scholarly journals ETHICS AND NURSING IN A WIRED WORLD

2020 ◽  
Vol 12 (2) ◽  
pp. 17-26
Author(s):  
Becky TSARFATI ◽  
Daniela COJOCARU
Keyword(s):  
Medical Information ◽  
Ethical Issues ◽  
Quality Care ◽  
Point Of View ◽  
Digital Information ◽  
Technological Systems ◽  
Patient Centered ◽  
Network Systems ◽  
Advantages And Disadvantages ◽  
Environment And Health

In recent years, healthcare givers and patients have extensively used computerized technologies and digital information. This changed the work environment and skills of nurses who learn to live with innovations, namely working with both “machines” and humans. Nursing is patient-centered, respecting human dignity and acknowledging patients' needs. Nurses are required to promote safe environment and health care, educate, and embrace a health policy for individuals of all ages and communities. Electronic health records are shared through network systems not only by patients but also by physicians, nurses, insurance personnel, government officials and more. This widespread access to health information requires finding ways for observing patients’ confidentiality and privacy by the users. This paper presents four central ethical issues stemming from the use of electronic records: the built-in conflict between nurses' quality care commitment to health system organization and their commitment to maintain patients' respect and privacy; the gap between the one-dimensional reporting of medical and therapeutic information through technological systems; the gap between the advantage of technological systems as being easy to operate and use and the risk of leaking confidential medical information, violating patients' privacy. 4) Conflict between nurses' classic professional identity as people who take care of and satisfy patients' needs and the new concept of nursing that advocates patients’ privacy, autonomy and dignity while learning new technological skills with all the advantages and disadvantages encompassed in it. This paper ends with a writes' point of view about ethical-technological solutions of the ethical issues.

Design process for serious activities inspired by play and games: a problem solving with a board game from disengamement and gamification processes (Preprint)

2020 ◽  
Author(s):  
Stéphane Goria ◽  
Louise Dupet ◽  
Maëva Négroni ◽  
Gabriel Sega ◽  
Philippe Arnoux ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Serious Games ◽  
Diagnostic Method ◽  
Scientific Literature ◽  
Imaging Techniques ◽  
Point Of View ◽  
Board Game ◽  
Advantages And Disadvantages ◽  
Design Result

BACKGROUND most serious games and other game-based tools are designed as digital games or escape games. They are designed for learning or sometimes in the field of medicine as an aid to care. However, they can also be seen as an aid to research, in our case, to evaluate the advantages and disadvantages of imaging techniques for cancer detection. OBJECTIVE we present a case study of action research on the design of a serious board game intended to consider the advantages and weaknesses of a diagnostic method in a different ways. The goal was to better understand the principles of designing a tool using game or play. METHODS we explicitly implemented another process than gamification to develop a structure reminiscent of the game to highlight the strengths and weaknesses of different imaging techniques from the point of view of the respondents (in this case specialists not directly involved in the project). Based on this feedback and the scientific literature on this subject, we detail the main categories of games and games developed for serious use in order to understand their differences. Concerning the cancer research part to which game contributes, our method is based on questions asked to experts and practitioners of this specialty. RESULTS an expert point of view translation tool in the form of a game has been realized to apprehend a research in a different way. CONCLUSIONS we show with the help of a diagram, some possible design paths leading to this type of design result including two hidden dimensions to consider (the awareness of the game or play by the "player" and his role as a contributor or recipient).

The ethics of pandemic preparedness revisited - autonomy, quarantine, transferability and trust

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Schröder-Bäck ◽  
T Schloemer ◽  
K Martakis ◽  
C Brall
Keyword(s):  
Crisis Management ◽  
Ethical Issues ◽  
Lessons Learned ◽  
Point Of View ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Ethical Aspects ◽  
Outbreak Management ◽  
Ethics Framework ◽  
Ethical Point

Abstract Background The outbreak of SARS in 2002 lead to a public health ethics discourse. The crisis management of that time was ethically analysed and lessons to be learned discussed. Scholarship and WHO, among others, developed an ethics of pandemic preparedness. The current “corona crisis” also faces us with ethical challenges. This presentation is comparing the two crises from an ethical point of view and a focus on Europe. Methods An ethics framework for pandemic preparedness (Schröder et al. 2006 and Schröder-Bäck 2014) is used to make a synopsis of ethical issues. Ethical aspects of 2002 and 2020 that were discussed in the literature and in the media are compared. For 2020, the focus is on interventions in Italy, Germany, Switzerland, and the Netherlands. Results Topics that emerged from the 2002 crisis were, among others, revolving around aspects of stigmatisation and fair distribution of scarce resources (esp. vaccines, antivirals). Currently, most urgent and ethically challenging aspects relate to social distancing vs. autonomy: Isolation and quarantine are handled differently across Europe and the EU. Questions of transferability of such interventions prevail. Contexts vary vertically over time (2002 vs. 2020) and horizontally (e.g. between Italy and Germany at the same time). Furthermore, trust in authorities, media and health information is a key issue. Conclusions Ethical aspects are key for good pandemic preparedness and management. The context of the crises between 2002 and 2020 has slightly changed, also based on “lessons learned” from 2002. This has implications on ethical issues that are being discussed. New lessons will have to be learned from the 2020 crisis. Key messages Pandemic preparedness and outbreak management entail many ethical tensions that need to be addressed. Currently, questions of trust and transferability are key to the crisis management, further ethical issues could still emerge.

