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Arbelaez Ossa L, Milford SR, Rost M, Leist AK, Shaw DM, Elger BS. AI Through Ethical Lenses: A Discourse Analysis of Guidelines for AI in Healthcare. SCIENCE AND ENGINEERING ETHICS 2024; 30:24. [PMID: 38833207 PMCID: PMC11150179 DOI: 10.1007/s11948-024-00486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/30/2024] [Indexed: 06/06/2024]
Abstract
While the technologies that enable Artificial Intelligence (AI) continue to advance rapidly, there are increasing promises regarding AI's beneficial outputs and concerns about the challenges of human-computer interaction in healthcare. To address these concerns, institutions have increasingly resorted to publishing AI guidelines for healthcare, aiming to align AI with ethical practices. However, guidelines as a form of written language can be analyzed to recognize the reciprocal links between its textual communication and underlying societal ideas. From this perspective, we conducted a discourse analysis to understand how these guidelines construct, articulate, and frame ethics for AI in healthcare. We included eight guidelines and identified three prevalent and interwoven discourses: (1) AI is unavoidable and desirable; (2) AI needs to be guided with (some forms of) principles (3) trust in AI is instrumental and primary. These discourses signal an over-spillage of technical ideals to AI ethics, such as over-optimism and resulting hyper-criticism. This research provides insights into the underlying ideas present in AI guidelines and how guidelines influence the practice and alignment of AI with ethical, legal, and societal values expected to shape AI in healthcare.
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Affiliation(s)
| | - Stephen R Milford
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Michael Rost
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Anja K Leist
- Institute for Research on Socio-Economic Inequality (IRSEI) in the Department of Social Sciences, University of Luxembourg, Esch-Sur-Alzette, Luxembourg
| | - David M Shaw
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Bernice S Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- Center for Legal Medicine (CURML), University of Geneva, Geneva, Switzerland
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Sowińska A, Pezoa Tudela R. Living with invisible medical disabilities: experiences and challenges of Chilean university students disclosed in medical consultations. Int J Qual Stud Health Well-being 2023; 18:2221905. [PMID: 37300841 DOI: 10.1080/17482631.2023.2221905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE The objective of this qualitative study is to explore experiences and challenges of university students living with invisible disabilities. METHODS Nine videotaped medical consultations with students, conducted at the health centre of a higher education institution in northern Chile, were analysed, drawing on the thematic analysis to organize the most salient themes. RESULTS Three major themes were identified in the analysis, along with their subthemes: (1) experiencing overpowering symptoms, including variable, multiple, and severe symptoms; (2) facing medical, social, and academic barriers; (3) engaging in self-management behaviours, such as self-medication, self-treatment, changing therapies, and non-compliance. CONCLUSION As the healthcare system is mostly ineffective in diagnosing students with invisible disabilities as well as providing them with long-lasting help, the students often have to manage their conditions by themselves, without much success. It seems essential to promote the development of stronger links between health providers and universities to allow for early disability detection and awareness-raising programs within educational institutions. Further research should focus on strategies promoting effective support mechanisms to decrease barriers and increase the inclusion of these individuals.
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Affiliation(s)
- Agnieszka Sowińska
- Department of Experimental Linguistics, Nicolaus Copernicus University, Torun, Poland (Country of Residence)
- Universidad Católica Del Norte, Escuela de Inglés, Antofagasta, Chile
| | - Rosa Pezoa Tudela
- Universidad Católica Del Norte, Escuela de Inglés, Antofagasta, Chile
- Faculty of Arts, Cultures, Languages and Linguistics, University of Auckland, Auckland, New Zealand (Country of Residence)
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What informs oral health and chronic disease policy development in Australia: a citation analysis. J Public Health Policy 2021; 42:635-646. [PMID: 34782735 DOI: 10.1057/s41271-021-00313-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 01/12/2023]
Abstract
Improvement of health services and patient outcomes depends on the translation of health research into health policy. Oral health research can inform policies to manage chronic diseases and improve quality of life of affected individuals. To determine if translation of this research into policy is occurring, we identify where policymakers obtain evidence to inform the development of Australian health policy. We conducted a citation analysis of oral health, cardiovascular disease, diabetes and cognitive impairment National policies to determine if current oral health research has informed oral health and chronic disease policy. We analysed five National policies with 268 individual references to policy or organizational documents (n = 179), peer-reviewed research (n = 74), grey literature (n = 12), or unidentifiable (n = 3). Although we found oral health references listed in the National policies (92), we did not find this information to have been translated into the oral health and chronic disease policies we analysed.
