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Medicine May 2024This paper examines the legal challenges associated with medical robots, including their legal status, liability in cases of malpractice, and concerns over patient data... (Review)
Review
This paper examines the legal challenges associated with medical robots, including their legal status, liability in cases of malpractice, and concerns over patient data privacy and security. And this paper scrutinizes China's nuanced response to these dilemmas. An analysis of Chinese judicial practices and legislative actions reveals that current denial of legal personality to AI at this stage is commendable. To effectively control the financial risks associated with medical robots, there is an urgent need for clear guidelines on responsibility allocation for medical accidents involving medical robots, the implementation of strict data protection laws, and the strengthening of industry standards and regulations.
Topics: Humans; Liability, Legal; China; Robotics; Malpractice; Computer Security; Confidentiality
PubMed: 38788002
DOI: 10.1097/MD.0000000000038330 -
Scientific Reports May 2024Narcolepsy type 1 (NT1) is a chronic neurological disorder characterized by symptoms such as excessive daytime sleepiness, sudden sleep episodes, disrupted nocturnal...
Narcolepsy type 1 (NT1) is a chronic neurological disorder characterized by symptoms such as excessive daytime sleepiness, sudden sleep episodes, disrupted nocturnal sleep, cataplexy, sleep paralysis, and hypnagogic hallucinations, which significantly impact the overall well-being and quality of life of individuals. While psychological factors have gained attention, there is limited research on the coping strategies employed by patients with NT1 and their association with quality of life. This study aimed to compare coping strategies in patients with NT1 and controls, as well as assess the relationship between coping strategies and quality of life in patients with NT1. A total of 122 individuals diagnosed with NT1 and 138 controls were enrolled in this cross-sectional study. Participants completed questionnaires assessing coping strategies and health-related quality of life. A Mann-Whitney U test was conducted to compare the use of different coping strategies by patients with NT1 and controls. Spearman's rho correlation was performed to examine the association between coping strategies and quality of life in the NT1 group. Results showed that patients with NT1 exhibited differences in the use of coping strategies compared to controls. They reported lower use of active coping, planning, instrumental, and emotional social support, and higher use of behavioral and mental disengagement. Denial and behavioral disengagement were significantly and negatively associated with quality of life. Identifying coping strategies and their association with quality of life may aid in the development of tailored interventions aimed at improving the adoption of effective coping strategies and reducing the use of maladaptive coping strategies.
Topics: Humans; Quality of Life; Narcolepsy; Adaptation, Psychological; Male; Female; Adult; Cross-Sectional Studies; Surveys and Questionnaires; Middle Aged; Young Adult; Case-Control Studies; Social Support; Coping Skills
PubMed: 38783152
DOI: 10.1038/s41598-024-62698-5 -
Indian Journal of Psychiatry Apr 2024Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their... (Review)
Review
Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems.
PubMed: 38778854
DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_799_23 -
BMC Nursing May 2024Home mechanical ventilation (HMV) is a treatment method for patients with chronic respiratory failure. HMV is a challenge for both patients and their caregivers. Some...
BACKGROUND
Home mechanical ventilation (HMV) is a treatment method for patients with chronic respiratory failure. HMV is a challenge for both patients and their caregivers. Some studies have shown a higher risk of depression, job loss, or lifestyle disturbance in family members caring for HMV patients. The purpose of the study was to measure caregiver burden, perceived social support, and coping strategies.
METHODS
In the cross-sectional study, 58 caregivers (65.52% female) of HMV patients treated at five healthcare institutions were surveyed. The questionnaires including patient/caregiver demographic data, the type and duration of MV, the Caregiver Burden Scale (CBS), the Social Support Scale (SSS), and the Brief-COPE questionnaire were applied. For statistical analysis, the Mann‒Whitney U test, the Kruskal‒Wallis H test, Dunn's test, and Spearman correlations were used.