scholarly journals Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

2021 ◽  
Author(s):  
Doriana Landi ◽  
Marta Ponzano ◽  
Carolina Gabri Nicoletti ◽  
Gaia Cola ◽  
Gianluca Cecchi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Point Of View ◽  
Physical Parameters ◽  
Chronic Medical Conditions ◽  
Socioeconomic Conditions ◽  
Web Based ◽  
Healthcare Facilities ◽  
Advantages And Disadvantages ◽  
Disease Characteristics ◽  
Degree Of Disability

AbstractRestrictions in the access to healthcare facilities during COVID-19 pandemic have raised the need for remote monitoring of chronic medical conditions, including multiple sclerosis (MS). In order to enable the continuity of care in these circumstances, many telemedicine applications are currently tested. While physicians’ preferences are commonly investigated, data regarding the patients’ point of view are still lacking. We built a 37 items web-based survey exploring patients’ propensity, awareness, and opinions on telemedicine with the aim to evaluate the sustainability of this approach in MS. Analysing 613 questionnaires out of 1093 that were sent to persons with MS followed at the Multiple Sclerosis Center of Tor Vergata University, Rome, we found that more than half of respondents (54%) were open to having a televisit. Propensity toward telemedicine significantly depended on having a higher income (p = 0.037), living farther from the center (p = 0.038), using computer and tablet (p = 0.010) and using the Internet for other remote activities (p < 0.001), conversely it was not influenced by any specific disease characteristics (i.e. degree of disability). The main advantages and disadvantages of televisit reported by participants were respectively saving time (70%) and impossibility to measure physical parameters (71%). Although the majority of respondents are in favour of televisit, so far this approach is restricted to those displaying better socioeconomic conditions and higher familiarity with technology. Implications of the study are that telemedicine platforms should be better tailored to patients’ demands in order to spread the use of telemedicine, to enhance usability and to increase patients’ adherence.

scholarly journals Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care

2021 ◽  
Author(s):  
Kari White ◽  
Subasri Narasimhan ◽  
Sophie A. Hartwig ◽  
Erin Carroll ◽  
Alexandra McBrayer ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Parental Involvement ◽  
Service Delivery ◽  
Quality Care ◽  
Health Service Delivery ◽  
Policy Implications ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Staff Members

Abstract Introduction Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent. Methods Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors’ and parents’ reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the Institute of Medicine’s healthcare quality framework, were used in the thematic analysis. Results Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult’s relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor’s decision, participants felt they had a duty to intervene to ensure the minor’s decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements. Conclusions Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast. Policy Implications Removing parental involvement requirements would protect minors’ reproductive autonomy and support the provision of equitable, patient-centered healthcare.

scholarly journals Interoperability frameworks linking mHealth applications to electronic record systems

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kagiso Ndlovu ◽  
Maurice Mars ◽  
Richard E. Scott
Keyword(s):  
Primary Healthcare ◽  
Developing World ◽  
Healthcare Delivery ◽  
Implementation Strategies ◽  
Electronic Record ◽  
Digital Information ◽  
Patient Centered ◽  
Health Records ◽  
Healthcare Needs ◽  
The Impact

