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In 2012 the American Academy of Pediatrics (AAP) revised its recommendations regarding neonatal male circumcision, transitioning from a recommendation against it to endorsing the practice. The current recommendations are based on the findings of three studies performed in Sub-Saharan Africa. In those studies, the researchers suggested that circumcision may result is reduced rates of Human Immunodeficiency Virus (HIV) transmission via heterosexual intercourse. In addition to the above studies there are several studies suggesting that circumcision can have benefits in reducing the rates of penile cancer, human papilloma virus transmission, and urinary tract infections. Based on the AAP recommendations some third-party payers have revised their policies regarding reimbursement procedures. While circumcision practices are a topic of debate in the United States, non-therapeutic circumcision is not recommended by the European Academy of Paediatrics and is not reimbursed by third-party payers. For instance, the National Health Service in Great Britain discontinued the practice of routine non-therapeutic circumcision in the mid twentieth century. This presentation will give a thorough review of the existing body of knowledge regarding the practices of non-therapeutic male infant circumcision. Existing studies regarding HIV risk reduction will be discussed in detail. At the same time, the generalizability and transferability of the above studies to the US health care system will be discussed. Finally, third-party reimbursement practices, costs associated with circumcision, and ethical issues related to this issue will be discussed.

Bakgrund: Fetma är ett folkhälsoproblem som har ökat dramatiskt de senaste två decennierna. För att behandla extrem fetma har magsäcksoperationer blivit en allt mer vanlig metod. De hälsoekonomiska aspekterna av operation har ännu inte studerats i Sverige. Syfte: Studiens syfte var att belysa hälsoekonomiska aspekter av magsäcksoperationer som intervention mot fetma. Metod: Metoden var en litteraturstudie. Elva vetenskapliga studier valdes ut, analyserades och sammanställdes utifrån hälsoekonomiska aspekter. Resultat: Magsäcksoperationer var kostnadseffektiva som intervention mot fetma i jämförelse med ingen intervention, traditionell intervention och medicinsk behandling. Studiernas resultat varierade i tid till break even och beräkning av inkrementell kostnadskvot. Troliga anledningar till dessa skillnader var studiernas olika ursprungsländer och tidsperspektiv. Slutsats: Ur ett hälsoekonomiskt perspektiv rekommenderas operationer som intervention mot fetma. Dock bör etiska aspekter beaktas när samhällets begränsade ekonomiska resurser ska fördelas mellan olika interventioner. / Background: Obesity has increased dramatically in the last 20 years and has become a major public health issue. Bariatric surgery has become a more commonly used method for treating morbid obesity. The health economic aspects of bariatric surgery have not yet been studied in Sweden. Aim: The study highlights the health economic aspects of bariatric surgery as an intervention to treat obesity. Method: The method used was a literature review. Eleven scientific studies were selected, analyzed and compiled using a health economic perspective. Results: Bariatric surgery was a cost effective intervention for treating obesity, compared with no interventions, traditional interventions and medical treatment. The results of the studies vary in time to break even and incremental cost ratio. The studies different countries of origin and time perspectives are possible reasons for these differences. Conclusion: From a health economic perspective bariatric surgery was recommended as an intervention for treating obesity. However, ethical issues should be considered when the society's limited financial resources are distributed between different interventions.

This thesis focuses mainly on the general ethical considerations of staff and not pre-defined specific ethical problems or dilemmas. The aims of this thesis were: first, to map ethical considerations as described by staff members in their everyday work in child and adolescent psychiatry as well as in adult psychiatry; second, from a normative ethical perspective, examine encounters between staff and patients; and third, to describe staff justification for decisions on coercive care in child and adolescent psychiatry. The material in the three first studies comprised ethical diaries written by staff in 13 inpatient clinics. The fourth study included all the medical records of patients who were admitted to coercive care during one year in child and adolescent psychiatry in Sweden. In a final analysis, combining all the four studies, three staff ideals were identified: being a good carer, respecting the patient’s autonomy and integrity and having good relations with patients and relatives. Staff often felt that the only reasonable way in many situations was to act in a paternalistic way and take responsibility, but they considered it to be problematic. Four main themes were identified as ethical considerations. These were the borders of coercion, the emphasis on order and clarity rather than a more reciprocal relationship with patients, a strong expectation of loyalty within the team, and feelings of powerlessness, mostly in relation to patients. I have identified four challenges for inpatient psychiatry. First, formal and informal coercion in inpatient care raise ethical concerns that also can be emotionally difficult for staff. Second, the professional role and care needs to be redeveloped from providing routinised care to providing more individualised care. Third, staff often worry about how patients manage their life after discharge, indicating that patients need better support. Fourth, staff also need support; they often experience feelings of being alone with their thoughts about ethical difficulties at work. Future research could contribute in the mapping of ethical considerations, in helping to develop, implement and evaluate methods for managing these issues in psychiatric settings, and to develop the normative ethical language so that it is more relevant to the clinic reality.

