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.

The performance of platform flexible employees is a core element that contributes to the rapid growth of the sharing economy platform. It is crucial to explore strategies to improve employees\' performance with the growing competition among these platforms. Only a handful of research evidence has been found evaluating platform flexible employees\' psychological capital and work engagement to improve their performance. In order to remedy the gap, we draw on self-determination theory to develop a moderated mediation model, which examines how psychological capital affects platform flexible employees\' job performance. We employed hierarchical regression analysis to test the theoretical model and carried out two rounds of surveys, resulting in 474 valid paired questionnaires. The questionnaire assessed the psychological capital, work engagement, job performance, and job autonomy of flexible platform employees. The results indicate that work engagement plays a mediating role between psychological capital affects platform flexible employees\' job performance. Moreover, job autonomy moderates the mediating effect. The findings not only contribute to the literature on employees\' psychological capital and job performance, but also broaden the research scope of self-determination theory, and provide new ideas for improving the job performance of platform flexible employees.

BACKGROUND: Locked-in syndrome (LIS) is characterized by tetraplegia, anarthria, paralysis of cranial nerves, and facial musculature, with the preservation of consciousness and cognitive abilities, as well as vertical eye movements and eyelid movements, hearing, and breathing. Three types of LIS are distinguished: classic, incomplete, and total. The aim of the present study was to describe the life history of a person with LIS, as well as the wife\'s experience and perspective of this life history.
METHODS: A qualitative life history study was conducted with two participants: a 54-year-old man diagnosed with LIS and his 50-year-old wife. Data were collected through interviews and autobiographical documents submitted by the participants and analyzed following Braun and Clarke\'s method of inductive thematic analysis.
RESULTS: Five main themes were identified: (1) how to understand and overcome the new situation; (2) the process of care and rehabilitation; (3) communication; (4) writing as a way of helping oneself and others; and (5) personal autonomy and social participation.
CONCLUSIONS: The participants valued the support of their friends and family in the acceptance stage of the new situation, giving special importance to the communication skills and medical attention received after diagnosis.

UNASSIGNED: To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery).
UNASSIGNED: Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted).
UNASSIGNED: Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the \"Decision-making\" and \"Freedom from coercion\" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the \"Total reproductive autonomy\" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women.
UNASSIGNED: The association of social determinants of health such as marital status, education, and age impacts women\'s reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Older adults have higher rates of emergency department (ED) admissions when compared to their younger counterparts. Mobility is the ability to move around, but also encompasses the environment and the ability to adapt to it. Walking aids can be used to improve mobility and prevent falls. According to international guidelines, they must be available in Geriatric EDs. This study aims to evaluate the efficacy of a program of training and provision of walking aids (WA), associated or not with telemonitoring, on fear of falling, mobility, quality of life and risk of falls up to 3 and 6 months in older adults cared for in an ED. A randomized controlled trial will be carried out in the ED. Participants will be randomized and allocated into three groups, as follows: A) walking aid group will be trained for the use of a walking aid and receive guidance on safe gait; B) walking aid and telemonitoring group will receive training for the use of a walking aid, guidance on safe gait, and telemonitoring (every two weeks for first three months); C) Control group will receive only guidance on safe gait. Patients will undergo a baseline evaluation encompassing sociodemographic and clinical data, mobility in life spaces, gait speed, muscle strength, functionality, quality of life, fear of falling, history of falls, cognition and mood before the intervention. Gait time and fear of falling will be assessed again after the intervention in ED. Finally, mobility in life spaces, functionality, quality of life, fear of falling, history of falls, cognition, and mood will be assessed 3 and 6 months after discharge from the geriatric ED through a telephone interview. Provision of walking aids in the geriatric ED is currently recommended. This study will be the first randomized controlled trial that will evaluate the impact of training and provision of these devices in the ED. Trial registration number: NCT05950269.