Abstract Background mHealth presents innovative approaches to enhance primary healthcare delivery in developing countries like Botswana. The impact of mHealth solutions can be improved if they are interoperable with eRecord systems such as electronic health records, electronic medical records and patient health records. eHealth interoperability frameworks exist but their availability and utility for linking mHealth solutions to eRecords in developing world settings like Botswana is unknown. The recently adopted eHealth Strategy for Botswana recognises interoperability as an issue and mHealth as a potential solution for some healthcare needs, but does not address linking the two. Aim This study reviewed published reviews of eHealth interoperability frameworks for linking mHealth solutions with eRecords, and assessed their relevance to informing interoperability efforts with respect to Botswana’s eHealth Strategy. Methods A structured literature review and analysis of published reviews of eHealth interoperability frameworks was performed to determine if any are relevant to linking mHealth with eRecords. The Botswanan eHealth Strategy was reviewed. Results Four articles presented and reviewed eHealth interoperability frameworks that support linking of mHealth interventions to eRecords and associated implementation strategies. While the frameworks were developed for specific circumstances and therefore were based upon varying assumptions and perspectives, they entailed aspects that are relevant and could be drawn upon when developing an mHealth interoperability framework for Botswana. Common emerging themes of infrastructure, interoperability standards, data security and usability were identified and discussed; all of which are important in the developing world context such as in Botswana. The Botswana eHealth Strategy recognises interoperability, mHealth, and eRecords as distinct issues, but not linking of mHealth solutions with eRecords. Conclusions Delivery of healthcare is shifting from hospital-based to patient-centered primary healthcare and community-based settings, using mHealth interventions. The impact of mHealth solutions can be improved if data generated from them are converted into digital information ready for transmission and incorporation into eRecord systems. The Botswana eHealth Strategy stresses the need to have interoperable eRecords, but mHealth solutions must not be left out. Literature insight about mHealth interoperability with eRecords can inform implementation strategies for Botswana and elsewhere.

scholarly journals The importance of soft skills development in a hard data world: learning from interviews with healthcare leaders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Traci H. Abraham ◽  
Greg L. Stewart ◽  
Samantha L. Solimeo
Keyword(s):  
Leadership Training ◽  
Soft Skills ◽  
Quality Care ◽  
Healthcare Delivery ◽  
Care Staff ◽  
Patient Centered ◽  
Data Infrastructure ◽  
Hard Data ◽  
Formal Leadership ◽  
Healthcare Leaders

Abstract Background Learning healthcare systems have invested heavily in training primary care staff to provide care using patient-centered medical home models, but less is known about how to effectively lead such teams to deliver high quality care. Research is needed to better understand which healthcare leadership skills are most utilized or in need of development through additional training. Method Semi-structured telephone interviews with healthcare leaders familiar with Patient-Aligned Care Teams (PACT) implementation in the U.S. Department of Veterans Affairs (VA). We interviewed sixteen (N = 16) physician, nursing, and administrative leaders at VA facilities located in the upper Midwestern United States. Content analysis of interviews transcripts using template techniques. Results Participants described instrumental challenges that they perceived hindered leadership effectiveness, including the supervisory structure; pace of change; complexity of the clinical data infrastructure; an over-reliance on technology for communication; and gaps in available leadership training. Factors perceived as facilitating effective leadership included training in soft skills, face-to-face communication, and opportunities for formal training and mentorship. A cross-cutting theme was the importance of developing “soft skills” for effective PACT leadership. Conclusions Although formal leadership training and development were perceived as beneficial, healthcare leaders familiar with PACT implementation in the VA described a mismatch between the skills and knowledge PACT leaders need to succeed and the training available to them. Closing this gap could improve retention of skilled and knowledgeable healthcare leaders, thereby reducing the costs associated with training and leading to improvements in healthcare delivery.

scholarly journals Landslide Awareness System (LAwS) to Increase the Resilience and Safety of Transport Infrastructure: The Case Study of Pan-American Highway (Cuenca–Ecuador)

2021 ◽  
Vol 13 (8) ◽  
pp. 1564
Author(s):  
Pietro Miele ◽  
Mariano Di Di Napoli ◽  
Luigi Guerriero ◽  
Massimo Ramondini ◽  
Chester Sellers ◽  
...  
Keyword(s):  
Point Of View ◽  
Transport Infrastructure ◽  
Slope Failures ◽  
Network Systems ◽  
Socioeconomic Impacts ◽  
Economic Point ◽  
Infrastructure Monitoring ◽  
Ground Deformations ◽  
Pan American

In most countries, landslides have caused severe socioeconomic impacts on people, cities, industrial establishments, and lifelines, such as highways, railways, and communication network systems. Socioeconomic losses due to slope failures are very high and they have been growing as the built environment expands into unstable hillside areas under the pressures of growing populations. Human activities as the construction of buildings, transportation routes, dams, and artificial canals have often been a major factor for the increasing damage due to slope failures. When recovery actions are not durable from an economic point of view, increasing the population’s awareness is the key strategy to reduce the effects of natural and anthropogenic events. Starting from the case study of the Pan-American Highway (the Ecuadorian part), this article shows a multi-approach strategy for infrastructure monitoring. The combined use of (i) DInSAR technique for detection of slow ground deformations, (ii) field survey activities, and (iii) the QPROTO tool for analysis of slopes potentially prone to collapse allowed us to obtain a first cognitive map to better characterize 22 km of the highway between the cities of Cuenca and Azogues. This study is the primary step in the development of a landslide awareness perspective to manage risk related to landslides along infrastructure corridors, increasing user safety and providing stakeholders with a management system to plan the most urgent interventions and to ensure the correct functionality of the infrastructure.

