Lay representations of artificial intelligence and autonomous military machines

This study is about how lay persons perceive and represent artificial intelligence in general as well as its use in weaponised autonomous ground vehicles in the military context. We analysed the discourse of six focus groups in Estonia, using an automatic text analysis tool and complemented the results by a qualitative thematic content analysis. The findings show that representations of artificial intelligence-driven machines are anchored in the image of man. A cluster analysis revealed five dominant themes: artificial intelligence as programmed machines, artificial intelligence and the problem of control, artificial intelligence and its relation to human life, artificial intelligence used in wars and ethical problems in developing autonomous weaponised machines. The findings are discussed with regard to people's tendency to anthropomorphise robots despite their lack of emotions, which can be seen as a last resort when confronting an autonomous machine where the usual interpersonal understanding of intentions does not apply.

Evidence use in the UK's COVID-19 Free School Meals Policy: a thematic content analysis

Free School Meals (FSM) are a well-recognised intervention for tackling food insecurity among school children. National school closures during the COVID-19 pandemic meant that there was a need to rapidly adapt the delivery of FSM. A range of food-assistance policies were implemented, but it is not clear if they were evidence-based. This study aimed to determine the transparency of evidence use and identify other competing influences in the UK's FSM policy decisions. Thematic content analysis was used to review 50 publicly available policy documents and debate transcripts on FSM policy published between March 2020-2021. This period covered the first national school closures (March 2020-July 2020), school holidays and the second national school closures (January 2021- March 2021). The Evidence Transparency Framework was used to assess the transparency of evidence use in policy documents. We found that overall transparency of evidence use was poor but was better for the Holiday Activities and Food (HAF) programme. The Government showed preference for replacing FSM with food parcels, rather than more agentic modes of food assistance such as cash-vouchers. This preference appeared to be closely aligned with ideological views on the welfare state. With an absence of evidence, value-based reasoning took precedent and was polarised by social media. This paper highlights the need for a formal review into FSM, one which includes a comparison of low and high agentic food assistance policies. Such a review would address the evidence gap, improve food assistance policy, and aid policymakers in future periods of uncertainty.

How patients with advanced cancer conceptualize prognosis: A phenomenological qualitative inquiry

BACKGROUND

Despite the importance of accurate prognostic understanding in patients with advanced cancer, there is little consensus around how to conceptualize and measure the multidimensional construct. Most studies focus on single aspects of prognostic understanding (e.g., curability) that clinicians have identified as important; no previous research has asked patients how they define "prognosis."

AIM

The present study examined how patients with advanced cancer conceptualize their "prognosis." It also explored how patients assigned value to prognostic information and the impact of prognosis on life perspectives.

DESIGN

A phenomenological approach was used to analyze semi-structured interviews with individuals with advanced cancer to examine how patients define prognosis.

SETTING/PARTICIPANTS

English and Spanish-speaking patients with advanced cancer (N = 29) were recruited from ambulatory clinics at a comprehensive cancer center in New York City.

RESULTS

To conceptualize prognosis, patients focused on concrete medical data, anticipated survival and quality of life, impact on meaningful life events, uncertainty, and physician affect. They discussed the importance of maintaining normalcy despite prognosis, knowledge as a form of coping, information reframing, and altered decision-making as means of coping with prognostic information.

CONCLUSIONS

Given the range of ways patients define prognosis and assign value to prognostic information, clinicians should incorporate a thorough assessment of patient information preferences, values, and coping styles when engaging in end-of-life discussions. Trainings should emphasize the importance of nonverbal cues (i.e., affect management, body language) in prognostic disclosure.

Occupational Stress and Its Effects on Nurses at a Health Facility in Ho Municipality, Ghana

Introduction

The prevalence of occupational stress among nurses varies significantly around the globe. Nursing is often considered a stressful occupation and can have negative effects on the mental, physical, family relationships, and quality of care given to patients. The aim of this study was to explore the experiences, causes, effects, and coping strategies of occupational stress among nurses working at a health facility in Ho Municipality in Ghana.

Methods

The study employed a qualitative research approach with an exploratory design. Data saturation was reached with 18 participants. Purposive sampling was used to select participants, while semistructured interview guide with voice recorders were used in data collection. Data were manually transcribed and analyzed using thematic analysis.

Results

Overall, four main themes and ten subthemes were developed from this study. The main themes were nurses' perception of occupational stress, sources of occupational stress, effects of occupational stress, and coping strategies adopted to cope with occupational stress. The subthemes were as follows: negative and positive stressful feeling, individual level, hospital level, general body pain and fatigue, mental health problems, ineffective relationships, low work output, diversional therapy, positive work outcomes, and psychological support from others (family and colleagues).

