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Background: To provide a better quality of death for patients at the end of life who choose to die at home and their families, the hospice care team at Taipei Veterans General Hospital has promoted an personalized discharged end-of-life care plan since the initial of 2018. Methods: This study is a retrospective analysis of administrative data. All incoming calls of the 24-hour specialist palliative care emergency telephone advice service records were analyzed. Personal information of any callers or consultants was not registered in the content. Results: A total of 728 telephone consultations was registered during the study period. The content of the consultation of different callers was significantly different (p < 0.001). The decrease in the number of calls from the patients who were discharged from the hospice ward had the largest reduction in proportion, from 80 (19.0%) to 32 (10.5%), There was a significant difference in the identity of the callers between 2017 and 2018 (p = 0.025). The proportion of consultation calls for the management of near-death symptoms significantly reduced from 15.6% to 10.5% (p = 0.027). Conclusions: Though the evidence from this study is not enough to support that the personalized discharged end-of-life care plan might reduce the frequency of dialing 24-hour hotlines by the family members of discharged terminally ill patients. For patients who choose to die at home and their families, the hotlines provide a 24-hour humane support. Thus, we need to conduct relevant research to determine whether the service of this dedicated line meets the needs of patients and their families in the terminal stage.

Background Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region of Denmark. Methods Explanatory simultaneous mixed method with thematic analysis and descriptive statistics was chosen. The study was carried out in an Out-Of-Hours service (OOH) in the Capital Region of Denmark, Copenhagen. Under-triage was defined as Potentially Under-Triaged Calls (PUTC) by specific criteria to an OOH Hotline, and identification by integration of three databases: Medical Hotline database, Emergency number database, including the Ambulance database, and electronic patient records. Distribution of PUTC were carried out using ICD-10 codes to identify diagnosis and main themes identified by qualitative analysis of audio recorded under-triaged calls. Study period was October 15 th to November 30 th 2014. Results Three hundred twenty seven PUTC were identified, representing 0.04% of all calls ( n  = 937.056) to the OOH. Distribution of PUTC according to diagnoses was: digestive (24%), circulatory (19%), respiratory (15%) and all others (42%). Thematic analysis of the voice logs suggested that inadequate communication and non-normative symptom description contributed to under-triage. Discussion The incidence of potentially under-triage is low (0.04%). However, the over-representation of digestive, circulatory, and respiratory diagnoses might suggest that under-triage is related to inadequate symptom description. We recommend that caller and call-handler collaborate systematically on problem identification and negotiate non-normative symptom description. Conclusion The incidence of under-triage is low (0.04%). However, the over-representation of digestive, circulatory, and respiratory diagnoses might suggest that under-triage is related to inadequate symptom description. We recommend that caller and call-handler collaborate systematically on problem identification and negotiate non-normative symptom description.

BackgroundOur regional assisted ventilation service has a cohort of almost 1000 patients receiving Long Term Ventilation (LTV) in the community. The clinical review of these patients has historically been delivered in the outpatient setting, either at the base hospital or at outreach clinics elsewhere in the region. During the early part of the COVID-19 pandemic, it was recognised that face-to-face contact with this shielded group of patients was impractical, therefore the routine outpatient review was replaced with a telephone consultation. Patients who required urgent assessment or review were prioritised, and were seen face-to-face either in the outpatient department or in the community, observing strict infection prevention and control measures in either setting.ObjectiveTo gain an understanding of the perspective of LTV patients about their clinical review being provided by telephone.MethodWe sent a survey to 930 patients asking:Whether they had received a telephone consultation during the last few monthsIf so, to score how helpful the telephone consultation wasWhether they would consider changing some of their future consultations to telephone/videoTo score what their preferred method of consultation would be in the futureResultsWe received feedback from 355 respondents who had participated in a telephone consultation. Most patients (98%) rated their telephone consultation as helpful. 66% would consider changing their future consultation to telephone review. When asked about future management, one third would prefer face-to-face consultation, one third would prefer telephone review and one third would prefer a mixture of both.DiscussionThroughout the COVID-19 pandemic, due to reduced face-to-face clinical contact, LTV patients have demonstrated a significant level of independence in self-managing their health care. This is an opportunity to embrace the flexibility in the way health care delivery has evolved during this time.ConclusionThe patient perspective on how their health care is delivered is critically important. LTV services will continue to need to apply clinical judgement when organising their patient review process, but this feedback demonstrates that most patients would be happy for telephone consultations to replace some, if not all, of the face-to-face review they have previously had.

