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The Agendas of Tibetan Refugees: Survival Strategies of a Government-in-Exile in a World of Transnational Organizationsby Thomas Kauffmann New York: Berghahn, 2015, pp. 226

The volume aims to capture a European gist of theoretical sensibilities, conceptual resources, and research interests, but not in an adversarial way, as opposed to American bioethics. The volume gathers contributions from European scholars as they collaborate and form a research network, drawing on a diversity of philosophical traditions and local knowledge, with the aim of debating universal bioethical problems.

Early release of seriously ill and elderly prisoners is possible in several countries, but only few prisoners gain such exemption. We identified hurdles to the implementation of early release laws in Europe by analyzing legal requirements for such release and with 40 stakeholder qualitative interviews. Provisions are based on prisoners' health status and the ability to care for them in prison. Interviews revealed three barriers: practical hurdles, penological goals, and multiple interests. Finally, early release is obstructed because three justifications are often confounded: compassion, the principle of equivalence, and practical concerns, such as costs and overcrowding.

Most prisoners wish to spend their last days outside prison. Early release of seriously ill and ageing prisoners, commonly termed compassionate release, can be granted based on legal regulations but is rarely successful. The aim of this paper is to present the views of ageing prisoners on compassionate release using qualitative interviews. Participants argued for compassionate release on the grounds of illness and old age, citing respect for human dignity. Their hopes of an early release however often contradicted their actual experiences. Framing these results within Garland's depiction of the criminology of the self and the criminology of the other, it is evident that in reality, the punitive strategy prevails. This strategy explains the rare use of compassionate release and how it negatively impacts prisoners' access to end-of-life care. A possible solution is the welfarist criminology, strongly supported by a human rights approach. Awareness of the dominance of the punitive strategy is crucial for medical personnel as they are best placed to ensure access to end-of-life care for prisoners through compassionate release.

ZusammenfassungDas Projekt Agequake II erhob Daten zur psychischen Gesundheit älterer inhaftierter Personen in der Schweiz, evaluierte die aktuelle Situation deren psychiatrischer Versorgung und untersuchte Optionen zu ethischen, rechtlichen und wirtschaftlichen Lösungen in Bezug auf altersbedingte Probleme. Agequake, benannt nach dem Phänomen der rapide wachsenden Anzahl älterer inhaftierter Personen, ist somit eines der wenigen Forschungsprojekte, das Daten zu der älteren Gefängnispopulation liefert und Ergebnisse zur Erweiterung des Wissens über diese wenig erforschte Gruppe beisteuert. Die Ergebnisse tragen zum besseren Verständnis der Lebensrealitäten gefangener älterer Personen bei, bieten Strategien zur Verbesserung derer physischer und psychischer Gesundheitsversorgung und zur Verringerung der Belastung des Gefängnispersonals und der größeren Öffentlichkeit.

Background: Various types of computational technologies can be used to access, store and wirelessly share private and sensitive user-related information. The 'big data' provided by these technologies may enable researchers and clinicians to better identify behavioral patterns and to provide a more personalized approach to care. The information collected, however, can be misused or potentially abused, and therefore could be detrimental to the very people who provided their medical data with the hope of improving care. This article focuses on the use of emerging mobile technologies that allow the collection of data about patients experiencing schizophrenia spectrum and related disorders. Schizophrenia has been recognized by the Sustainable Development Goals of the United Nations for its burden on our health care system and society [1]. Our analysis provides an overview of the range of available mobile technologies for people with schizophrenia and related conditions along with the technology's reported capabilities and limitations, and efficacy of mHealth interventions based on the data from articles. Thus, the focus of this review is first and foremost to update the scope of existing technologies as previous systematic reviews such as the ones by Alvarez-Jimenez et al. and by Firth and Torous are outdated [2, 3]. Although we also examine the ethical issues arising from the use of these technologies, for an in-depth analysis of the ethical implications of mobile Health technologies (mHealth), we refer the readers to our follow-up article. In terms of the ubiquitous availability of technology on the internet, our article summarizes significant information for mental health specialists and apprises the reader about the existence of these technologies. Objectives: In terms of the ubiquitous availability of technology on the internet, our article summarizes significant information for mental health specialists and apprises the reader about the existence of these technologies.

