scholarly journals Unintended Consequences of Tele Health and their Possible Solutions

2016 ◽  
Vol 25 (01) ◽  
pp. 41-46 ◽  
Author(s):  
A. Maeder ◽  
M. Mars ◽  
G. Hartvigsen ◽  
A. Basu ◽  
P. Abbott ◽  
...  

SummaryObjectives: Assess unforeseen consequences of Telehealth and suggest solutionsMethods: An outline was created collecting all possible ill effects classified into Clinical considerations, Administrative concerns including interpersonal relations, Technical issues, Legal / Ethical concerns and Miscellaneous. Each topic was assigned to a particular WG member to lead, gather opinion and review existing literature.Results and Conclusion: A wide array of problems have been described. Except for technical issues, literature on this topic is scant, so this article is based more on personal experience and data collected from surveys. Much can be done to prevent such problems, such as a need for standardization with related clinical studies for devices as well as processes used for telehealth is underlined, besides evaluation of outcomes of projects undertaken.

1999 ◽  
Vol 27 (2) ◽  
pp. 137-152 ◽  
Author(s):  
Margaret A. Clark

New technologies are changing our lives radically and quickly. New biotechnologies are moving to commercial uses faster than government regulators or private citizens can monitor. This tension manifests itself in the current debates over xenotransplantation technologies in medicine. The possibility of removing cells, tissues, and organs from animals and transplanting them into human beings is startling and unnerving. Natural immunesystem barriers between species, and even between individuals within a species, are formidable. Typically, transplantation results in violent rejection and death of the grafted organ. But despite the natural barriers to transplantation, xenotransplantation aims specifically to overcome them.In this paper, I will discuss applications of xenograft technology, which raises clinical risks, ethical concerns, and policy issues. I conclude with a set of specific recommendations. As a recent letter to the journal Nature puts it, there is a “split between those who want to get it right, and those who want to get it right now.” No one knows what all the risks, benefits, and unintended consequences of xenotransplantation will be.


Author(s):  
Stephanie Vanderhook ◽  
Joanna Abraham

Healthcare is at a different place than it once was, over the past few decades, there has been an accelerated revolution with information technology (IT) and how it is used. Electronic Health Record (EHR) systems are a common healthcare IT deemed as a crucial step in advancing healthcare with both positive and negative impacts. Many unintended consequences stem from technical issues and/or sociotechnical issues – workflows, culture and interactions with the EHR system. The complexity of both the healthcare industry and EHR systems demonstrate the criticality to keep investigating and addressing issues with interaction of the two. This paper reports on the common factors leading to unintended consequences and medical errors, while exploring mitigation factors to address the associated risks.


Author(s):  
Alessandro Checco ◽  
Lorenzo Bracciale ◽  
Pierpaolo Loreti ◽  
Stephen Pinfield ◽  
Giuseppe Bianchi

AbstractThe scientific literature peer review workflow is under strain because of the constant growth of submission volume. One response to this is to make initial screening of submissions less time intensive. Reducing screening and review time would save millions of working hours and potentially boost academic productivity. Many platforms have already started to use automated screening tools, to prevent plagiarism and failure to respect format requirements. Some tools even attempt to flag the quality of a study or summarise its content, to reduce reviewers’ load. The recent advances in artificial intelligence (AI) create the potential for (semi) automated peer review systems, where potentially low-quality or controversial studies could be flagged, and reviewer-document matching could be performed in an automated manner. However, there are ethical concerns, which arise from such approaches, particularly associated with bias and the extent to which AI systems may replicate bias. Our main goal in this study is to discuss the potential, pitfalls, and uncertainties of the use of AI to approximate or assist human decisions in the quality assurance and peer-review process associated with research outputs. We design an AI tool and train it with 3300 papers from three conferences, together with their reviews evaluations. We then test the ability of the AI in predicting the review score of a new, unobserved manuscript, only using its textual content. We show that such techniques can reveal correlations between the decision process and other quality proxy measures, uncovering potential biases of the review process. Finally, we discuss the opportunities, but also the potential unintended consequences of these techniques in terms of algorithmic bias and ethical concerns.


