This study examines public perceptions of the brand images of Grab and Gojek, leading online transportation platforms in Indonesia, as articulated through social media interactions during the 2024 online transportation strikes, which disrupted essential urban mobility services, constituted a crisis that required rapid and strategic responses from both companies. Beyond drawing attention to drivers’ working conditions, the events underscored the central role of social media in shaping and reflecting public sentiment toward corporations in crisis. Adopting a qualitative interpretive approach, this research applies the Social-Mediated Crisis Communication (SMCC) model to analyses how audience responses influenced public evaluations of Grab and Gojek, thereby emphasizing the importance of effective crisis communication in safeguarding brand reputation. The questions: How did the public perceive the drivers’ strikes and demonstrations based on social media discourse?, What crisis communication strategies did Grab and Gojek employ in response to the social media crisis?. The findings indicate strong public empathy toward drivers’ demands and declining trust in both platforms, with some users considering alternative services. In response, Grab and Gojek emphasized openness to dialogue and feedback to foster mutual understanding. The study further highlights the necessity of government involvement in establishing comprehensive regulatory frameworks to support all stakeholders.
Alaa O. Khadidos, Hariprasath Manoharan, Shitharth Selvarajan
et al.
Abstract In this paper, the effective transportation units that provides secured data transmission using a communication protocol is examined. Since the development phase of vehicle connectivity is present with low reliability the proposed method examines the security of each transportation unit by using twin representations. Moreover to analyze exact characteristics of transportation units similarity index is measured by using artificial intelligence algorithm thereby individual node connections are represented with Internet of Things (IoT). An analytical representation with dynamic transportation units are provided with different parameters where at minimized energy rates it is possible to transmit the data for included vehicular systems. The outcome of projected model is examined in terms of attacks, trust values, interference and congestion and a comparison is Made with existing approach. From the comparison outcome the proposed method proves to provided improved security with reduced congestion rate of 4% for each transmitted packets. In addition, the comparison results proves that with reduced interference of 0.003% effective data transmission can be utilized for all connected transportation units.
With the rapid development of intelligent transportation systems, voice assistants are increasingly integrated into driving environments, providing an effective means to mitigate the risks of fatigued driving. This study explored drivers’ interaction preferences with voice assistants under different fatigue states and proposed a fatigue-state-based dialogue-awakening mechanism. Using Grounded Theory and the Stimulus–Organism–Response (SOR) framework, in-depth interviews were conducted with 25 drivers from diverse occupational backgrounds. To validate the qualitative findings, a driving simulation experiment was carried out to examine the effects of different voice interaction styles on driver fatigue arousal across various fatigue levels. Results indicated that heavily fatigued drivers preferred highly stimulating and interactive voice communication; mildly fatigued drivers tended toward gentle and socially supportive dialogue; while drivers in a non-fatigued state preferred minimal voice interference, activating voice assistance only when necessary. Significant occupational differences were also observed: long-haul truck drivers emphasized practicality and safety in voice assistants, taxi drivers favored voice interactions combining navigation and social content, and private car owners preferred personalized and emotional support. This study enriches the theoretical understanding of fatigue-sensitive voice interactions and provides practical guidance for the adaptive design of intelligent voice assistants, promoting their application in driving safety.
This research presents the development of an intelligent control platform for continuous coal mining equipment in open-pit mines, aimed at enhancing operational efficiency, reducing labor intensity, and advancing automation. The platform integrates advanced technologies, including dual-ring network transmission, network security protocols, multi-machine cooperative control, digital twin modeling, and big data analytics, facilitating effective coordination among coal miners, transfer machines, unloaders, and conveyors for seamless continuous mining operations.Three critical technical challenges are addressed: ① The implementation of dual-ring network transmission technology reduces data transmission latency and enhances network stability. ② A secure network transmission framework has been developed to safeguard data confidentiality and integrity. ③ The multi-machine cooperative control system incorporates data acquisition, process control, and 3D visualization modules, employing real-time monitoring and optimized control algorithms to boost mining and transportation efficiency while ensuring the continuity of multi-machine operations. Leveraging digital twin theory, a synchronized multi-machine digital twin system is constructed to address data integration and real-time responsiveness issues prevalent in open-pit mining. A unified communication standard is established to support diverse protocols, ensuring robust information sharing among equipment. Additionally, edge computing technology is utilized for rapid field data processing, minimizing latency and facilitating real-time analysis and decision-making. This significantly enhances monitoring and control capabilities, achieving a high degree of synchronization between the digital model and physical operations. The platform delivers multiple functionalities, including comprehensive multi-machine synchronous monitoring, online fault self-diagnosis, and early warning systems, alongside improved multi-machine cooperative control efficiency. Test results indicate that the platform successfully achieves multi-machine synchronous control, with a data packet loss rate of ≤ 0.25% and latency of ≤ 2 seconds, enabling coal extraction of 11 meters with an annual production capacity of 130000 tons, while maintaining a failure-free rate of up to 90% during continuous operation. All functionalities align with actual production requirements.