scholarly journals Anthropological analysis on recent covid-19 infection in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V A Sironi ◽  
M A Riva
Keyword(s):  
Medical Information ◽  
National Level ◽  
The Elderly ◽  
Point Of View ◽  
Cognitive Distortion ◽  
Psychological Reactions ◽  
Foreign Countries ◽  
The Social ◽  
Informative Role ◽  
Globalized World

Abstract The recent epidemic caused by the Covid-19 virus, which originated in China and then spread rapidly, can rightly be defined as the real 'first' epidemic in the social era. In an increasingly globalized world other recent epidemics (but more circumscribed, even if severely more lethal, such as Ebola and Sars) have been experienced with less media and emotional involvement, while the recent epidemic due to the new coronavirus has generated deserving reactions of analysis from an anthropological and social point of view, rather than on a health aspect. In Italy the epidemic event provoked sometimes excessive and irrational psychological reactions (from an unjustified panic to an irresponsible underestimation) and a cognitive distortion on anthropological level (wrong perspective perception of the pathological event). It has also generated disproportionate social repercussions at national level (refusal of stay for subjects coming from the lands in which diseased people are present) and at international level (foreclosure of landing of Italian tourists in some foreign countries). There was also incorrect medical information (confusion between infected - asymptomatic and/or non-hospitalized paucisymptomatic -, real patients with important symptoms - hospitalized - and sometimes in need of intensive care, subjects - the elderly and carriers of other serious diseases - died not for but with the Covid-19 infection) generated and amplified also by the pounding informative role of the mass media and by the news (often inaccurate and generating fake-news) spread in real time through social media. Key messages Irrational reactions must be avoided. Correct medical information are indispensable.

New Trends in Asymptotic Approaches: Summation and Interpolation Methods

2001 ◽  
Vol 54 (1) ◽  
pp. 69-92 ◽  
Author(s):  
Igor V. Andrianov ◽  
Jan Awrejcewicz
Keyword(s):  
Applied Sciences ◽  
Solid Mechanics ◽  
State Of The Art ◽  
Asymptotic Methods ◽  
Perturbation Series ◽  
Review Article ◽  
Point Of View ◽  
Advantages And Disadvantages ◽  
New Methods ◽  
Local Character

In this review article, we present in some detail new trends in application of asymptotic techniques to mechanical problems. First we consider the various methods which allows for the possibility of extending the perturbation series application space and hence omiting their local character. While applying the asymptotic methods very often the following situation appears: an existence of the asymptotics ε → 0 implies an existence of the asymptotics ε → ∞ (or, in a more general sense, ε → a and ε → b). Therefore, an idea of constructing a single solution valid for a whole interval of parameter ε changes is very attractive. In other words, we discuss a problem of asymptotically equivalent function constructions possessing for ε → a and ε → b a known asymptotic behavior. The defined problems are very important from the point of view of both theoretical and applied sciences. In this work, we review the state-of-the-art, by presenting the existing methods and by pointing out their advantages and disadvantages, as well as the fields of their applications. In addition, some new methods are also proposed. The methods are demonstrated on a wide variety of static and dynamic solid mechanics problems and some others involving fluid mechanics. This review article contains 340 references.

A Tsunami of Love: Overcoming the Violence of Curiosity—The Lived Experiences of Young Adults Born with Variations of Sex Characteristics

2021 ◽  
Vol 14 (2) ◽  
pp. 11-35
Author(s):  
Eva De Clercq
Keyword(s):  
Young Adults ◽  
Interpretative Phenomenological Analysis ◽  
Quality Care ◽  
Phenomenological Analysis ◽  
Sex Characteristics ◽  
Health Providers ◽  
Structured Interviews ◽  
Patient Centered ◽  
Medical Settings ◽  
Insight Into

This study provides insight into the experiences of young adults born with variations of sex characteristics to identify aspects of care and social support that need improvement. Semi-structured interviews with intersex youths in Switzerland were analyzed using interpretative, phenomenological analysis. Young adults desire timely, patient-centered information about their diagnoses. Peer support is key to delivering high-quality care but rarely systematically implemented. Intersex youth often face misrepresentation, stigma, and discrimination in medical settings and in society. Increased visibility alone cannot tackle these issues, but a feminist curiosity of care will enable health providers and society to overcome preconceptions of body normativity.

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