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Artificial intelligence (AI) offers potential strategies to address existing challenges facing health systems in the United States (U.S.). However, the development of the AI market for health care over the past decade also poses risks to public value in the short- and long-term. In this commentary, we describe the nature of large technology companies’ interface with health care in the U.S., outlining their roles in the context of their leadership in the platform economy. First, we describe the risks associated with the potential dominance of Big Tech companies in healthcare and outline the short-term context for regulating AI as it relates to Big Tech’s role in healthcare. We then explore the possibilities of regulatory approaches that might encourage the anticipation of risks and enforcement of responsible technology practices while retaining the goal of enhancing public value as a primary aim of healthcare policy. [ABSTRACT FROM AUTHOR]

Aims: The HypoCOMPaSS multi‐centre trial achieved improvement in hypoglycaemia awareness and 20‐fold reduction in severe hypoglycaemia (SH) in a cohort with long‐standing type 1 diabetes (T1D). All participants received 'my hypo compass' (MHC) brief structured psycho‐educational intervention in addition to optimisation of insulin delivery/glucose monitoring. In this 24‐week, prospective, single‐centre feasibility RCT, we piloted MHC as a sole intervention in comparison to standard clinical care alone (CON). Methods: Participants with T1D and impaired hypoglycaemia awareness (IAH) (Clarke score ≥4) were recruited. MHC comprised a group/individual 1–2 h face‐to‐face session followed by a telephone call and second face‐to‐face session at 4 weeks. Outcome measures at 24 weeks were compared with baseline. Results: Fifty‐two individuals provided consent for screening with 39 fulfilling eligibility criteria. Fifteen withdrew before any study intervention. Twenty‐four adults with (mean ± SD) T1D duration 41.0 ± 15.1 years commenced/completed the study (100% visit attendance); 12 randomised to MHC and 12 to CON. All had IAH at baseline and at 24 weeks. Annualised SH rate following MHC was 3.8 ± 19.0 (24 weeks) versus 12.6 ± 3.5 (Baseline) and in CON group 2.0 ± 19.0 (24 weeks) versus 4.6 ± 11.5 (Baseline). 'Immediate Action' for and 'Worry' about hyperglycaemia measured by the Hyperglycaemia Avoidance Scale appeared lower following MHC. Participants attended all study visits and reflected positively on the MHC intervention. Conclusions: Feasibility of MHC implementation without additional intervention has been demonstrated. MHC education was associated with positive changes in attitudes and behaviours with the potential to reduce SH risk. MHC provides a validated, simple, well‐received programme to fulfil the educational component within RCTs targeting problematic hypoglycaemia and as part of holistic clinical care. [ABSTRACT FROM AUTHOR]

Persons living with dementia and their caregivers often face challenges in accessing support for their complex needs. This study aims to understand how program administrators, people living with dementia, unpaid caregivers, and decision-makers perceive specific dementia care programs and whether they are adequately meeting the needs of individuals living with dementia. Forty semi-structured interviews were conducted between 2018 and 2020 in five North American jurisdictions. Three main gaps were identified (1) disconnected system infrastructure, (2) lack of comprehensive services to meet diverse needs, and (3) inconsistent understandings of dementia. Despite having programs in place, there remain significant limitations in systems that could be addressed to adequately meet the needs of individuals living with dementia and their caregivers. [ABSTRACT FROM AUTHOR]

Introduction: Cadaveric dissection shapes the ways in which healthcare students understand the human body and the attitudes, identities and behaviors they exhibit as health professionals. There is however a paucity of related research with physiotherapy (PT) students. Purpose: The purpose of this interpretivist study was to investigate PT students' conceptions of the human body in relation to experiences with human cadavers in anatomy education. Methods: Ten semi-structured interviews were conducted with PT students along with four optional written reflections completed. Data was thematically analyzed. Results: Students engaged in a continuous process of habituation involving oscillation between "humanization" and "dehumanization" of cadavers in the anatomy lab. We describe the contextual mediators that shaped the process, the multi-sensory and emotional experience of the students, and the "interruptions" that contributed to the variability in their conceptions over time and contexts. Students ultimately habituated toward dehumanization which had multiple effects on learning and professionalization. Conclusion: Study findings highlight the complexity of PT students' experiences and learning within the cadaver lab outside of the formal goals of anatomy education. We discuss the implications for anatomy curricula, including the potential advantages of incorporating a biopsychosocial approach. [ABSTRACT FROM AUTHOR]

Among the challenges in delivering integrated health and social care services is the need to attend to the coordination of tasks, roles, activities, and operations, while considering how these efforts are experienced by patients, carers and communities. The literature has noted an important disconnect between how providers and leaders view their efforts to coordinate service delivery, and how patients perceive these efforts on the receiving end. Our team has provided guidance to integrated care efforts in Ontario, Canada by drawing on Goffman's theory of Dramaturgy to help classify the actions of integrated care delivery as linked to the roles individuals play in the delivery of care. Using this framing helps to uncover how "backstage" processes (such as team-functioning, funding models, and digital infrastructures) create a necessary foundation on which "frontstage" actions (or performances) can be effectively delivered. [ABSTRACT FROM AUTHOR]