Marta Rinaldi, Mario Caterino, Stefano Riemma
et al.
<i>Background</i>: Emergency scenarios present unprecedented challenges for supply chains worldwide, particularly in the management and distribution of critical supplies, where timely delivery and maintaining integrity are crucial. <i>Methods:</i> This article explores an innovative approach to enhance the emergency management of supply chains using blockchain technology and simulation-based modelling. The proposed methodology aims to tackle issues such as transparency, efficiency, and security, which are vital for managing logistics during crises. A case study involving a vaccine rollout is used to demonstrate how blockchain can optimise supply chain operations, reduce bottlenecks, and ensure better traceability and accountability throughout the process. The case study is specifically developed based on the distribution of COVID-19 vaccines in Italy. <i>Results:</i> The integration of blockchain technology not only enhances data integrity and security but also facilitates real-time monitoring and decision-making. <i>Conslusions:</i> The findings suggest that the proposed blockchain-based model can significantly improve supply chain resilience in emergency situations compared to traditional methods, thereby offering valuable insights for policymakers and supply chain managers facing future crises.
Transportation and communication, Management. Industrial management
Joshua Oppong, Bridget Setornyo Letsa, Gifty Botwey
et al.
Introduction Health systems globally face challenges, including geographical barriers, and inadequate health workers. Telemedicine has turned up as a potential solution to bridge these gaps, relying on technology to enhance healthcare accessibility and improve the quality of health services. A relatively unexplored area in Ghana, the adoption of telemedicine in healthcare delivery has great potential to address health inequalities in the country. We explored the implementation of telemedicine using the Hub and Spokes model. Methodology A qualitative case study was conducted among 15 health professionals working at the telemedicine unit in the Hohoe Municipality. Face-to-face in-depth interviews were used in collecting data, which were analyzed thematically using Atlas.ti. Results Telemedicine has significantly improved healthcare accessibility by bridging geographical gaps and improving service delivery. The hub has effectively supported the spokes leading to improved patient satisfaction, reduced mortality, and stillbirth rates. However, challenges such as communication barriers (network issues, one-way communication), and logistical constraints (lack of transportation systems, telephones, and funds to buy airtime for calls) militated against effective delivery of services. Despite these challenges, telemedicine holds significant opportunities for improving healthcare delivery by ensuring timely referrals, bridging knowledge gap between practitioners, and enhancing overall service quality and efficiency. Discussion Integrating telemedicine into routine patient care in the Hohoe Municipality has proven beneficial in addressing healthcare inequalities. Telemedicine has enhanced the quality of healthcare and increased accessibility for remote areas by applying HSM. This highlights telemedicine as an important strategy towards achieving universal health coverage (SDG 3.8) by 2030.
