Back Issue: Vol.10 No.2 (Summer 2024)
ISSN 2474-2309
narrative review
- Daniel C. Eisner, DMSc, MHA, PA-C
Address correspondence to: Daniel C. Eisner, DMSc, MHA, PA-C. E-mail: email.eisner@gmail.com
Pages: 1-14
OBJECTIVE: This narrative review seeks to identify the scope, causes, and suggested solutions to both eliminating the toxic work environment (TWE) within a healthcare setting and maintaining a harmonious work environment, especially those in high volume areas such as emergency departments, primary care clinics, and urgent care clinics. BACKGROUND: Despite the end of the COVID-19 Public Health Emergency (PHE), turnover and shortages in the healthcare sector labor force continues at an alarming rate. While the causes have been implicated, little is known about specific practices proven helpful in reversing this trend. METHODS: The selected search engines identified studies published within the last 10 years focusing on the toxic healthcare work environment, workplace stress, burnout, and healthcare worker (HCW) turnover. Suggested solutions were then explored. DISCUSSION: Numerous publications defined attributes of a TWE, as well as causes and damages incurred, but few gave substantial suggestions for management. No studies or articles discussed the development or use of a standardized protocol on how to manage a TWE. CONCLUSION: The TWE is a growing concern for stakeholders, as it affects both the organization and the community it serves. Determining the scope, measuring the damage, and addressing the causes are critical in ending it. Numerous solutions are outlined but a commitment to maintaining a harmonious workplace by all stakeholders is key. More studies are needed to develop best practices for the elimination of the TWE by way of tested and standardized protocols.
Literature Review
- Mahhum Naqvi, Mahrukh Naqvi, MPH, Justin Stout, MBA, Colton Spencer
Address correspondence to: Mahhum Naqvi. Email: naqvim14@rowan.edu
Pages: 15-27
Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. Sources of exposure, including dust, soil, consumer products, and water, contribute to this issue, particularly prevalent in Philadelphia due to lead-based paint in older housing units. This literature review examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia’s most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and rectification of systemic and institutional factors contributing to health disparities. Moreover, this review includes a comprehensive policy analysis of existing legislation targeting this concern in Philadelphia. Through stakeholder collaboration and historical insights, this review aims to offer guidance for shielding the city’s most at-risk children from lead exposure. Additionally, it evaluates current policies to inform and steer future endeavors aimed at mitigating childhood lead exposure in Philadelphia.
Research Ethics
- Fredy Abboud, Aubrey Kenefick, Peter Clark, Alexandra Colman, Celine Beltran, Cameron Lyons, Nouhad Khoury, Kristina Kristo
Address correspondence to: Fredy Abboud. Email: fa10761786@sju.edu
Pages: 28-45
The Black, Indigenous and People of Color (BIPOC) Health Promoter (HP) is a preventive medicine-based clinic serving the Black and Indigenous communities in Philadelphia, Pennsylvania. As part of Saint Joseph’s University’s Institute of Clinical Bioethics’ (ICB) health promoter program, the BIPOC clinic is modeled after the ICB’s four other health promoters—African, Hispanic, Asian, and Mobile/Rural. The BIPOC clinic is founded on the principles of education, community outreach, solidarity, respect for the human person, and accompaniment; it is also built on the availability and cohesion among seven elements: 1) program coordinators, 2) volunteering medical and dental professionals, 3) undergraduate and graduate volunteers, 4) organizational partnerships, 5) location, 6) funding, and 7) community support/engagement. Offering monthly medical and dental services to African American and Hispanic communities affected by the opioid epidemic in Philadelphia’s Kensington—an open-air drug market—the BIPOC HP may be a paradigm for preventive medical services and community outreach worth adopting and implementing by city officials in regions struck with illicit substance use.
- Kizito Uzoma Ndugbu, DHA, MPH, ACHE, BCC
Address correspondence to: Kizito Uzoma Ndugbu, DHA, MPH, ACHE, BCC. Email: kizykn@gmail.com
Pages: 46-57
In a nation where out-of-pocket medical expenses push many into poverty, access to healthcare is a critical social justice issue in Nigeria. This work argues that achieving universal health insurance (UHI) is not just a healthcare reform, but a cornerstone of building a more just society. By outlining Nigerians’ current challenges in accessing healthcare, we demonstrated the significant socioeconomic disparities it creates. We then explored how UHI can dismantle these barriers, promoting health equity, economic empowerment, and social mobility. Ultimately, this task contended that UHI is a vital step towards a Nigeria where health is not a privilege, but a basic right enjoyed by all.
- Divya K J, MBE.
Address correspondence to: Divya K J, MBE. ICREP, CUSAT, KOCHI. Ernakulam, Kerala Ph. No : 7907462347. Email : divyakj2001@gmail.com
Pages: 58-83
The cosmetics industry is diverse, encompassing products aimed at cleansing, beautifying, and altering appearance. Within this realm, the concept of cruelty free cosmetics has gained prominence, denoting products that eschew animal testing throughout development and production. While certifications like the Leaping Bunny Program offer assurance, discrepancies in interpretation and enforcement persist, leading consumers to scrutinize labels for authenticity. Moreover, distinctions exist between cruelty free, vegan, vegetarian, and organic cosmetics, each reflecting varying degrees of animal derived ingredients and production standards. Despite the functional necessity of animal testing for assessing safety and efficacy, ethical concerns have fueled debates on its justification. While some argue for its scientific validity and regulatory utility, others criticize its ethical implications and advocate for alternative testing methods, citing issues of reproducibility and relevance. The emergence of the 3Rs principle: Replacement, Reduction, and Refinement; proposed by Russell and Burch in 1959, underscores efforts to minimize animal usage while advancing scientific progress.
Historically, public outcry and activism have shaped regulations and practices surrounding animal experimentation, prompting initiatives like the Committee for the Purpose of Control and Supervision of Experiments on Animals (CPCSEA) to enforce ethical standards. Despite acknowledgment of the necessity of animal research for human welfare, calls for innovation and collaboration underscore the pursuit of alternative methods and the enhancement of animal welfare standards in laboratories. Advancements in biotechnology have spurred the development of in vitro models, offering promising alternatives to animal testing. These methods, ranging from organ and tissue cultures to computer simulations, present cost effective and scientifically robust options for toxicity testing and research. Acknowledgment of the biological complexities inherent in in vitro models underscores the importance of careful preparation and maintenance for reliable research outcomes.
In summary, the cosmetics industry stands at a crossroads, balancing scientific innovation with ethical considerations regarding animal testing. As stakeholders continue to advocate for cruelty free practices and alternative testing methods, collaboration and innovation offer avenues for advancing both scientific excellence and animal welfare.