Autonomy

OBJECTIVE: Aim: To research how the future dentists' professional self-determination (reflects the cognitive-reflexive component of higher medical education applicants' readiness to use digital technologies in their professional activities) develops within the formation of information technology competence in the modern realities of Ukraine. PATIENTS AND METHODS: Materials and Methods: The author's questionnaire consisted of 15 questions. The questionnaire surveys covered 98 future dentists who studied 'Medical Informatics' and 'Information Technology in Dentistry' at the Ivano-Frankivsk National Medical University in the September-December 2017-2018 and September- December 2022-2023 academic years...

OBJECTIVE: To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. DESIGN: Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. PARTICIPANTS: Thirty-three Hispanic/Latinx caregivers, predominantly of low income. PHENOMENON OF INTEREST: Patterns in goal content and anticipated barriers and facilitators...

As the principle of respect for patient autonomy has gained salience over the past 75 years, surgeons now struggle to resolve conflicts between autonomy and beneficence in certain clinical scenarios. One such conflict occurs when a patient desires a surgical intervention, but the surgeon concludes that the patient is "too sick for surgery" and thus would not benefit from the operation. We provide historical context for the principle of respect for patient autonomy and review recent qualitative data that demonstrate surgeons experience significant moral distress when asked to perform non-beneficial surgery...

Corporate procurement management assumes a pivotal role within the contemporary business landscape, yet confronts an array of challenges as markets continue to evolve and globalize. Conventional procurement management systems frequently grapple with issues of inefficiency, resource depletion, and noncompliance, necessitating the exploration of innovative avenues for optimization. This paper delves into the realm of risk mitigation associated with collusion behavior in the administration of intelligent procurement systems, presenting a novel procurement collusion identification model founded on a convolutional neural network (CNN) with reinforcement learning techniques...

This paper examines the public views - a total of 10,348 persons - on restrictions of personal autonomy of others to protect the interest of children. We use representative country samples of the adult populations of Austria, England, Estonia, Finland, Germany, Ireland, Norway, and Spain, and ask them to consider an experimental vignette with three different parental conditions: substance abuse, mental health problems, and learning difficulties. The findings display that most people would restrict parental freedom to protect the child, and a stricter restriction when the parent struggles with substance abuse compared to mental health compared to learning difficulties...

Exercise intensity and perceived autonomy are important factors for the affective response toward exercise and adherence. Dual-mode theory suggests an inverted-J response curve of affect with increased exercise intensity, but little is known about how different running programs affect the affective response and subsequent incidental affect in daily life. This ambulatory assessment study examines the short- to long-term effects of two 8-week running interventions (affect-based vs. polarized-prescribed) on subjective vitality and perceived fatigue in young female novices...

OBJECTIVE: Self-management interventions may enhance health-related quality of life (HRQoL) in epilepsy. However, several barriers often impair their implementation in the real world. Digital interventions may help to overcome some of these barriers. Considering this, the Helpilepsy Plus Prototype was developed as a prototype smartphone-delivered self-care treatment program for adults with epilepsy. METHODS: The 12-week Helpilepsy Plus Prototype was evaluated through a randomized controlled feasibility trial with a waiting-list control (WLC) group...

INTRODUCTION: In South Asia, younger women have high rates of unmet need for family planning and low empowerment. Life skills interventions can equip young women with agency, but the effectiveness of these interventions in reproductive and sexual autonomy and contraception has not been examined. METHODS AND ANALYSIS: A two-arm, parallel, cluster randomised controlled trial will evaluate the impact of TARANG (Transforming Actions for Reaching and Nurturing Gender Equity and Empowerment), a life skills and reproductive health empowerment group-based intervention for newly married women, compared with usual services in the community in rural and tribal Rajasthan, India...

BACKGROUND: Digital health technologies offer the potential to improve the daily lives of older adults, maintain their health efficiently, and allow aging in place. Despite increasing evidence of benefits and advantages, readiness for adopting digital interventions among older people remains underexplored. OBJECTIVE: This study aims to explore the relationships between sociodemographic-, health-, and lifestyle-related factors and technology use in everyday life and community-dwelling older adults' readiness to adopt telemedicine, smartphones with texting apps, wearables, and robotics...