Computer applications to medicine. Medical informatics
Paul D. Larson, Robert V. Parsons, Deepika Kalluri
<i>Background</i>: Pressure is growing in North America for heavy-duty, long-haul trucking to reduce greenhouse gas (GHG) emissions, ultimately to zero. With freight volumes rising, improvement depends on zero-emissions technologies, e.g., battery electric vehicles (BEVs) and fuel cell electric vehicles (FCEVs). However, emissions reductions are constrained by technological and commercial realities. BEVs and FCEVs are expensive. Further, BEVs depend on existing electricity grids and FCEVs rely on steam–methane reforming (SMR) or electrolysis using existing grids to produce hydrogen. <i>Methods</i>: This study assembles publicly available data from reputable sources to estimate breakeven vehicle purchase prices under various conditions to match conventional (diesel) truck prices. It also estimates GHG emissions reductions. <i>Results</i>: BEVs face numerous obstacles, including (1) limited range; (2) heavy batteries and reduced cargo capacity; (3) long recharging time; and (4) uncertain hours-of-service (HOS) implications. On the other hand, FCEVs face two primary obstacles: (1) cost and availability of hydrogen and (2) cost of fuel cells. <i>Conclusions</i>: In estimating emissions reductions and economic feasibility of BEVs and FCEVs versus diesel trucks, the primary contributions of this study involve its consideration of vehicle prices, carbon taxes, and electricity grid capacity constraints and demand fees. As electricity grids reduce their emissions intensity, grid congestion and capacity constraints, opportunities arise for BEVs. On the other hand, rising electricity demand fees benefit FCEVs, with SMR-produced hydrogen a logical starting point. Further, carbon taxation appears to be less important than other factors in the transition to zero-emission trucking.
Transportation and communication, Management. Industrial management
Roopa Devi E. M, T. Abirami, Ashit Kumar Dutta
et al.
The progress of autonomous transport systems (ATS) involves efficient multimedia communication for real-time data tradeoffs and environmental issues. Deep learning (DL) powered visual place recognition (VPR) was developed as an effective tool to improve mobile multimedia communication in ATS. VPR relates to the capability of a method or device to recognize and identify particular places or locations from the visual scene. This procedure involves inspecting visual data, like images or video frames, to control the unique features or features connected with diverse locations. By leveraging camera sensors, VPR allows vehicles to detect their surroundings, enabling context-aware communication and enhancing the entire system's performance. DL-empowered VPR offers a transformative manner to improve mobile multimedia communication in ATS. By identifying and understanding their situation, autonomous vehicles can communicate most effectively and operate reliably and safely, paving the way for a future characterized by seamless and intelligent transportation. This article develops a novel Deep Learning-Powered Visual Place Recognition for Enhanced Multimedia Communication in Autonomous Transport Systems (DLVPR-MCATS) methodology. The main aim of the DLVPR-MCATS methodology is to recognize visual places or not utilize optimal DL approaches. For this purpose, the DLVPR-MCATS approach utilizes a bilateral filtering (BF) based preprocessing model. For the feature fusion model, the DLVPR-MCATS approach follows three models: residual network (ResNet), EfficientNet, and MobileNetv2. Moreover, the hyperparameter tuning method uses the Harris Hawks Optimization (HHO) model. Finally, the bidirectional long short-term memory (BiLSTM) technique is implemented to recognize visual places. A wide range of simulations is executed to validate the solution of the DLVPR-MCATS method. The experimental validation of the DLVPR-MCATS method portrayed a superior performance over other models concerning various aspects.
Oleg N. Makarov, Elvira B. Abduryakhimova, Polina S. D'yakova
There are two main methods commonly used for decision-making: multi-criteria analysis (MCA) and cost-benefit analysis (CBA).
The significance of this research lies in the fact that currently, the rationale behind the final decision in choosing among multiple options is often based solely on the anticipated financial and economic outcomes of the project. However, the project itself encompasses other strategic implications that are disregarded during the decision-making process. These include, but are not limited to, social, environmental, cultural, and natural consequences. This paper aims to propose a more comprehensive multi-criteria approach, providing a multi-agent solution for selecting from a diverse range of alternatives that align with national interests.
The objective of this research is to identify the most promising subproject within the scope of the national transport project, considering not only financial aspects but also other crucial factors such as social, cultural impacts, human capital development, the creation of a new environment, the emergence of fresh opportunities, and the dismantling of institutional obstacles.
The paper discusses two main methods used for decision-making in transportation policy: MCA and CBA. A practical experiment was conducted to select and rank promising sub-projects using T. Saaty's hierarchy analysis method, which takes into account the multi-agent approach to the development of transportation systems and their integration with state development in Russia. As part of the study, a practical experiment was conducted to select and rank promising subprojects using the T. Saati method of hierarchical analysis. Criteria for evaluating and prioritizing projects were developed, as well as new tools for future use in public administration of the transport industry.
