scholarly journals DID in resurgence, not retreat

2019 ◽  
Vol 25 (05) ◽  
pp. 296-298
Author(s):  
Pamela Radcliffe ◽  
Keith Rix
Keyword(s):  
Professional Training ◽  
Dissociative Identity Disorder ◽  
Human Memory ◽  
Diagnosis And Treatment ◽  
Guidance Document ◽  
Treatment Model ◽  
Potential Harm ◽  
Treatment Techniques ◽  
Dissociative Amnesia ◽  
Randomised Controlled

SUMMARYContrary to the assertion of Paris, diverse indicators suggest that the diagnosis and treatment of dissociative identity disorder (DID) are resurgent rather than retreating. This commentary reviews the evidence that justifies the description of this condition as controversial, including research into dissociative amnesia. The potential harm that can result from a diagnosis of DID and risky treatment techniques, including hypnosis and abreaction, are described. It is suggested that this scientifically unproven and potentially harmful treatment model should be confronted and quelled and its diagnosis and treatment subjected to critical clinical review, including randomised controlled trials, as a matter of urgency. A plea is made for the Royal College of Psychiatrists to update its 1997 guidance document and for professional training to incorporate updated psychological and neurobiological research on human memory.DECLARATION OF INTERESTNone.

scholarly journals The Application of Dynamic Uncertain Causality Graph Based Diagnosis and Treatment Unification Model in the Intelligent Diagnosis and Treatment of Hepatitis B

Symmetry ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1185
Author(s):  
Nan Deng ◽  
Qin Zhang
Keyword(s):  
Hepatitis B ◽  
Response Probability ◽  
Logic Gates ◽  
Current Treatment ◽  
Subsequent Treatment ◽  
Diagnosis And Treatment ◽  
Treatment Model ◽  
Treatment Scheme ◽  
Treatment Plans ◽  
Dynamic Uncertain Causality Graph

Although hepatitis B is widespread, it is hard to cure. This paper presents a new and more accurate model for the diagnosis and treatment of hepatitis B. Based on previous research, the diagnosis and treatment modes were combined into one. By adding more influencing factors and risk factors, the overall diagnosis and treatment model will be further expanded, and a richer and more detailed overall diagnosis and treatment model will be constructed. Reverse logic gates are used in the model to improve the accuracy of the treatment planning. The new unified model is more accurate in subdividing diagnosis results, and it is more flexible and accurate in providing dynamic treatment plans. The prediction process and the static diagnosis process of the model are symmetric, and the related sub-graph is symmetric in structure. In addition, an algorithm for predicting the response probability of treatment scheme is developed, so as to predict the subsequent treatment effects of the current treatment scheme, such as the probability of drug resistance. The results show that this method is more accurate than other available systems, and it has encouraging diagnostic accuracy and effectiveness, which provides a promising help for doctors in diagnosing hepatitis B.

Dissociative Amnesia and Dissociative Identity Disorder

2021 ◽  
Vol 11 (73) (1) ◽  
pp. 207-216
Author(s):  
Bogdan Eduard Patrichi ◽  
Cristina Ene ◽  
Cristina Rîndaşu ◽  
Arina Cipriana Trifu
Keyword(s):  
Life Events ◽  
Dissociative Identity Disorder ◽  
Current Paper ◽  
Dissociative Disorders ◽  
Contemporary Society ◽  
Traumatic Life Events ◽  
Dissociative Amnesia ◽  
The Individual ◽  
The Mind

The current paper aims to describe and exemplify the pathology that is increasingly common in contemporary society, compared to the Freudian period in which repression was dominating. Dissociative disorders are usually associated with overwhelming stress, which can be generated by traumatic life events, accidents or disasters experienced directly or witnessed by the individual, or unbearable inner conflicts, which force the mind to separate incompatible or unacceptable pieces of information and feelings.

scholarly journals Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial

2019 ◽  
Vol 29 (2) ◽  
pp. 122-134 ◽  
Author(s):  
Erik Lenguerrand ◽  
Cathy Winter ◽  
Dimitrios Siassakos ◽  
Graeme MacLennan ◽  
Karen Innes ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Apgar Score ◽  
Professional Training ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Stepped Wedge ◽  
Unit Level ◽  
Positive Effects ◽  
Training Package ◽  
Randomised Controlled

