The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should (...) do what, with whom and why? Departing from a relational and hermeneutic perspective, this article shows that professionals in integrated service networks embark upon a moral learning process when starting to work together for the client’s benefit. In this context, instrumental ways of thinking about responsibilities are actually counterproductive. Instead, professionals need to find out who they are in relation to other professionals, what core values they share and what responsibilities derive from these aspects. This article demonstrates moral learning by examining the case of an integrated social service network. The network’s development and implementation were supported by responsive evaluation, enriched by insights of care ethics and hermeneutic ethics. (shrink)

In the current literature, the impacts of the transformation undergone by the Quebec health and social services network (RSSS) in 2015 deal mainly with issues of accessibility, efficiency and performance. The impacts of this reform on the place of ethics in the RSSS are to date little documented. In this article, we are interested in the place occupied by clinical and organizational ethics in the institutions created by this reform, namely the integrated health and (...) class='Hi'>social services centres (CISSS) and the integrated university health and social services centres (CIUSSS). How is ethics regulated? In a self-regulatory manner, that is to say based on rational reflection based on values? Or is it rather in a hetero-regulatory manner, based on obedience to norms dictated by an external authority? The aim of our study was to gain a better understanding of how clinical and organizational ethics are regulated in the CISSS and CIUSSS of the RSSS. To this end, an analysis of ethics-related documents developed by these establishment and made available to the public on their websites was carried out, using the conceptual framework that guided this study. In doing so, we were able to observe the predominance of hetero-regulatory regulation of ethics. Thus, although ethics seems to have a greater place than in the past within RSSS establishments, the regulation of clinical and organizational ethics remains largely and predominantly hetero-regulatory. (shrink)

This study investigates how social franchises extend health care in rural areas, thus addressing vast and persistent disparities in health care access. We conducted an inductive study of Unjani, a South African organization that extended primary health services to disadvantaged rural communities through a network of 135 health clinics. Our analysis focused on the process of impact intermediation—the propagation of impact across multiple layers of the franchise network, including franchisees and downstream beneficiaries. (...) To facilitate impact intermediation, the franchisor harmonized the mission of the franchisees with its own mission and integrated community impact among franchisees. Such coordination and monitoring activity exposed franchisees to intermediation problems in the form of mission conflict and impact divergence. Our analysis reveals how Unjani nurtured network stewardship that afforded the franchisee nurses with greater support, autonomy, and ownership, thus overcoming intermediation problems in their pursuit of shared communal responsibilities to extend health care to rural communities. (shrink)

Millions of Americans are dependent on what is often called the “safety net.” These loosely-organized networks of health and social service providers serve the many Americans who are uninsured, dependent on public coverage, or for a variety of reasons unable to access other private systems of care. The Institute of Medicine report, America’s Health Care Safety Net: Intact but Endangered, called attention to both the fragility and the resilience of this health care safety net. The IOM (...) report underscored the critical importance of the safety net to the health and well-being of millions of individuals and called for efforts to strengthen it and improve the nation’s ability to monitor its viability. Given this central role, any health care reform efforts need to be fully informed by an understanding of what the safety net includes, how it is financed, and how it is responding to a series of challenges it now faces. (shrink)

Background and purpose Educators’ ethical competence is of crucial importance for developing students’ ethical thinking. Previous studies describe educators’ ethical codes and principles. This article aims to widen the understanding of health- and social care educators’ ethical competence in relation to core values and ethos. Theoretical background and key concepts The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. Methods Data material was collected from nine educational units for healthcare (...) and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. Ethical considerations The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. Findings The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. Conclusion Educators’ personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators’ training regarding ethical competence. (shrink)