Research methods and methodology included T. Saati's hierarchical analysis method, statistical analysis, specification, mathematical modeling, and statistical tests.
The main results of the study were the analysis of four existing promising projects: modernization of railway infrastructure, development of high-speed rail communication, modernization of automotive infrastructure, and development of inland waterway transport. Based on these projects, an applied multi-agent toolkit was proposed for decision-making in public transport administration. The results of the study can be used to inform decision-making processes in transport policy and to evaluate the effectiveness and economic feasibility of projects.
The study used methods such as multi-criteria decision analysis (MCDA) and cost-benefit analysis (CBA) to analyze various aspects of transport projects and make informed decisions about their implementation.
Vehicle Ad-hoc network (VANET) can provide technical support and solutions for the construction of intelligent and efficient transportation systems, and the routing protocol directly affects the efficiency of VANET. The rapid movement of nodes and uneven density distribution affect the routing stability and data transmission efficiency in VANET. To improve the local optimality and routing loops of the path-aware greedy perimeter stateless routing protocol (PA-GPSR) in urban sparse networks, a weight-based path-aware greedy perimeter stateless routing protocol (W-PAGPSR) is proposed. The protocol is divided into two stages. Firstly, in the routing establishment stage, the node distance, reliable node density, cumulative communication duration, and node movement direction are integrated to indicate the communication reliability of the node, and the next hop node is selected using the weight greedy forwarding strategy to achieve reliable transmission of data packets. Secondly, in the routing maintenance stage, based on the data packet delivery angle and reliable node density, the next hop node is selected for forwarding using the weight perimeter forwarding strategy to achieve routing repair. The simulation results show that compared to the greedy peripheral stateless routing protocol (GPSR), for the maximum distance–minimum angle greedy peripheral stateless routing (MM-GPSR) and PA-GPSR protocols, the packet loss rate of the protocol is reduced by an average of 24.47%, 25.02%, and 14.12%, respectively; the average end-to-end delay is reduced by an average of 48.34%, 79.96%, and 21.45%, respectively; and the network throughput is increased by an average of 47.68%, 58.39%, and 20.33%, respectively. This protocol improves network throughput while reducing the average end-to-end delay and packet loss rate.
Muhammad Khan, Amal Nasser Alshahrani, Julija Jacquemod
<i>Background:</i> This article’s main goal is to examine how digital platforms and supply chain traceability (SCT) might contribute to robust information and efficient inventory management (EIM); <i>Methods:</i> SmartPLS3 software was used in conjunction with the partial least squares structural equation modeling (PSL-SEM) technique. Using the snowball sampling method, the software was used to collect data from Pakistani supply chain (SC) specialists; <i>Results:</i> According to this study’s conclusions, robust information and inventory management using digital platforms and SC traceability depend greatly on transparency; <i>Conclusions:</i> Even though investing in digital platforms is a complex process including multiple internal and external parties, this study will be helpful for the decision-makers who make such decisions. The paper identifies research gaps and presents the potential for more research while also increasing awareness of digital platforms, traceability, and transparency in the SC system. There is a shortage of empirical evidence on how digital platforms and SCT lead to robust information and EIM through the mediation association of transparency, notwithstanding the abundance of research conducted on SCT and transparency.
Transportation and communication, Management. Industrial management
Photo by National Cancer Institute on Unsplash
ABSTRACT
The COVID-19 pandemic has brought about the advent of many new telehealth technologies as providers have been forced to shift their practice from the clinic to the cloud. Perhaps, none of these fields has been as widely advertised and expanded as telemental health. While many have lauded this change, it is important to question whether this method of practice is truly beneficial for patients, and further whether it benefits all patients. This paper critically examines the current structure of telemental health interventions and compares them to more traditional in-person interactions, reflecting on the unique benefits and challenges of each method, and ultimately concluding that telemental health is the wrong modality for certain patients and modalities.