Discussion

There are more negative effects of occupational stress on nurses. However, most of the nurses adopted coping strategies to reduce stress with little or no support from the hospital. More support from the hospital will be required to totally manage occupational stress.

Conclusion

The study findings revealed how stress affects the daily life and work output of nurses. It is crucial to comprehend how work-related stress affects nurses and what aspects of their workplace are the most burdensome.

Understanding Alcohol Use Discourse and Stigma Patterns in Perinatal Care on Twitter

(1) Background: perinatal alcohol use generates a variety of health risks. Social media platforms discuss fetal alcohol spectrum disorder (FASD) and other widespread outcomes, providing personalized user-generated content about the perceptions and behaviors related to alcohol use during pregnancy. Data collected from Twitter underscores various narrative structures and sentiments in tweets that reflect large-scale discourses and foster societal stigmas; (2) Methods: We extracted alcohol-related tweets from May 2019 to October 2021 using an official Twitter search API based on a set of keywords provided by our clinical team. Our exploratory study utilized thematic content analysis and inductive qualitative coding methods to analyze user content. Iterative line-by-line coding categorized dynamic descriptive themes from a random sample of 500 tweets; (3) Results: qualitative methods from content analysis revealed underlying patterns among inter-user engagements, outlining individual, interpersonal and population-level stigmas about perinatal alcohol use and negative sentiment towards drinking mothers. As a result, the overall silence surrounding personal experiences with alcohol use during pregnancy suggests an unwillingness and sense of reluctancy from pregnant adults to leverage the platform for support and assistance due to societal stigmas; (4) Conclusions: identifying these discursive factors will facilitate more effective public health programs that take into account specific challenges related to social media networks and develop prevention strategies to help Twitter users struggling with perinatal alcohol use.

Connecting lived experiences of pre-nursing students during COVID-19 with learner well-being: A qualitative inquiry

AIM

To explore pre-nursing students' experiences and identify factors influencing their well-being as learners during COVID-19.

DESIGN

A qualitative descriptive design was used.

METHODS

Short answer study data (n = 289) were collected in Fall 2020 as part of a larger IRB-approved survey-based study focused on pre-nursing students. Participants were presented with three short answer questions designed to elicit a description of their experiences as a pre-nursing student. NVivo and reflexive thematic analysis were used to analyse participant responses.

RESULTS

Six themes related to learner well-being emerged from the data. Learner well-being was supported by achieving academic goals, experiencing positive feelings about current course content, creating connections with peers and envisioning themselves as nurses in the future. Negative contributors to pre-nursing student well-being included managing fears of program rejection and juggling multiple roles and demands. Online learning necessitated by COVID-19 created opportunities for loneliness and isolation from peers, technological difficulties and additional psychological stress, which also contributed negatively to learner well-being.

CONCLUSION

These findings illustrate pre-nursing students' experiences and provide support for the influence of the learning environment and factors within the individual on the well-being of learners.

IMPACT

Students preparing to apply to nursing programs are an understudied population and little is known about their well-being as learners. Survey-based open-ended short answer questions can be utilized to gain rich insight into their experiences. The study themes and sub-themes can be utilized for discussion and reflection in courses with pre-nursing students and as a starting point for additional conversations between pre-nursing students and educators regarding improving the support of well-being in learners. Additional research and evidence-based interventions that promote learner well-being in pre-nursing students are needed as they prepare for nursing program admission and to support their academic progression.

PATIENT OR PUBLIC CONTRIBUTION

Members of the public were not involved in the design or conduct of the study, analysis, or interpretation of the data, or in the preparation of the manuscript because the study focus is on gaining an understanding the experiences of pre-nursing students and their well-being.

Ethical challenges of cord blood banks: a scoping review

Cord blood is a rich source of hematopoietic stem cells used to treat many diseases of blood origin. Thus, storage banks were created to store and provide umbilical cord cells. With the development of diagnostic and therapeutic technologies and techniques in medicine, ethical issues have also become more widespread and complex. After the creation of the cord blood banks, efforts were made to address the ethical issues associated with such banks. The present study attempts to identify the ethical challenges in these banks in the published studies. Databases including PubMed, Scopus, Web of Science (WOS), Embase, Proquest, and Google Scholar were searched from January 1996 to January 2021. Then, the ethical challenges of the cord blood bank were extracted from the results section using thematic content analysis. 22 studies were selected based on inclusion and exclusion criteria. The ethical challenges raised in the studies included private or public ownership of the bank, fair access to banking services, informed and voluntary consent, failure to provide sufficient information to individuals about the process, confidentiality of user's information, conflict of interest of bank founders (who are commonly doctors). The findings of this study indicated that there are serious ethical concerns regarding umbilical cord blood banks. Responding clearly to these ethical challenges calls for the attention of policymakers and medical ethics professionals; this will require a clear statement of the various aspects of these banks for society.

