The introduction of variolation 'A La Turca' to the West by Lady Mary Montagu and Turkey's contribution to this

Aims: This study deals with the history of variolation as the oldest immunization method to be transferred from East to West, with emphasis on Turkey's role in this transmission

Quebrando o silêncio dos cordeiros: integrando o pessoal médico na prevenção do tráfico de seres humanos

Introduction: Human trafficking, including forced prostitution, is a form of human rights violation regarding right to life and respect for human dignity. The Physician-patient relationship may serve as a process for victim identification on the basis of physicians’ responsibilities to detect human trafficking. Method: This empirical study was based on a survey among physicians who may have been in contact with foreign sex workers. Almost eighty physicians in three health facilities were selected according to their high potentiality for coming into contact with foreign sex workers as patients. 228 physicians selected to that aim. 82 of them responded to the questionnaire which was performed in order to evaluate their perception and knowledge human trafficking and their attitudes towards sex work. Results: All physicians think that some women among the sex workers are exploited, exposed to violence and coerced to work against their will (100%). Almost all of them know that it is compulsory for the healthcare professionals to inform the security forces of the women who are exploited (80.0%). Nearly half of them have given medical care to a sex worker (46.9%) and 39.0 percent have thought that it may be related to human trafficking. The ones who have informed the police of a human trafficking case are only 10 per cent. Conclusions: We think that the professional should be equipped with ethical values encompassing both a patient’s dignity and general welfare. This may include the professional’s responsibility to make an assessment as to whether the patient is a victim or a sex worker. Furthermore human trafficking in sex work and sexual health are public health issues therefore it should be covered under standards of practice and ethical codes of conduct.Introducción: El tráfico humano, incluyendo prostitución forzada, es una forma de violación de derechos humanos relacionada con el derecho a la vida y el respeto a la dignidad humana. La relación médico-paciente puede servir como un proceso para identificar víctimas, con base en la responsabilidad del médico de detectar tráfico humano. Método: Este estudio empírico se basó en un cuestionario aplicado a médicos que podían haber estado en contacto con trabajadores sexuales extranjeros. Se seleccionaron unos 80 médicos de tres centros de salud, de acuerdo con su alta probabilidad de entrar en contacto con trabajadores sexuales extranjeros como pacientes. Se seleccionaron 228 médicos para ese objetivo. De estos, 82 respondieron al cuestionario desarrollado para evaluar su percepción y conocimiento del tráfico humano y sus actitudes hacia el trabajo sexual. Resultados: Todos los médicos piensan que algunas mujeres trabajadoras sexuales son explotadas, expuestas a violencia y forzadas a trabajar en contra de su voluntad (100%). Casi todos saben que es obligatorio para el profesional de la salud el informar a las fuerzas de seguridad sobre las mujeres que son explotadas (80,0%). Casi la mitad han proporcionado cuidado médico a un trabajador sexual (46,9%) y 39,0% ha pensado que puede estar relacionado con el tráfico humano. Solo un 10% ha informado a la policía sobre un caso de tráfico humano. Conclusiones: Pensamos que los profesionales deberían formarse en valores éticos incluyendo tanto la dignidad del paciente como su bienestar general. Esto puede incluir la responsabilidad profesional de evaluar si el paciente es una víctima o un trabajador sexual. Además, el tráfico humano en el trabajo sexual y la salud sexual son temas de salud pública, por lo tanto debieran cubrirse de acuerdo con los estándares de la práctica y códigos éticos de conducta.Introdução: O tráfico de pessoas, incluindo a prostituição forçada, é uma forma de violação dos direitos humanos sobre o direito à vida e o respeito pela dignidade humana. A relação médico-paciente pode servir como um processo para a identificação das vítimas, com base em responsabilidades dos médicos para detectar o tráfico de seres humanos. Método: Este estudo empírico foi baseado numa pesquisa entre os médicos que possam ter estado em contacto com os trabalhadores do sexo estrangeiros. Quase oitenta médicos em três unidades de saúde foram selecionados de acordo com sua alta potencialidade para entrar em contato com profissionais do sexo estrangeiros como pacientes. 228 médicos foram selecionados para esse objetivo. 82 deles responderam ao questionário que foi realizado com a finalidade de avaliar a sua percepção e o seu conhecimento sobre o tráfico de seres humanos e as suas atitudes em relação ao trabalho sexual. Resultados: Todos os médicos pensam que algumas mulheres entre os trabalhadores do sexo são exploradas, expostas à violência e coagidas a trabalhar contra a sua vontade (100%). A maioria deles sabe da obrigação dos profissionais de saúde de informar às forças de segurança sobre mulheres que são exploradas (80,0%). Quase metade deles tem dado assistência médica a trabalhadora do sexo (46,9%) e 39,0 por cento pensaram que isto pode estar relacionado ao tráfico de seres humanos. Os que informaram à polícia de um caso de tráfico de seres humanos são apenas 10 por cento. Conclusões: Nós pensamos que o profissional deve estar incorporado de valores éticos que abrangem tanto a dignidade do paciente como o bem-estar geral. Isso deve incluir a responsabilidade do profissional em avaliar se o paciente é uma vítima ou um profissional do sexo. Além disso o tráfico humano no trabalho do sexo e saúde sexual são questões de saúde pública, por isso, devem ser cobertos pelos padrões de prática e códigos éticos de conduta