Multifunctional agricultural systems seek to expand upon production-based benefits to enhance family wellbeing and animal health, reduce inputs, and improve environmental services such as biodiversity and water quality. However, in many countries a landscape-level conversion is uneven at best and stalled at worst. This is particularly true across the eastern rural landscape in the United States. We explore the role of social networks as drivers of system transformation within dairy production in the eastern United States, specifically rotational (...) grazing as an alternative management option. We hypothesize the importance of weak ties within farmer social networks as drivers of change. In Wisconsin, Pennsylvania, and New York, we conducted 53 interviews with confinement, low-intensity, and rotational grazing dairy producers as well as 35 interviews with associated network actors. Though confinement and grazier networks had similar proportions of strong and weak ties, confinement producers had more market-based weak ties, while graziers had more weak-ties to government agencies and other graziers in the region. These agency weak ties supported rotational graziers through information exchange and cost sharing, both crucial to farmers’ transitions from confinement-based production to grazing systems. While weak ties were integral to initial innovation, farmers did not maintain these relationships beyond their transition to grazing. Of equal importance, grazier weak-tie networks did not include environmental organizations, suggesting unrealized potential for more diverse networks based on environmental services. By understanding the drivers, we can identify barriers to expanding weak tie networks and emergent properties in order to create institutions and policies necessary for change. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 373-378 [Access article in PDF] The Forgotten Self:Training Mental Health and Social Care Workers to Work With Service Users Kim Woodbridge Keywords self, workers perspective, them and us, win-win situation The three main papers and the case studies presented in this issue of Philosophy, Psychiatry, & Psychology all focus on the service user perspective in relation to the self as illustrated (...) by different aspects of philosophy. This is also in the context of the service user looking for help during a time when they are experiencing levels of distress and difficulty.Important as this is, evident by the substantial clinical and philosophical literature in this area, what has been overlooked is the perspective of the mental health and social care worker responsible for the care of individuals whose sense of self is disturbed. The significance of this omission has been brought home to me through my experiences in running training workshops for workers working with service users with a diagnosis of personality disorder. (From here on, in this paper, the terms worker and trainee are used interchangeably to refer to the mental health and social care worker).During these workshops challenges to the worker's sense of self have been revealed emotionally ("this doesn't feel like me"), ideologically ("I am not a bad person"), and/or practically ("I don't usually behave like this") when discussing their work with service users. This paper draws from the workshop experiences to explore and consider the workers perspective in relation to the self in more detail.There follows a descriptive account of three workshop sessions which include the trainees responses. With each activity the responses are considered within the context of the self, particularly from the worker's perspective. In the conclusion the argument is made, as evidenced by these illustrations, for the importance of including the workers' perspective when attempting to understand the self. The Trainees and Service Users Workers from various professional and nonprofessional backgrounds attend the workshops. They include psychiatrists, nurses, social workers, support workers, and occupational therapists who work in both in-patient and community settings. They usually have several years of clinical experience working with people with a [End Page 373] diagnosis of personality disorder, but rarely have they had any formal education or training in the area. Discussing their experiences of working with this service user group generates strong and highly emotionally charged personal responses during training.It is their experiences of the relationships with service users whose sense of self is absent, inconsistent, or unstable, that make a substantial contribution to the content of the workshops.Often service users are struggling with fragmented, distorted, or threatening perceptions of the world, themselves, and others. The worker, while embedded within their own sense of self, is engaged in a relationship with the service user. The issues that arise as a part of this relationship can be challenging and distressing for the workers. There are two main areas:The impact the service user's chaotic, fragmented, and unstable sense of self has on the worker's own sense of self.The response of the workers when their sense of self is challenged, and the impact that response has on the service user. These can be seen in more detail in the examples taken from the training sessions presented later in this paper. The Training Sessions The training sessions are either run alone or form part of a 1- or 2-day workshop. As mentioned, the groups are composed of a variety of professionally and nonprofessionally qualified staff. The experiences they share mainly relate to people with a diagnosis of Borderline Personality Disorder, although other subcategories are mentioned occasionally. Information regarding these and other related sessions can be found in two recent publications: Making positive connections (Duff, Meredith, & Woodbridge,2003) and "Whose good practice?" (Woodbridge & Fulford, 2003). The First Activity: Revealing Internal Models Given the lack of available evidence, even the best-informed trainees are likely to have to fill in the knowledge gaps with their own interpretations of... (shrink)

This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological (...) care of the whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals. After presenting this account, some major challenges for the future of mental health care provision, such as the overburdening of services or the overt exclusion of a significant group of potential users, are identified and briefly discussed. (shrink)

Background Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. Research aim To describe and compare professional value orientation among different health and social care workers in Finland. Research design A quantitative cross-sectional study. Participants and research context We carried out an online survey of health and social care workers from 8 (...) March to 31 May 2022, using the Finnish version of the Nurses’ Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. Ethical considerations Permission was received from all participating organizations and those who completed the survey provided informed consent. Results A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. Discussion Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. Conclusions Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career. (shrink)

A number of experiences have demonstrated how digital solutions are effective in improving quality of life (QoL) and health outcomes for older adults. Smart Health Age-Friendly Environments (SHAFE) is a new concept introduced in Europe since 2017 that combines the concept of Age-Friendly Environments with Information Technologies, supported by health and community care to improve the health and disease management of older adults and during the life-course. This chapter aims to provide an initial overview of the (...) experiences available not only in Europe, based on the research work of the participants of the International Interdisciplinary Network on Health and Well-being in an Age-Friendly Digital World (NET4Age-Friendly), which could be of interest to preventive, health and social authorities. The chapter reports good practices, pain points, and bottlenecks that may require a collaborative, interdisciplinary research approach to facilitate the transformations towards smart, sustainable, health and age-friendly cities and communities. (shrink)

