During the COVID-19 pandemic, bioethical concerns were raised and there was even a ″resurgence of bioethics. ″ In this work, we review the scientific articles published by Spanish authors in relation to bioethical issues in the three years following the declaration of the pandemic. Seventy publications have been selected. Of all of them, the topic that lent itself to the most debate was that of prioritization in the use of health resources. A consensus was reached that ruled out that age could be considered as a sole exclusion criterion in healthcare or in a possible admission to the ICU. And the importance of taking special care of the most vulnerable and adapting care to the conditions of each patient without excluding anyone was recalled. Other relevant topics were the contrast between autonomy and the common good, the immune passport, vaccination, rigor in research and the publication of results, the professionalism of health personnel, misinformation, care for nursing homes, telemedicine, and the importance of the exercise of virtues. After the experience of both vulnerability and the need to exercise solidarity, many works raise the desire and the possibility of being able to overcome the pandemic being better.

BACKGROUND: Personal Health Monitoring (PHM) has the potential to enhance soldier health outcomes. To promote morally responsible development, implementation, and use of PHM in the armed forces, it is important to be aware of the inherent ethical dimension of PHM. In order to improve the understanding of the ethical dimension, a scoping review of the existing academic literature on the ethical dimension of PHM was conducted.
METHODS: Four bibliographical databases (Ovid/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, and Elsevier/SCOPUS) were searched for relevant literature from their inception to June 1, 2023. Studies were included if they sufficiently addressed the ethical dimension of PHM and were related to or claimed relevance for the military. After selection and extraction, the data was analysed using a qualitative thematic approach.
RESULTS: A total of 9,071 references were screened. After eligibility screening, 19 articles were included for this review. The review identifies and describes three categories reflecting the ethical dimension of PHM in the military: (1) utilitarian considerations, (2) value-based considerations, and (3) regulatory responsibilities. The four main values that have been identified as being of concern are those of privacy, security, trust, and autonomy.
CONCLUSIONS: This review demonstrates that PHM in the armed forces is primarily approached from a utilitarian perspective, with a focus on its benefits, without explicit critical deliberation on PHM\'s potential moral downsides. Also, the review highlights a significant research gap with a specific lack of empirical studies focussing specifically on the ethical dimension of PHM. Awareness of the inherent ethical dimension of PHM in the military, including value conflicts and how to balance them, can help to contribute to a morally responsible development, implementation, and use of PHM in the armed forces.

OBJECTIVE: The importance of self-determination in restoring the wellbeing of Australian First Nations peoples is becoming understood. For thousands of years, Aboriginal women gave birth on Country and Grandmothers\' Lore and Women\'s Business facilitated the survival of the oldest living civilisations on earth. Following colonisation, however, Aboriginal and Torres Strait Islander practices of maternal and perinatal care were actively dismantled, and self-determination by Aboriginal people was destroyed. This had significant implications for the wellbeing of Aboriginal and Torres Strait Islander people and their Cultures and practices.
METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based systematic review of research about programmes of birthing and perinatal health care for Australian Aboriginal and Torres Strait Islander women and their children was undertaken. The review\'s primary aim was to assess the Cultural context of programme development and delivery, its secondary aim was to assess the Cultural appropriateness of programme components. Electronic databases SCOPUS, PsycINFO, Medline, and CINAHL were searched for peer-reviewed studies published in English in Australia between 2000 and 2023.
RESULTS: Twenty-eight publications met inclusion criteria. Included studies were assessed for their methodological characteristics, birthing-support characteristics, perinatal care and continuity of care characteristics. Overall, programmes were limited in meeting the Cultural needs of women, children, and individual Communities. The role of Aboriginal Communities in identifying, delivering, and reviewing programmes was also limited.
CONCLUSIONS: Findings articulate the importance of self-determination in maintaining strong Indigenous Cultures and informing the Culturally appropriate development and delivery of Culturally safe programmes of perinatal care for Aboriginal women, children, and Communities.
CONCLUSIONS: Programmes and services for use by Aboriginal and Torres Strait Islander people must involve Aboriginal and Torres Strait Islander people and their Communities in processes of programme planning, delivery, and review. The evaluation of a programme or service as \"Culturally safe\" represents a determination that is most appropriately made by service users based on their experience of that programme or service.