RESULTS
In the CBS, a high level of burden was observed mainly in the isolation and disappointment subscales. The female caregivers achieved a higher score for general strain than did the male caregivers (p = 0.023). Differences in the distribution of the isolation (p = 0.028) and disappointment (p = 0.03) variables between the financial situation groups were observed. The older the patient, the lower the burden in the domains of isolation (p = 0.015) and disappointment (p = 0.005) was elicited. Invasive MV was associated with greater burdens of general strain (p = 0.005), isolation (p = 0.001), and disappointment (p = 0.001). A medium total SSS score was shown (74.5 ± 7.56). Caregivers used various coping strategies. The most common were planning, acceptance, and active coping. Self-blame and denial were positively related to several CBS subscales, whereas acceptance of difficult situations and positive reframing were related to lower scores.
CONCLUSIONS
Caregivers most frequently experienced a medium level of burden. Female caregivers were characterized by higher level of burden. Invasive ventilation increased the burden. Respondents who assessed their financial situations as good, had lower burden in the selected subscales. Using some positive coping strategies may reduce the level of burden. Interventions to ensure that caregivers overcome these burdens should be undertaken.
PubMed: 38778402
DOI: 10.1186/s12912-024-02024-6 -
Data in Brief Jun 2024The proliferation of Internet of Things devices has ushered in a new era of connectivity and con-venience, yet it has also exposed a myriad of security challenges, with...
The proliferation of Internet of Things devices has ushered in a new era of connectivity and con-venience, yet it has also exposed a myriad of security challenges, with Distributed Denial of Service attacks posing a significant threat. This paper introduces the IoT-DH dataset, a novel and extensive dataset designed for the purpose of classifying, identifying, and detecting DDoS attacks within IoT ecosystems. The dataset encompasses diverse scenarios and network configurations, providing a realistic representation of IoT environments. We present a systematic analysis of the IoT-DH dataset, exploring its features and characteristics that mirror the complexities of real-world IoT net-works. The dataset includes a variety of attack scenarios, incorporating different attack vectors and intensities to capture the evolving nature of DDoS threats in IoT. Our approach facilitates the development and evaluation of robust machine learning and deep learning models for effective DDoS attack mitigation. Furthermore, we propose a multi-faceted methodology for leveraging the IoT-DH dataset, encompassing classification techniques to categorize attack types, identification mechanisms to pinpoint malicious entities, and detection algorithms to promptly respond to ongoing DDoS incidents. The efficacy of these methodologies is demonstrated through extensive experiments and evaluations, showcasing their ability to enhance the security posture of IoT environments.
PubMed: 38774247
DOI: 10.1016/j.dib.2024.110496 -
Data in Brief Jun 2024The world's need for energy is rising due to factors like population growth, economic expansion, and technological breakthroughs. However, there are major consequences...
The world's need for energy is rising due to factors like population growth, economic expansion, and technological breakthroughs. However, there are major consequences when gas and coal are burnt to meet this surge in energy needs. Although these fossil fuels are still essential for meeting energy demands, their combustion releases a large amount of carbon dioxide and other pollutants into the atmosphere. This significantly jeopardizes community health in addition to exacerbating climate change, thus it is essential need to move swiftly to incorporate renewable energy sources by employing advanced information and communication technologies. However, this change brings up several security issues emphasizing the need for innovative cyber threats detection and prevention solutions. Consequently, this study presents bigdata sets obtained from the solar and wind powered distributed energy systems through the blockchain-based energy networks in the smart grid (SG). A hybrid machine learning (HML) model that combines both the Deep Learning (DL) and Long-Short-Term-Memory (LSTM) models characteristics is developed and applied to identify the unique patterns of Denial of Service (DoS) and Distributed Denial of Service (DDoS) cyberattacks in the power generation, transmission, and distribution processes. The presented big datasets are essential and significantly helps in identifying and classifying cyberattacks, leading to predicting the accurate energy systems behavior in the SG.
PubMed: 38774244
DOI: 10.1016/j.dib.2024.110461 -
PLOS Global Public Health 2024Female genital mutilation/cutting is a harmful practice that violates the sexual and reproductive health rights of women and girls. The practice is often perpetrated...
'It is what was handed over to us as our heritage and must not be taken away just like that': Traditional birth attendants' attitudes towards the elimination of intergenerational female genital mutilation/cutting in Osun State, Nigeria.