The purpose of this research was to examine counselor educators’ perceptions of the gatekeeping process. To fulfill this purpose, a qualitative methodology using grounded theory procedures was utilized. Eight counselor educators participated in three rounds of individualinterviews. These counselor educators were located in the south-east region of the United States and had five or more years of experience teaching in CACREP-accredited graduate programs. Initial interviews occurred face-to-face and follow-up interviews were conducted via electronic mail. Initial face-to-face interviews were audio taped and transcribed for the purpose of data analysis. Electronic mail interviews were printed for analysis purposes. For each round of individual interviews, coding procedures were utilized to identify emergent themes. Emergent themes were organized in four general categories: pre-admission screening phase, postadmission screening phase, remediation plan phase, and remediation outcome phase. Additionally, two interwoven themes emerged related to each gatekeeping phase: support and cultural sensitivity. Verification procedures are discussed and methods to address potential limitations are presented. Implications for counselor educators, counselor education programs, related educational programs, CACREP, and ACA are highlighted. Finally, suggestions for further research are offered.

Facial reconstructions, like archaeology, consists of many layers that one must get through to understand the whole picture. The development of the methods that reconstructions rely on, occurred during the 20th century. By focusing on the various elements such as studies of tissue depth, chemical processes (DNA and isotope analysis), solid craftsmanship and the development of computer technology, researchers around the world have been able to build a method that can give us an extended understanding of history. However, a lot of opinions have risen for the subject, people begin to question it ́s accuracy and what the real purpose really is. Besides the reliability of facial reconstruction, the experience of how a facial reconstruction is perceived by another person is equally important, the ethical principles have been brought up to discussion because it involves human remains. Discussions may occur during cases when facial reconstructions are inevitable, one example could be with minority groups that have a different view on how a body should be handled and treated after death. These scenarios are more likely to develop in the identification in forensic contexts, but the problem may also increase in archaeological contexts if the remains are from more recent times and the individuals as a population group has suffered repression. Therefore, this paper aims to discuss such questions but also embark on a mission to perform a facial reconstruction of an individual from the medieval church of St. Hans and the challenges that may occur during the way. The American method used in this essay shows that you can get a good result by following the instructions and guidelines that are displayed in various books and articles.

The aim of this research study is to explore what ethical issues emerge in the Indonesian mining industry? What shapes the emergence of these issues and how do organisations engage with them? Many research studies (e.g. Dierksmeier, 2013; Bowie, 2002; Cragg, 2002; and Moberg, 1997) emphasise the relevance of ethical theories in understanding ethical issues in business organisations. However, there remains a significant gap in the business ethics literature in understanding ethical issues in a context-sensitive manner. There is little awareness in most of these studies of the influence of the social structure of a multi-ethnic and multicultural society like Indonesia or of the specific industrial and organisational contexts which are being explored. There is therefore a challenge for researchers to provide a conceptual framework to study ethical issues which will fit the Indonesian mining companies’ situation. This research employed Critical Realism (CR) and a qualitative approach. Data was collected from forty-eight participant interviews with managers and employees of four mining companies in Indonesia. This made it possible to understand what ethical issues emerge in the mining industry and to examine what shapes their emergence, as well as how mining companies engage with the ethical issues. The findings revealed that the companies’ ethical concerns result from the particular characteristics of the industry and the Indonesian national culture. However, their ethical concerns typically reside in risk management and regulatory compliance. The findings showed that cultural mechanisms shape the emergence of ethical issues in the industry: family perspective and paternalism, religiosity, and multi-ethnicity. The study findings suggest that the mechanisms shaping the emergence of ethical issues at the organisations presented at times conflicting cases of instrumental or possibly unethical behaviour but also evidence of set rules and regulations as well as moral awareness, practices aimed at considering others and stakeholders’ interests. This research argues that to understand the ethical issues and how business organisations engage with them in a multi-ethnic and multicultural context, it is essential to ground the conceptual framework in both ethical theories and specific cultural sensitivities, as only then can the full story be grasped.

Book Summary: In this versatile new book, practicing school counselors share their favorite group activities 67 of them in all for working with children and adolescents in the schools. For ease of use, activities are arranged by age as well as by stage. Introductory chapters highlight selection, use, and processing of activities, as well as ethical issues inherent in working with students in the schools. Each activity contains specific directions, goals, materials, and suggestions for adaptation. Suggestions for creating a supportive environment for groups are also included.

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Book Summary: In this versatile new book, practicing school counselors share their favorite group activities 67 of them in all for working with children and adolescents in the schools. For ease of use, activities are arranged by age as well as by stage. Introductory chapters highlight selection, use, and processing of activities, as well as ethical issues inherent in working with students in the schools. Each activity contains specific directions, goals, materials, and suggestions for adaptation. Suggestions for creating a supportive environment for groups are also included.