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Niezrównoważenie w kryzysie

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PL
W czasach kryzysu Europy nadmierne koncentrowanie się na kwestiach rynkowych i gospodarczych w analizowaniu przyczyn i szukaniu rozwiązan wspo łczesnych problemo w wydaje mi się działaniem niedostatecznym. Co więcej, uważam za niebezpieczne zaniedbywanie dobrobytu obywateli rozumianego szerzej niż dostatek zasobo w finansowych. W niniejszej pracy, korzystając z badań naukowych prowadzonych w celu odnalezienia korelato w deklarowanego poziomu szczęścia/dobrostanu (SWB, Subjective Well-Being), uznawszy je za najtrafniejszy miernik skuteczności polityki danego rządu, chciałbym pokazac alternatywne do najbardziej obecnie rozpowszechnionych teorii szczęścia. W pracy przedstawiam porównanie dwóch dominujących ostatnimi czasy współczynników, używanych w mierzeniu sukcesu danej polityki (IEF - Index of Economic Freedom oraz GCI, Global Competitiveness Index) ze stosunkowo niedawno stworzonym trzecim (SDGI, Sustainable Development Goals Index), prezentując badania wykazujące najwyższą moc tego ostatniego w przewidywaniu poziomu dobrostanu jednostek. Jeśli wyniki tych badań mona uznać za poprawne, oznacza to, że obecne, uważane przez niektórych za nader redukcjonistyczne, podejście do kwestii poprawy losu obywateli jest mylne i należy przynajmniej rozważyć inną drogę. Jedną z propozycji „innej drogi” przedstawiam w skrócie w formie opisu celów paradygmatu zrównoważonego rozwoju.
EN
In the time of the European crisis, I find actions motivated by excessive attention paid to the financial and economic matters in analysing its reasons and the search for ways of amending it largely insufficient. Moreover, I believe it is dangerous to neglect the well-being of citizens understood more broadly than just a deficit of financial resources. In this paper, basing on research into finding correlates of subjective well-being of individuals, believing that they are the most effective measure of the quality of policies of any given government, I want to show an alternative approach to the current mainstream theories of happiness. I present a comparison of two dominant indexes used for measuring the quality of governance (IEF - Index of Economic Freedom and GCI, Global Competitiveness Index) and juxtapose them with the relatively recently created third index (SDGI, Sustainable Development Goals Index), citing results suggesting a higher explanatory power of the latter in predicting the well-being of individuals. If those results are correct, it seem that the contemporary, deemed by some to be overly reductionist, approach to improving the well-being of individuals is wrong and a different attitude should at least be considered. One of the „different attitudes” is presented in short in the form of a list of goals within the paradigm of sustainable development.
PL
Artykuł prezentuje obraz sytuacji epidemiologicznej AIDS/HIV na świecie i w Polsce, ze szczególnym uwzględnieniem województwa łódzkiego w latach 2001-2009, na podstawie meldunków epidemiologicznych Państwowego Zakładu Higieny oraz Wojewódzkiej Stacji Sanitarno-Epidemiologicznej w Łodzi. Szczególną uwagę zwraca autorka na porównanie sytuacji epidemiologicznej w zakresie AIDS/HIV w regionie łódzkim na tle innych polskich województw. Ponadto, autorka poszukuje odpowiedzi na pytanie, dlaczego region łódzki znajduje się wśród trzech województw o największej liczbie odnotowywanych zakażeń wirusem HIV. Wśród hipotez wyjaśniających to zjawisko znajdują się – po pierwsze takie, które dotyczą podejmowania przez mieszkańców aglomeracji łódzkiej zachowań antyzdrowotnych (np podejmowanie ryzykownych zachowań seksualnych); po drugie, te, które dotyczą podejmowania zachowań prozdrowotnych (wysoki odsetek odnotowywanych zakażeń wirusem HIV świadczy o wysokiej wykrywalności wirusa, będącej efektem m.in. wykonywania przez mieszkańców Łodzi testów na obecność wirusa HIV).
