person-centered Approach
Authors: Ierodiakonou Charalampos
Published: July 2021

Aristotle respected medicine very much as a positive and dependable science, so he very often in his texts refers to its principles and methodology as a rule for his views on ethics. The philosopher’s parallelism of medicine and ethics brought philosophy into more human measures, and especially his consideration for each person to be taken as a special case reminds one of today’s person-centered medicine. Aristotle believed that in ethics, and generally in life, mathematical exactness cannot be applied, taking the example from medicine in which treatment changes according to the needs of each patient. Relativity is obvious in his motto that we should seek “what is relative to us”, while at the same time keeping a holistic approach, similar to today’s bio-psycho-social approach of modern medicine. Aristotle had the ability to study intra-psychic phenomena so deeply and in detail, that he used them as a model in order to shape his ethical virtues.
Professional health education and person centered medicine
Authors: Mezzich Juan E , Braš Marijana , Dorđević Veljko , Appleyard James
Published: July 2021

Health professional education and training is a major concern and activity in the field of medicine. Thus, not surprisingly, a person- and people-centered approach to health professional education has been a continuous topic in programmatic international efforts aimed at placing the whole person at the center of medicine and health. This has been certainly the case in the endeavors of the International College of Person Centered Medicine (ICPCM) through events such as its Geneva Conferences and International Congresses and its publications, particularly the International Journal of Person Centered Medicine. Further reflecting the ICPCM’s educational priorities have been institutional collaboration with the educational units of the World Health Organization, the consistent engagement of the World Federation for Medical Education and the International Association of Medical Colleges, and the increasing collaboration with distinguished academic institutions around the world. The First International Congress of the International College of Person Centered Medicine in Zagreb had as main theme Whole Person Health Education and Training. This event and its proceedings are highlighted in this editorial, which then briefly introduces the papers included in the present issue of the Journal.
Integration as a Key Strategy for Achieving Person- and People-Centered Care
Authors: Mezzich Juan E , Appleyard James
Published: July 2021

The fundamental purpose of Person Centered Medicine (PCM) (and by extension of Person- and People-centered Care), is to promote the health and well-being of the totality of the person. Here the person is the central concept, which should be understood in a contextualized manner. This is illustrated by Ortega y Gasset aphorism "I am I and my circumstance, and if do not care for it I do not care for myself". In the discussion of what is central and what is instrumental in PCM, the eminent Indian scholar Shridhar Sharma (personal communication, 2012) has cogently stated that in medicine science is essential and humanism is the essence of medicine. It can be argued that the instrumental role of science could be shared by other important concepts and activities, such as integration, with similar functional roles vis-a-vis person- and people-centered care. Thus, when examining the World Health Organization's emerging six-year work plan seeking as a major objective person-centered integrated care, one could understand people-centered as the soul or essence and integration as a key methodology or strategy.
2014 Geneva Declaration on Person- and People-centered Integrated Health Care for All
Authors: Mezzich Juan
Published: July 2021

We, participants in the 7th Geneva Conference on Person-centered Medicine, call on everyone to join together to promote person-centered and people-centered health care in order to improve health for all in ways that are equitable, sustainable, and cost-effective. Equity and integration in person-centered health care are crucial foundations for targeting opportunities for effective action. The International College of Person-Centered Medicine (ICPCM) adheres to the new perspectives on universal health care endorsed by the World Health Assembly since 2009 and reads with interest the 2013 Lancet Commission Report on “Global Health 2035:  World converging within a generation”, both of which outline objectives, research, and strategies for developing Person- and People-centered Integrated Care (PPCIC) for all people
WMA´s perspectives on ethics and person centered medicine
Authors: Snaedal Jon
Published: July 2021

The World Medical Association (WMA), an association of 9 million doctors worldwide, has been their leading body in medical ethics. The most respected policy of the WMA is the Declaration of Helsinki on research involving human subjects. Another one is the Lisbon Declaration on the rights of patients and the Association is currently processing its views on Person Centered Medicine. It has been decided to produce a white paper, describing the various terms that exist on person centeredness in health care. These terms differ in content and use but as their naming is similar, confusion on their meaning easily arises. The WMA needs to balance the views of associations from all corners of the world and the correct use of language and terms is of great importance. Based on this work, a clear policy document on Person Centered Medicine will be produced. Apart from this, person centeredness has been influencing various policies of the WMA for a long time but the actual terms used differ and the term “patient” is still the most prevalent in the various policy documents when addressing the persons physicians are serving on an individual basis.
Nursing Perspectives on Person- and People-Centered Integrated Care for All
Authors: Kusano Yukiko
Published: July 2021

