Socio-ethical challenges and opportunities for advancing diversity, equity, and inclusion in digital medicine.

Digitalization in medicine offers a significant opportunity to transform healthcare systems by providing novel digital tools and services to guide personalized prevention, prediction, diagnosis, treatment and disease management. This transformation raises a number of novel socio-ethical considerations for individuals and society as a whole, which need to be appropriately addressed to ensure that digital medical devices (DMDs) are widely adopted and benefit all patients as well as healthcare service providers. In this narrative review, based on a broad literature search in PubMed, Web of Science, Google Scholar, we outline five core socio-ethical considerations in digital medicine that intersect with the notions of equity and digital inclusion: (i) access, use and engagement with DMDs, (ii) inclusiveness in DMD clinical trials, (iii) algorithm fairness, (iv) surveillance and datafication, and (v) data privacy and trust.

Nurses' continuance intention to use electronic health record systems: The antecedent role of personality and organisation support.

Nurses play a crucial role in the adoption and continued use of Electronic Health Records (EHRs), especially in developing countries. Existing literature scarcely addresses how personality traits and organisational support influence nurses' decision to persist with EHR use in these regions. This study developed a model combining the Five-Factor Model (FFM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to explore the impact of personality traits and organisational support on nurses' continuance intention to use EHR systems.

Residents' perceptions of what makes feedback valuable in workplace-based learning: A discrete choice experiment.

Introduction: Research on feedback has shifted emphasis away from its 'delivery' to consideration of the interaction between individual learners and their 'feedback provider'. The complexity inherent in determining whether feedback is perceived as valuable by learners, however, can quickly overwhelm educators if every interaction must be considered completely idiosyncratic. We, therefore, require a better understanding of variability in the ways in which feedback is perceived.

Effectiveness of intra-articular analgesia in reducing postoperative pain after minimally invasive sacroiliac joint fusion: a double-blind randomized controlled trial.

During the first postoperative days following minimally invasive sacroiliac joint fusion (MISJF), patients often report serious pain, which contributes to high utilization of painkillers and prevention of early mobilization. This prospective, double-blind randomized controlled trial investigates the effectiveness of intraoperative SIJ infiltration with bupivacaine 0.50% versus placebo (NaCl 0.

The effectiveness of Function Focused Care among patients acutely admitted to hospital: A stepped wedge cluster trial.

Background: During acute hospital admission, patients often experience loss of functional status. A low level of physical activity is associated with higher levels of loss of functional status. Stimulating physical activity to maintain functional status is considered essential nursing care.

Documentation of shared decision-making in diagnostic testing for dementia in Dutch general practice: A retrospective study in electronic patient records.

Objective: To explore (1) documentation of shared decision-making (SDM) in diagnostic testing for dementia in electronic patient records (EPR) in general practice and (2) study whether documentation of SDM is related to specific patient characteristics.

Methods: In this retrospective observational study, EPRs of 228 patients in three Dutch general practices were explored for the documentation of SDM elements using Elwyn's model (team talk, option talk, decision talk). Patient characteristics (gender, age, comorbidities, chronic polypharmacy, the number of consultations on memory complaints) and decision outcome (wait-and-see, GP diagnostics, referral) were also extracted.

Validation of the Updated "LIfestyle for BRAin health" (LIBRA) Index in the English Longitudinal Study of Ageing and Maastricht Aging Study.

Background: The "LIfestyle for BRAin health" (LIBRA) index was recently updated with three new modifiable factors: hearing impairment, social contact, and sleep (LIBRA2), but has not yet been validated.

Objective: Comparison of the performance of both LIBRA versions in predicting dementia risk.

Methods: Longitudinal data from the English Longitudinal Study of Ageing (ELSA) and the Maastricht Aging Study (MAAS) were used.

Country-level income inequality and risky health behaviors of "golden youth" in the post-Communist countries of Europe: A cluster analysis.

Objective: We aim to study the "golden youth" hypothesis, which suggests that risky behaviors might be prevalent among affluent adolescents in post-Communist countries of Europe (PCCE) with high income inequality.

Methods: We included 71,119 adolescents aged 11-15 from 14 PCCE participating in the Health Behavior in School-aged Children survey 2017/18. A K-means cluster analysis was conducted to group adolescents based on risky behavior.

A comparative analysis of 24-hour movement behaviors features using different accelerometer metrics in adults: Implications for guideline compliance and associations with cardiometabolic health.

Background: Movement behavior features such as time use estimates, average acceleration and intensity gradient are crucial in understanding associations with cardiometabolic health. The aim of this study was to 1) compare movement behavior features processed by commonly used accelerometer metrics among adults (i.e.

The contribution of avoidable mortality to life expectancy differences and lifespan disparities in the European Union: a population-based study.