BACKGROUND: Social media is an integral part of adolescents\' lives and has a strong influence on development and wellbeing. Research examining adolescent social media use and wellbeing is confusing as findings are inconsistent, inconclusive and contradictory. To address this issue, digital wellbeing scholars recommend that researchers adopt a theoretical approach with the aim of increasing meaningfulness and applicability of findings. Hence, this review applies self-determination theory to investigate how adolescent social media use supports and thwarts the basic psychological needs of relatedness, autonomy and competence. Satisfaction of all three psychological needs is essential for optimal development and wellbeing.
METHODS: A scoping review was conducted using a systematic search of five databases relating to adolescent social media use. The preferred items for systematic review and meta-analysis protocols (extension for scoping reviews) was applied resulting in 86 included studies.
RESULTS: Adolescent social media use both supports and thwarts relatedness, autonomy and competence. The findings highlighted how different aspects of adolescent social media use (including intra-personal, inter-personal, situational and environmental factors) contribute to the satisfaction and frustration of basic psychological needs.
CONCLUSIONS: This review illustrates how social media can be both beneficial and detrimental to satisfying the basic psychological needs of relatedness, autonomy and competence. This is important when considering that if psychological needs are satisfied or frustrated in adolescence, the repercussions can have a cascading effect throughout adulthood. This review identifies gaps in the literature and provides suggestions for future research.

This systematic review aimed to examine whether higher comorbidity burden, as assessed by comorbidity indices, was associated with a functional autonomy decline in individuals with cognitive impairment. The search was conducted in the following databases: PubMed/MEDLINE, ScienceDirect, Cochrane, and Embase. Both cross-sectional and longitudinal studies that examined the relationship between comorbidity indices and scales measuring activities of daily living (ADL) in individuals with cognitive impairment were included. The quality assessment tool for observational cohort and cross-sectional studies of the National Institutes of Health (NIH) was used. Overall, 12 studies were included, among which three were longitudinal. Significant association was frequently reported by cross-sectional designs (n=7 studies) and only one study reported a significant longitudinal association. This longitudinal study repeatedly assessed both comorbidity burden and functional autonomy, and considered comorbidity burden as a time-varying covariate. Considering comorbidity burden as a time varying covariate may deal with the dynamic nature of comorbidity burden over time, and conducting repeated assessments during the follow-up using both comorbidity index and ADL scales may increase their sensitivity to reliably measure comorbidity burden and functional autonomy decline over time. In conclusion, a higher comorbidity index was associated with a lower level of functional autonomy in people with cognitive impairment. This relationship seems to be dynamic over time and using comorbidity indices and ADL scales only once may not deal with the fluctuation of both comorbidity burden and functional autonomy decline. To cope with complexity of this relationship this review highlights some methodological approaches to be considered.

This paper has as its theme the autonomy of pregnant women in relation to choosing the method of birth for their child. The objective was to carry out a scoping review to study the literature and evidence of how autonomy is being offered to parturient women. Study design and location: In October 2023, a search was carried out using the terms \"pregnant women\" AND \"delivery\" AND \"autonomy\" in the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. The search included articles from 2016 to 2023. Of the 179 articles found, 15 met the criteria and were selected for this review. Results: the pregnant woman\'s autonomy in choosing the method of childbirth is influenced by several factors, such as the obstetrician\'s recommendation, the medical team, and negative and positive experiences. Thus, when this autonomy is shared with the obstetrician, the obstetrician recommends cesarean section as the safest route, but does not explain the benefits and harms of both routes (vaginal and cesarean section), causing the woman to accept the cesarean section. Midwives recommend vaginal birth because they believe it to be natural and safe and explain the benefits and harms of both methods, respecting the pregnant woman\'s choice of the method she prefers. Conclusion: women have the fundamental right to choose their method of birth and must be properly guided throughout prenatal care, whether by an obstetrician or a midwife, about the options, risks and benefits of each method of childbirth, respecting the ethical principle of beneficence.

