Application of Topic Modeling on Artificial Intelligence Studies as a Foundation to Develop Ethical Guidelines in African American Dementia Caregiving.

We applied natural language processing and topic modeling to publicly available abstracts and titles of 263 papers in the scientific literature mentioning AI and demographics (corpus 1 before Covid-19, corpus 2 after Covid-19) extracted from the MEDLINE database. We found exponential growth of AI studies mentioning demographics since the pandemic (Before Covid-19: N= 40 vs. After Covid-19: N= 223) [forecast model equation: ln(Number of Records) = 250.543*ln(Year) + -1904.38, p = 0.0005229]. Topics related to diagnostic imaging, quality of life, Covid, psychology, and smartphone increased during the pandemic, while cancer-related topics decreased. The application of topic modeling to the scientific literature on AI and demographics provides a foundation for the next steps regarding developing guidelines for the ethical use of AI for African American dementia caregivers.

Assistência ginecológica aos transgênero / Gynecological care for transgenders

Transgênero (trans) é um termo que alberga toda a diversidade de gênero. A incongruência de gênero faz parte desse espectro e refere-se à pessoa cuja identidade de gênero é oposta ao sexo que lhe foi atribuído no nascimento. A terapia hormonal de afirmação de gênero, bem como a cirurgia de afirmação de gênero, é necessária para adequar o corpo ao gênero ao qual a pessoa se identifica. Os homens trans necessitam da terapia com testosterona, que visa reduzir as concentrações de estradiol e incrementar a testosterona circulante para níveis fisiológicos masculinos, resultando em masculinização. A mulher trans receberá o estradiol, associado ou não a um antiandrogênico, visando reduzir a testosterona e incrementar o estrogênio para níveis femininos, resultando em feminização. A cirurgia de afirmação de gênero é, frequentemente, requerida para completar as modificações fenotípicas para o homem e a mulher trans. O ginecologista e obstetra tem um papel crucial no provimento de cuidados a essa população. O presente artigo visa sistematizar algumas ações que o ginecologista e obstetra pode oferecer e que têm potencial para melhorar a qualidade de vida dos homens e mulheres trans. (AU)

Transgenero (trans) is an umbrella term that encompasses all gender diversity. Gender Incongruity is part of this spectrum and refers to the person whose gender identity is opposed to the sex assigned to them at birth. Gender-affirming hormone therapy as well as gender-affirming surgery are necessary to adapt the body to the gender to which the person identifies. Trans men require testosterone therapy to reduce estradiol concentrations and increase circulating testosterone to male physiological levels resulting in masculinization. Trans women will receive estradiol associated or not with an antiandrogenic to reduce testosterone and increase estrogen to female levels resulting in feminization. gender-affirming surgery is often required to complete phenotypic modifications for trans men and women. The gynecologist and obstetrician plays a crucial role in to provide care to this population. This article aims to systematize some actions that the gynecologist and obstetrician can offer to improve the quality of life of trans men and women. (AU)

The Hospitalized Adolescent.

This clinical report provides pediatricians evidence-based information on the developmentally appropriate, comprehensive clinical care for hospitalized adolescents. Included in this report are opportunities and challenges facing pediatricians when caring for specific hospitalized adolescent populations. The companion policy statement, "The Hospitalized Adolescent," includes detailed descriptions of adolescent hospital admission demographics, personnel recommendations, and hospital setting and design advice, as well as sections on educational services, legal and ethical matters, and transitions to adult facilities.

Chapitre 5. L'innovation frugale au service de systèmes de santé durables.

Bioethics is sometimes presented as a series of universal guidelines aimed at regulating health care practices and research on human beings. Such a presentation, however, does not hold water in the face of the history of the discipline. Bioethics was born in the ideological context that prevailed in the United States in the 1960s and 1970s. Should we then abandon all hope of universality for ethical benchmarks that have proven their usefulness in illuminating health practices? By carefully distinguishing the universal from the uniform, this contribution shows, based on the work of G. Tangwa, that it is possible to respect the specificities of cultures around the world, while maintaining a universal aim for bioethics.

Chapitre 5. L'innovation frugale au service de systèmes de santé durables.

Bioethics is sometimes presented as a series of universal guidelines aimed at regulating health care practices and research on human beings. Such a presentation, however, does not hold water in the face of the history of the discipline. Bioethics was born in the ideological context that prevailed in the United States in the 1960s and 1970s. Should we then abandon all hope of universality for ethical benchmarks that have proven their usefulness in illuminating health practices? By carefully distinguishing the universal from the uniform, this contribution shows, based on the work of G. Tangwa, that it is possible to respect the specificities of cultures around the world, while maintaining a universal aim for bioethics.

Attacks on Health Care Used as a Weapon of War in Ukraine and Globally: The Demand for Accountability.

In this Viewpoint, authors from Physicians for Human Rights and the Ukrainian Healthcare Center present findings from a joint report documenting the attacks on health care workers and facilities as a weapon of war in the Russian war with Ukraine.

Salve Lucrum: The Existential Threat of Greed in US Health Care.

In this Viewpoint, Donald Berwick explores the pursuit of profit in US health care across sectors­such as pharmaceutical companies, insurers, hospitals, and physician practices­and its harms to patients, and then offers potential solutions.