The Origin of Military Radiology Use of X-Rays During the Late Ottoman Era

After its discovery by WC. Roentgen by the end of 1895, X-Rays were immediately used for medical and surgical purposes to detect foreign objects within the human body due to injuries and/or gunshots, which inspired discussions over its functionality in military surgery. X-Rays were first used in the beginning of 1896 at the British River Wars in Nile, Egypt. In May 1896, the Italian Doctor Guiseppe Alvaro took two wounded soldiers from Ethiopia to Italy and shot radiographies of them by making use of X-Rays in the Naples Military Hospital. He published his observations in Giornale Medico del Regio Esercito. Before Alvaro's piece, an article had been published in Medizinische Wohenschrift, on February 4, 1896 about the use of X-Rays on the wounded soldiers in the Prussian Army

Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily

Background: Human immunodeficiency virus (HIV) infection rates have been gradually increasing in Istanbul, Turkey. Many people living with HIV (PLWH) here encounter difficulties, for example, in adapting to the chronic disease and obtaining continuous access to healthcare services. In this study, we aimed to explore the challenges PLWH face in their daily lives and understand their perceptions of themselves, healthcare professionals and services, and their social spheres via their expressed lived experiences in the healthcare setting. Method: Individual semi-structured in-depth interviews were conducted face-to-face with 20 PLWH in Istanbul. All the interviews were voice-recorded and transcribed verbatim except one, upon participant request, for which the interviewer took notes. These logs and the interviewer’s notes were analyzed thematically using the inductive content analysis method. Results: The themes concerned experiences in three distinct contexts: 1) Interactions with healthcare providers; 2) Participants’ responses to their HIV diagnosis; and 3) Interactions with their social networks. Firstly, the results highlighted that the participants perceived that healthcare professionals did not inform them about the diagnosis properly, failed to protect patients’ confidentiality and exhibited discriminative behaviors towards them. Secondly, after the diagnosis the participants had difficulty in coping with their unsettled emotional state. While many ceased sexual activities and isolated themselves, some sought support. Lastly, living with HIV affected their relationships with their families and friends either positively or negatively. Moreover, they had to face the difficulties concerning spouse/partner notification issues about which many needed professional support. Conclusion: Healthcare professionals’ discriminative or inappropriate attitudes and customs in healthcare institutions are perceived to impair PLWH’s utilization of healthcare services. Structural factors such as social pressure, societal ignorance about HIV, limited access to HIV prevention, and regulatory barriers might contribute to these challenges. The results suggest that it is necessary to raise healthcare professionals’ and society’s awareness about HIV and develop national policies to establish a well-functioning referral system and appropriate spouse/partner notification services

Integrating patient management, reflective practice, and ethical decision-making in an emergency medicine intern boot camp

Background: Integration of clinical skills, ethical decision-making, and reflection skills have emerged as cornerstones of clinical teaching in medical schools. This study aimed to detect whether a multimodal learning environment approach consisting of lectures, a drill, post-drill video debriefing, and written reflection in an emergency medicine rotation boot camp improves interns’ patient management skills, ethical decision-making, and reflection skills. Methods: A multimodal learning environment was created by the collaboration of emergency medicine, ethics, and medical education specialists. Multiple educational techniques involving lectures, case discussions, and role-playing a crisis scenario were applied. Pre-test and post-test, debriefing on performances on video records, video-recorded performance assessment, and reflective essays about their own and group’s performances were used to assess various aspects of the student performances. Additionally, a meeting was organized with the presence of the authors to create qualitative data obtained through the program evaluation meeting conducted on three themes: influences of teaching methods, students’ performances, and common achievements and mistakes of students. Results: 133 students participated. Post-test multiple-choice question (MCQ) test scores were slightly higher than pre-test. A low and medium correlation was detected among pre-test and post-test patient management problem (PMP) and reflection scores, which was more prominent for female students. Multiple linear regression showed that pre-test and post-test PMP scores significantly contributed to reflection scores. These results might support that better patient management predicts more robust reflective practice. Teachers observed that students appreciated being inspired by well-performing peers, particularly noting the empathic needs of patients, companions, and other health professionals. However, students overlooked summoning forensic or social services and were inhibited by the pressure of the contextual traits of the drill. Conclusion: The multimodal learning environment created by multidisciplinary collaboration contributed to the improvement of components of situational awareness of the interns: patient management skills, ethical decision-making, and reflective practice. During this research, we created a toolbox better to capture the richness and diversity of student interactions. Considering the scarcity of context-specific assessment methods and widespread use of MCQs or generic scales for higher-order thinking skills in medicine, this study might be regarded as a step forward in that context