Person-centeredness resides at the heart of nursing and nurses also place people at the centre of their activities to achieve a healthier society. The commitment of the International Council of Nurses (ICN) to deliver person- and people-centered care is evident in the ICN Code of Ethics for Nurses [1], ICN policy papers and is translated into various guidelines, programmes and research.  Person- and people-centered healthcare requires not only commitment of individual nurses and other healthcare workers but also changes in healthcare systems including service delivery systems and other structures. It is necessary to take a whole government approach where person- and people-centered healthcare is considered by all ministries including non-health sectors. Active involvement of care recipients, nurses and other healthcare professionals in healthcare design and decision making is essential to achieve person- and people-centered healthcare.
WMA Declaration of Geneva
Authors: Medical Association World
Published: July 2021

WMA Declaration of Geneva
An Ethical Analysis of Person Centered Psychiatry
Authors: Jousset David
Published: July 2021

Dealing with Person Centered Psychiatry (PCP) allows the meta-ethical foundations for person-centered medicine to be questioned. First, we will analyze the ethics inherent to PCP, arguing that they are a necessary break with some of the risks associated with the current development of ‘mental health medicine’, and a significant shift from the major contemporary ethical theories that moves away from a subject-centered approach to caring towards an interpersonal one. Then, we will address the PCP ethics that still need to be formulated. Addressing ethical requirements that have been enriched by practice leads to problematizing the main features of PCP: the integrative approach, dialogue with patients, patient participation, humanism and personalism as philosophical foundations, and the epistemological and ethical functioning of the concept of ‘person’. The theoretical proximity and discrepancy with value-based psychiatry will also be specifically discussed. Finally, this paper argues that PCP needs to go beyond the simple reversal of an illness-centred approach to a patient-centred approach in order to achieve an interpersonal relationship approach, which is the core principle of health care as a ‘remediation’ of humanity.
Continuity of Life Interview: Development and Evaluation of a Novel Instrument for the Assessment of Recovery from Mental Illness
Authors: Janca Aleksandar , Lillee Alyssa , Sng Adelln , Cooper John
Published: July 2021

Background: Recovery is not simply the absence of symptoms, but a journey and process of establishing a meaningful life. This concept of recovery aligns closely with the principles of person-centred medicine. Objectives: The aim of the present study was to develop and evaluate the psychometric properties of a measure entitled Continuity of Life Interview (COLI) that could capture an individual’s perceptions of continuity of life, and that might be used in the assessment of recovery in the spirit and context of person-centred medicine. Method: Thirty mental health clients participated in the COLI interview at two time points to examine its test-retest reliability. Additionally, the first COLI interview was rated by the interviewer and an observer to assess its inter-rater reliability. Results: Results showed that the COLI had high internal consistency and inter-rater reliability, and moderate test-retest reliability. The COLI was also perceived as a tool relevant to clients’ clinical care, and in a number of cases, enhanced clinicians’ understanding of their clients.Discussion: The COLI was found to be a reliable and suitable instrument that complements the concepts of recovery and person-centred medicine. The COLI appears to be a feasible and reliable instrument that may engage the client and clinician in important conversations about provision of care and engender hopefulness for clients and clinicians in the recovery process.Conclusion: The assessment of an individual’s perceptions of continuity of life using COLI may have important implications for guiding treatment, management and recovery from mental illness and thus is in line with the key principles embedded in person-centred medicine.
International Journey and the Development of Person Centered Medicine
Authors: Mezzich Juan E , Appleyard James , Botbol Michel , Ghebrehiwet Tesfa , Groves Joanna , Salloum Ihsan M , Van Dulmen Sandra
Published: July 2021