ObjectiveTo assess whether the implementation of an intrapartum training package (PROMPT (PRactical Obstetric Multi-Professional Training)) across a health service reduced the proportion of term babies born with Apgar score <7 at 5 min (<75mins).DesignStepped-wedge cluster randomised controlled trial.SettingTwelve randomised maternity units with ≥900 births/year in Scotland. Three additional units were included in a supplementary analysis to assess the effect across Scotland. The intervention commenced in March 2014 with follow-up until September 2016.InterventionThe PROMPT training package (Second edition), with subsequent unit-level implementation of PROMPT courses for all maternity staff.Main outcome measuresThe primary outcome was the proportion of term babies with Apgar<75mins.Results87 204 eligible births (99.2% with an Apgar score), of which 1291 infants had an Apgar<75mins were delivered in the 12 randomised maternity units. Two units did not implement the intervention. The overall Apgar<75mins rate observed in the 12 randomised units was 1.49%, increasing from 1.32% preintervention to 1.59% postintervention. Once adjusted for a secular time trend, the ‘intention-to-treat’ analysis indicated a moderate but non-significant reduction in the rate of term babies with an Apgar scores <75mins following PROMPT training (OR=0.79 95%CI(0.63 to 1.01)). However, some units implemented the intervention earlier than their allocated step, whereas others delayed the intervention. The content and authenticity of the implemented intervention varied widely at unit level. When the actual date of implementation of the intervention in each unit was considered in the analysis, there was no evidence of improvement (OR=1.01 (0.84 to 1.22)). No intervention effect was detected by broadening the analysis to include all 15 large Scottish maternity units. Units with a history of higher rates of Apgar<75mins maintained higher Apgar rates during the study (OR=2.09 (1.28 to 3.41)) compared with units with pre-study rates aligned to the national rate.ConclusionsPROMPT training, as implemented, had no effect on the rate of Apgar <75mins in Scotland during the study period. Local implementation at scale was found to be more difficult than anticipated. Further research is required to understand why the positive effects observed in other single-unit studies have not been replicated in Scottish maternity units, and how units can be best supported to locally implement the intervention authentically and effectively.Trial registration numberISRCTN11640515.

Dissociative Disorders

2017 ◽  
Author(s):  
David Matuskey
Keyword(s):  
Dissociative Identity Disorder ◽  
Dissociative Disorders ◽  
Dissociative Amnesia ◽  
Depersonalization Disorder

In this chapter topics related to dissociative disorders are reviewed including dissociative amnesia, dissociative fugue, dissociative identity disorder, depersonalization disorder and derealization disorder

scholarly journals Is untargeted iron supplementation harmful when iron deficiency is not the major cause of anaemia? Study protocol for a double-blind, randomised controlled trial among non-pregnant Cambodian women

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037232
Author(s):  
Jordie AJ Fischer ◽  
Lulu X Pei ◽  
David M Goldfarb ◽  
Arianne Albert ◽  
Rajavel Elango ◽  
...  
Keyword(s):  
British Columbia ◽  
Iron Deficiency ◽  
Research Ethics ◽  
Iron Supplementation ◽  
Double Blind ◽  
Ferritin Concentration ◽  
Potential Harm ◽  
Research Ethics Board ◽  
Randomised Controlled ◽  
Forms Of Iron

IntroductionThe WHO recommends daily oral iron supplementation for 12 weeks in women and adolescents where anaemia prevalence is greater than 40%. However, if iron deficiency is not a major cause of anaemia, then, at best, untargeted iron supplementation is a waste of resources; at worst, it could cause harm. Further, different forms of iron with varying bioavailability may present greater risks of harm.Methods and analysisA 12-week three-arm, double-blind, randomised controlled supplementation trial was conducted in Cambodia to determine if there is potential harm associated with untargeted iron supplementation. We will recruit and randomise 480 non-pregnant women (ages 18–45 years) to receive one of three interventions: 60 mg elemental iron as ferrous sulfate (the standard, commonly used form), 18 mg ferrous bisglycinate (a highly bioavailable iron amino acid chelate) or placebo. We will measure ferritin concentrations (to evaluate non-inferiority between the two forms of iron), as well as markers of potential harm in blood and stool (faecal calprotectin, gut pathogen abundance and DNA damage) at baseline and 12 weeks. Mixed-effects generalised linear models will be used to assess the effect of iron on ferritin concentration and markers of potential harm at 12 weeks.Ethics and disseminationEthical approval was obtained from the University of British Columbia Clinical Research Ethics Board (H18-02610), the Children's and Women's Health Centre of British Columbia Research Ethics Board (H18-02610) and the National Ethics Committee for Health Research in Cambodia (273-NECHR). Findings will be published in peer-reviewed journals, presented to stakeholders and policymakers globally and shared within participants’ communities.Trial registration numberClinicalTrials.gov Registry (NCT04017598).

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