Barriers to mental health interventions globally remain a health concern; however, these are more prominent in low- and middle-income countries. The barriers to accessibility include stigmatization, financial strain, acceptability, poor awareness, and sociocultural and religious influences. Exploring the barriers to the utilization of mental health services might contribute to mitigating them. Hence, this research aims to investigate these barriers to mental health service utilization in depth at the Kabutare District Hospital of the Southern Province of (...) Rwanda. The qualitative approach was adopted with a cross-sectional study design. The participants were patients with mental illnesses seeking mental health services at the hospital. Ten interviews were conducted in the local language, recorded, and transcribed verbatim and translated by the researchers. Thematic analysis was applied to analyze the data collected. The results revealed that the most common barriers are fear of stigmatization, lack of awareness of mental health services, sociocultural scarcity, scarcity of financial support, and lack of geographical accessibility, which limit the patients to utilize mental health services. Furthermore, it was revealed that rural gossip networks and social visibility within the communities compounded the stigma and social exclusion for patients with mental health conditions. Stigmatization should be reduced among the community members for increasing their empathy. Then, the awareness of mental disorders needs to be improved. Further research in Rwanda on the factors associated with low compliance to mental health services with greater focus on the community level is recommended. (shrink)

The notion of social capital focuses attention on social connectedness within communities and the ways that this connectedness may affect health and well‐being. There are many competing definitions of social capital but most suggest that it involves trust, social networks and reciprocity within communities, not necessarily geographically defined. The usefulness of social capital and related theories that help in understanding the function of nurses in rural communities are explored in this paper. Nurses and (...) class='Hi'>health service planners are becoming increasingly aware of the potential contribution of community nurses in rural and/or remote areas, as evidenced in the development of nurse practitioners. Through their interrelational role and status in rural communities, nurses are often ‘immersed’ or ‘embedded’ in the social networks that make up the fabric of rural life and may therefore be important contributors to social capital. For a concept such as social capital to be useful in nursing research, it must have distinct attributes, delineated boundaries, and well‐described preconditions and outcomes in multiple contexts. (shrink)

This paper evaluates the indoor temperature and thermal sensation inside the naturally ventilated small-medium size, historical Anadolchioi Mosque, built in Constanta, in 1870, for the Muslim minority living in Constanta. Are considered Friday prayers (Dhuhr). The methodology used for this assessment is related to the outdoor and indoor temperatures measurements, each Friday, in July, between 10 AM and 4 PM, due to the fact that in Constanta, Friday prayers (in July) starts between 1.20 PM and 1.23 PM (depending on the (...) sun position). The measurements will indicate that, although indoor temperature is slightly higher than the outdoor one, the average indoor temperature, for the considered period, is in the recommended thermal comfort temperature range, according to ASHRAE 2010. Also, the measured indoor air temperatures and predicted temperature for comfortable indoors- given by Humphreys formula, have been compared, in order to have an idea if the building is able to provide pleasant indoor temperatures. On the other hand, the methodology is focusing on ASHRAE seven point scale, when assessing the thermal sensation. In this respect, a survey regarding the thermal sensation of the occupants indicated that a low percent (5.55%) felt uncomfortable during the religious services. The majority of occupants (77.77%) felt comfortable and do not need a cooler environment. The results are in concordance with the participants’ age profiles: older persons preferring higher indoor temperatures. (shrink)

Background The world is urbanizing rapidly; more than half the world’s population now lives in urban areas, leading to significant transition in lifestyles and social behaviours globally. While offering many advantages, urban environments also concentrate health risks and introduce health hazards for the poor. In Bangladesh, although many public policies are directed towards equity and protecting people’s rights, these are not comprehensively and inclusively applied in ways that prioritize the health rights of citizens. The country is (...) thus facing many issues that raise moral and ethical concerns. Methods A narrative literature review was conducted between October 2016 and November 2017 on issues related to social justice, health, and human rights in urban Bangladesh. The key questions discussed here are: i) ethical dilemmas and inclusion of the urban poor to pursue social justice; and ii) the ethical obligations and moral responsibilities of the state and non-state sectors in serving Bangladesh’s urban poor. Using a Rawlsian theory of equality of opportunity to ensure social justice, we identified key health-related ethical issues in the country’s rapidly changing urban landscape, especially among the poor. Results We examined ethical dilemmas in Bangladesh’s health system through the rural–urban divide and the lack of coordination among implementing agencies. The unregulated profusion of the private sector and immoral practices of service providers result in high out-of-pocket expenditures for urban poor, leading to debt and further impoverishment. We also highlight policy and programmatic gaps, as well as entry points for safeguarding the right to health for Bangladeshi citizens. Conclusions The urban health system in Bangladesh needs a reform in which state and non-state actors should work together, understanding and acknowledging their moral responsibilities for improving the health of the urban poor by engaging multiple sectors. The social determinants of health should be taken into account when formulating policies and programs to achieve universal health coverage and ensure social justice for the urban poor in Bangladesh. (shrink)

This textbook looks at how different world faiths approach ethics in health and social care, and how their faith informs their practice. Equipping practitioners with the information they need, it will help them to be more reflective regarding spirituality, ethics and their provision of care.

