Comparative, collaborative, and integrative risk governance for emerging technologies.

Various emerging technologies challenge existing governance processes to identify, assess, and manage risk. Though the existing risk-based paradigm has been essential for assessment of many chemical, biological, radiological, and nuclear technologies, a complementary approach may be warranted for the early-stage assessment and management challenges of high uncertainty technologies ranging from nanotechnology to synthetic biology to artificial intelligence, among many others. This paper argues for a risk governance approach that integrates quantitative experimental information alongside qualitative expert insight to characterize and balance the risks, benefits, costs, and societal implications of emerging technologies. Various articles in scholarly literature have highlighted differing points of how to address technological uncertainty, and this article builds upon such knowledge to explain how an emerging technology risk governance process should be driven by a multi-stakeholder effort, incorporate various disparate sources of information, review various endpoints and outcomes, and comparatively assess emerging technology performance against existing conventional products in a given application area. At least in the early stages of development when quantitative data for risk assessment remain incomplete or limited, such an approach can be valuable for policymakers and decision makers to evaluate the impact that such technologies may have upon human and environmental health.

Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association.

The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating the use of telemedicine in cardiovascular and stroke care and to provide consensus policy suggestions. We evaluate the effectiveness of telehealth in advancing healthcare quality, identify legal and regulatory barriers that impede telehealth adoption or delivery, propose steps to overcome these barriers, and identify areas for future research to ensure that telehealth continues to enhance the quality of cardiovascular and stroke care. The result of these efforts is designed to promote telehealth models that ensure better patient access to high-quality cardiovascular and stroke care while striving for optimal protection of patient safety and privacy.

[Identification and management of violence in psychiatry: Nurse and patient perceptions of safety and dangerousness]. / Identification et gestion de la violence en psychiatrie: perceptions du personnel infirmier et des patients en matiére de sécurité et dangerosité.

This paper reports the results of a study on the identification and management of violence on a psychiatric ward and in the psychiatric emergency of a Quebec hospital. The purpose of this exploratory and descriptive study was to examine patients' and nurses' perceptions and strategies for identifying and managing patient aggression and violence. Results show that the type of setting influences the way aggressive behaviour issues are perceived and managed. The types of behaviours deemed aggressive or risky also vary between the two units. Moreover, patients and nurses are similarly described by all participants as susceptible to being violent and to being a victim of violence. Prevention of aggression and violence remains a significant challenge in psychiatric nursing, where administrative and environmental constraints, the growing complexity of clinical profiles, divergent interprofessional approaches to care, and collective feelings of apprehension and vulnerability interact.

Characteristics and classification of nanoparticles: expert Delphi survey.

Research needs assessment regarding environmental health and safety (EHS) of nanoparticles is problematic. Generating benchmark data to assess research and policy initiatives seems daunting. This study's findings present more granular and qualitative assessments of expert preferences and concerns. This three-round Delphi study elicits expert estimations of problematic nanoparticle characteristics and classifications from a sample of nanoscience experts in chemistry, EHS policy, engineering, environmental toxicology, and human toxicology (n = 18). The Delphi method is a forecasting tool designed for expert evaluation of events under high degrees of uncertainty. Results demonstrate high concordance indicating favorable consensus among the sample concerning characteristics and classifications of nanoparticles that are potentially or actually problematic to EHS. These findings establish a benchmark for future investigations of expert preferences and concerns.

The public acceptance of nanomedicine: a personal perspective.

Limited understanding of a subject leads to limited perceptions, including misinformed biases and associations. In regard to the field of nanotechnology, prior biotechnologies have harmed public perception of nanotechnology through association alone. While public bias is slow to convert toward truth, it is likely that the medical applications of nanotechnology will foster a renewed interest and trust in the field through the prolonged escape from death.