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Kalichman SC, El-Krab R, Shkembi B, Kalichman MO, Eaton LA. Prejudicial beliefs and COVID-19 disruptions among sexual minority men living with and not living with HIV in a high SARS-CoV-2 prevalence area. Transl Behav Med 2021; 11:1310-1317. [PMID: 33956159 PMCID: PMC8135944 DOI: 10.1093/tbm/ibab050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic has had profound health and social impacts. COVID-19 also affords opportunities to study the emergence of prejudice as a factor in taking protective actions. This study investigated the association of COVID-19 concerns, prejudicial beliefs, and personal actions that involve life disruptions among people not living with and people living with HIV. 338 Black/African American men not living with HIV who reported male sex partners and 148 Black/African American men living with HIV who reported male sex partners completed a confidential survey that measured COVID-19 concern, COVID-19 prejudice, and personal action and institutionally imposed COVID-19 disruptions. Participants reported having experienced multiple social and healthcare disruptions stemming from COVID-19, including reductions in social contacts, canceling medical appointments, and inability to access medications. Mediation analyses demonstrated that COVID-19 concerns and COVID-19 prejudice were associated with personal action disruptions, indicating that these social processes are important for understanding how individuals modified their lives in response to COVID-19. It is imperative that public health efforts combat COVID-19 prejudice as these beliefs undermine investments in developing healthcare infrastructure to address COVID-19 prevention.
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Affiliation(s)
- Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Renee El-Krab
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Bruno Shkembi
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Moira O Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Lisa A Eaton
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
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Fjørtoft AK, Oksholm T, Førland O, Delmar C, Alvsvåg H. The position of home-care nursing in primary health care: A critical analysis of contemporary policy documents. Nurs Inq 2021; 29:e12445. [PMID: 34289213 DOI: 10.1111/nin.12445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 11/27/2022]
Abstract
Internationally, primary health care has in recent years gained a more central position in political priorities to ensure sustainable health care for the population. Thus, more people receive health care locally and in their own homes, where home-care nursing plays a large role. In this article, we investigate how home-care nursing is articulated and made visible in contemporary Norwegian policy documents. The study is a Fairclough-inspired critical discourse analysis seeking to uncover the position of nursing in the prevailing political ideologies on current primary health care. In the documents, we identified several complementary and conflicting understandings about home-care nursing. Home-care nursing is presented as a basic part of a municipality's health services, but at the same time, its content and contribution are unclear and almost invisible. We argue that the absence of nursing leads to significant perspectives being left out and tie this to the fact that some patient groups and tasks seem to be disadvantaged. The political placement of home-care nursing in the health-care landscape is thus not just about nursing as a professional practice but also concerns fundamental care values in our society in relation to disadvantaged groups and work tasks.
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Affiliation(s)
- Ann-Kristin Fjørtoft
- Center of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.,Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Trine Oksholm
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Oddvar Førland
- Centre for Care Research Western Norway, Western Norway University of Applied Sciences, Bergen, Norway
| | - Charlotte Delmar
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway.,Department of Nursing Science, Institute of Public Health, Health Faculty, Aarhus University, Aarhus, Denmark
| | - Herdis Alvsvåg
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
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Krabbe JS. Resisting the muddy notion of the 'Inclusionary Other': A re/turn to the philosophical underpinnings of Othering's construction. Nurs Philos 2021; 22:e12352. [PMID: 33929781 DOI: 10.1111/nup.12352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 03/08/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022]
Abstract
The notion of 'Inclusionary Othering,' in garnering uptake within diverse nursing spheres, muddies a critical understanding of Othering by obscuring the colonial production, exploitation and perpetuation of the Other for economic and political gain. The ongoing genocide of Indigenous women and girls in Canada is a direct manifestation of the Othering process and in response to the report's Calls for Justice, it is an apt time to re-enliven the conversation of the process of Othering's philosophical construction. The purpose of this article is to re/turn to the philosophical underpinnings of the process of Othering in hopes of enlivening a new wave of resistance within nursing and elsewhere to the means by which the Other is constructed as well as to the notion of Inclusionary Othering itself. Perhaps this re/turn to the philosophy of Edward Said and Sylvia Wynter can result in further thwarting the Othering construct by highlighting its colonial construction and usher in a pragmatic shift, increasing critical engagement with the construct as well as inspiring a re/newed resistance toward Othering in nursing practice.