BACKGROUND: Testing positive for COVID-19 was associated with higher rates of detrimental psycho-social and physical health outcomes. The COVID-19 pandemic caused unprecedented disruption to everyday life. This included major reconfiguration of maternal, child, and perinatal mental health and care services and provision. This study aimed to investigate the experiences of those who tested positive for COVID-19 during pregnancy, labour and birth, or the early postnatal period.
METHODS: National on-line recruitment from across the United Kingdom resulted in sixteen mothers being invited to qualitative semi-structured interviews to understand the experiences of mothers who had been infected by COVID-19 during pregnancy, labour and birth, or the early postnatal period. Interviews were conducted, recorded, and transcribed using video-conferencing software. A Grounded Theory approach was used to analyse the data gathered pertaining to women\'s experiences of their positive COVID-19 diagnosis during pregnancy, labour and birth, or the early postnatal period.
RESULTS: The theory of \'Oscillating Autonomy - Losing and Seeking to Regain Control by Striving for Agency\' was developed, comprising three main themes: \'Anxious Anticipation: The fear of infection was worse than COVID-19 itself\'; \'Fluctuating Agency: What changed when COVID-19 took control\'; and \'Reclaiming Control: Seeking reassurance during COVID-19 positivity\'. Testing positive for COVID-19 whilst pregnant, during labour or birth, or in the early postnatal period was associated with a perceived loss of control. Those who were able to regain that control felt more secure in their situation.
CONCLUSIONS: Support was paramount to manage increased vulnerability, as was reassurance achieved by information seeking and positive action including increased health monitoring and COVID-19 vaccination.

BACKGROUND: Though women in sub-Saharan Africa have increased risk of intimate sexual violence, research on the association between sexual autonomy and intimate partner violence among this population has not received the requisite attention. Consequently, we investigated if sexual autonomy is a protective factor against intimate partner violence among women in sub-Saharan Africa.
METHODS: Secondary data analysis was conducted based on the Demographic and Health Surveys (DHSs) of 27 sub-Saharan African countries from 2008 to 2021. A total of 104,523 married or cohabitating women were included in the study. We applied a multilevel Poisson regression model with robust variance to identify associated factors. Variables with a p-value<0.2 in the bi-variable multilevel Poisson regression analysis were considered for the multivariable analysis. The Adjusted Prevalence Ratio (APR) with its 95% confidence interval (CI) was reported, and variables with a p-value <0.05 were included in the multivariable analysis.
RESULTS: The prevalence of intimate partner violence and sexual autonomy among women in SSA were 32.96% [95% CI: 32.68%, 33.25%] and 88.79% [95% CI: 88.59%, 88.97%], respectively. Women in Sierra Leone had the highest prevalence of IPV (52.71%) while Comoros had the lowest prevalence of IPV (8.09%). The prevalence of sexual autonomy was highest in Namibia (99.22%) and lowest in Mali (61.83%). The MOR value in the null model was 1.26. We found that women who had sexual autonomy are 1.28 times [APR = 1.28, 95% CI: 1.17, 1.40] more likely to experience IPV than women who had no sexual autonomy.
CONCLUSIONS: This study has demonstrated that sexual autonomy is significantly associated with intimate partner violence, however, it does not necessarily act as a protective factor. The study suggests the need for more education on intimate partner violence targeting women\'s partners. This can help secure the commitment of the perpetrators to rather become proponents of anti-intimate partner violence and further offer women the necessary support for them to attain their full fundamental rights in all spheres of life.