Background: Twenty years after the 2004 European Union (EU) enlargement, life expectancy differences between established (EMS) and new member states (NMS) remain large. Contributing to this gap are deaths that can be avoided through preventive services or adequate medical treatment. We estimate the impact of reducing avoidable mortality on life expectancy and lifespan disparities in the enlarged EU.

A landscape analysis of digital health technology in medical schools: preparing students for the future of health care.

Although Digital Health Technology is increasingly implemented in hospitals and clinics, physicians are not sufficiently equipped with the competencies needed to optimize technology utilization. Medical schools seem to be the most appropriate channel to better prepare future physicians for this development. The purpose of this research study is to investigate the extent to which top-ranked medical schools equip future physicians with the competencies necessary for them to leverage Digital Health Technology in the provision of care.

The Plasma Glucose Threshold Values Associated with Adverse Pregnancy Outcomes Among Asian Indian Pregnant Women: MAASTHI Birth Cohort Analysis.

Background: To assess the association of adverse pregnancy and infant outcomes with different cut-off levels of glucose intolerance during pregnancy in the MAASTHI cohort.

Design: Pregnant women (n = 1470) underwent Oral glucose tolerance test between 24 and 36 weeks using a 75-g oral glucose load, with plasma glucose estimations measured at fasting and two hours later. Follow-up was done within 72 hours of delivery for recording type of delivery, infant weight, mid-upper arm circumference, and skinfold thickness.

Acceptance and commitment therapy for people with depressive and anxiety symptoms following acquired brain injury: Results of the BrainACT randomized controlled trial.

Objective: This study aimed to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people who experience anxiety and/or depressive symptoms following acquired brain injury.

Methods: The study is a multicentre randomized controlled two-arm parallel trial. In total, 72 people who survived a stroke or traumatic brain injury were randomized into an eight-session ACT or control (i.

Barriers and facilitators to application of treat-to-target management in psoriatic arthritis and axial spondyloarthritis in practice: A systematic literature review.

Objective: To review the evidence on barriers and facilitators to application of treat-to-target (T2T) in axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) in daily practice.

Methods: A systematic search was conducted in MEDLINE/Embase up to December 2023, focusing on axSpA/PsA. Any type of quantitative/qualitative original research was eligible for inclusion if barriers or facilitators to application of T2T were explored.

Sexual and Reproductive Health Rights and Service Use among Undocumented Migrants in the EU: A Systematic Literature Review.

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024.

Stated Preferences of At-Risk Populations for the Treatment of Osteoporosis: A Systematic Review.

Introduction: Poor adherence to anti-osteoporosis treatment is a well-recognized problem, partly due to misalignment with patient preferences. In recent years, several quantitative preference studies have been conducted. This study aimed to systematically review stated preference research to provide a comprehensive overview of patient preferences in osteoporosis, in particular on conditional relative attribute importance and preference heterogeneity.

Early life socioeconomic inequalities and type 2 diabetes incidence: Longitudinal analyses in the Maastricht study.

Aim: Type 2 diabetes (T2D) is a common chronic disease that disproportionally affects groups with a low socioeconomic position (SEP). This study aimed to examine associations between childhood SEP and incident T2D, independent of adult SEP.

Methods: Longitudinal data from The Maastricht Study were used (N=6,727, 55.

Impact of a large-scale event on SARS-CoV-2 cases and hospitalizations in the Netherlands, carnival seasons 2022 and 2023.

Objectives: The COVID-19 pandemic highlights the importance of understanding facilitators for disease transmission. Events such as Carnival, characterized by large gatherings and extensive social interactions, have the potential to become 'super spreading events' for respiratory infections. This paper aims to assess the impact of large gatherings on virus transmission, providing crucial insights for the development of effective public health strategies.

Do poor psychosocial resources mediate health inequalities in type 2 diabetes mellitus? Findings from the Maastricht study.

Low socioeconomic position (SEP) has been identified as a risk factor for type 2 diabetes mellitus (T2DM), and psychosocial resources might be on the pathway in this association. We examined two poor psychosocial resources, low control beliefs and inferiority beliefs, that might link low SEP with T2DM. 8292 participants aged 40-75 living in Southern Netherlands participated in The Maastricht Study starting from September 2010 to October 2020 and were followed up to 10 years with annual questionnaires.

Tools and Strategies to Integrate Multi-Domain Information for Personalized Decision-Making in Oncological Care Pathways: A Scoping Review.

Introduction: There is a growing interest in personalized decision-making in oncology. According to the Integrated Oncological Decision-Making Model (IODM), decisions should be based on information from three domains: (1) medical technical information, (2) patients' general health status and (3) patients' preferences and goals. Little is known about what kind of tool/strategy is used to collect the information, by whom this is collected (nurse, clinician) when this is collected (moment in the care pathway), and how this information should be collected and integrated within decision-making in oncological care pathways, and what its impact is.