Primary Care Physicians' and Patients' Perspectives on Equity and Health Security of Infectious Disease Digital Surveillance.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic facilitated the rapid development of digital detection surveillance (DDS) for outbreaks. This qualitative study examined how DDS for infectious diseases (ID) was perceived and experienced by primary care physicians and patients in order to highlight ethical considerations for promoting patients' autonomy and health care rights. METHODS: In-depth interviews were conducted with a purposefully selected group of 16 primary care physicians and 24 of their patients. The group was reflective of a range of ages, educational attainment, and clinical experiences from urban areas in northern and southern China. Interviews were audio recorded, transcribed, and translated. Two researchers coded data and organized it into themes. A third researcher reviewed 15% of the data and discussed findings with the other researchers to assure accuracy. RESULTS: Five themes were identified: ambiguity around the need for informed consent with usage of DDS; importance of autonomous decision making; potential for discrimination against vulnerable users of DDS for ID; risk of social inequity and disparate care outcomes; and authoritarian institutions' responsibility for maintaining health data security. The adoption of DDS meant some patients would be reluctant to go to the hospital for fear of either being discriminated against or forced into quarantine. Certain groups (older people and children) were thought to be vulnerable to DDS misappropriation. CONCLUSIONS: These findings indicate the paramount importance of establishing national and international ethical frameworks for DDS implementation. Frameworks should guide all aspects of ID surveillance, addressing privacy protection and health security, and underscored by principles of social equity and accountability.Annals "Online First" article.

Pathways and obstacles to social recovery following the elimination of SARS-CoV-2 from Aotearoa New Zealand: a qualitative cross-sectional study.

BACKGROUND: Many public health experts have claimed that elimination strategies of pandemic response allow 'normal social life' to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement. METHODS: Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand. RESULTS: A majority of participants reported that life after elimination was 'more or less the same' as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social. CONCLUSIONS: Elimination strategies can successfully allow 'normal social life' to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies.

Ethics, Integrity, and Retributions of Digital Detection Surveillance Systems for Infectious Diseases: Systematic Literature Review.

BACKGROUND: The COVID-19 pandemic has increased the importance of the deployment of digital detection surveillance systems to support early warning and monitoring of infectious diseases. These opportunities create a "double-edge sword," as the ethical governance of such approaches often lags behind technological achievements. OBJECTIVE: The aim was to investigate ethical issues identified from utilizing artificial intelligence-augmented surveillance or early warning systems to monitor and detect common or novel infectious disease outbreaks. METHODS: In a number of databases, we searched relevant articles that addressed ethical issues of using artificial intelligence, digital surveillance systems, early warning systems, and/or big data analytics technology for detecting, monitoring, or tracing infectious diseases according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and further identified and analyzed them with a theoretical framework. RESULTS: This systematic review identified 29 articles presented in 6 major themes clustered under individual, organizational, and societal levels, including awareness of implementing digital surveillance, digital integrity, trust, privacy and confidentiality, civil rights, and governance. While these measures were understandable during a pandemic, the public had concerns about receiving inadequate information; unclear governance frameworks; and lack of privacy protection, data integrity, and autonomy when utilizing infectious disease digital surveillance. The barriers to engagement could widen existing health care disparities or digital divides by underrepresenting vulnerable and at-risk populations, and patients' highly sensitive data, such as their movements and contacts, could be exposed to outside sources, impinging significantly upon basic human and civil rights. CONCLUSIONS: Our findings inform ethical considerations for service delivery models for medical practitioners and policymakers involved in the use of digital surveillance for infectious disease spread, and provide a basis for a global governance structure. TRIAL REGISTRATION: PROSPERO CRD42021259180; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259180.

