The ever-debated question of triage and allocating the life-saving ventilator during the COVID-19 pandemic has been repeatedly raised and challenged within the ethical community after shortages propelled doctors before life and death decisions (Anderson-Shaw and Zar 2020 ; Huxtable 2020 ; Jongepier 2020; Peterson, Largent, and Karlawish 2020 ). The British Medical Association’s ethical guidance highlighted the possibility of an initial surge of patients that would outstrip the health system’s ability to deliver care “to existing standards,” where utilitarian measures have to be applied, and triage decisions need to maximize “overall benefit” (British Medical Association 2020 , 3) In these emergency circumstances, triage that “grades according to their needs and the probable outcomes of intervention” will prioritize or eliminate patients for treatment, and health professionals may be faced with obligations to withhold or withdraw treatments to some patients in favour of others (British Medical Association 2020 , 4). This piece is a response and extension to articles published on the manner of involvement for ethics and ethicists in pandemic triage decisions, particularly examining the ability and necessity of establishing triage committees to ameliorate scarce allocation decisions for physicians.
Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods We conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusion The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543.
Background The worldwide increase in older persons demands technological solutions to combat the shortage of caregiving and to enable aging in place. Smart home health technologies (SHHTs) are promoted and implemented as a possible solution from an economic and practical perspective. However, ethical considerations are equally important and need to be investigated. Methods we conducted a systematic review according to the PRISMA guidelines to investigate if and how ethical questions are discussed in the field of SHHTs in caregiving for older persons. Results 156 peer-reviewed articles published in English, German and French were retrieved and analyzed across 10 electronic databases. Using narrative analysis, 7 ethical categories were mapped: privacy, autonomy, responsibility, human vs. artificial interactions, trust, ageism and stigma, and other concerns. Conclusions The findings of our systematic review show the (lack of) ethical consideration when it comes to the development and implementation of SHHTs for older persons. Our analysis is useful to promote careful ethical consideration when carrying out technology development, research and deployment to care for older persons. Registration We registered our systematic review in the PROSPERO network under CRD42021248543
Objectives: To provide a reference for CT imaging changes for patients discharged from a Fangcang shelter hospital, a large-scale, temporary hospital for the centralized treatment of patients with mild to moderate Coronavirus disease 2019 (COVID-19) to provide essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, essential living and social engagement) to them..Methods: Patients with mild to moderate COVID-19 admitted to the Wuchang Fangcang Shelter Hospital who had undergone pre-discharge and previous CT scans were included. Changes in the CT imaging features were defined as progression, no change, improvement or recovery. Basic patient information was obtained, and imaging signs were compared between the two CT scans.Results: A total of 83 patients were included. The median age was 53 years old. The course of disease was 28.3±10.7 days. CT imaging changes indicated progression, no change, improvement, and recovery in 3, 12, 66, and 2 patients, respectively. Between the two CT scans, the imaging signs showed a significant reduction in consolidation, a significant increase in fibrosis, and a reduction or / and thinning of ground-glass opacities. None of the patients showed signs of deterioration on follow-up and thus did not need to return to the hospital for treatment.Conclusion: In the COVID-19 Fangcang shelter hospital, given the shortage of medical staff and lack of medical resources, CT imaging diagnostic methods can be used to accurately discharge patients who had met the discharge criteria for isolation and observation from the Fangcang Shelter Hospital.
As a greater part of the global population reaches the golden age, smart home technologies are said to allow older persons to remain independent at a place of residence, or “home”, of their own choice. Though their development has been making their way to the market, there has not been a systematic review of the empirical literature on the knowledge associated with their use for persons who are 65 years or older. Hence, we conducted a systematic review of empirical peer-reviewed English, German, and French articles in ten electronic databases. Data was textually described, separated into key characteristics, logged into a customized data extraction document, and analysed using narrative synthesis. The search across ten databases revealed 144 empirical papers that were admissible to our inclusion criteria. Of which, we discovered 5 first-order categories of benefits and 5 of barriers of smart home health technologies with further sub-themes that together form the concurrent array of existing knowledge. These categories included, for example, allows older persons to live independently at home, reminds older persons to promote self-care, and alternatively, concerns about usability, cost, and social acceptance. These systematically-derived categories of benefits and barriers could be a starting point for researchers interested in caregiving for older persons to conduct further empirical and reflective research. Furthermore, having this understanding of existing challenges and opportunities associated with smart home health technologies then allows the research and technical communities to collaborate upon a joint foundation to inform policy and improve caregiving for the global aging population.
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