EN
The paper takes up the problem of the macro- and micro-allocation of scarce medical resources in the frames of the health care system in Poland. Some types of medical treatment in public health care system are analysed and presented in the form of the algorithms of: • contracted medical services • heroic-aggressive therapy • futile treatment • utilitarian • care limited by justice Social choices concerning allocation of medical resources are presented in the form the three case studies: 1) an elderly patient and a choice of treatment 2) a patient suffering from pancreas cancer; 3) the guidelines of the Congregation for Doctrine of Faith as to terminal care. The analyses lead to the following conclusions: the most important thing is to satisfy the needs of security on the level of the access to the basic health care services; there are legal and moral premises of just health care; the health condition of the society can be improved by an adequate allocation of medical resources on macro and micro-levels; the management of medical resources should take into account economic rules, but health care professionals should follow the principles of medical ethics.
EN
Contemporary medicine as a science and art of healing constitutes a significant portion of theoretical knowledge and practical human skill. In the historical and philosophical Perspective it can be viewed as based on two prevailing and mutually complementary paradigms - holistic and reductionist. The first stems from a pragmatism oriented therapy, the latter is based on the technological aspect of medical science. Holism is related to the model of the world as an organism, reductionism is a consequence of the world-is-a-mechanism approach. In the first the responsibility of a doctor is to restore, prevent and promote health, in the other his chief ambition is to explore and specialize in ever smaller portions of human body and health. It seems that the task for the medicine of the future - a science both natural and humanistic in nature - would be to elaborate a system of healthcare that secures free progress of medicine but has human in the center of its concern.
EN
The aim of the study was evaluation of the opinion of medical students on selected controversial medical ethics problems like abortion, contraceptives usage, euthanasia, cloning, tissue and organ transplantations, prenatal testing as well as gen engineering. One hundred seventy students (61 men and 109 women) of the 5th year of the Medical Faculty of the Medical University in Łódź took part in the study. Besides answering questions on the above mentioned issues, the students could indicate on specific restrictions or conditions under which the discussed problems might be morally and legally acceptable. Abortion without any restrictions was allowed in the opinion of 22% of the students who answered this question, while abortion under some conditions like threatening of mother’s life or health, serious genetic defects or malformations of a fetus, pregnancy in a raped woman, incestuous pregnancy, and difficult social or financial situation of a woman/family were accepted in total by 57.1% of the group. Contraceptives usage was accepted by 98.2% of the investigated medical students, of which 94.6% do not restrict this issue, while 3.6% of the group exclude “early abortion” contraceptives. Among medical students, 98.8% have no objections for prenatal testing. Euthanasia is acceptable by 47.9% of the investigated group. Cloning without any restrictions would be permitted by 7.5% of the medical students, although 52.5% would allow cloning of cells, tissue and organs, pointing out on cloning of a whole human being as unacceptable. In the investigated group, 91.7% do not see problems with gen engineering applied for medical purposes. Organ transplantations from the persons who suddenly died, usually in an accident, is acceptable by 97.6% of the students, while tissue or organ transplants from spontaneously aborted fetuses would be allowed only by 43.5% of the group- The selected problems mentioned above are discussed, and the data are compared with some other similar studies performed both in Poland and all over the world on medical students, medical residents and staff as well as on professionals and students of other faculties.
EN
In mine article I was presenting features and advantages associated with insurance for life and to live (to last). Starting-point of my considerations was argument that insurances for life and to last are the part of institutional projects of health promotion and refer to society justice. I execute presentation the main agreement for life and to live with additional agreements, which present universal procedure to contain and service individual insurances. I took a trial to answer to the question: can justice be a medical category? I touched ethical and moral matters associated with medical profession and insurance agent trade. By comparison doctor’s ethical principles and ethical base of agent insurance I showed what kind of rules and obligations should have been presented by these professions to the society they live. I was trying to show that justice ought to be achieved by good health promotion for life and to live. Prospects which are given by life insurances, show that everyone who’s the owner of insurance policy is able to have an equal access to limited medical resources.