INTRODUCTION
As the e-health revolution rapidly progresses, scientists, healthcare professionals, and technology experts are attempting to determine which areas of medical practice will best adapt to changing dynamics. Two key professions that are ripe for this kind of disruption are psychiatry and psychology. The American Psychiatric Association, along with its partners in the American Telemedicine Association, states that “telemental health in the form of interactive videoconferencing has become a critical tool in the delivery of mental health care. It has demonstrated its ability to increase access and quality of care, and, in some settings, to do so more effectively than treatment delivered in-person.”[1]
This claim, though appearing bombastic, is also reflected, though with more nuance, by the American Psychological Association. For its part, the American Psychological Association states that “the expanding role of technology and the continuous development of new technologies that may be useful in the practice of psychology present unique opportunities, considerations, and challenges to practice.”[2] Thus, the point of this paper will be to examine whether the rapidly expanding system of telemental health is ethical based on its adherence to accepted standards of care, privacy concerns, and concerns about the boundaries of the patient-provider relationship.
l. Standard of Care Concerns
One of the most considerable objections to the broader implementation of telemental health services is the speculation that it is less effective than in-person treatment. It would follow that a system that is broadly implemented would not only fail to be beneficent, but it would also fail to be non-maleficent. Providers would be knowingly providing an ineffective treatment. Some may argue that such a system would also violate the principle of justice. It would create an unequal system of care in which those patients who could afford to see their therapist in person would benefit more than those who could not. However, data from a wide variety of sources at first glance, would seem to contradict these fears.[3]
A review of the literature regarding the implementation of telemental health in geriatric patients, for example, showed that telemental health was as good as in-patient psychiatric care in several areas, including the diagnosis of dementia, nursing home consultations, and in conducting psychotherapy for geriatric patients and their caregivers.[4] On the other end of the age spectrum, a review of nineteen randomized controlled trials and one clinical trial demonstrated high comparative effectiveness between telemental health interventions in children and adolescents.[5] Hailey et al. found that telemental health interventions were effective in over half of the 65 studies reviewed. These studies encompassed a diverse and wide-ranging number of psychiatric disciplines, including child psychiatry, post-traumatic stress disorder, dementia, cognitive decline, smoking cessation, and eating disorders. Methods included phone- and web-based interventions.[6]
Indeed, the data is not just limited to outpatient settings. For example, Reinhardt et al. conducted a literature review of studies about telemental health visits for psychiatric emergencies and crises. They found that no studies reported a significant statistical difference in diagnosis or disposition among psychiatric patients who presented to the Emergency Department. In addition, their review demonstrated a reduction in length of stay, reduction in time to care, and decreased costs among these patients. The authors also reviewed literature pertaining to crisis response teams and patients with severe mental illness. Both studies demonstrated that telemental health visits for these patients were similar, if not better, than face-to-face visits. In addition, both patients and practitioners showed high satisfaction with these services.[7] Thus, the implementation of telemental health is limited to out-patient settings and could feasibly be implemented in the in-patient and emergency settings.
There is, however, one particularly glaring gap in telemental health services: group therapy. Perhaps the most famous example of group therapy is Alcoholics Anonymous, but group therapy has expanded to include many different modalities. Group therapy is a common intervention for many mental illnesses and can be incredibly effective in treating diseases ranging from PTSD to borderline personality disorder.[8] In a pilot study comparing a video teleconference based Dialectical Behavioral Therapy (DBT) group to an in-person DBT group, Lopez et al. found that while patients had similar levels of cohesion with the facilitator, participants in the video teleconference group saw less group cohesion than their peers in the in-person group. Further, while many patients in the video teleconference group believed that the convenience offset the adverse effects, many also wished for an in-person group. Attendance was also significantly higher in the video teleconference group.[9]
Thus, while the video teleconference group did report some positives, some significant differences raise ethical questions. How well does a group do without cohesion? For example, if a person needing to be consoled breaks down and cries in front of the group, the in-person response may be different from the video conference. In the in-person group, other group members may place a gentle hand on the shoulder of the grieving person or maybe even hug them. The group facilitator or group members in the video conference group could say the same words of consolation as those in the in-person group. However, there still seems to be some missing action. The idea of physical touch, in this way, can mean a lot more than just a small action. Van Wynsberghe and Gastmans argue that this kind of deprivation may lead to feelings of depersonalization.[10] And, to an extent, their supposition is supported by the data presented by Lopez et.al. The low level of group cohesion in the video conference group could suggest that other group members seem unimportant to the participants. They are simply things on a screen, not real people.