A significant number of inmates with mental illness reside within the New York State Department of Corrections (NYSDOCS). New York State has taken the initiative to provide mentally ill inmates with necessary services through a collaboration of the New York State Department of Correctional Services and the New York State Office of Mental Health (NYSOMH). The collaboration results in a mental health delivery system that provides many essential services to mentally ill inmates. This paper focuses (...) on the organization of mental health services within NYSDOCS, best practices, past and current litigation, and staff responsibilities. As the population of mentally ill inmates continues to grow, implications for the Human Services professions of OMH and DOCS needs to continue to address and provide adequate mental health care and resources for this special population. (shrink)

To the Editor: In the November–December 2010 issue, the Seattle Growth Attenuation and Ethics Working Group (“Navigating Growth Attenuation in Children with Profound Disabilities”) analyzed the arguments for and against growth attenuation in children with permanent, profound intellectual disabilities and identified conditions under which its use may be ethically acceptable. The working group’s conclusion is based on a particular construction of the issue that is not always justified. It focuses on the possibility that growth attenuation will increase children’s involvement in (...) family social and recreational activities. The critique of the biomedical model of disability, however, highlights the potential gap between .. (shrink)

This current study aims to know the impact of a nurse completing his educational attainment and its impact on the health services provided to society in general. It is also important to know the effect of completing his educational attainment on the quality of work and better dealing with patients and medical staff. It is also important to know its impact on increasing the organization of his time at work. Knowing its impact on increasing his efficiency in his (...) work environment, A questionnaire was prepared via Google Drive and distributed to the population aged 25-55 years, men and women, in the city of Mecca. As for the questionnaire, it was distributed via the social networking program (WhatsApp) for the purpose of distancing for fear of the presence of the Corona virus. 400 questionnaires were distributed, and 395 responses were obtained via email to the principal researcher. The current study concluded that the impact of completing the educational attainment of male and female nurses and its impact on the health service provided was a very positive impact of 94.8%, and it also helped improve the health service provided to patients by a greater percentage of 90%. (shrink)

Reason and Rationality in Health and Human Services Delivery is the first book to discuss the topic of decisionmaking and services from a multidisciplinary approach. It uses theory and social considerations, not just technology, as a basis for improved services. Health and human service students and professionals will learn how to form rational and reasonable decisions that take their clients'cultural backgrounds into consideration when identifying an illness or appropriating any kind of intervention. With a (...) particular emphasis on theories, models, organizational settings, technologies, and practitioner training methods that lead to culturally sensitive decisions, Reason and Rationality will help you deliver efficient and improved medical and social services to clients from all ethnic backgrounds. Recognizing reason as the centerpiece of most of Western philosophy, this text reveals how our idea of truth, fact, and order are wrongly thought to be universal; yet, Western principles are continually used in the decision-making process for health and social services. Focusing on the policy implications of decisionmaking in medical and social service settings, this text works to incorporate a broad range of factors into the reasoning process, such as cultural traditions and beliefs, that will result in better treatment for patients. Giving you suggestions and strategies for upgrading reasoning and decision-making processes and applying them to every area of service, Reason and Rationality discusses different themes that will help you improve services to patients, such as: the rationale currently used to justify decision-making strategies concerning medical and human services using computer technology to make clinical assessments revising administrative structure, management theories, and organizational strategies so that decision-making processes enhance the overall quality of service delivery how the practitioner/patient relationship is important in choosing the proper treatment soliciting community-based input to assess the public's health and human service needs in order to lessen political involvement in decision-making stages In addition, Reason and Rationality provides information and examples that show why you should consider the "life-world"--the values, beliefs, and commitments of a culture's history-- as the key to understanding the powers of reasoning that specify parameters of health and illness. (shrink)

Background More than one in 10 of all prisoners in England and Wales are Foreign Nationals. This article discusses whether the research applications to one London prison are aimed at understanding a prisoner population characterised by significant multinational and multilingual complexity. Methods We studied all accessible documents relating to research undertaken at a women's prison between 2005 and 2009 to assess the involvement of Foreign National prisoners and women with limited English. The source of information was prison research applications and (...) protocols. We also looked at available final research reports and journal articles. Results Two key findings emerged from this study. First, studies at this prison frequently excluded Foreign National prisoners and women with limited English. Second, Foreign National prisoners were often clustered as a homogeneous category in the research reports reviewed. This is despite their diverse cultural backgrounds, their variable immigration status and their differing competence in English, all of which affect their lives. Conclusions The failure to include and/or identify social subgroups of the population can undermine the value of research, including, in the case of the study prison, funded health research. This can compromise associated needs assessments and service delivery, particularly important in already disadvantaged populations; this may encourage and/or perpetuate a range of health inequalities. There is a pressing need to examine cultural exclusion in other health and criminal justice settings, to assess the ways in which—and the extent to which—such exclusion may compromise the merit of proposed and completed health and social research. (shrink)

Rich in case studies, practical photocopiable activities and downloadable resources, this is a beginner's guide to how values are formed and developed in varying professional contexts across health and social care services. It invites the reader to reflect on their own values, and on how these define the quality of the care they deliver.