EN
Contemporary medicine changes its visage under the influence of new technologies. This process is complex and its nature is ambiguous. Although the technologies applied by medicine open new opportunities for diagnostics, therapy and prophylaxis, they also - on the other hand make medicine more invasive and associate its increasing therapeutical efficiency with variety of undesirable side effects, that being nearly impossible to justify ethically basing on traditional deontologica) codes. The author’s aim is to sketch basic apories of contemporary bioethics, especially medical ethics, and their interpretation in the perspective of just medicine, would be able to reconcile the patients’ hopes (arisen by progresses of medical sciences)with opportunities given to the doctors in the limits defined by technologically organized health care system.
EN
The aim of the study is to draw attention to ethical problems in medicine observed in the physician - patient relation. In some cases this relation is characterized by the phenomenon of dehumanization, especially when the patient is treated like an object. It means, among other things, that an economic purpose is more important the patient’s good, his/her health and life. The ethical argumentation of the Polish 19th century School of History, Philosophy and Ethics in Medicine presented in the article postulates subjective treatment of the patient and provision of selfless care and help in disease.
EN
The purpose of this study was to assess the incidence of depression and factors determining its occurrence among beneficiaries of the City Social Care Centre Lodz-Polesie aged 65 and over. In conducting the study health related quality of life geriatric depression rating scale was used. The first stage of the research was conducted in 2011 among 108 people. In statistical analysis there were used: structure indices, measurable features distribution and χ2 test of independence. In the study there were 88 (81.5%) women and 20 (18.5%) men. The average age of beneficiaries was 78.2 years. Men receiving social care benefits were mainly bachelors or widowers, while women most often were widowed. Older people mainly benefited from the care services (77.1%). 22.9% of all patients benefited from financial assistance in the form of benefits. 81.2% of seniors indicated that they suffer from chronic diseases, while only 18.8% indicated that they are ill rarely or never. Among 78% of people probable depression was found. There was found statistic correlation between the incidence of depression and education, subjective assessment of health status and level of satisfaction with life. The most important conclusions are: 1) older people receiving social assistance are highly prone to depression, 2) understanding of the determinants of depression in the elderly can help to improve their quality of life and to reduce costs of medical aid caused this disease.
PL
Celem niniejszej pracy była próba oceny częstości występowania depresji i wybranych czynników warunkujących jej występowanie wśród podopiecznych Miejskiego Ośrodka Pomocy Społecznej Łódź-Polesie w wieku 65 lat i więcej. Przeprowadzając badanie jakości życia związanej ze stanem zdrowia osób starszych jako jedno z narzędzi badania stosowano Geriatryczną Skalę Oceny Depresji. Pierwszy etap badania przeprowadzono w 2011 roku wśród 108 osób. W analizie statystycznej danych wykorzystano wskaźniki struktury, miary położenia dla cech mierzalnych oraz test niezależności χ2. W badaniu wzięło udział 88 (81,5%) kobiet i 20 (18,5%) mężczyzn. Średni wiek badanych wynosił 78,2 lat. Mężczyźni uzyskujący świadczenia pomocy społecznej najczęściej byli kawalerami lub wdowcami, zaś kobiety najczęściej były owdowiałe. Osoby starsze w głównej mierze korzystały z usług opiekuńczych (77,1%). Niemal 23% wszystkich badanych korzystało z pomocy finansowej w postaci zasiłków. Aż 81,2% badanych seniorów wskazało, że choruje przewlekle lub często, zaś jedynie 18,8%, że rzadko lub wcale. U 78% badanych stwierdzono prawdopodobną depresję. Stwierdzono istotną statystycznie zależność pomiędzy występowaniem depresji, a wykształceniem, subiektywną oceną stanu zdrowia, a także poziomem zadowolenia z życia. Najważniejsze wnioski płynące z badania to: 1) osoby starsze korzystające z pomocy społecznej są w dużym stopniu narażone na występowanie depresji; 2) poznanie uwarunkowań występowania depresji u osób starszych może przyczynić się do poprawy ich jakości życia i do zmniejszenia wydatków na opiekę medyczną powodowaną tą chorobą.
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