Building on historical precedents, both ancient and contemporary, the concept of Person Centered Medicine as a theoretical proposal and a practical approach has been explored since the earliest Geneva Conferences on Person Centered Medicine. At the same time, it can be said from personal and group reflection and insights that Person Centered Medicine is also an experience, an attitude, and a process.Experience is a crucial aspect of everybody’s life. Experience and trajectory is also a fundamental domain of any institution’s identity and life. This denotes the value of appraising, recognizing, and delineating institutional journeys such as that underlying the development of Person Centered Medicine.The meaning of such institutional journey may be illuminated by the consideration of Odysseus’ journey to Ithaca in Homer’s Iliad. The delineation of the itinerary and vicissitudes in the process of constructing Person Centered Medicine might contribute to the clarification and understanding of what is Person Centered Medicine as much as a philosophical analysis of its principles and arguments.
2014 Buenos Aires Declaration on Humanism and Science in Latin America for Person Centered Medicine
Authors: College of Person Centered Medicine International
Published: July 2021

Pre-Colombian medicine, initially identified in La Venta or Monte Alban as Mesoamerican civilized centers, like the Maya, Azteca and Inca cultures, was expressed within their cosmology in a religious-magical context in which the state of health or illness were strictly related to conditions of balance or imbalance. Their concept of health relies on a fundamental balance among the physical, social and religious dimensions of the person. Moderation in diet, exercise and behavior was considered essential for a healthy life. Prehispanic American medicine vision was holistic and integrative in context and in beliefs and was consistent with concepts of medicine and health in the earliest Asian and Hellenic civilizations, all of them fundamental roots of a medicine centered in the totality of the person. These historic notions are reflected in the comprehensive definition of health inscribed in the Constitution of the World Health Organization which refers to a dynamic state of complete physical, mental and social well-being and not merely the absence of disease.
International Mental Health Perspectives on Person Centered Integrated Care
Authors: Kallivayalil Roy Abraham , Garg Kabir , Tripathi Adarsh
Published: July 2021

Modern medicine, with all its scientific and technological advancements overshadowing the humanistic components, has time and again found to be falling short of the expectations of clients and service providers alike. Person Centered Integrated Care has been rapidly gaining momentum as the reply to the current shortcomings of health care delivery and has consistently been ranked as desirable. The need of the hour is to take coordinated and consolidated steps in this direction. This requires research, changes in the education and training system of the physicians and integration of service delivery. The present article discusses these avenues and outlines international efforts in this direction, with a special focus on mental health care.
Multimorbidity in Mentally Ill People: The Need for a Person-centered Integrated Approach
Authors: Millar Helen , Abou-Saleh Mohammed T
Published: July 2021

The need for person-centered integrated care is particularly compelling for people who experience multimorbidity. The concept of multimorbidity has attracted increasing interest in the past decade with the recognition of multiple burdens of disease and their escalating costs for the individual and the community. It is evident in clinical practice that multimorbidity has become the norm rather than the exception, occurring in an increasingly younger population particularly in areas of socioeconomic deprivation and in low income countries.  It is now well established that the mentally ill have a markedly reduced life expectancy due to predominantly cardiovascular and metabolic diseases. The combination of a chronic medical condition and a mental health problem presents specific complex challenges for the single disease model of care which continues to prevail as the current delivery system in which health care professionals are trained and operate. The growing evidence and experience for adopting an integrated collaborative person-centered approach demonstrates the need for a more effective model of care which is individualised, and focused on patient engagement to prevent disease and manage multiple conditions systematically. Given the limited resources in our current health care systems, this approach requires innovation and redesign of the system to provide comprehensive person-centered care encompassing early detection, co-ordinated multidisciplinary working across specialities as well as between primary and secondary care with easy access to basic healthy lifestyle care programs.
Holistic Professional Education of the Healthcare Team: Person-centered Approach in a New Ecuadorian Nursing School
Authors: Costa Olga Castillo
Published: July 2021