Female genital mutilation/cutting is a harmful practice that violates the sexual and reproductive health rights of women and girls. The practice is often perpetrated directly or indirectly from one generation to another as a way of preserving the culture, thus making it difficult to tackle using ordinary prevention interventions. The purpose of the study was to assess the attitude of the traditional birth attendants as community leaders towards the elimination of intergenerational female genital mutilation/cutting (FGM/C) of girls and to determine their level of readiness and preparedness towards achieving it in Osun State, Nigeria. A qualitative research design, using the adapted REPLACE community readiness tool to end female genital mutilation/cutting interview guide, was used to individually interview eight traditional birth attendants who were identified through purposive sampling method as community leaders and key informants. Thematic Analysis was used to analyze the data which yielded female genital mutilation/cutting as traditional heritage, defiance against government efforts and debunking all "western" information about dangers of female genital mutilation to women as lies as findings. The current defensive attitudes of the TBAs as community leaders and custodians of the FGM/C tradition are that of denial and resistance which is characterised by misconception and incorrect knowledge about the issue as well as misconception and lack of support for addressing the issue which is an indication of low level of no readiness for any intervention to prevent or eliminate FGM/C in Osun state, Nigeria. Serious engagement and dialogue between policy makers and health professionals on FGM/C and its effects on women is highly recommended for effective FGM/C elimination strategies to be co-developed with community leaders. Such engagements should adopt a non-confrontational, respectful, and honest approach so as to not alienate the TBAs.
PubMed: 38768111
DOI: 10.1371/journal.pgph.0001585 -
Health Affairs Scholar Feb 2024In response to a government audit report in 2021, the Philippine health insurance system transitioned its case-based payment system back into a fee-for-service model...
In response to a government audit report in 2021, the Philippine health insurance system transitioned its case-based payment system back into a fee-for-service model capped at individual case rates. This commentary discusses the adverse effects of this policy on health care accessibility and affordability in the country. A rapid review of data shows that it may have resulted in delayed insurance payments, increased denial rates, and reduced coverage, and weakened the strategic purchasing capacity of public health insurance, hugely affecting vulnerable populations and public health care facilities. The commentary calls for a reconsideration of the policy and emphasizes the importance of aligning financial auditing procedures with the needs of health-financing institutions. It advocates for a transformation of audits, moving beyond their traditional role as compliance checks, to become valuable tools supporting a nation's health care purchasing strategies, ultimately benefiting both health care providers and the broader public.
PubMed: 38756555
DOI: 10.1093/haschl/qxae004 -
JAMA Health Forum May 2024
PubMed: 38753351
DOI: 10.1001/jamahealthforum.2024.1749 -
Women's Health (London, England) 2024Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact... (Review)
Review
Transgender and gender diverse people presumed female at birth experience gynaecological conditions, such as chronic pelvic pain at elevated rates, estimated to impact between 51% and 72% of this population, compared to rates of up to 26.6% in cisgender women. The negative impact of these conditions is likely amplified due to limited access to safe and affirming healthcare. Despite this high prevalence rate, there is limited research investigating the prevalence, presentation or management options for trans and gender diverse people with endometriosis. Cisgender women with endometriosis report barriers to accessing care, with lengthy times to diagnosis and limited treatment options available. However, barriers for trans and gender diverse individuals are enhanced by physician bias and lack of education in gender-affirming care. This is reflected in stories of discrimination and denial of basic healthcare. A healthcare environment built on the presumption that gynaecological patients are women, others trans and gender diverse patients, which can result in avoidance of needed medical care. A lack of knowledge of gender-affirming care alongside healthcare provider bias highlights a need for gender-affirming care and bias reduction training in undergraduate healthcare provider curricula. Research to date assessing current curriculum in Australia and Aotearoa (New Zealand) shows limited inclusion of lesbian, gay, bisexual, trans, queer, intersex, asexual and other related identities content as a whole with gender-affirming care being among the least-frequently addressed topics. This review will detail barriers to accessing gender-affirming healthcare specific to gynaecology, interweaving the experiences of a non-binary individual seeking access to gender-affirming endometriosis care.
Topics: Humans; Endometriosis; Female; Transgender Persons; Male; Health Services Accessibility; Australia; Gynecology
PubMed: 38742674
DOI: 10.1177/17455057241251974