2020 ◽  
Vol 44 (2) ◽  
pp. 130-156
Author(s):  
Antoaneta L. Dimitrova

This article argues that the EU’s enlargement negotiations with Eastern European applicants have become possible to a large extent by the introduction of objective assessment by the Commission, which allowed integration to proceed despite the threat of deadlock. The process of negotiations and preparation, however, should be better seen as a constant switching between the technical parts of the acquis and their (potential) political consequences. These arguments are developed in an analysis of Bulgaria’s path to accession. The analysis shows that in the domestic arena, the same tensions between the seemingly technical character of the negotiations and their political implications and consequences can be observed. The article will argue that while the emphasis on objective criteria and technical issues obscured the potential political consequences and effects on various sectors of the economy and society, stalled reforms in public administration or the judiciary belonged to the realm of its unintended consequences. Rule of law did not reform significantly despite the introduction of a special tool of political conditionality, the EU’s Cooperation and Verification Mechanism (cvm). The politicization of issues changed over time, with some measures affecting political cleavages more than a decade after Bulgaria’s accession.


Author(s):  
Danah Boyd ◽  
Eszter Hargittai ◽  
Jason Schultz ◽  
John Palfrey

Facebook, like many communication services and social media sites, uses its Terms of Service (ToS) to forbid children under the age of 13 from creating an account. Such prohibitions are not uncommon in response to the Children’s Online Privacy Protection Act (COPPA), which seeks to empower parents by requiring commercial Web site operators to obtain parental consent before collecting data from children under 13. Given economic costs, social concerns, and technical issues, most general–purpose sites opt to restrict underage access through their ToS. Yet in spite of such restrictions, research suggests that millions of underage users circumvent this rule and sign up for accounts on Facebook. Given strong evidence of parental concern about children’s online activity, this raises questions of whether or not parents understand ToS restrictions for children, how they view children’s practices of circumventing age restrictions, and how they feel about children’s access being regulated. In this paper, we provide survey data that show that many parents know that their underage children are on Facebook in violation of the site’s restrictions and that they are often complicit in helping their children join the site. Our data suggest that, by creating a context in which companies choose to restrict access to children, COPPA inadvertently undermines parents’ ability to make choices and protect their children’s data. Our data have significant implications for policy–makers, particularly in light of ongoing discussions surrounding COPPA and other age–based privacy laws.


2021 ◽  
pp. 86-93
Author(s):  
Yu. S. Filatova ◽  
I. N. Solovyov

The article discusses the treatment of osteoarthritis. To prevent serious structural and functional changes, it is extremely important to start therapy in the early stages of the disease. Symptomatic slow-acting drugs for the treatment of osteoarthritis (SYSADOA) are an important class in the pharmacological arsenal of OA treatment. The results of the use of this group of drugs in numerous clinical studies have demonstrated good effectiveness in the long-term achievement of the goal. The SYSADOA class (chondroprotectors) includes many different drugs, including glucosamine, chondroitin, diacerein, and soy unsaponifiable avocado substances. Particular attention is paid to the injectable forms of chondroprotective drugs, data from experimental and clinical studies confirming their effectiveness. The authors discuss the issue of intra-articular administration of drugs for knee osteoarthritis and the choice of optimal access. Intra-articular drug delivery has a number of advantages over systemic delivery, including increased local bioavailability, reduced systemic exposure, fewer side effects, and reduced cost. To minimize side effects, it is important to determine the injection site and to have some preparation in the correct placement of the needle during these procedures. To improve the accuracy of intraarticular injections, various imaging methods can be used, but ultrasound of the musculoskeletal system is the most practical. The article presents the data of personal experience of choosing access under the control of ultrasound. Taking into account the anatomy of the knee joint, performing an intra-articular injection from the inside into the upper inversion is the most affordable and optimal. The article presents the data of a clinical example of the introduction of chondroprotectors through the selected access.