Dr. Thomas Insel, former National Institute of Mental Health Director writes that while technology may hold the key to improving mental health on the population level, there is a human-sized piece of the puzzle missing from these interventions. The solution, he asserts, lies somewhere in the integration of these two types of experiences, one that he terms “high-tech and high-touch.”[11] The lack of touch and physical presence is an obstacle for both patients and providers. At best this may lead to a slightly poorer provider-patient relationship and at worst may result in poorer quality care.
ll. Privacy & Confidentiality Concerns
Privacy and confidentiality are among the most serious concerns for practitioners and patients, made more complex by the advent of e-health. Major news outlets provide plenty of examples of breaches of confidentiality of people’s electronic records. Even significant systems, often thought to be secure, used to facilitate direct contact between people in the wake of COVID-19, like Zoom, have been breached. Not too long ago, "Zoom Bombing” was a national phenomenon, appearing in online classrooms, often sharing explicit or politically motivated content.
Psychiatric patients are susceptible to issues surrounding privacy and confidentiality, and they may even come from communities that ostracize and stigmatize mental illness. These concerns must be taken seriously. Of course, both the American Psychiatric Association and the American Psychological Association address privacy concerns. Both organizations note in their guidelines that relevant HIPAA regulations apply to telehealth and doctors must use apps and videoconferencing tools with the highest levels of security.[12]
Interestingly, the American Psychiatric Association takes these instructions one step further. It requires providers to be in a private room during telehealth videoconferences or calls and that people seeking care also have a private space so that any conversations are not overheard. This not only prevents violations of privacy but reassures the therapeutic relationship between provider and patient.[13]
While providers can take these steps to ensure their patients’ privacy, an internet connection may not guarantee privacy. Many privacy issues are more easily mitigated in a clinical space. For example, walls and doors can be soundproofed, or white noise can be played in the waiting room to ensure that therapeutic conversations are not overheard. And while the American Psychiatric Association asks providers to mitigate these risks as they would in their respective clinics, there is another layer to online privacy. Providers should be concerned about telecommunications providers, how they collect information, and what types of information they collect.[14] If, for example, the patient must navigate to the practitioner’s webpage to enter into the therapy portal, that information might be tracked and used to generate personalized ads for the patient. If a person suffering from severe paranoia started receiving ads for psychiatric medication, they may react negatively to the invasion of privacy. That type of targeted advertising could even exacerbate a mental health condition.
The scandals surrounding the National Security Administration (NSA) in recent years have added another layer of complexity to the issue of privacy. Whistleblowers like Edward Snowden, revealed that the government was collecting metadata from text messages, videos, and social media. Government surveillance is an added risk of mental health videoconferencing.[15] The government would not be bound by the rules that require privacy with few exceptions like the Tarasoff law, which could require disclosure to stop a violent act as a clinical care provider. The government might judge someone a risk-based on ill-gotten surveillance data, wrongly add a person to a watch list, or engage in further surveillance of a patient whom non-clinicians working in government assess to be a potential danger. Protection from government surveillance is a fundamental ethical endeavor. Yet government as a collector of data without a warrant or with easily attained FISA and other warrants is problematic. Scenarios may seem far-fetched but are within the realm of possibility.
Secondly, the provider must envision how this might hinder care. For example, patients aware of the possibility of government surveillance may be reluctant to show up to online meetings if they show up at all. Perhaps they are so sensitive to these issues that they stop checking with their therapist altogether. It is easy to see how a person who has schizophrenia and shows signs of paranoia may avoid telehealth for fear of being tracked.
Of course, one could also have privacy concerns about a therapist’s office. Perhaps patients are nervous about being seen in the office or parking lot. They might worry about being overheard. These concerns, however, can be mitigated fairly simply, for example, patients could find anonymous means of transportation and practitioners can soundproof their offices. Thus, in both the office and the videoconference, concerns can be mitigated easily and tangibly, but not eliminated entirely. Mental health providers should use the highest quality communication services with end-to-end encryption to bolster online privacy.
lll. Boundary Issues and Professionalism
The boundaries here are philosophical, not physical. Both the American Psychiatric Association and the American Psychological Association work to ensure that the patient-professional boundaries are kept as close to normal as possible. Both organizations expect practitioners to maintain the highest levels of professionalism when dealing with patients using telemental health services.[16] Practitioners are responsible for enforcing boundaries through informing their patients about appropriate behavior so that patients are discouraged from calling at inappropriate times absent an emergency. Videoconferencing systems and multi-layered protections like passwords and gatekeeping would prevent patients from logging into another patient’s appointment.