During the past thirty years a high proportion of all long stay hospital beds have been closed. The responsibility for those who would have occupied those beds previously has to a large extent been transferred from health to social services departments, or to family, voluntary and private care. The overall effect has been to prioritize acute medical care, and to expose the public provision and funding of long term residential care, whether medical or social, to the (...) direct determination of political and economic forces. These policy changes have been introduced under the banner of community care, but are dependent on complex concepts which are morally contentious and often obscure. The purpose of this paper is to analyse these processes as a prerequisite to devising better policies in future. (shrink)

This book clarifies the distinctions between three key concepts - Anti-Racist Practice (ARP), Anti-Discriminatory Practice(ADP) and Anti-Oppressive Practice (AOP). Critically and constructively analysing these three approaches to practice it reappraises their potential in the light of emerging equality issues in the health service. With contributions from leading teachers and practitioners in the field, Equalising Opportunities provides students and practitioners in health and social care with a clear overview of an area where there is much confusion and imperfect (...) understanding. (shrink)

Social commerce as a subset of e-commerce has been emerged in part due to the popularity of social networking sites. Social commerce brings new challenges to marketing activities. And social commerce transactions like e-commerce transactions can be dangerous and cause harmful losses to personal finances, time, and information privacy. This article examines ethical issues and consumer assessments of the risks of using an e-service and how risk affects consumer evaluations and usage of Internet-based services and (...) self-service technologies. Results from two surveys totaling 1024 consumers indicated that as usage risk concerns increased, the perceived usefulness of an e-service and intention to use it decreased. Additionally as usage risk concerns increased the effect of subjective norm on PU and intention to use an e-service strengthened, and the effect of perceived ease of use on PU and intention to use an e-service weakened. These findings advance theory and contribute to the foundation for future research aimed at improving our understanding of how consumers evaluate new e-services, new commerce systems and settings, and self-service technologies in the social commerce era. (shrink)

Objectives:Social isolation is increasing in aging societies and several studies have shown a relation with worse cognition in old age. However, less is known about the association in the oldest-old (85+); the group that is at highest risk for both social isolation and dementia. Methods:Analyses were based on follow-up 5 to 9 of the longitudinal German study on aging, cognition, and dementia in primary care patients (AgeCoDe) and the study on needs, health service use, costs, and (...) class='Hi'>health-related quality of life in a large sample of oldest-old primary care patients (AgeQualiDe), a multi-center population-based prospective cohort study. Measurements included the Lubben Social Network Scale (LSNS-6), with a score below 12 indicating social isolation, as well as the Mini-Mental Status Examination (MMSE) as an indicator of cognitive function. Results:Dementia-free study participants (n = 942) were M = 86.4 (SD = 3.0) years old at observation onset, 68.2% were women. One third (32.3%) of them were socially isolated. Adjusted linear hybrid mixed effects models revealed significantly lower cognitive function in individuals with smaller social networks (β = 0.5, 95% CI = 0.3-0.7, p <.001). Moreover, changes in an individual's social network size were significantly associated with cognitive changes over time (β = 0.2, 95% CI = 0.1-0.4, p =.003), indicating worse cognitive function with shrinking social networks. Conclusion:Social isolation is highly prevalent among oldest-old individuals, being a risk factor for decreases in cognitive function. Consequently, it is important to maintain a socially active lifestyle into very old age. Likewise, this calls for effective ways to prevent social isolation. (shrink)

This study will be of interest to anyone concerned with a critical appraisal of mental health service users’ and carers’ participation in research collaboration and with the potential of the postcolonial paradigm of cultural safety to contribute to the service user research (SUR) movement. The history and nature of the mental health field and its relationship to colonial processes provokes a consideration of whether cultural safety could focus attention on diversity, power imbalance, cultural dominance and structural inequality, identified (...) as barriers and tensions in SUR. We consider these issues in the context of state‐driven approaches towards SUR in planning and evaluation and the concurrent rise of the SUR movement in the UK and Australia, societies with an intimate involvement in processes of colonisation. We consider the principles and motivations underlying cultural safety and SUR in the context of the policy agenda informing SUR. We conclude that while both cultural safety and SUR are underpinned by social constructionism constituting similarities in principles and intent, cultural safety has additional dimensions. Hence, we call on researchers to use the explicitly political and self‐reflective process of cultural safety to think about and address issues of diversity, power and social justice in research collaboration. (shrink)

With the development of learning abroad, deep learning is used in research fields. On the basis of deep learning, this article studies physical education. First, this article analyzes and explains the related concepts and current situation of physical education, and explains the measurement and definition of the mental health. Then, the function analysis algorithm of deep learning is explained and analyzed, in which the algorithm of the convolution neural network of deep learning is mainly described. Finally, through experimental (...) analysis, it shows that the research performance of deep learning in the physical education on college students’ mental health is relatively high. At the same time, through investigation and analysis, it is proposed that physical education in deep learning can improve mental health and social adaptability relatively high. And the content of physical education should focus on increasing physical psychological education and physical practice education, which can improve college students’ mental health and social adaptability compared with other teaching contents. Therefore, when introducing deep learning, universities should strengthen the physical education of college students. (shrink)