Introduction: Health research is gradually embracing a more collectivist approach, fueled by a new movement of open science, data sharing and collaborative partnerships. However, the existence of systemic contradictions hinders the sharing of health data and such collectivist endeavor. Therefore, this qualitative study explores these systemic barriers to a fair sharing of health data from the perspectives of Swiss stakeholders. Methods: Purposive and snowball sampling were used to recruit 48 experts active in the Swiss healthcare domain, from the research/policy-making field and those having a high position in a health data enterprise (e.g., health register, hospital IT data infrastructure or a national health data initiative). Semi-structured interviews were then conducted, audio-recorded, verbatim transcribed with identifying information removed to guarantee the anonymity of participants. A theoretical thematic analysis was then carried out to identify themes and subthemes related to the topic of systemic fairness for sharing health data. Results: Two themes related to the topic of systemic fairness for sharing health data were identified, namely (i) the hypercompetitive environment and (ii) the legal uncertainty blocking data sharing. The theme, hypercompetitive environment was further divided into two subthemes, (i) systemic contradictions to fair data sharing and the (ii) need of fair systemic attribution mechanisms. Discussion: From the perspectives of Swiss stakeholders, hypercompetition in the Swiss academic system is hindering the sharing of health data for secondary research purposes, with the downside effect of influencing researchers to embrace individualism for career opportunities, thereby opposing the data sharing movement. In addition, there was a perceived sense of legal uncertainty from legislations governing the sharing of health data, which adds unreasonable burdens on individual researchers, who are often unequipped to deal with such facets of their data sharing activities.

INTRODUCTION The digitalization of medicine has led to a considerable growth of heterogeneous health datasets, which could improve healthcare research if integrated into the clinical life cycle. This process requires, amongst other things, the harmonization of these datasets, which is a prerequisite to improve their quality, re-usability and interoperability. However, there is a wide range of factors that either hinder or favor the harmonized collection, sharing and linkage of health data. OBJECTIVE This systematic review aims to identify barriers and facilitators to health data harmonization-including data sharing and linkage-by a comparative analysis of studies from Denmark and Switzerland. METHODS Publications from PubMed, Web of Science, EMBASE and CINAHL involving cross-institutional or cross-border collection, sharing or linkage of health data from Denmark or Switzerland were searched to identify the reported barriers and facilitators to data harmonization. RESULTS Of the 345 projects included, 240 were single-country and 105 were multinational studies. Regarding national projects, a Swiss study reported on average more barriers and facilitators than a Danish study. Barriers and facilitators of a technical nature were most frequently reported. CONCLUSION This systematic review gathered evidence from Denmark and Switzerland on barriers and facilitators concerning data harmonization, sharing and linkage. Barriers and facilitators were strictly interrelated with the national context where projects were carried out. Structural changes, such as legislation implemented at the national level, were mirrored in the projects. This underlines the impact of national strategies in the field of health data. Our findings also suggest that more openness and clarity in the reporting of both barriers and facilitators to data harmonization constitute a key element to promote the successful management of new projects using health data and the implementation of proper policies in this field. Our study findings are thus meaningful beyond these two countries.

BACKGROUND: The availability of palliative care facilities for children vary considerably among the European member states. In Romania, a country where health expenditure is among the lowest in Europe, palliative care has been mainly provided by charitable organizations. Despite the high number of children needing palliative care, there is scant literature and research available on paediatric palliative care in Romania. The study explores the viewpoints of various paediatric oncology providers with regard to paediatric palliative care provision in Romania. METHODS: Four mixed focus groups were conducted at four university-affiliated paediatric oncology centres located in three distinct Romanian regions (Bucuresti-llfov, Nord-Est and Nord-Vest). The focus groups were analyzed using thematic coding. RESULTS: For many healthcare professionals, emotional burden inherent to the profession; unhealthy work-life balance and understaffing were among the biggest barriers to the successful integration of pediatric palliative care. The lack of staff was attributed to a shortage of financial resources, and to the persisting cultural stigma surrounding palliative care and oncology. Also political turmoil was identified as an important obstacle to palliative care implementation. CONCLUSION: Significant barriers persist limiting the broader implementation of pediatric palliative care in Romania. In order to render palliative care in pediatric oncology more sustainable, more attention should be paid to the mental health care of healthcare professionals working in this field, to the development of mobile palliative care services and to the emigration of skilled medical staff.