These boundaries exist for a good reason. A 2017 report demonstrated that there is an escalating shortage of psychiatrists.[17] Nearly 1 in 5 people in the US has a mental health condition.[18] Mental health providers are nearly overwhelmed, therefore inappropriate, frequent, and unnecessary contact adds another level of complexity to treating patients. Mental health providers need to be stewards of the resource they provide. They must concentrate on the patient they are with. They also must guard themselves against burnout, because dealing with patients too often, even though technology allows for it, will lead to them being less effective for the rest of their patients.
While these professional boundaries must be policed carefully, practitioners should also be careful of having boundaries that are too high. Thus, providers must balance between too much intimacy and too little.[19] Presence and physical touch have symbolic meaning. Being with a person reaffirms their personhood, and both provider and patient can feel that. Humans are relational beings, and a physical relationship often comforts people. It may also legitimize and reinforce the patient through sensation and perception. There may be something inherently missing from the practice of telemental health, as exemplified by the group members’ inability to console others in group therapy sessions over teleconference.[20] The screen may also be an agent of depersonalization. It may make the patient’s complaints seem less real. Or perhaps the patient may feel as though they are not being heard.
Although the evidence of telemedicine’s successes above may seem to contradict this, none of the studies that extoll the benefits of telemental health have follow-up periods greater than one year. And while many studies show that patients are highly satisfied with telemental health, measurements of satisfaction are not standardized. It remains unclear whether patients benefit enough from their telemental sessions or whether they require more regular sessions to stay as satisfied as they were with in-person mental health care. Perhaps as time goes on, patients become more frustrated with telemental health. The research must answer these questions, but currently, it does not sufficiently address metaphysical arguments against telemental health.
CONCLUSION
Privacy is a key practical issue that remains. Although providers try to combat issues of privacy by using high-level conferencing software, which has end-to-end encryption,[21] surveillance and breaches may occur. While not suitable for all kinds of patients, telemental health services prove to be effective for groups of people that otherwise may not have been able to receive care over the past two years. There are some settings, such as group therapies, that are best suited for in-person meetings. Although online sessions encourage individuals to show up regularly, their downsides are not yet known.
There is incredible power in the idea of presence, and humans are inherently relational beings. For some, a lack of contact is unwelcomed and makes therapy less satisfying. Opportunities to use in-person clinical care remain a priority for some patients, and healthcare providers should further investigate prioritizing in-person care for those who want it. Telemental health could be beneficial for emergencies, natural disasters, vulnerable groups, or when patients cannot get to their provider's office. However, for now, telemental health should not take a leading role in providing mental health treatment.
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[1] Chiauzzi E, Clayton A, Huh-Yoo J. Videoconferencing-Based Telemental Health: Important Questions for the COVID-19 Era from Clinical and Patient-Centered Perspectives. JMIR Ment Health, 2020. doi:10.2196/24021
[2] Joint Task Force for the Development of Telepsychology Guidelines for Psychologists. Guidelines for the practice of telepsychology. American Psychologist, 2020. 791–800. doi.org/10.1037/a0035001
[3] Gentry MT, Lapid MI, Rummans TA. Geriatric Telepsychiatry: Systematic Review and Policy Considerations. Am J Geriatr Psychiatry. 2019 doi: 10.1016/j.jagp.2018.10.009; Campbell R, O'Gorman J, Cernovsky ZZ. Reactions of Psychiatric Patients to Telepsychiatry. Ment Illn. 2015;7(2):6101, 2015. doi:10.4081/mi.2015.6101; Malhotra S, Chakrabarti S, Shah R. Telepsychiatry: Promise, potential, and challenges. Indian J Psychiatry, 2013. doi: 10.4103/0019-5545.105499; Reinhardt I, Gouzoulis-Mayfrank E, Zielasek J. Use of Telepsychiatry in Emergency and Crisis Intervention: Current Evidence. Curr Psychiatry Rep, 2019. doi: 10.1007/s11920-019-1054-8
[4] Gentry, Lapid, and Rummans, Geriatric Telepsychiatry
[5] Abuwalla, Zach & Clark, Maureen & Burke, Brendan & Tannenbaum, Viktorya & Patel, Sarvanand & Mitacek, Ryan & Gladstone, Tracy & Voorhees, Benjamin. Long-term Telemental health prevention interventions for youth: A rapid review, 2017. Internet Interventions. Doi.11. 10.1016/j.invent.2017.11.006.