Author(s):  
Weronika Lipszyc

Epic Fail: About Two Photographic ProjectsThe paper discusses images of failure in Polish photography created in 1970–2000, drawing on three particular projects: Archeology of Photography by Jerzy Lewczyński and the exhibitions The New Documentalists (2006) and Postdocument: Missing Documents: Documents of the Polish Transformation After 1989 (2012). As such, it concentrates on documentary, or post-documentary, photography which suffers no illusions as to the mimetic power of the medium, but persists in hoping that photos can have social impact.As the analyzed projects aim to create a critical picture of reality, they focus on spaces and people subject to exclusion and on the experience of failure (e.g., Unfinished Houses by Konrad Pustoła and Wojciech Wilczyk’s There’s No Such Thing as an Innocent Eye), as well as on the erosion of interpersonal relations (e.g., Aneta Grzeszykowska’s Album). Disappointments stemming from both the socialist reality and Polish capitalism mix with the desire to find and preserve what is intimate and authentic. The discussed artists devote the majority of their attention to the problem of photography as a medium and its ability to generate social change. However, they remain fully aware of the fact that the very nature of the photographic image, with its media entanglements, makes it difficult to create an unadulterated reflection of reality; it also makes it difficult to accept anything that does not fit the visual poetics of success, anything old, damaged, démodé, or kitschy. Accordingly, the artists raise important questions about the rules for creating images in the photographic universe and about the possibility of transcending them to create a new type of document, one that would elude the rules of “dominant images” (a term first coined by Rafał Drozdowski), and to enable such a use of photography as was postulated by John Berger: rooted in personal experience and memory. Totalna porażka. O dwóch projektach fotograficznychArtykuł ukazuje obrazy porażki w fotografii polskiej powstałej w okresie 1970–2000. Odwołuje się do trzech projektów: Archeologii fotografii Jerzego Lewczyńskiego oraz wystaw Nowi dokumentaliści (2006) i Postdokument. Świat nie przedstawiony. Dokumenty polskiej transformacji po 1989 roku (2012). Skupia się więc na fotografii nurtu dokumentalnego czy postdokumentalnego – nieżywiącej złudzeń co do mimetycznej mocy medium, ale nieporzucającej nadziei na społeczne oddziaływanie zdjęć.Przywoływane projekty stawiają sobie za cel stworzenie krytycznego obrazu rzeczywistości, a więc koncentrują się na przestrzeniach i ludziach podlegających wykluczeniu, przegranych (np. Niedokończone domy Konrada Pustoły, Niewinne oko nie istnieje Wojciecha Wilczyka), a także na erozji stosunków międzyludzkich (np. Album Anety Grzeszykowskiej). Rozczarowania związane zarówno z rzeczywistością socjalistyczną, jak i polskim kapitalizmem, mieszają się z pragnieniem odnalezienia i ocalenia tego, co żywe, bliskie, autentyczne.Artyści najwięcej uwagi poświęcają problemowi fotografii jako medium i jej zdolności generowania społecznej zmiany. Zdają sobie sprawę, że specyfika obrazu fotograficznego z jego medialnymi uwikłaniami utrudnia przekazanie niezafałszowanego obrazu rzeczywistości oraz akceptację tego, co nie mieści się w obrębie wizualnej poetyki sukcesu, tego, co stare, zniszczone, niemodne, kiczowate. Zadają w ten sposób pytanie o reguły tworzenia obrazów w fotograficznym uniwersum i o możliwość ich przekroczenia – stworzenia nowego dokumentu. Miałby on wymykać się regułom „obrazów dominujących” (określenie Rafała Drozdowskiego), umożliwić takie użycie fotografii, jakie postulował John Berger: zakorzenione w osobistym doświadczeniu i pamięci.


Prospects ◽  
1979 ◽  
Vol 4 ◽  
pp. 459-516 ◽  
Author(s):  
Fred Matthews

This essay on the middlebrow popularization of the role and influence of psychiatric ideas in the United States suggests that the world view variously described as the secular social gospel, progressivism, or (after about 1930) liberalism can best be understood in terms of the great influence that society's popularized medical models have had upon it. That is, liberal or progressive thinkers came to conceive of society as “a patient etherized upon a table,” an organism subject to illness but able to benefit from therapy as prescribed by trained experts. The popularization of psychiatric models also offered norms of health for the individual and (often by implication) for the group based upon the degree of adjustment to a reality external to the individual and subsuming smooth interpersonal relations and a variety of social norms. The most concrete institutional expression of this popular medical model of human nature and society was the network of local, state, and national societies for mental hygiene, and I have therefore used “mental hygiene” as a shorthand term for the concepts under discussion. However, it should be obvious that the fit between ideal-typical concepts and institutions is never perfect and that there is always a mix of ideas and motives among the individuals who constitute an institution at any one time. The concern here is with ideas and their diffusion, rather than with the close evolution of institutions or the development and effectiveness of therapeutic techniques. Furthermore, while this study is written from a viewpoint somewhat critical of the popular effects of a hygienic mentality, it should not be read as imputing either conscious self-interest or “bad faith” to the advocates of popular psychiatry, who appear to have been sincere, energetic individuals convinced that the diffusion of their own beliefs would have enormous social benefit. One of the regrettable tendencies of recent revisionist history has been a vulgar imputation of a conscious selfseeking or promotion of class interests to reformers and other actors who sought to change their environment—apparently from a Utopian view of what constitutes true sincerity and disinterestedness that finds only contamination in the mixed motives and unintended consequences of action in bourgeois society. A tragic or ironic view of history, obviously, avoids this naive faith and anger by assuming that consequences are rarely exact reflections of intentions, that action is as hazardous and morally ambiguous as it is necessary.


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