Sociocognição e saúde mental: a 'leitura do outro' no cuidado em saúde / Cognición social y salud mental: la 'lectura de la mente' en la assistencia a salud / Social cognition and mental health: the mindreading in the healthcare work

RESUMO. Teoria da mente é a habilidade sociocognitiva de inferir pensamentos, sentimentos e intenções. É uma habilidade que sustenta as relações sociais e parece particularmente relevante para o exercício de certas atividades que estão ligadas à 'leitura do outro', como a prática de profissionais que exercem o cuidado em equipamentos de saúde, como ocorre nos Centros de Atenção Psicossocial. Este estudo teórico teve o objetivo de analisar a importância das habilidades sociocognitivas para o trabalho em saúde, especialmente na saúde mental, a fim de identificar e discutir possíveis fatores que podem ter impacto na inferência que os profissionais fazem a respeito do que os usuários do serviço estão pensando, sentindo ou querendo. A análise permitiu observar as formas pelas quais a teoria da mente pode se tornar importante ferramenta para o profissional no processo terapêutico. Além disso, foi possível identificar que, no formato em que tem funcionado atualmente, o trabalho em Centros de Atenção Psicossocial tem exposto o profissional a diversos estressores que parecem produzir efeitos em suas habilidades sociocognitivas, podendo prejudicar não apenas sua saúde como também o exercício do cuidado.

RESUMEN. Teoría de la mente es la capacidad sociocognitiva de inferir pensamientos, sentimientos e intenciones. Es una habilidad que apoya las relaciones sociales y parece particularmente relevante para el ejercicio de determinadas actividades que están vinculadas a 'leer al otro', como la práctica de los profesionales que brindan atención en equipos de salud, como ocurre en los Centros de Atención Psicosocial. Este estudio teórico tuvo como objetivo analizar la importancia de las habilidades socio-cognitivas para el trabajo en salud, especialmente en salud mental, buscando identificar y discutir posibles factores que pueden incidir en la inferencia que hacen los profesionales sobre lo que piensan, sienten o sienten los usuarios del servicio. El análisis permitió observar las formas en que la teoría de la mente puede convertirse en una herramienta importante para los profesionales en el proceso terapéutico. Además, se pudo identificar que, en el formato en el que se ha operado actualmente, el trabajo en Centros de Atención Psicosocial ha expuesto a los profesionales a diversos estresores que parecen afectar sus habilidades sociocognitivas, los cuales pueden perjudicar no solo su salud sino también el ejercicio del cuidado.

ABSTRACT. Theory of mind is a social cognition ability to infer thoughts, feelings and intentions. It is a skill that underpins social relationships and seems particularly relevant to the exercise of certain activities linked to mindreading, such as healthcare practice, for example, in Psychosocial Care Centers. This theoretical study aims to analyze the importance of social cognition skills for mental health practitioners, seeking to identify and discuss possible factors that impact how these professionals infer what service users are thinking, feeling or wanting. The analysis allowed us to observe how the theory of mind can become an important tool for professionals in the therapeutic process. In particular, the study concludes that work in Psychosocial Care Centers has exposed professionals to various stressors that seem to have an effect on their social cognition skills, which can harm not only their health but also their ability to attend to the needs of service users.

Clinician and Ethicist Perspectives: Understanding Moral Distress in Gender-Affirming Care for Pediatric Patients.

Using case examples and other common scenarios, the authors outline several types of moral distress that clinicians may experience when providing pediatric gender-affirming care. The authors also offer strategies for managing moral distress and issue a call to action for professional organizations to enhance support for gender-affirming clinicians.

Artificial Intelligence in Cardiovascular Imaging: "Unexplainable" Legal and Ethical Challenges?

Nowhere is the influence of artificial intelligence (AI) likely to be more profoundly felt than in health care, from patient triage and diagnosis to surgery and follow-up. Over the medium-term, these effects will be more acute in the cardiovascular imaging context, in which AI models are already successfully performing at approximately human levels of accuracy and efficiency in certain applications. Yet, the adoption of unexplainable AI systems for cardiovascular imaging still raises significant legal and ethical challenges. We focus in particular on challenges posed by the unexplainable character of deep learning and other forms of sophisticated AI modelling used for cardiovascular imaging by briefly outlining the systems being developed in this space, describing how they work, and considering how they might generate outputs that are not reviewable by physicians or system programmers. We suggest that an unexplainable tendency presents 2 specific ethico-legal concerns: (1) difficulty for health regulators; and (2) confusion about the assignment of liability for error or fault in the use of AI systems. We suggest that addressing these concerns is critical for ensuring AI's successful implementation in cardiovascular imaging.

Nursing students' experience of learning cultural competence.

INTRODUCTION: European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. MATERIALS AND METHODS: A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal. RESULTS: 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. CONCLUSION: The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.

Dos and don'ts for mHealth-based clinical support among clinicians in South Africa: Results from a 1-day workshop.

Digital technologies continue to penetrate the South African (SA) healthcare sector at an increasing rate. Clinician-to-clinician diagnostic and management assistance through mHealth is expanding rapidly, reducing professional isolation and unnecessary referrals, and promoting better patient outcomes and more equitable healthcare systems. However, the widespread uptake of mHealth use raises ethical concerns around patient autonomy and safety, and guidance for healthcare workers around the ethical use of mHealth is needed. This article presents the results of a multi-stakeholder workshop at which the 'dos and don'ts' pertaining to mHealth ethics in the SA context were formulated and aligned to seven basic recommendations derived from the literature and previous multi-stakeholder, multi-country meetings.