Tutor's Role in WhatsApp Learning Groups: A Quali-Quantitative Methodological Approach

In recent years, digital tools, such as WhatsApp, have been increasingly deployed to support group interaction and collaboration in higher education contexts. To understand contemporary, digitally-mediated collaborative dynamics – including the role played by tutors and the situated nature of group development – robust and innovative methodologies are needed. In this paper, we illustrate how integrating qualitative methods with quantitative tools used in qualitative ways makes it possible to trace how tutors adapt their style to support group development, which in turn triggers student development in a circular and responsive process. To make visible this contemporary phenomenon, we combine thematic content analysis – a qualitative tool – with a quantitative method: Social Network Analysis. Drawing on data generated by two WhatsApp learning groups (six students and four academic tutors) in research exploring the collaborative construction of boundary objects in a master’s level “E-learning Psychology” course, we suggest that our methodological approach has the potential to support interrogation of complex and dynamic digitally-mediated group interactions. Our results show the situational nature of an effective tutorship style through its complex adaptation to learners’ maturity, digital tools, and learning goals.

Fall Prevention Program Characteristics and Experiences of Older Adults and Program Providers in Canada: A Thematic Content Analysis

Objectives: To document the characteristics of fall prevention programs in specific regions in two Canadian provinces and to explore older adults' and program providers' experiences with these programs. Methods: Semi-structured interviews were conducted with 16 program providers/managers from 12 different programs. Ten semi-structured focus groups were conducted with 59 older adults. Data were analyzed using thematic content analysis. Results: Older adults reported functional and social benefits. Program providers identified barriers to program success, including cognitive impairment, frailty, and lack of motivation. The need for general attitudinal changes toward older adults' needs and broader community changes were identified as important by the older adults. Discussion: Easily accessible information about fall prevention programs for older adults and no-cost, ongoing initiatives were critical. Health care providers play keys roles in disseminating information, facilitating referrals, and advocating for initiatives that best meet the needs of older adults in their communities.

Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study

BACKGROUND

Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention.

METHOD

A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis.

RESULTS

Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course.

CONCLUSIONS

A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Don't Shoot the Messenger: Experiences of Delivering Prognostic Information in the Context of Advanced Cancer

The study of prognostic understanding is imperative as the trend toward individualized medicine continues. However, without guidelines for discussing prognosis, palliative care clinicians face challenges presenting prognostic information in a way that optimizes patient understanding, psychological adjustment, and decision-making. The present study draws on the experiences of experts in the field of palliative care in order to examine the communication of prognostic information. Fifteen oncology, psycho-oncology, and palliative care professionals with expertise in doctor-patient communication participated in semi-structured interviews that focused on identifying the breadth of factors underlying prognostic understanding, as well as methods to identify and quantify this understanding. Three independent raters utilized a thematic content analysis framework to identify core themes that reflected unique aspects of prognostic understanding. Interviews yielded 2 types of information. Participants described the multifaceted nature of prognostic understanding and identified 5 distinct elements of prognostic understanding: understanding of current state of disease, life expectancy, curability, decline trajectory, and available treatment options. Participants also offered "best practice" techniques, including methods for determining a patient's preferences for and understanding of prognostic information, assessing patient fears and concerns, and communicating medical uncertainties. Results emphasize the need for clinicians to join with patients to ensure that prognostic information is well understood. These results highlight the salience of health information preferences and strategies to provide comprehensive prognostic information, compassionately and with respect for each individual patient.

Analysing news media coverage of the 2015 Nepal earthquake using a community capitals lens: implications for disaster resilience

South Asia is one of the regions of the world most vulnerable to natural disasters. Although news media analyses of disasters have been conducted frequently in various settings globally, there is little research on populous South Asia. This paper begins to fill this gap by evaluating local and foreign news media coverage of the earthquake in Nepal on 25 April 2015. It broadens the examination of news media coverage of disaster response beyond traditional framing theory, utilising community capitals (built, cultural, financial, human, natural, political, and social) lens to perform a thematic content analysis of 405 news items. Overall, financial and natural capital received the most and the least emphasis respectively. Statistically significant differences between local and foreign news media were detected vis-à-vis built, financial, and political capital. The paper concludes with a discussion of the social utility of news media analysis using the community capitals framework to inform disaster resilience.

