Purpose: To evaluate the readability, accountability, accessibility, and source of online patient education materials for treatment of age-related macular degeneration (AMD) and to quantify public interest in Syfovre and geographic atrophy after US Food and Drug Administration (FDA) approval. Methods: Websites were classified into 4 categories by information source. Readability was assessed using 5 validated readability indices. Accountability was assessed using 4 benchmarks of the Journal of the American Medical Association (JAMA). Accessibility was evaluated using 3 established criteria. The Google Trends tool was used to evaluate temporal trends in public interest in \"Syfovre\" and \"geographic atrophy\" in the months after FDA approval. Results: Of 100 websites analyzed, 22% were written below the recommended sixth-grade reading level. The mean (±SD) grade level of analyzed articles was 9.76 ± 3.35. Websites averaged 1.40 ± 1.39 (of 4) JAMA accountability metrics. The majority of articles (67%) were from private practice/independent organizations. A significant increase in the public interest in the terms \"Syfovre\" and \"geographic atrophy\" after FDA approval was found with the Google Trends tool (P < .001). Conclusions: Patient education materials related to AMD treatment are often written at inappropriate reading levels and lack established accountability and accessibility metrics. Articles from national organizations ranked highest on accessibility metrics but were less visible on a Google search, suggesting the need for visibility-enhancing measures. Patient education materials related to the term \"Syfovre\" had the highest average reading level and low accountability, suggesting the need to modify resources to best address the needs of an increasingly curious public.

Why is it that some care order cases result in the child being removed from parental care, while in others she is not, despite the cases being similar? This paper investigates how decision-makers reason and justify different outcomes for similar cases, by an analysis of four pairs of judgments (from Norway, Estonia, and Finland) about care orders, using thematic analysis. The comparison is within the pairs and not across countries. I find that the variance in outcome and reasoning seems to be a result of discretionary evaluations: risk, cooperation of the parents, and the potential of services to alleviate the situation are interpreted differently in the cases and lead to different outcomes. This appears to be a legitimate use of the discretionary space available to the decision-makers. The decisions are justified with \'good reasons\' mostly related to threshold, the least intrusive intervention principle, and the best interests of the child. Such justifications are suitable to provide accountability and legitimacy, but the reasoning is at times lacking transparency and thoroughness. The reasoning is longer in the non-removal cases, suggesting that more thorough reasoning is required when the decision-makers depart from the most common outcome.
The reasoning is longer in the non-removal cases, indicating that more thorough reasoning is required when the decision-makers depart from the most common outcome.Hvorfor er det slik at noen omsorgsovertakelser ender med at barnet blir fjernet fra foreldrenes omsorg, mens i andre blir hun ikke det, til tross for at sakene er like? Denne artikkelen undersøker hvordan beslutningstakere resonnerer og begrunner ulike utfall for like saker, gjennom en analyse av fire par av dommer (fra Norge, Estland, og Finland) i omsorgsovertakelser, gjennom å bruke tematisk analyse. Sammenligningen er innad i parene, og ikke på tvers av land. Jeg finner at variasjonen i utfall og resonnering virker å være et resultat av skjønnsmessige vurderinger: risiko, foreldrenes samarbeid, og hjelpetjenesters potensiale til å forbedre situasjonen blir vurdert ulikt i sakene og leder til forskjellige utfall. Dette virker å være legitim bruk av beslutningstakernes skjønnsrom. Beslutningene er begrunnet med «gode grunner», for det meste relatert til terskel for inngripen, det minste inngreps prinsipp, og barnets beste. Slike begrunnelser er godt egnet til å gi ansvarlighet og legitimitet, men resonneringen mangler tidvis transparens og grundighet. Resonneringen er lengre i saker der barnet ikke blir fjernet, som indikerer at mer grundig resonnering er nødvendig når beslutningstakerne avviker fra det mest vanlige utfallet.