Stay-at-home orders imposed during Covid-19 have left many victims of intimate partner violence trapped with their abusers and unable to safely connect with services. Certain steps could promote more equitable access to services as a second wave of infections looms.

The charity Marie Curie, which helps terminally ill people and their families, says the staff operating its telephone information line will regularly include nurses. It added clinical support to its information line as a trial in February.

The questions that automated decision-making tools raise are not entirely new, notes Suresh Venkatasubramanian, a theoretical computer scientist at the University of Utah in Salt Lake City. [...]there are even more ways of defining fairness, mathematically speaking: at a conference this February, computer scientist Arvind Narayanan gave a talk entitled '21 fairness definitions and their politics' - and he noted that there were still others. [...]Goel and his colleagues this year launched the Stanford Computational Policy Lab, which is conducting collaborations with government agencies, including the San Francisco District Attorney's office. The California legislature, for instance, has a draft bill that calls for risk-assessment tools to help reduce how often defendants must pay bail - a practice that has been criticized for penalizing lower-income defendants. In May, Ghani and his colleagues released open-source software called Aequitas to help engineers, policymakers and analysts to audit machine-learning models for bias.

The novel coronavirus pneumonia (COVID-19) epidemic has brought serious social psychological impact to the Chinese people, especially those quarantined and thus with limited access to face-to-face communication and traditional social psychological interventions. To better deal with the urgent psychological problems of people involved in the COVID-19 epidemic, we developed a new psychological crisis intervention model by utilizing internet technology. This new model, one of West China Hospital, integrates physicians, psychiatrists, psychologists and social workers into Internet platforms to carry out psychological intervention to patients, their families and medical staff. We hope this model will make a sound basis for developing a more comprehensive psychological crisis intervention response system that is applicable for urgent social and psychological problems.

Background China’s smart home for elderly care emerged in 2008, and had went through four developmental stages which consists of seed stage, start-up stage, development stage and popularization stage. Main text The status quo and development of smart home for elderly care in China is reviewed, and suggestions are provided on how to further develop China’s smart home for elderly care. The focus of China’s policies on smart home for elderly care were different during those four developmental stages. Compared with Western countries, China’s smart home for elderly care is a policy-driven product rather than technology-driven or demand-driven one. In addition, it is quasi-public goods rather than private goods. These unique characteristics of China’s smart home for elderly care not only become the driving force of its rapid development, but also bring many challenges to its development, such as the insufficient demand, the disorderly development, and the waste of public and private resources. Conclusions Although great progress has been made in China’s smart home care, much efforts are still needed to further advance its development. The technical standards for the elderly care services should be formulated as soon as possible and the existing public and private smart home for elderly care platforms should be combined. Enterprises involved in smart home care services should be encouraged to develop new technologies to reduce the cost of products and services provided by smart home for elderly care.

Background During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic. Methods PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist. Results In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 ( n  = 19). Providing psychological support ( n  = 23), reliable information about Covid-19 ( n  = 10), healthcare advices about Covid-19 ( n  = 8), and triage ( n  = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators. Conclusion According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.

As the coronavirus pandemic continues its deadly path, dramatic changes in how people live are reducing some instances of other medical problems. Bryn Nelson writes that the irony may hold valuable lessons for public health