Components of palliative care interventions addressing the needs of people with dementia living in long term care: a systematic review

© The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: People with dementia requiring palliative care havemultiple needs that require complex, multicomponent interventions. Thisneed is amplified in the long term care setting. The European Associationfor Palliative Care (EAPC) White Paper offers recommendations forpalliative care in dementia and highlights domains of care integral forthis population, thus providing useful guidance to developing suchinterventions. This review maps components of palliative careinterventions for people with dementia in LTCFs, with a particular focuson shared decision-making.Peer reviewe

Spoilt for choice: When user-system relationship becomes one-to-many

Traditionally, a user would use one system for a particular task, defining a one-to-one user-system relationship. However, the advances in technology are changing this premise. An emerging trend is the notion of one-to-many, where a user has a choice of multiple systems to complete the same task. This phenomenon purports to alter the current status quo of potentially many of the individual and group level theories, especially those on how users accept a system. The study engages in analytic induction. Therein, it employs the dual process theory to observe the acceptance journey of users, when they are presented with a choice of systems to complete the same task. The study identifies the importance of the emotional and rational facets of the dual process theory, while introducing compliance as a possible third facet. Finally, the study introduces ‘complete agnosticism’ as a novel notion that explains how one-to-many user-system relationships are facilitat

Social Life Cycle Assessments: A Review on Past Development, Advances and Methodological Challenges

Society’s interest in social impacts of products, services and organizational behaviors is rapidly growing. While life cycle assessments to evaluate environmental stressors have generally been well established in many industries, approaches to evaluate social impacts such as Social Life Cycle Assessment (S-LCA) lack methodological consistency and standardization. The aim of this paper is to identify past developments and methodological barriers of S-LCA and to summarize how the automotive industry contributed to the advancement or application of this method. Therefore, a qualitative content analysis of 111 studies published between 2015 and 2020 is used to gather information on past scientific and political milestones, methodological barriers impeding S-LCA and the participation of the automotive sector. The review shows that a broad range of sectors such as the automotive industry contributed to the testing and advancement of S-LCA in the past but that S-LCA remains a young and immature method. Large-scale application is impeded by major barriers such as the variety of impact categories and sub-categories, the lacking integration of the Sustainable Development Goals (SDGs), issues of linking LCA structures to social phenomena or the difficult tracking of social impact pathways. Further research on standardization possibilities, the connection to political social targets and the testing of methods is necessary to overcome current barriers and increase the applicability and interpretability results

Healthcare System Digital Transformation across Four European Countries: A Multiple-Case Study

Multiple-case study; Digital transformation; Digital healthEstudio de casos múltiples; Transformación digital; Salud digitalEstudi de casos múltiples; Transformació digital; Salut digitalDigitization has become involved in every aspect of life, including the healthcare sector with its healthcare professionals (HCPs), citizens (patients and their families), and services. This complex process is supported by policies: however, to date, no policy analysis on healthcare digitalization has been conducted in European countries to identify the main goals of digital transformation and its practical implementation. This research aimed to describe and compare the digital health policies across four European countries; namely, their priorities, their implementation in practice, and the digital competencies expected by HCPs. A multiple-case study was performed. Participants were the members of the Digital EducationaL programme invoLVing hEalth profEssionals (DELIVER), a project funded by the European Union under the Erasmus+ programme, involving three countries (Denmark, Italy, and Slovenia) and one autonomous region (Catalonia—Spain). Data were collected using two approaches: (a) a written interview with open-ended questions involving the members of the DELIVER project as key informants; and (b) a policy-document analysis. Interviews were analysed using the textual narrative synthesis and the word cloud policy analysis was conducted according to the Ready, Extract, Analyse and Distil approach. Results showed that all countries had established recent policies at the national level to address the development of digital health and specific governmental bodies were addressing the implementation of the digital transformation with specific ramifications at the regional and local levels. The words “health” and “care” characterized the policy documents of Denmark and Italy (309 and 56 times, 114 and 24 times, respectively), while “development” and “digital” (497 and 478 times, respectively) were common in the Slovenia document. The most used words in the Catalonia policy document were “data” and “system” (570 and 523 times, respectively). The HCP competencies expected are not clearly delineated among countries, and there is no formal plan for their development at the undergraduate, postgraduate, and continuing educational levels. Mutual understanding and exchange of good practices between countries may facilitate the digitalization processes; moreover, concrete actions in the context of HCP migration across Europe for employment purposes, as well as in the context of citizens’ migration for healthcare-seeking purposes are needed to consider the differences emerged across the countries

A Cloud Telemedicine Platform Based on Workflow Management System: A Review of an Italian Case Study

The paper aims to describe a new technological and organizational approach in order to manage teleconsultation and telemonitoring processes involving a Physician, who remotely interacts with one or more Specialists, in order to evaluate and discuss the specific clinical conditions of a patient, based primarily on the sharing of digital clinical data, reports and diagnostic images. In the HINT project (Healthcare INtegration in Telemedicine), a teleconsultation and telemonitoring cloud platform has been developed using a Hub and Spoke architecture, based on a Business Process Management System (BPMS). The specialized clinical centres (Hubs) operate in connection with the territorial hospital centres (Spokes), which receive specific diagnostic consultations and telemonitoring data from the appropriate Specialist, supported by advanced AI systems. The developed platform overcomes the concepts of a traditional and fragmented teleconsultation and consequently the static organization of Hubs and Spokes, evolving towards an integrated clinical workflow management. The project platform adopts international healthcare standards, such as HL7 FHIR, IHE (XDS and XDW) and DICOM for the acquisition and management of healthcare data and diagnostic images. A Workflow Management System implemented in the platform allows to manage multiple and contemporaneous processes through a single platform, correctly associating the tasks to the Physicians responsible for their execution, monitoring the status of the health activities and managing possible clinical issues

Digital research data: from analysis of existing standards to a scientific foundation for a modular metadata schema in nanosafety

Background: Assessing the safety of engineered nanomaterials (ENMs) is an interdisciplinary and complex process producing huge amounts of information and data. To make such data and metadata reusable for researchers, manufacturers, and regulatory authorities, there is an urgent need to record and provide this information in a structured, harmonized, and digitized way. Results: This study aimed to identify appropriate description standards and quality criteria for the special use in nanosafety. There are many existing standards and guidelines designed for collecting data and metadata, ranging from regulatory guidelines to specific databases. Most of them are incomplete or not specifically designed for ENM research. However, by merging the content of several existing standards and guidelines, a basic catalogue of descriptive information and quality criteria was generated. In an iterative process, our interdisciplinary team identified deficits and added missing information into a comprehensive schema. Subsequently, this overview was externally evaluated by a panel of experts during a workshop. This whole process resulted in a minimum information table (MIT), specifying necessary minimum information to be provided along with experimental results on effects of ENMs in the biological context in a flexible and modular manner. The MIT is divided into six modules: general information, material information, biological model information, exposure information, endpoint read out information and analysis and statistics. These modules are further partitioned into module subdivisions serving to include more detailed information. A comparison with existing ontologies, which also aim to electronically collect data and metadata on nanosafety studies, showed that the newly developed MIT exhibits a higher level of detail compared to those existing schemas, making it more usable to prevent gaps in the communication of information. Conclusion: Implementing the requirements of the MIT into e.g., electronic lab notebooks (ELNs) would make the collection of all necessary data and metadata a daily routine and thereby would improve the reproducibility and reusability of experiments. Furthermore, this approach is particularly beneficial regarding the rapidly expanding developments and applications of novel non-animal alternative testing methods