This systematic review provides an understanding of existing human factors research on adaptive autonomy, its design, its impacts, and its definition. We conducted a search on adaptive autonomy and additional relevant search terms in four databases, which produced an initial 245 articles. The application of inclusion and exclusion criteria produced a total of 60 articles for in-depth review. Through a collaborative coding process and analysis, we extracted triggers for and types of autonomy adaptations, as well as human factors dependent variables that have been studied in previous adaptive autonomy research. Based on this analysis, we present a definition of adaptive autonomy for use in human factors artificial intelligence research, as well as a comprehensive review of existing research contributions, notable research gaps, and the application of adaptive autonomy.

BACKGROUND: Self-determination is associated with lifelong positive outcomes. Students with intellectual disabilities typically have lower self-determination than their peers. Universal basic education access offers schools the opportunity to rectify this disparity. This is the first systematic review investigating the school-based practices that target self-determination development for students with intellectual disabilities.
METHODS: The review follows the PRISMA guidelines, spanning five databases (ProQuest databases, EMBASE, Scopus, Sage Journals, Taylor and Francis Online) from 2006 to 2021.
RESULTS: Across the 18 studies, the most used practice is the SDLMI. Research focuses on United States-based transition-aged students with mild to moderate intellectual disabilities. Social validity tends to be assessed in summative and informal ways. Students are not generally involved in decision-making about practices and individualisation of support.
CONCLUSIONS: Self-determination development for this population can begin before puberty. Future research should critically investigate social validity and holistic integration of student self-determination learning opportunities throughout the pedagogical cycle.

Background: Self-determination theory (SDT) may provide important insights for understanding substance misuse and treatment outcomes. However, to date, the literature applying SDT to substance use and its treatment is varied and difficult to integrate. Methods: The authors searched psycINFO and PubMed on October 26th, 2021 to identify articles applying SDT to substance use and its treatment. Eligible studies were published in peer-reviewed articles in English, on adult populations (18+), and explicitly applied SDT to the context of substance use or its treatment. Results were categorized as studies applying SDT in non-treatment or treatment settings and were synthesized within these categories by substance(s) of focus, primary outcome(s), component(s) of SDT utilized, and relevant findings. Results: The search revealed 38 articles applying SDT in non-treatment (k = 16) and treatment (k = 22) settings. Causality orientations and the basic psychological needs were the most frequently studied components of SDT. Studies that applied SDT in non-treatment settings placed a greater emphasis on causality orientations, whereas treatment studies more frequently targeted or measured basic psychological needs. Conclusions: SDT constructs consistently predicted both substance misuse and treatment outcomes in a theoretically consistent manner, however, several important gaps remain and opportunities for future research are discussed.

This narrative explores the impact of deinstitutionalization policies on the quality of life and care outcomes for individuals with Alzheimer\'s disease and related dementias. We offer a historical perspective on these policies, their implications on dementia care, and the barriers to deinstitutionalization. The potential benefits of deinstitutionalization, such as improved quality of life and access to community-based support and services, are highlighted. Challenges and controversies surrounding safety, caregiver burden, and resource allocation are also examined. Ethical considerations related to the autonomy and decision-making capacity of people living with dementia are discussed. We present best practices and innovative models in dementia care that balance deinstitutionalization with appropriate care. We further put forth recommendations for future research and policy development in dementia care and deinstitutionalization, emphasizing the need for a balanced approach that respects the autonomy and preferences of people living with dementia while ensuring their safety and well-being.