'I am not drunk, I have an ABI': findings from a qualitative study into systematic challenges in responding to people with acquired brain injuries in the justice system

The over-representation of acquired brain injury (ABI) amongst prisoner and juvenile justice populations is a significant issue across jurisdictions. This article reports on the findings of over 100 interviews conducted in Victoria, Australia with people who have an ABI, as well as key stakeholder groups who work in, or with, the justice system. The study identified systemic problems faced by people with ABI along multiple points of the justice system continuum. Improved identification and diagnosis of ABI, well-resourced support for those with the condition, comprehensive training to improve ABI literacy among all stakeholder groups, and a more appropriate and therapeutic approach to people with ABI in the justice system are all recommended.

Postoperative Rehabilitation Strategies Used by Adults With Cochlear Implants: A Pilot Study

Objectives/Hypothesis

Aural rehabilitation is not standardized for adults after cochlear implantation. Most cochlear implant (CI) centers in the United States do not routinely enroll adult CI users in focused postoperative rehabilitation programs due to poor reimbursement and lack of data supporting (or refuting) the efficacy of any one specific approach. Consequently, patients generally assume a self‐driven approach toward rehabilitation. This exploratory pilot study examined rehabilitation strategies pursued by adults with CIs and associated these strategies with speech recognition and CI‐specific quality of life (QOL).

Study Design

Cross‐sectional study of 23 postlingually deafened adults with CIs.

Methods

Participants responded to an open‐ended questionnaire regarding rehabilitation strategies. A subset underwent in‐depth interviews. Thematic content analysis was applied to the questionnaires and interview transcripts. Participants also underwent word recognition testing and completed a CI‐related QOL measure. Participants were classified as having good or poor performance (upper or lower quartile for speech recognition) and high or low QOL (upper or lower quartile for QOL). Rehabilitation themes were compared and contrasted among groups.

Results

Five rehabilitation themes were identified: 1) Preimplant expectations of postoperative performance, 2) personal motivation, 3) social support, 4) specific rehabilitation strategies, and 5) patient‐perceived role of the audiologist. Patients with good speech recognition and high QOL tended to pursue more active rehabilitation and had greater social support. Patient expectations and motivation played significant roles in postoperative QOL.

Conclusion

Postoperative patient‐driven rehabilitation strategies are highly variable but appear to relate to outcomes. Larger‐scale extensions of this pilot study are needed.

Nurses' views of shortcomings in patent care encounters in one hospital in Sweden

AIM AND OBJECTIVE

To describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden.

BACKGROUND

Shortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being.

DESIGN

A qualitative design was used in the study.

METHODS

Three focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis.

RESULTS

The results are presented in two themes. The first theme, 'Disregard for the patient's unique nursing needs', describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, 'Difficulty managing obstacles', nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability.

CONCLUSION

The findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff.

RELEVANCE TO CLINICAL PRACTICE

Nurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care.

Therapeutic affordances of social media: emergent themes from a global online survey of people with chronic pain

BACKGROUND

Research continues to present tenuous suggestions that social media is well suited to enhance management of chronic disease and improve health outcomes. Various studies have presented qualitative reports of health outcomes from social media use and have examined discourse and communication themes occurring through different social media. However, there is an absence of published studies examining and unpacking the underlying therapeutic mechanisms driving social media's effects.

OBJECTIVE

This paper presents a qualitative analysis thoroughly describing what social media therapeutically affords people living with chronic pain who are self-managing their condition. From this therapeutic affordance perspective, we aim to formulate a preliminary conceptual model aimed at better understanding "how" social media can influence patient outcomes.

METHODS

In total, 218 people with chronic pain (PWCP) completed an online survey, investigating patient-reported outcomes (PROs) from social media use. Supplementary to quantitative data collected, participants were also given the opportunity to provide further open commentary regarding their use of social media as part of chronic pain management; 68/218 unique users (31.2%) chose to provide these free-text responses. Through thematic content analysis, 117 free-text responses regarding 10 types of social media were coded. Quotes were extracted and tabulated based on therapeutic affordances that we had previously identified. Inductive analysis was then performed to code defining language and emergent themes central to describing each affordance. Three investigators examined the responses, developed the coding scheme, and applied the coding to the data.