暂无摘要。

The aim of this study is to examine the risks associated with the use of artificial intelligence (AI) in medicine and to offer policy suggestions to reduce these risks and optimize the benefits of AI technology. AI is a multifaceted technology. If harnessed effectively, it has the capacity to significantly impact the future of humanity in the field of health, as well as in several other areas. However, the rapid spread of this technology also raises significant ethical, legal, and social issues. This study examines the potential dangers of AI integration in medicine by reviewing current scientific work and exploring strategies to mitigate these risks. Biases in data sets for AI systems can lead to inequities in health care. Educational data that is narrowly represented based on a demographic group can lead to biased results from AI systems for those who do not belong to that group. In addition, the concepts of explainability and accountability in AI systems could create challenges for healthcare professionals in understanding and evaluating AI-generated diagnoses or treatment recommendations. This could jeopardize patient safety and lead to the selection of inappropriate treatments. Ensuring the security of personal health information will be critical as AI systems become more widespread. Therefore, improving patient privacy and security protocols for AI systems is imperative. The report offers suggestions for reducing the risks associated with the increasing use of AI systems in the medical sector. These include increasing AI literacy, implementing a participatory society-in-the-loop management strategy, and creating ongoing education and auditing systems. Integrating ethical principles and cultural values into the design of AI systems can help reduce healthcare disparities and improve patient care. Implementing these recommendations will ensure the efficient and equitable use of AI systems in medicine, improve the quality of healthcare services, and ensure patient safety.

Nursing education holds a history framed in white supremacy and whiteness. Efforts to employ antiracist strategies have been hindered, largely due to an inability for faculty to acknowledge and hold accountability for racialized harms that occur within nursing educational structures. A nurse-midwifery program in the Pacific Northwest United States uncovered harm that impacted students and identified a need to respond and hold accountability. Guided by the framework of Transformative Justice, a truth and reconciliation process was implemented as a first step to better address racism within nursing and nurse-midwifery education. This paper describes the process to support other institutions in their work to address harms within nursing education.

UNASSIGNED: Translating health policy into effective implementation is a core priority for responding effectively to the tuberculosis (TB) crisis. The national TB Recovery Plan was developed in response to the negative impact that the COVID-19 pandemic had on TB care in South Africa. We aimed to explore the implementation of the TB Recovery Plan and develop recommendations for strengthening accountability for policy implementation for this and future TB policies.
UNASSIGNED: We interviewed 24 participants working on or impacted by TB policy implementation in South Africa. This included perspectives from national, provincial, and local health department representatives, civil society, and community representatives. In-depth interviews were conducted in English and isiXhosa and we drew on reflexive thematic methods for analysis.
UNASSIGNED: Participants felt that there was potential for COVID-19 innovations and urgency to influence TB policy development and implementation, including the use of data dashboards. Implementation of the TB Recovery Plan predominantly used a top-down approach to implementation (cascading from national policy to local implementers) but experienced bottlenecks at provincial level. Recommendations for closing the TB policy-implementation gap included using phased implementation and enhancing provincial-level accountability. Civil society organisations were concerned about the lack of provincial implementation data which impeded advocacy for improved accountability and inadequate resourcing for implementation. Community health workers were viewed as key to implementation but were not engaged in the policy development process and were often not aware of new TB policies. At local level, there were also opportunities to strengthen community engagement in policy implementation including through community-led monitoring. Participants recommended broader multi-stakeholder engagement that includes community and community health worker representatives in the development and implementation phases of new TB policies.
UNASSIGNED: Communities affected by TB, with the support of civil society organisations, could play a bigger role in monitoring policy implementation at local level and need to be capacitated to do this. This bottom-up approach could complement existing top-down strategies and contribute to greater accountability for TB policy implementation.
UNASSIGNED: The online version contains supplementary material available at 10.1186/s44263-024-00077-y.