Blended Learning in Aotearoa New Zealand and Australian programmes that lead to registration as a nurse: An integrative review

E kīa ana tēnei mea te ako hanumi ko te tuinga o ngā wheako akoranga tuihono, akoranga ā-kanohi hoki, ā, kua tere horapa i te akoranga tapuhi huri noa i te ao. Ko te whāinga o tēnei arotake tuitui, he whakahou i ngā āhuatanga e mōhiotia ana mō te ako hanumi i roto i te horopaki akoranga tapuhi o Aotearoa me Ahitereiria, he whakaputa māramatanga hou hoki hei tautoko i te whakamahinga akoranga hanumi i runga taunakitanga. I whakamahia tētahi ara arotake tuitui. I kawea ētahi rangahau pūnahanaha o ngā pātengi raraunga o Scopus, Web of Science, CINAHL Complete, ERIC via Ovid, PsychInfo via Ovid, me Google Scholar. I whakaurua he tuhinga hei arotake me i whakaputaina i waenga i 2021 me 2020, i tuku pūrongo hoki mō te rangahau, he haumitanga o ngā akoranga tuihono, akoranga ā-kanohi kei roto, i ngā hōtaka tapuhi paetahi o Aotearoa, o Ahitereiria rānei, e puta ai te tangata hei tapuhi rēhita. I whakaputaina ngā tuhinga e whitu, i tutuki ai ngā paearu whakauru, i waenga i 2016 me 2020, ā, i puta katoa i Ahitereiria. I tātaritia, i whakarāpopototia ngā kitenga kia rere ētahi kāwai matua e rima: ngā tautuhitanga o te akoranga hanumi;ngā painga kaiako;ngā hua o te akoranga hanumi;ngā taki mo te ara akoranga hanumi;me ngā āhuatanga hei whiriwhiri mo āpopo. Ahakoa i kitea i tēnei arotake, āe, he pānga to ngā painga kaiako ki ngā whakaaro me ngā wheako ākonga mo te akoranga hanumi, me āta rangahau ano kia mohiotia ai ngā whakaaro me ngā wheako o te hanga kaiako mo te akoranga hanumi. Ahakoa i piki ake te whakamahinga o te ako hanumi tuihono, ā-kanohi hoki i te pānga o COVID-19, i tautohutia tētahi korenga mohiotanga taketake mo te whāinga hua me ngā wheako o te akoranga hanumi puta noa i te akoranga tapuhi i Aotearoa me Ahitereiria, i tēnei arotakenga. Mehemea ka kitea he tautuhitanga hohonu kē atu o te akoranga hanumi ka āwhinatia te whakawhanake rautaki akoranga hanumi whai hua, tāwariwari hoki a te hanga rangahau, kaiako hoki, i te horopaki o Aotearoa me Ahitereiria. I runga ano i te pikinga ake o ngā tono mo ētahi ara akoranga hanumi tāwariwari i roto i te akoranga tapuhi, he totika te wā mo tēnei arotakenga tuhinga, ā, ka hua ake ētahi whakahoutanga hira mā ngā kaiwhakaako tapuhi mo ngā tikanga pai hei hora akoranga hanumi, me te whakatakoto anga ano mo ngā rangahau ā ngā rā kei mua.Alternate abstract:Blended learning is understood to be the combination of online and face-to-face learning experiences and has developed rapidly within nursing education globally. The purpose of this integrative review was to update what is currently known about blended learning within the Aotearoa New Zealand and Australian nursing education context and to generate new perspectives to inform the evidence-based use of blended learning. An integrative review approach was utilised. Systematic searches of the databases Scopus, Web of Science, CINAHL Complete, ERIC via Ovid, PsychInfo via Ovid, and Google Scholar were conducted. Articles were included for review if they were published between 2010 and 2020 and reported on research involving a combination of online and face-toface teaching in undergraduate nursing programmes in Aotearoa New Zealand or Australia that led to a registered nurse qualification. All seven articles that met the inclusion criteria were from Australia and were published between 2016 and 2020. The findings were analysed and summarised into five main categories: definitions of blended learning;teacher qualities;benefits of blended learning;challenges of the blended learning approach;and future considerations. While this review found that teacher qualities influenced students' perceptions and experiences of blended learning, further research is needed on how teachers perceived and experienced blended learning. While COVID-19 has accelerated the use of online and blended learning internationally;this review identified a lack of empirical knowledge on the efficacy and experience of blended learning across nursing education in Aotearoa New Zealand an Australia. A more nuanced definition of blended learning would assist researchers and educators to develop effective and adaptable blended learning teaching strategies in the Aotearoa New Zealand and Australian context. With increased directives for adaptable blended learning modalities within nursing education, this review of the current literature within Aotearoa New Zealand and Australia was timely and will provide important updates for nurse educators on how best to provide blended learning and provide a framework for future research.