[6]Hailey D, Roine R, Ohinmaa A. The effectiveness of telemental health applications: a review, 2008. Can J Psychiatry. doi:10.1177/070674370805301109.
[7] Reinhardt, Gouzoulis-Mayfrank, and Zielasek, Use of Telepsychiatry in Emergency and Crisis Intervention
[8] Kealy, David & Piper, William & Ogrodniczuk, John & Joyce, Anthony & Weideman, Rene. Individual goal achievement in group psychotherapy: The roles of psychological mindedness and group process in interpretive and supportive therapy for complicated grief, 2018. Clinical Psychology & Psychotherapy. doi:10.1002/cpp.2346. Schwartze D, Barkowski S, Strauss B, Knaevelsrud C, Rosendahl J. Efficacy of group psychotherapy for posttraumatic stress disorder: Systematic review and meta-analysis of randomized controlled trials. Psychother Res, 2019. doi: 10.1080/10503307.2017.1405168; Wetzelaer P, Farrell J, Evers SM, Jacob GA, Lee CW, Brand O, van Breukelen G, Fassbinder E, Fretwell H, Harper RP, Lavender A, Lockwood G, Malogiannis IA, Schweiger U, Startup H, Stevenson T, Zarbock G, Arntz A. Design of an international multicentre RCT on group schema therapy for borderline personality disorder. BMC Psychiatry, 2014. doi: 10.1186/s12888-014-0319-3
[9] Lopez, Amy et al. “Therapeutic groups via video teleconferencing and the impact on group cohesion.” mHealth, 2020. doi:10.21037/mhealth.2019.11.04
[10] Van Wynsberghe A, Gastmans C. Telepsychiatry and the meaning of in-person contact: a preliminary ethical appraisal. Med Health Care Philos, 2009. doi: 10.1007/s11019-009-9214-y.
[11]Thomas Insel, “Tech Can Help Solve Our Mental Health Crisis. But We Can’t Forget The Human Element.,” Substack newsletter, Big Technology (blog), January 27, 2022, https://bigtechnology.substack.com/p/tech-can-help-solve-our-mental-health.
[12] Armstrong, C. M., Ciulla, R. P., Edwards-Stewart, A., Hoyt, T., & Bush, N. Best practices of mobile health in clinical care: The development and evaluation of a competency-based provider training program, 2018. Professional Psychology: Research and Practice. doi.org/10.1037/pro0000194
[13] Armstrong, C. M., Ciulla, R. P., Edwards-Stewart, A., Hoyt, T., & Bush, N. Best practices of mobile health in clinical care: The development and evaluation of a competency-based provider training program
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Highway users can apprehension to certain subjects with utilizing of Vehicular Ad-hoc Networks (VANET) applications if the rules for safe overtaking movement are violated to make the lane change maneuver between vehicles on the highway road. In our research, we suggest an algorithm for semi-automated vehicles S-AV compliant lane change to emphasize rules for safe overtaking between vehicles on the highway. The proposed algorithm technique classify the safe overtaking into major categories and critically analyzed them depending on various classes of lane change movements between vehicles interrelated to road condition based on different performance criteria; this technique will add awareness to drivers traveling on highway to increasing the comfort and safety of driving. Finally, we have conclude and suggest research issues associated to Vehicular Ad-hoc Networks to investigate and ensure the real-time decision of safe overtaking between vehicles on the highway, which is important research task to motivate researchers to connect the semi-automated vehicles with driver face emotion detection and increase driving safety.