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Persistent Physical Symptoms
Published in James Matheson, John Patterson, Laura Neilson, Tackling Causes and Consequences of Health Inequalities, 2020
It is easy to miss, or dismiss, the possibility of underlying mood disorder in these patients, as they can often be complicated and seem difficult to communicate with. There is a risk of over-normalisation by clinicians (‘well of course they’d be depressed if they have all this pain all the time’). Remember, a good proportion of these patients don’t develop any significant mood disruption. Evidence also shows that patients with MUS can be reluctant to reveal an underlying mental disorder to clinicians, for fear of their symptoms being solely attributed to that and being dismissed as ‘it’s all in their head’. Careful discussion with the patient can help, covering how commonly the two problems present together (appropriate normalisation by the clinician) and how treating one may help the other using previous ideas around central sensitisation and sensation processing.
MATLAB Essentials and Principles of Simple Programming
Published in Pavel Dvorak, Clinical Radiotherapy Physics with MATLAB®, 2018
Effect of normalization. Regardless of official definition, dose profile normalization based on point maximum, robust maximum or CAX dose were all considered in the description of the algorithm and alternative options. It is a simple lab exercise to test sensitivity of the result to the data normalization approach. Results for two sample profiles from Figure 1.3 for simulated normalization levels are shown in Table 1.16. Considering that for FFF beams the CAX and position of dose maximum should be identical, and that for flat beams the overcompensated dip in profile around CAX is around 3% maximum, any associated variation of the result would not be dramatic. However, the point here is that the author of the case study application considered this aspect during testing. Given the data in Table 1.16 and considering the required accuracy of the application too, one could conclude that the issue of normalization is not dramatic. So for practical applications it is reasonable to stick with the original algorithm based on a single point maximum and minimum, provided that data quality is reasonable unless, of course, the CAX normalization is strictly required.
Medical imaging and the intrusive gaze
Published in Lesa Scholl, Medicine, Health and Being Human, 2018
While there is no doubt that advances in medical technologies have extended many lives, they also raise an inconvenient problem: interpretation. Technologically derived evidence is perceived by both patients and most doctors as objective data, and therefore accurate and correct. All data must, however, be interpreted, and this interpretative step is subjective. As medical anthropologists Margaret Lock and Vihn-Kim Nguyen observe, “it is commonly assumed in the medical sciences that the human body is readily standardizable by means of systematic assessments” (2010, 20). This sort of standardisation, or normalisation, might be referred to in Foucauldian terms as a disciplining of patient bodies. Raw objective data requires a human interpreter, someone to decide whether a health problem exists, and if so, how it should be treated. The imperfections of the technology itself aside, interpretation of data destabilises the notion that technologically derived data is purely objective, and inserts a human actor who may make errors. The accuracy of technologically supported medical diagnostics was further destabilised by several studies undertaken from the 1950s to the 2000s providing evidence of observer error, subjective misinterpretation, mechanical error, lack of lab training or regulation, incompetence, or poor inter-professional communication.
Assessment and feedback of the COVID-19 pandemic’s effects on physicians’ day-to-day practices: good knowledge may not predict good behavior
Published in Libyan Journal of Medicine, 2023
Esra Nurlu Temel, Gül Ruhsar Yılmaz, Merve Büyükçelik, Özgür Önal, Onur Ünal, Onur Kaya, Füsun Zeynep Akçam
The guidelines Republic of Turkey Ministry of Health recommend that patient rooms are rearranged to be single rooms to decrease infection risk in non – COVID-19 wards [13,18]. However, the rate of implementing this recommendation by residents decreased significantly in the second year of the pandemic compared to the first year. Various studies have determined factors decreasing conformity to be inappropriate physical conditions of hospitals, deficiency in supervisory hierarchies, and the inability to evaluate the potential risk of the transmission [32,33]. In our hospital, the physical conditions and the increase in the number of patients after the beginning of the normalization process may have had negative effects on assuring and maintaining recommended organizational changes. Another instance where institutional policy has been reflected in the pandemic process is in the difficulty procuring personal protective equipment. Other studies support that this difficulty is related to the strategy for the limited use of resources due to the uncertainty and insecurity brought about by the protracted pandemic process [34,35]. Although this strategy sounds meaningful when there is a limited number of PPE, we believe that hospitals need to be more prepared for epidemic and pandemic conditions.
Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation
Published in Disability and Rehabilitation, 2022
Charlie Giurleo, Amanda McIntyre, Anna Kras-Dupuis, Dalton L. Wolfe
The second and third core components included the following: at the time of the initial assessment, the occupational therapist would screen for sexual health concerns and identify sexual health goals with each patient. The Sexual Rehabilitation Framework [18] was used to guide that goal setting. If a sexual health goal was identified and found to be outside the scope of occupational therapy, the patient was guided to the appropriate team member or referral source (Supplementary Appendix G available upon request). This encounter provided another opportunity for permission-giving and limited information while setting the groundwork for the provision of specific suggestions and referrals for intensive therapy where needed. Specific scripts were also drafted by the implementation team for both nursing and occupational therapy staff to facilitate the instances of permission-giving described above. These scripts are outlined in the Practice Profile. The sexual health domain (goal) was also integrated into every patients’ interdisciplinary plan of care and as such, if a goal was identified, it was reviewed regularly within team rounds along with all other rehabilitation goals. This process further promoted normalization of the practice among health care providers.
Estimation of the Development of Depression and PTSD in Children Exposed to Sexual Abuse and Development of Decision Support Systems by Using Artificial Intelligence
Published in Journal of Child Sexual Abuse, 2022
Ilknur Ucuz, Ali Ari, Ozlem Ozel Ozcan, Ozgu Topaktas, Merve Sarraf, Ozlem Dogan
The computer which CADSS was designed on had a 2.8 GHz processor and 16 GB RAM memory. All program code were written in MATLAB 2018 environment. In the designed CADDS, the gender of the victim, the type of sexual abuse, the age of exposure, the duration until reporting, the time of abuse, the proximity of the abuser to the victim, number of sexual abuse, whether the child is exposed to threats and violence during the abuse, the person who reported the event, and the intelligence level of the victim are used as input parameters. At first, data belonging to the patients were subjected to normalization process. The input of the ANN was the normalized data and two outputs were identified for PTSD and MDD diagnoses. The ANN model used in the study has the characteristics of the Multilayer Perceptron (MLP). The 3-k cross validation method was used to test the success of the designed system. In the 3-k cross validation method the data is divided into three parts. At each stage, one part was used for testing and the second and third parts were used for training. The designed system model is shown in Figure 2.