Although various scholars underscore the importance of innovating responsibly in view of today's societal challenges, less attention has been paid to the entrepreneurial skillset, that is, the range of individual skills and organizational capabilities, that innovation-based organizations mobilize to deliver new responsible products and services. This paper thus explores the relationships between the entrepreneurial skillsets of 16 Canadian and Brazilian for-profit and not-for-profit organizations producing Responsible Innovations in Health (RIH) and their degree of responsibility. Our mixed methods study (...) includes interviews with entrepreneurs (n = 23) and fieldnotes as well as quantitative results from the RIH Assessment Tool. Our findings identify four skillset orientations—Technical, Technical + Business, Social, and Social + Business—that not only reflect (co)founders' training and entrepreneurial motivations but also a proclivity toward the consolidation of either “Technical” or “Social” skills and capabilities. Such consolidation is made possible by recruiting high-level executives with diverse backgrounds or by tapping on external knowledge sources (e.g., boards of directors, incubators, or volunteers). As five enterprises had no formal business skills, patterns associated to their overall RIH score (ranging from 1 to 5) reveal intriguing results. Organizations with a Social + Business skillset have a slightly lower RIH score (4.1) than those with a Social skillet (4.4) and those with a Technical + Business skillset have a slightly higher score (3.5) than those with a Technical skillset (3.0). The presence of business skills thus appears to mediate the relationship between entrepreneurial skillsets and the degree of responsibility, which may be linked to the distinct roles of ordinary (“doing things right”) and dynamic capabilities (“doing the right things”). These exploratory findings have scholarly and practical implications. First, the tensions and synergies characterizing responsible value creation should be approached by examining the complementary skills and capabilities that need to be assembled and consolidated. Second, the eight cases with a Social + Business skillset clarify the unique capabilities needed to produce highly responsible health innovations. Third, entrepreneurs with a scientific or engineering background should recognize that a Technical skillset is not enough. Fourth, recognizing that “falling in love with the cause” of RIH is not sufficient, investors and boards of directors should adequately support responsible entrepreneurs towards the proper orchestration of skills and capabilities that can reconcile economic and social goals. (shrink)

In Mexico, significant ethical and social issues have been raised by the COVID-19 pandemic. Some of the most pressing issues are the extent of restrictive measures, the reciprocal duties to healthcare workers, the allocation of scarce resources, and the need for research. While policy and ethical frameworks are being developed to face these problems, the gender perspective has been largely overlooked in most of the issues at stake. Domestic violence is the most prevalent form of violence against women, which (...) can be exacerbated during a pandemic: stress and economic uncertainty are triggers for abuse, and confinement limits access to support networks. Confinement also exacerbates the unfair distribution of unpaid labor, which is disproportionately assigned to women and girls, and highlights inequality in the overall labor market. Lack of security measures has resulted in attacks towards health workers, particularly female nurses, due to fear of contamination. Finally, resource results in lack of access to other health necessities, including sexual and reproductive health services. Research across all disciplines to face—and to learn from—this crisis should be done through a gender lens, because understanding the realities of women is essential to understand the pandemic’s true effects in Mexico and the world. (shrink)

Given the profound influence of social media and emerging evidence of its effects on human behavior and health, bioethicists have an important role to play in the development of professional standards of conduct for health professionals using social media and in the design of online systems themselves. In short, social media is a bioethics issue that has serious implications for medical practice, research, and public health. Here, we inventory several ethical issues across four areas (...) at the intersection of social media and health: the impact of social networking sites on the doctor‐patient relationship, the development of e‐health platforms to deliver care, the use of online data and algorithms to inform health research, and the broader public health consequences of widespread social media use. In doing so, we review discussions of these topics and emphasize the need for bioethics to focus more deeply on the ways online technology platforms are designed and implemented. We argue that bioethicists should turn their attention to the ways in which consumer engagement, bias, and profit maximization shape online content and, consequently, human behavior and health. We also offer a set of recommendations and suggest future directions for addressing ethical challenges in these domains. (shrink)

This qualitative study investigated the personal and professional stances of 40 health and social care professionals confronted with assisted suicide of older persons living in nursing homes or supported by social welfare or home care and support services in French-speaking Switzerland. Requests of assisted suicide triggered questions with regard to the professional mission, the quality of accompaniment, values, and ethical principles. Four types of stances emerged from the analysis performed according to the principles of the grounded (...) theory: favorable in principle, professional compromise, personal compromise, and opposed in principle. Each stance results from the combination of several dimensions: personal or professional concordance or compatibility with assisted suicide; implication in, and impact of, the process; appreciation of the process; and satisfaction with the resources at disposal. The differentiated stances adopted by professionals depend largely on their way of interpreting their mission, deontology, and the relationship to the older person. (shrink)

The authors of the concept Health-Related Digital Autonomy have laid the first building block to examine the interactions between artificial intelligence, social media, and depression f...