Healthcare services are evolving towards the consideration of comprehensive models of the human being. This is consistent with the definition of health as the state of complete “physical, mental, and social well-being and not merely the absence of disease or infirmity”, as affirmed in the Constitution of the World Health Organization. Also pertinent in the educational programs of health professionals are the concepts formulated by De Sousa in his work, “El Arte de Cambiar las Personas que Cambian las Cosas” (The Art of Changing People who Change Things). His recommendations promote a comprehensive training of the healthcare team, with a vision of training the best talented individuals to serve as health-care professionals. Imbued with these viewpoints, the Universidad Técnica Particular de Loja is developing a new School of Nursing with a humanistic vision. The proposal is designed to reflect key tenets of person-centered care, including interaction with the community, collaboration between the nurse and the doctor and with others members of the healthcare team. The focus is on the patient, including self-care and the participation of family members in order to achieve the desired outcomes. The proposed educational methodology promotes the cultivation of self-esteem as a cross-cutting issue. This contributes to a paradigmatic shift towards total personal development and humane and social professional practice.
Gender Comparisons on Quality-of-Life and Comorbid Alcohol Dependence and Major Depression
Authors: Hyman Scott M , Khazai Ladan , Botros Mousa , Torres Yadira I. , Cornelius Jack R. , Miao Feng , Mezzich Juan E , Salloum Ihsan M.
Published: July 2021

Introduction and Objectives: Compared to men, substance-addicted women have greater social vulnerabilities that may impact their symptom presentation and overall quality-of-life (QOL). The latter is gaining prominence as an outcome measure and key element of person-centered care. We aimed to compare in this study treatment-seeking men and women with co-morbid alcohol dependence and major depression on measures of depression severity, addiction severity, and quality-of-life and to examine associations between addiction/depression severity and quality-of-life separately in men and women. Methods: Men (n = 34) and women (n = 33) participating in a psychopharmacology trial for co-morbid alcohol dependence and major depression were administered the Addiction Severity Index (ASI), the 25-item Hamilton Rating Scale for Depression (HAM-D), and the Multicultural Quality of Life Index at baseline as part of a large assessment battery. Results: Women reported greater global QOL impairment than men despite being similar on measures of depression and addiction severity. Depression severity, but not addiction severity, was significantly associated with QOL impairment in both men and women. Discussion and Conclusions: Treatment-seeking women with co-morbid major depression and alcoholism report lower QOL (i.e., happiness and life satisfaction) than their male counterparts. Depressive symptoms, but not addiction-related problems, may contribute to global QOL impairment. Alternatively, QOL impairment may increase depressed mood. Overall, QOL assessments may identify areas of impairment and opportunities for health promotion not assessed through traditional measures used in addiction treatment programs, and these measures may be more sensitive to the specific needs of women. Consideration of all these factors is likely to enhance person-centered care.
Primary Health Care and Person Centered Medicine
Authors: Mezzich Juan E , Appleyard James , Botbol Michel , Ghebrehiwet Tesfa , Groves Joanna , Salloum Ihsan M. , Van Dulmen Sandra
Published: July 2021

The popular usual meaning of primary care is health care at a basic rather than specialized level for people making an initial approach to a doctor or nurse for treatment. The concept of primary health care has evolved dramatically over the past four decades, particularly under the aegis of the World Health Organization with the additional participation of other institutional actors around the world. It is increasingly recognized as a fundamental concept and strategy for the advancement of health care and the promotion of health at national and international levels.Separately, as the programmatic global initiative on person centered medicine has been unfolding over the past decade, primary care, not surprisingly, is emerging as a prominent topic and concern for advancing person-centered medicine and health care. There are certainly conceptual and strategic reasons for such emergence. There have been as well institutional reasons for this. At the same time, person-centeredness is an open road for the optimization of primary care.Further understanding of the prominent position, special role, and particular challenges of primary care in person centered medicine is contributed by several of the papers published in the present issue of the International Journal of Person Centered Medicine.
Persons Caring For Persons: A Public Health Policy Architecturally Presented
Authors: Carbone-Campoverde Fernando
Published: July 2021