INTRODUCTION: Opioid agonist treatment (OAT) tapering involves a gradual reduction in daily medication dose to ultimately reach a state of opioid abstinence. Due to the high risk of relapse and overdose after tapering, this practice is not recommended by clinical guidelines, however, clients may still request to taper off medication. The ideal time to initiate an OAT taper is not known. However, ethically, taper plans should acknowledge clients' preferences and autonomy but apply principles of shared informed decision-making regarding safety and efficacy...

In goals of care conversations and through the care trajectory, to avoid insensitive or discriminatory care, it is vital clinicians recognize lesbian, gay, bisexual, transgender, queer+ patients' values and wishes. In clinical settings, implicit bias operating within unconscious awareness may challenge the commitment to equitable care, negatively affecting patient outcomes. In this composite case, during a conversation with a social worker/nurse team, a cisgender woman repeatedly expressed her wishes for her female partner to be her decision maker instead of her biological family...

The occupational health burden and mechanisms that link gig work to health are understudied. We described injury and assault prevalence among food delivery gig workers in New York City (NYC) and assessed the effect of job dependence on injury and assault through work-related mechanisms and across transportation modes (electric bike and moped versus car). Data were collected through a 2022 survey commissioned by the NYC Department of Consumer and Worker Protection among delivery gig workers between October and December 2021 in NYC...

PURPOSE OF REVIEW: The scarcity of organs available for lung transplantation makes it necessary to develop consistent practices for candidate selection and organ allocation. Such policies are mainly built on prognostic estimations, which are again built on medical evidence. In addition, however, other factors also guide these practices. These factors are not always explicit. The purpose of this review is to discuss some of these factors. RECENT FINDINGS: While one candidate may be considered to be in need of a transplant, the extent to which this need is weighed up against other patients at need varies, depending on how societal responsibility is conceived at the transplant center...

Anesthesiology training programs are tasked with equipping trainees with the skills to become medically and ethically competent in the practice of anesthesia and to be prepared to obtain board certification, yet there is currently no standardized ethics curriculum within anesthesia training programs in the United States. To bridge this gap, and to provide a validated ethics curriculum to meet the aforementioned needs, in July 2021, a survey was sent to anesthesia scholars in the field of biomedical ethics to identify key areas that should be included in such an ethics curriculum...

Motivation is central for successful learning processes and lifelong learning. In the present study, the motivational development of vocational students in a learning environment promoting self-regulated learning (SRL) was examined in comparison to a control group with regular, teacher-centered instruction. The first aim was to examine the development of the dispositional and situational motivation of vocational students. The second aim was to gain a deeper understanding of the students' motivational experiences and the factors of the learning environment that promote and impede motivation...

Discitis linked to Pott's spine is an infrequent yet severe issue, especially difficult to manage among elderly individuals due to age-related bodily changes and concurrent health issues. This report details the successful physiotherapy-based recovery of a senior patient afflicted with discitis related to Pott's spine. The individual, a 61-year-old man, presented symptoms including intense back pain, restricted movement, and neurological issues. The diagnosis was confirmed via imaging scans, indicating spinal tuberculosis and vertebral disc involvement...

Assessing patient decision-making capacity while adhering to the requests of patients with mental illness remains a great ethical challenge. In patients with severe mental illness, the assessment of decision-making capacity can be difficult, particularly when a care team is also trying to navigate cultural, educational, and linguistic barriers. It becomes especially complex in situations where the patient is not only diagnosed with a severe mental illness but also suffers from a comorbid medical illness that the patient refuses to have treated appropriately...

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Biohybrid machines (BHMs) are an amalgam of actuators composed of living cells with synthetic materials. They are engineered in order to improve autonomy, adaptability and energy efficiency beyond what conventional robots can offer. However, designing these machines is no trivial task for humans, provided the field's short history and, thus, the limited experience and expertise on designing and controlling similar entities, such as soft robots. To unveil the advantages of BHMs, we propose to overcome the hindrances of their design process by developing a modular modeling and simulation framework for the digital design of BHMs that incorporates Artificial Intelligence powered algorithms...

PROBLEM: The coronavirus disease 2019 (COVID-19) pandemic has highlighted global disparities in accessing essential health products, demonstrating the critical need for low- and middle-income countries to develop local production and innovation capabilities. APPROACH: The health economic-industrial complex approach changed the values that guided innovation and industrial policies in Brazil. The approach directed health production and innovation to universal access; the health ministry led a whole-of-government approach; and public procurement was strategically applied to stimulate productive public and private investments...