The Family Planning Association Northern Ireland (F.P.A.N.I.) has recently been successful in holding the state accountable for its duty to safeguard women’s reproductive health and welfare, and clarify the circumstances in which abortion is lawful. By demanding that the Minister for Health investigate abortion provision and produce abortion guidance, F.P.A.N.I. hope to improve the quality of abortion services and alleviate the situation of those women who are legally entitled to abortion in Northern Ireland but cannot access it (...) there. This action has challenged a public failure which impacts most negatively on those women who cannot easily escape its effects. Although the case succeeded in shaming the state for such a failure, the judicial review strategy could not challenge the legal ethos which denies women a say over their reproductive lives. This case commentary argues that pro-choice strategic litigation needs to positively and generally assert women’s reproductive rights at the same time as it seeks to accommodate the needs of the most vulnerable. (shrink)

Ethics, Aging and Society...is the first major work in ten years to critically address issues and methodologies in aging and ethics...This well-organized volume begins theoretically and offers new ways of thinking about ethics that can handle the complexities and realities of aging in particular social contexts."--Choice This new research-based book, by experts in the field of ethics, is excellent and much-needed...I challenge you to consider reading this book and seeing all the ways in which you might be forced to (...) rethink things that most of us take as given for ethics and aging. I know you will not be disappointed and I guarantee you will end up thinking long and hard about personal and professional decisions you may have made as well as your assumptions about aging in America."--CFLE Network Newsletter This is a book that should be required reading for all involved in the ethical provision of services to the aging on any level, as well as for policy makers and administrators in positions of influence over the lives of older patients."--PsycCRITIQUES...the authors' application of feminist ethics to frail elders rings true to both my clinical experience working with frail elders, and my research experience trying to understand their quality of life concerns...there were true gems of ideas [in this book] that illuminated the limitations of the dominant paradigm of autonomy in bioethics. [The authors] make a compelling critique of end-of-life care."--GeriPal: A Geriatrics and Palliative Care Blog This book presents second generation issues in ethics, aging, and society by presenting critical outcomes that arise when ethics is applied to the practical concerns that occur in day-to-day elder care. The first volume in over 10 years to address ethics and gerontology, it is unparalleled in its comprehensiveness and integration of well-developed philosophical arguments with empirical research, humanistic scholarship, and insights gained from practical experience. This book challenges the tried and true approaches to ethical issues in aging and opens avenues for creative problem-solving. The authors' diverse backgrounds bring the advantages of both interdisciplinary scholarship and practical experience to this comprehensive textbook. It is an essential resource for those interested in, and working with, older people, from upper-level undergraduate students and graduate-division students, to gerontology practitioners in training. Key Features: Presents the first major work in over 10 years to integrate the disciplines of ethics and aging Includes case studies derived from day-to-day practice Addresses individual/clinical ethics in health and long-term care and ethical issues raised by public policy, cultural norms and social attitudes Examines such critical issues as Alzheimer's disease, long-term care, ageism, public policy, anti-aging medicine, elder abuse, and natural disasters Explores new directions in ethical and social philosophy as they pertain to gerontology and care. (shrink)

BackgroundSocial media has globalised compassion enabling requests for donations to spread beyond geographical boundaries. The use of social media for medical crowdfunding links people with unmet healthcare needs to charitable donors. There is no doubt that fundraising campaigns using such platforms facilitates access to financial resources to the benefit of patients and their caregivers.Main textThis paper reports on a critical review of the published literature and information from other online resources discussing medical crowdfunding and the related ethical questions. The (...) review highlighted the benefits of crowdfunding as well as the under-exploration of the risk of having patients’ desires and human rights undermined during online fundraising campaigns. Majority of these campaigns get initiated on behalf of the patients, especially the very sick and dependant. The ethical questions raised relate to the voluntariness of informed consent and the possibility of patients being used as a means to an end. Vulnerability of patients may expose them to coercion, undue influence, manipulation, and violation of their human rights. The success of these campaigns is influenced by the digital skills, pre-existing social networks and, the emotional potency. Healthcare is a public good, and online market forces should not determine access to essential health services. The benefits of crowdfunding cannot be subverted, but it can perpetuate unintended injustices, especially those arising from socio-economic factors.ConclusionsPolicymakers ought to monitor the utilisation of crowdfunding sites to identify policy failures and unmet essential health care needs responsible for driving individuals to use these platforms. The upholding of human rights and the fundamental respect of the individual’s wishes is a moral imperative. The need for an ethics framework to guide different stakeholders during medical crowdfunding needs further examination. (shrink)