Background: In 2001 a number of limitations and inconsistencies were noted in the Peruvian national health system. In addition to long-standing structural issues, challenges emerged related to social determinants of health as well as health workers’ attitudes and skills. Objectives: The purpose of this paper is to describe some of the national health policy changes that the Ministry of Health of Peru considered necessary in 2002 to address the prevailing challenges and the particular implementation of such policies. Methods: The formulation of the desired national health policy changes were based on critical readings of the pertinent scientific literature, the collation of national health policy experience, and consultations with Ministry officers and recognized national experts. Results:  The thrust of the national health policy changes, involving the crucial relationship between service providers and users resulting from such process was summarized by the dictum “Persons Caring for Persons” (In Spanish, “Personas que Atendemos Personas”). In order to extend the impact of this policy dictum, it was decided to inscribe it right under the Ministry’s name on the façade or frontispiece of the Ministry’s central building in Lima, the capital of Peru. Discussion: The focus of health care on persons was based on well considered Peruvian and international experience, particularly those maturing at the World Health Organization since the Alma Ata Declaration. The dictum “Persons Caring for Persons” has remained present in national health discussions as well as on the frontispiece of the Ministry’s central building across several changes in national political leadership over the past 13 years. Conclusions: The policy statement “Persons Caring for Persons”, reflects well considered national experience and wisdom, consistent with growing international aspirations. Its endurance over many years calls for renewed efforts to deepen such perspectives towards greater respect for human rights and the full humanization of health care and social life.
A Year in the Life of a Person Recently Diagnosed with Atrial Fibrillation: a Danish Single-Case Study.
Authors: Hoegh Vibeke , Cummings Elizabeth , Riahi Sam , Lundbye-Christensen Soeren , Frederiksen Kirsten , Delmar Charlotte
Published: July 2021

Healthcare services target delivery of a connected patient journey as an indicator of a high quality of care, but knowledge of the patients’ experience is sparse. This case study explores the lived experience of the quality of life and perception of health during the first year of the journey of a person recently diagnosed with atrial fibrillation. Data sources include field notes, transcripts, medical records, letters, and scores from standardized questionnaires. A phenomenologically inspired approach for qualitative data analysis and a descriptive approach for discovering exceptional changes in scores from questionnaires are used. The patient journey in the study consists of; 38 visits to general practice, five visits to the outpatient clinic, and two radio frequency ablations at hospital. Four central themes; balancing responsibilities, navigating the system, adjusting to the situation, and recognizing bodily reactions, are elaborated. In conclusion, hope for a better future is evident throughout the journey. Difficulties of balancing responsibility, conflicting information and lack of support and connection between general practice and the hospital result in putting the participant’s dignity at stake. Despite two ablations the participant is affected in his daily life and family life due to physical limitations. Along the study adjustment to the situation is seen, and his new status as grandfather is surprisingly seen to facilitate this adjustment.
Nursing Profession’s Contribution to Person- and People-Centered Primary Health Care
Authors: Kusano Yukiko , Ehrhardt Erica
Published: July 2021

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.
Person Centered Medicine: Core and Diversity
Authors: Mezzich Juan E , Salloum Ihsan M.
Published: July 2021

In the conceptualization of Person Centered Medicine (PCM) one can recognize core concepts as well as diversity at multiple levels. The core concepts convey vision and depth. Diversity displays plurality, richness and scope. And both are intertwined and articulated through the unfolding process and journey that the construction of PCM represents. This paper briefly elaborates on these complementary perspectives of PCM. And ends introducing a set of papers that illustrate its core and diversity.
Providing Patient Centered Care for Adolescents with Chronic Conditions
Authors: Al-Yateem Nabeel
Published: July 2021

Background: It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease.Objectives: To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions.Methodology: A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice.Results: The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.
Metanephric Adenoma: A Case Report of a Rare Benign Renal Tumor
Authors: Allameh Farzad , Ahadi Mahsa , Faraji Saba , Hojjati Seyyed Ali
Published: July 2021

Introduction: Metanephric adenoma (MA) is a rare benign kidney tumor with an excellent prognosis, which is usually diagnosed incidentally with no symptoms. The mean age of patients with MA is about 41 years, ranging from 5 months to 83 years in previous studies. Case Presentation: In this study, we present the case of a 29-year-old woman with a diagnosis of MA after nephrectomy. The ultrasound study showed a hyperechoic mass. The intravenous (IV) contrast-enhanced abdominopelvic computed tomography (CT) scan showed a hypodense mass. Based on the results of pathological features and immunohistochemistry (IHC) (positive vimentin, WT1, and PAX8), the diagnosis of MA was established. Conclusions: The diagnosis of MA is commonly based on pathological findings. Therefore, if MA is suspected, renal biopsy, partial nephrectomy, or follow-up of the patient can be used. However, further studies are needed to differentiate MA from papillary renal cell carcinoma and nephroblastoma before taking aggressive measures.