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Affiliation(s)
- Janina S Krabbe
- University of British Columbia, Vancouver, British Columbia, Canada
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Vaagan A, Sandvin Olsson AB, Arntzen C, By Rise M, Grue J, Haugland T, Langeland E, Stenberg U, Koren Solvang P. Rethinking long-term condition management: An actor-level framework. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:392-407. [PMID: 33635559 DOI: 10.1111/1467-9566.13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
To understand the complexities of managing long-term conditions and develop appropriate responses, micro-, meso- and macrolevels must be considered. However, these levels have not been combined in a single analytical framework of long-term condition management (LTCM). This article aims to describe a framework of LTCM practice and research that combines societal levels and key agents. The actor-level framework, based on the works of Abram De Swaan and Randall Collins, provides a broader understanding of LTCM as an interdisciplinary research field compared to previous contributions. The framework has three main advantages. First, it encourages knowledge production across levels and actors that address the complexity of long-term illness management. Second, it broadens the scope of LTCM as an interdisciplinary research field and practice field. Finally, it facilitates the integration of knowledge production from different disciplines and research traditions. The framework could stimulate interdisciplinary research collaboration to enhance knowledge of processes and interactions influencing the lives of individuals with long-term conditions.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo, Norway
| | | | - Cathrine Arntzen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Marit By Rise
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Grue
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Trude Haugland
- Faculty of Health Studies, VID Specialized University, Norway and Inland Norway University of Applied Sciences, Hamar, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health and Frambu Competence Center of Rare Diagnosis, Oslo, Norway
| | - Per Koren Solvang
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Fuoco RE. People-Centered Language Recommendations for Sleep Research Communication. Sleep 2017; 40:3062257. [PMID: 28329207 DOI: 10.1093/sleep/zsx039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The growing embrace of patient-centered outcomes research (PCOR) in sleep medicine is a significant step forward for the field. In engaging and incorporating the unique perspectives of people with sleep disorders, PCOR enhances the relevance of findings and facilitates the uptake of research into practice. While centering research design around what matters most to people with sleep disorders is critical, research communication must be similarly people-centered. One approach is using "people-centered language" in both professional and public communications. People-centered language is rooted in sociolinguistic research demonstrating that language both reflects and shapes attitudes. People-centered language puts people first, is precise and neutral, and respects autonomy. By adhering to the language guidelines described in this article, sleep researchers will better serve the field's most important stakeholders.
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Andersen AB, Frederiksen K, Kolbaek R, Beedholm K. Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care. Nurs Inq 2017; 24. [DOI: 10.1111/nin.12196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Bendix Andersen
- Department of Science in Nursing; Aarhus University Health; Aarhus Denmark
- Medical Department and Department of Cardiology; Regional Hospital Viborg; Viborg Denmark
- Center for Clinical Research in Nursing; Regional Hospital Viborg; Viborg Denmark
| | | | - Raymond Kolbaek
- Center for Clinical Research in Nursing; Regional Hospital Viborg; Viborg Denmark
| | - Kirsten Beedholm
- Department of Science in Nursing; Aarhus University Health; Aarhus Denmark
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Vahabi M, Wong JPH. Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada. BMC Public Health 2017; 17:498. [PMID: 28535792 PMCID: PMC5442647 DOI: 10.1186/s12889-017-4431-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/15/2017] [Indexed: 11/16/2022] Open
Abstract
Background Canada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services. Method In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis. Results A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants’ narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women. Conclusion A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant caregivers to apply for permanent residence upon arrival; the TFWs Program to establish fair wages and subsidized housing so that caregivers can truly access the live-out option; and local ethno-specific, settlement and faith organizations be leveraged to provide TFWs with social support as well as information about their rights and how to access health and social care.
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Affiliation(s)
- Mandana Vahabi
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada. .,Daphne Cockwell School of Nursing, Faculty of Community Services Ryerson University, Toronto, ON, Canada. .,Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada. .,Ryerson Centre for Global Health and Health Equity, Toronto, ON, Canada.
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada.,Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada
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