BACKGROUND: Dementia impairs the ability of people with dementia to be autonomous and independent. They need support from third parties, who should ideally respect their autonomy and independence as much as possible. Supporting people with dementia can be very burdensome for caregivers and numbers of patients increase while numbers of potential caregivers decline. Digital assistive technologies (DATs) that directly support patients or their caregivers may help bridging the increasing gap between need of support and available resources. DATs have the potential to preserve the autonomy and independence of people with dementia and promote their abilities, if they are properly designed in close interaction with future users. In our study, we focused on ethical concerns, technological requirements, and implementation criteria for DAT in general and specifically to support outdoor mobility of people with dementia.
METHODS: We applied a qualitative approach and conducted a World Café (2 tables, n = 7) and an online focus group (n = 6) with people with dementia, relatives, healthcare professionals, scientists, ethics experts, and experts for digitally-assisted medical care. We descriptively analyzed the data using a content analysis approach.
RESULTS: The participants reported technological (e.g., lack of Wi-Fi), financial (e.g., expensive devices or lack of budget for DATs), political (e.g., legal hurdles such as the European Medical Device Law or data protection regulations) as well as user-related hurdles (e.g., lack of digital competence) for the implementation of DAT in dementia care. Among the issues discussed were the importance of autonomy, independence, safety, privacy, and questions of decision making capacity in DAT\'s use. Participants identified opportunities and benefits in self-learning, situation-aware DATs and wished for dementia-friendly communities. They emphasized the value of personal interaction that should not be replaced, but rather supported by DAT.
CONCLUSIONS: The results revealed multiple hurdles and ethical concerns for DAT use and provided recommendations for designing and implementing DATs. Further investigations are needed on the impact of DAT on personal interactions in caregiving and the role of DAT in dementia-friendly communities.

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.

OBJECTIVE: In Ethiopia, information about health system responsiveness (HSR) in conflict-affected areas is limited. No previous local study was conducted on the assessment of HSR at the community level. Hence, the study assessed HSR for intrapartum care in conflict-affected areas in Amhara region, Ethiopia.
METHODS: Community-based cross-sectional study design.
METHODS: Wadila, Gayint and Meket districts, Amhara region, Ethiopia.
METHODS: The participants were 419 mothers who gave birth in conflict-affected areas within the last 6 months. The study included all mothers who gave birth at health facilities but excluded those who delivered at home, critically ill or unable to hear.
RESULTS: HSR was the outcome variable. In this regard, the study assessed how mothers were treated and the situation in which they were cared for in relation to their experience during the conflict.
METHODS: We conducted the study in the community, where we analysed eight domains of HSR to identify 30 measurement items related to intrapartum care responsiveness. The domains we looked at were dignity (4), autonomy (4), confidentiality (2), communication (5), prompt attention (5), social support (3), choice (3) and basic amenities (4). We used a multiple linear regression model to analyse the data, and in this model, we used an unstandardized β coefficient with a 95% CI and a p value of less than 0.05 to determine the factors significantly associated with HSR.
RESULTS: The findings of our study revealed that the overall proportion of HSR in intrapartum care was 45.11% (95% CI: 40.38 to 49.92). The performance of responsiveness was the lowest in the autonomy, choice and prompt attention domains at 35.5%, 49.4% and 52.0%, respectively. Mothers living in urban areas (β=4.28; 95% CI: 2.06 to 6.50), government employees (β=4.99; 95% CI: 0.51 to 9.48), those mothers stayed at the health facilities before delivery/during conflict (β=0.22; 95% CI: 0.09 to 0.35), those who were satisfied with the healthcare service (β=0.69; 95% CI: 0.08 to 1.30) and those who perceived the quality of healthcare favourable (β=0.96; 95% CI: 0.72 to 1.19) were more likely to rate HSR positively. On the other hand, joint decision-making for health (β=-2.46; 95% CI: -4.81 to -0.10) and hospital delivery (β=-3.62; 95% CI: -5.60 to -1.63) were negatively associated with HSR.
CONCLUSIONS: In the Amhara region of Ethiopia, over 50% of mothers living in areas affected by conflict reported that health systems were not responsive with respect to intrapartum care. Therefore, all stakeholders should work together to ensure that intrapartum care is responsive to conflict-affected areas, with a focus on providing women autonomy and choice.