ABSTRACT
Scholarship drawing from a wide array of perspectives including field theoretical and functional differentiation approaches has shed increasing light on the sectoral dimensions of world politics. In contrast to dominant approaches emphasizing hierarchy and power in relations between global fields, this article offers a novel interpretive framework for understanding how diverse fields, systems, or sectors may interact and facilitate change in world politics beyond the operation of established hierarchies and power dynamics. Taking forward the previously underutilized concept of symbolically generalized media of communication, this article elucidates two processes of international political change by which different fields, systems, or sectors may transform world politics. The first process, lateral retreat, is illustrated with reference to the case study of the Protestant Reformation, in which internal changes in the religious field facilitated the development of an increasingly autonomous political domain. The second process, lateral penetration, is illustrated with reference to the international political response to the climate change and Covid-19 crises, in which the scientific sector contributed toward transformed political priorities and associated hierarchies, at least in the short term. These diverse cases are used to indicate the broad potential scope of application of the concept of symbolically generalized media of communication to enrich relational theorizing in the study of international relations, and to improve understanding of diverse dynamics of international political change missed in traditional power- (and anarchy-) centric accounts.
ABSTRACT
Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) are at greater risk of intensive care unit admission, need for mechanical ventilation, or death compared to immunocompetent patients. eHealth is one of the multidisciplinary components that can have the greatest impact on quality of life, accessibility, and quality of service due to its potential to improve efficiency and productivity in health service system processes.The objective of this study is to determine the scientific evidence on eHealth strategies, the level of implementation and their role in HSCT. Methods: The search strategy used was: (Hematopoietic Stem Cell Transplantation OR Stem Cell Transplantation, Hematopoietic OR Transplantation, Hematopoietic Stem Cell) AND (Telemedicine OR Mobile Health OR mHealth OR Telehealth OR eHealth OR Health, Mobile). In the bibliographic search, 98 articles were obtained from PubMED and Scopus sources. By means of evaluating pairs a first selection was made by title and abstract, in the discrepancies consensus was sought by means of discussion between pairs. Of the articles chosen for full reading, those that reported results of eHealth-based interventions were included. Articles not performing a transplant and eHealth application were excluded. Results: A total of 46 articles were selected for full reading and 26 were finally included in this review. We identified that the majority of the studies were conducted in the USA (n = 10), the publication concentrates mostly on the year 2020, and a first study in 2007. The purpose of the interventions included the follow-up and management of risk factors related to cardiovascular disease, accompaniment for symptom detection and improvement of the quality of life of patients, remote monitoring of patients with telemetry, and training of patients (eLearning). The objectives of these interventions included: medication adherence, physical activity monitoring, infection prevention, patient participation in content creation, symptom tracking and management, follow-up with self-reporting of data, mainly in patients with complications associated with post-HSCT treatment, and pain management in adults. The population involved in the interventions included: patients with allogeneic and autologous transplants, adolescents, caregivers, parents of transplanted children, among others. It should be noted that the projects where patient follow-up was sought managed to improve the patient's quality of life. Remote monitoring with adequate teaching is useful for the rapid detection of complications and in adolescents it can take advantage due to their affinity with mobiles, it also had an impact for patients who lived far from the transplant centers by reducing complications and cost. The most frequent type of intervention was the use of mobile applications for data collection, monitoring and monitoring of symptoms. The interventions with the greatest impact on patients were applications due to their accessibility, feasibility, benefits, and acceptance by patients. Conclusions: The scientific evidence on eHealth for HSCT shows products such as applications, mobile health and telemedicine, with the greatest publication of works in the last year. A multidisciplinary commitment is necessary in planning for development, costs, times and execution of projects with information technology, as well as the need for a focus on User Experience, important and necesary after the experience of COVID-19.