Conflicts of interest. None to report Healthcare is a context where individuals with disability confront important ethical and social challenges. Adolescents and young adults with cerebral palsy (CP) seem to face additional challenges but we have little insight into their perspectives. This qualitative study aimed to identify and better understand such challenges. We interviewed 14 participants with CP aged 18 to 25. Participants described a range of challenges experienced when using health services, including: lack of long-term follow-up, (...) shortcomings in physical access to infrastructures, and situations of injustice. Challenges specific to medical consultations were reported (e.g., rude attitudes, belittlement, inadequate communication, lack of consideration). We discuss and explain further that: (1) the ethical principle of respect for persons needs to be concretely specified to improve current practices; (2) respect for autonomy calls for further direct empowerment of individuals with CP and, (3) gaps in dedicated healthcare resources for CP and the long-term needs associated should be addressed. (shrink)

This article critically engages with Mandeville et al.'s case discussion of using social networking services for the purposes of contact tracing in infectious disease outbreaks. It will be argued that their discussion may be overstating the utility of such approaches, while simultaneously underestimating the ethical concerns that arise from this method of contact tracing. The article separates between ethical and technological concerns and suggests that due to the particular design of networking sites such as Facebook and the usage (...) patterns of subscribers, the positive effect of contact tracing through such services may be overstated. At the same time, using social networking sites raises serious concerns regarding the privacy of patients and the ownership of information posted online. (shrink)

Introducción: se presenta un ensayo cuyo objetivo es fijar posiciones frente al resumen del Informe de la Comisión sobre Determinantes Sociales de la Salud (CDSS) proponer las acciones políticas que los movimientos sociales en salud deben emprender. Análisis: las recomendaciones de la CDSS no enfocan el problema en toda su compleja naturaleza y en especial desconoce la influencia decisiva de la formación económica social sobre la situación crítica de la salud en el mundo. Acción: se propone la unidad de (...) los movimientos sociales que actúan en el campo de salud para luchar contra los efectos de las políticas económicas y sociales dominantes en el mundo: reducción del papel del estado, privatización de servicios, desregulación laboral, privatización de la seguridad social, políticas migratorias y otras. Denunciemos toda política neoliberal en relación con la salud, practiquemos la solidaridad con los que luchan contra esas políticas, derrotemos el monopolio mediático neoliberal, enfocar el problema de los DSS como asunto político social, no técnico y defendamos el papel protagónico del estado, único capaz de asegurar servicios de salud al alcance de todos. Conclusión: "Nuestro deber es luchar", como nos advirtió Fidel Castro. Introduction: An essay is presented in order to set positions against the Report´s summary of the Commission on social determinants of public health (CSDPH) that suggests the political actions to be undertaken by Health social movements. Analysis: The CSDPH recommendations do not focus the problem in all its complex nature and do not recognize the decisive influence of the social economic formation on the critical situation of Health in the world. Action: unity of social movements acting in the field of health to fight against the effects of the dominant economic and social policies of today´s world: reduction of the role of the State, privatization of services, labour deregulation, privatization of social security, migratory policies and others. We denounce any neo-liberal policy in relation to Health. Let´s support those who struggle against those policies; let´s defeat the neoliberal media monopoly, let´s focus on the problem of social determinants as a sociopolitical issue , not as a technical one; let´s defend the leading role of the State, the only one capable to ensure health services to everyone. Conclusion: As Fidel Castro expressed: "Our duty is to fight. (shrink)

In collaboration with the 31st European Social Services Conference (ESSC) of the European Social Network, to be held in Malmö, Sweden, on 14–16 June 2023, we invite the submission of papers presented at the conference for inclusion in a Special Issue of Social Sciences. There will be no charge for papers submitted to the Special Issue. In line with the conference, the Special Issue will focus on accelerating the digital and technological transformation of social (...) services by governments, public authorities, and agencies involved in their development. It will also discuss how technological advancements can help improve the delivery of social services by simplifying the access and sharing of information, enhancing coordination between services, encouraging early intervention, supporting decision-making, and promoting people’s autonomy and choice. The Special Issue seeks to gather theoretical, empirical and practical findings relating to this area of practice and study. Only contributions already included in the conference programme can be accepted. The following article types are encouraged: brief report, case report, communication, essay, hypothesis, opinion, perspective, project report, and review. Authors can submit an abstract to the editors of the Special Issue in advance of submitting a full article so that the editors can provide initial feedback and opportunities to strengthen the submission. Abstracts can be submitted through the Special Issue website. (shrink)

Consumer-operated services organizations (COSOs) are independent, non-profit organizations that provide peer support and other non-clinical services to seriously mentally ill people. Mental health consumers provide many of these services and make up at least a majority of the organization’s leadership. Although the dominant conception of the COSO is as an adjunct to clinical care in the public mental health system, this paper reconceives the organization as a civic association and thereby a locus of citizenship. Drawing (...) on empirical research on COSOs in one state and the citizenship and civic democracy literatures, COSOs are analyzed here as membership organizations with democratic norms and strong ties to local communities. The suggestion is made that by embracing and enhancing their status as civic associations, COSOs may advance the goals of the social movement that spawned them and avoid predictable obstacles to further growth and development. (shrink)