RESULTS

We extracted 155 quotes from 117 free-text responses. The largest source of quotes came from social network site users (78/155, 50.3%). Analysis of component language used to describe the aforementioned affordances and emergent themes resulted in a final revision and renaming of therapeutic affordances: "exploration" (52/155, 33.5% of quotes), "connection" (50/155, 32.3% of quotes), "narration" (33/155, 21.3% of quotes), "adaptation" (13/155, 8.4% of quotes), and "self-presentation" (7/155, 4.5% of quotes). Of the most described affordances, "exploration" was based on a propensity for participants to explain their social media use for information seeking purposes. "Connection" placed greater emphasis on interaction, highlighting themes of "exchanging information" and "mitigating isolation". Responses regarding "narration" highlighted the value of shared experiences and the emotionally cathartic role this plays.

CONCLUSIONS

Much of the efficacy of social media may be explicable via a closer examination of therapeutic affordances. Particular areas that warrant attention include social media's ability to filter and guide people to useful information, connect individuals, and share experiences. Further research into a variety of chronic conditions is warranted. Coupled with the results of the present study, a greater theoretical basis detailing how social media may foster health outcomes may lead to an improved evidence base for conducting research and may inform recommendations for social media use in chronic disease management.

District nurses' views on quality of primary healthcare encounters

Good encounters are fundamental for good and professional nursing care, and can be described as treating patients with respect and protecting their integrity and autonomy. This study describes district nurses' views on quality of healthcare encounters in primary healthcare. A purposive sample of 27 district nurses participated in five focus group interviews. The focus groups interviews were digitally recorded and transcribed verbatim. The interview texts were analysed using a thematic content analysis. The analysis resulted in four themes, including being aware of the importance and difficulties during encounters, being the patient's advocate, being attentive to the unique person and being informed when a meeting turned out poorly. The results show that district nurses believed that encounters formed the basis of their work and it was vital for them to be aware of any difficulties. District nurses found that acting in a professional manner during encounters is the most significant factor, but this type of interaction was sometimes difficult because of stress and lack of time. The district nurses considered themselves to be the patients' advocate in the healthcare system; in addition, the acts of seeing, listening, believing and treating the patient seriously were important for providing good quality care. If a poor encounter occurred between the district nurse and the patient, the district nurses found that it was necessary to arrange a meeting to properly communicate what problems arose during the interaction. The district nurses highlighted that providing an apology and explanation could improve future encounters and establish a better nurse-patient relationship. In conclusion, this study shows the importance of confirming and respecting patients' dignity as the fundamental basis for a good quality encounter in primary healthcare.

The consumption of protein-rich foods in older adults: an exploratory focus group study

OBJECTIVE

Many older adults consume inadequate protein for their needs. This study explored the factors associated with the consumption of high-protein foods in older adults.

METHODS

Participants over the age of 65 years (n = 28) took part in 1 of 4 focus group discussions on meat, fish, eggs, dairy products, nuts, and pulses. Discussions were audio taped, transcribed, and analyzed using thematic analysis.

RESULTS

Numerous and various reasons for the consumption and non-consumption of high-protein foods were reported. Many of these reasons result from reductions in chemosensory, dental and physical abilities, and changes in living situation in the older population, and have impact specifically on high-protein foods because of their often hard, perishable and need-to-be-cooked nature, and high cost.

CONCLUSIONS AND IMPLICATIONS

Further work is required to establish the importance of each of these reasons in relation to protein intakes, to prioritize those of likely greatest impact for increasing intakes.

How is organ transplantation depicted in internal medicine and transplantation journals

BACKGROUND

In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey's critiques of organ transplantation were still relevant.

METHODS

Using the PubMed database, we retrieved 1,120 articles from the top ten internal medicine journals and 4,644 articles from the two main transplantation journals (Transplantation and American Journal of Transplantation). Out of the internal medicine journal articles, we analyzed those in which organ transplantation was the main topic (349 articles). A total of 349 articles were randomly selected from the transplantation journals for content analysis.

RESULTS

In our sample, organ transplantation was described in positive terms and was presented as a routine treatment. Few articles addressed ethical issues, patients' experiences and uncertainties related to organ transplantation. The internal medicine journals reported on more ethical issues than the transplantation journals. The most important ethical issues discussed were related to the justice principle: organ allocation, differential access to transplantation, and the organ shortage.

CONCLUSION

Our study provides insight into representations of organ transplantation in the transplant and general medical communities, as reflected in medical journals. The various portrayals of organ transplantation in our sample of articles suggest that Fox and Swazey's critiques of the procedure are still relevant.