OBJECTIVE: This paper examines the availability of legal provisions, or the lack thereof, that support women to progress equitably into leadership positions within the health workforce in India and Kenya.
METHODS: We adapted the World Bank\'s Women, Business and Law framework of legal domains relevant to gender equality in the workplace and applied a \'law cube\' to analyse the comprehensiveness, accountability and equity and human rights considerations of 27 relevant statutes in India and 11 in Kenya that apply to people in formal employment within the health sector. We assessed those laws against 30 research-validated good practice measures across five legal domains: (1) pay; (2) workplace protections; (3) pensions; (4) care, family life and work-life balance; and (5) reproductive rights. In India, the pension domain and related measures were not assessed because the pension laws do not apply to the public and private sector equally.
RESULTS: Several legal domains are addressed inadequately or not at all, including pay in India, reproductive rights in Kenya and the care, family life and the work-life balance domain in both countries. Additionally, we found that among the Kenyan laws reviewed, few specify accountability mechanisms, and equity and human rights measures are mainly absent from the laws assessed in both countries. Our findings highlight inadequacies in the legal environments in India and Kenya may contribute to women\'s under-representation in leadership in the health sector. The absence of specified accountability mechanisms may impact the effective implementation of legislation, undermining their potential to promote equal opportunities.
CONCLUSIONS: Government action is needed in both countries to ensure that legislation addresses best practice provisions, equity and human rights considerations, and provides for independent review mechanisms to ensure accountability for implementation of existing and future laws. This would contribute to ensuring that legal environments uphold the equality of opportunity necessary for realising gender justice in the workplace for the health workforce.
UNASSIGNED: Bill & Melinda Gates Foundation (INV-031372).

A recent comment by Boivin et al. urges academia and governments to address sexism and fight bias at higher education and research institutions as losing female academics is costing science and society too much. Herein, I discuss further underlying reasons of sexism in academia and the importance of a deep dive into the causes of inequity at individual faculty and school levels to develop bespoke and enforceable gender equity plans, the importance of not using basic statistic as the only tool to measure equity/inequity as well as how key performance indicators could be better used to advance gender equity and end sexism in academia.

So-called \"middle authors,\" being neither the first, last, nor corresponding author of an academic paper, have made increasing relative contributions to academic scholarship over recent decades. No work has specifically and explicitly addressed the roles, rights, and responsibilities of middle authors, an authorship position which we believe is particularly vulnerable to abuse via growing phenomena such as paper mills. Responsible middle authorship requires transparent declarations of intellectual and other scientific contributions that journals can and should require of co-authors and established guidelines and criteria to achieve this already exist (ICMJE/CRediT). Although publishers, editors, and authors need to collectively uphold a situation of shared responsibility for appropriate co-authorship, current models have failed science since verification of authorship is impossible, except through blind trust in authors\' statements. During the retraction of a paper, while the opinion of individual co-authors might be noted in a retraction notice, the retraction itself practically erases the relevance of co-author contributions and position/status (first, leading, senior, last, co-corresponding, etc.). Paper mills may have successfully proliferated because individual authors\' roles and responsibilities are not tangibly verifiable and are thus indiscernible. We draw on a historical example of manipulated research to argue that authors and editors should publish publicly available, traceable contributions to the intellectual content of an article-both classical authorship or technical contributions-to maximize both visibility of individual contributions and accountability. To make our article practically more relevant to this journal\'s readership, we reviewed the top 50 Q1 journals in the fields of biochemistry and pharmacology, as ranked by the SJR, to appreciate which journals adopted the ICMJE or CRediT schools of authorship contribution, finding significant variation in adhesion to ICMJE guidelines nor the CRediT criteria and wording of author guidelines.

BACKGROUND: Equitable inclusion of low-income and middle-income country (LMIC) researchers and women in research authorship is a priority. A review of progress in addressing WHO-identified priorities provided an opportunity to examine the geographical and gender distribution of authorship in herpes simplex virus type-2 (HSV-2) research.
METHODS: Publications addressing five areas prioritised in a WHO workshop and published between 2000 and 2020 were identified. Data on author country, gender, authorship position and research funding source were collected by manuscript review and internet searches and analysed using IBM SPSS V.26.
RESULTS: Of, 297 eligible papers identified, (n=294) had multiple authors. Of these, 241 (82%) included at least one LMIC author and 143 (49%) and 122 (41%) had LMIC first and last authors, respectively. LMICs funded studies were more than twice as likely to include an LMIC first or last author as high-income country-funded studies (relative risk 2.36, 95% CI 1.93 to 2.89). Respectively, 129 (46%) and 106 (36%) studies had female first and last authors. LMIC first and last authorship varied widely by HSV-2 research area and increased over time to 65% and 59% by 2015-2020.
CONCLUSIONS: Despite location of the research itself in LMIC settings, over the 20-year period, LMIC researchers held only a minority of first and last authorship positions. While LMIC representation in these positions improved over time, important inequities remain in key research areas and for women. Addressing current and historical power disparities in global health research, research infrastructure and how it is funded may be key addressing to addressing these issues.