scholarly journals The most important things I have learnt in my career as a psychiatrist

2017 ◽  
Vol 41 (1) ◽  
pp. 51-55
Author(s):  
Julian Leff
Keyword(s):  
Psychiatric Symptoms ◽  
Clinical Work ◽  
Lessons Learned ◽  
Dropping Out ◽  
Solid Base ◽  
Careful Observation ◽  
Somatic Condition ◽  
Research Activities

SummaryThis paper is something of a patchwork, incorporating many issues that have intrigued me during 34 years of research. I have included the importance of maintaining a solid base in clinical work, alongside research activities, and being alert to the possibility of a somatic condition contributing to psychiatric symptoms. I stress the value of careful observation of patients, their response to treatments and reasons for dropping out. In addition, I have included 14 more lessons, learned from my experience of research, which I hope will be of use to those readers who aspire to become researchers.

scholarly journals The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving Inter-Observer Agreement

2021 ◽  
Vol 10 (16) ◽  
pp. 3454
Author(s):  
Joep G. J. Wijnand ◽  
Devin Zarkowsky ◽  
Bian Wu ◽  
Steven T. W. van Haelst ◽  
Evert-Jan P. A. Vonken ◽  
...  
Keyword(s):  
Staging System ◽  
The United States ◽  
Lessons Learned ◽  
Observer Agreement ◽  
Lesion Length ◽  
Solid Base ◽  
Stepwise Approach ◽  
Additional Tool ◽  
Atherosclerotic Lesions ◽  
Stenosis Severity

Objective: The 2020 Global Vascular Guidelines aim at improving decision making in Chronic Limb-Threatening Ischemia (CLTI) by providing a framework for evidence-based revascularization. Herein, the Global Limb Anatomic Staging System (GLASS) serves to estimate the chance of success and patency of arterial pathway revascularization based on the extent and distribution of the atherosclerotic lesions. We report the preliminary feasibility results and observer variability of the GLASS. GLASS is a part of the new global guideline and posed as a promising additional tool for EBR strategies to predict the success of lower extremity arterial revascularization. This study reports on the consistency of GLASS scoring to maximize inter-observer agreement and facilitate its application. Methods: GLASS separately scores the femoropopliteal (FP) and infrapopliteal (IP) segment based on stenosis severity, lesion length and the extent of calcification within the target artery pathway (TAP). In our stepwise approach, we used two angiographic datasets. Each following step was based on the lessons learned from the previous step. The primary outcome was inter-observer agreement measured as Cohen’s Kappa, scored by two (step 1 + 2) and four (step 3) blinded and experienced observers, respectively. Steps 1 (n = 139) and 2 (n = 50) were executed within a dataset of a Dutch interventional RCT in CLTI. Step 3 (n = 100) was performed in randomly selected all-comer CLTI patients from two vascular centers in the United States. Results: In step 1, kappa values were 0.346 (FP) and 0.180 (IP). In step 2, applied in the same dataset, the use of other experienced observers and a provided TAP, resulted in similar low kappa values 0.406 (FP) and 0.089 (IP). Subsequently, in step 3, the formation of an altered stepwise approach using component scoring, such as separate scoring of calcification and adding a ruler to the images resulted in kappa values increasing to 0.796 (FP) and 0.730 (IP). Conclusion: This retrospective GLASS validation study revealed low inter-observer agreement for unconditioned scoring. A stepwise component scoring provides acceptable agreement and a solid base for further prospective validation studies to investigate how GLASS relates to treatment outcomes.

scholarly journals EULAR portfolio for Rheumatology training: a EULAR School of Rheumatology initiative

RMD Open ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. e001684
Author(s):  
Marloes van Onna ◽  
Sofia Ramiro ◽  
Catherine Haines ◽  
Mette Holland-Fischer ◽  
Jose Antonio Pereira da Silva ◽  
...  
Keyword(s):  
Personal Development ◽  
Portfolio Assessment ◽  
Clinical Work ◽  
Multisource Feedback ◽  
Reflective Writing ◽  
Learning Goals ◽  
Moderate Risk ◽  
Research Activities ◽  
Curriculum Vitae ◽  
Personal Reflections

ObjectiveAbout half of the rheumatology trainees do not use a portfolio. This project was established to reach consensus about the content of a EULAR portfolio for Rheumatology training and subsequently develop portfolio assessment forms.MethodsAfter establishing a portfolio working group (WG), including nine rheumatologists and one educationalist, a systematic literature review (SLR) on the content and structure of portfolios for postgraduate learning was conducted (November 2018). This was followed by a survey among WG members and members of the EMerging EUlar NETwork, inquiring about the content and structure of existing national portfolios. The portfolio WG selected the key components of the portfolio, taking previous experience and feasibility into account. Assessment forms (eg, case-based discussion) were developed and pilot-tested.Results13/2034 articles were included in the SLR (12 high/1 moderate risk of bias). Information on procedural skills, personal reflections, learning goals and multisource feedback was most often included a portfolio. Twenty-five respondents completed the survey (response≈50%). Feedback from assessors, reflective writing and formulation of learning goals were considered important dimensions to be covered in a portfolio. Six key components of the portfolio were established: curriculum vitae, personal development plan, clinical work, professional behaviours, education and research activities. Suggested minimal content for each component was formulated. Four assessment forms were successfully pilot-tested by 11 rheumatologists and their trainees.ConclusionA EULAR portfolio for Rheumatology training and assessment forms were developed. Portfolio implementation, particularly in countries without an existing portfolio, may promote a higher standard of rheumatology training across Europe.

scholarly journals Artificial Intelligence and Behavioral Science Through the Looking Glass: Challenges for Real-World Application

2020 ◽  
Vol 54 (12) ◽  
pp. 942-947
Author(s):  
Pol Mac Aonghusa ◽  
Susan Michie
Keyword(s):  
Climate Change ◽  
Artificial Intelligence ◽  
Machine Learning ◽  
Behavior Change ◽  
Behavioral Science ◽  
Lessons Learned ◽  
Learning Approaches ◽  
Intervention Evaluation ◽  
Research Activities ◽  
Behavior Change Interventions

Abstract Background Artificial Intelligence (AI) is transforming the process of scientific research. AI, coupled with availability of large datasets and increasing computational power, is accelerating progress in areas such as genetics, climate change and astronomy [NeurIPS 2019 Workshop Tackling Climate Change with Machine Learning, Vancouver, Canada; Hausen R, Robertson BE. Morpheus: A deep learning framework for the pixel-level analysis of astronomical image data. Astrophys J Suppl Ser. 2020;248:20; Dias R, Torkamani A. AI in clinical and genomic diagnostics. Genome Med. 2019;11:70.]. The application of AI in behavioral science is still in its infancy and realizing the promise of AI requires adapting current practices. Purposes By using AI to synthesize and interpret behavior change intervention evaluation report findings at a scale beyond human capability, the HBCP seeks to improve the efficiency and effectiveness of research activities. We explore challenges facing AI adoption in behavioral science through the lens of lessons learned during the Human Behaviour-Change Project (HBCP). Methods The project used an iterative cycle of development and testing of AI algorithms. Using a corpus of published research reports of randomized controlled trials of behavioral interventions, behavioral science experts annotated occurrences of interventions and outcomes. AI algorithms were trained to recognize natural language patterns associated with interventions and outcomes from the expert human annotations. Once trained, the AI algorithms were used to predict outcomes for interventions that were checked by behavioral scientists. Results Intervention reports contain many items of information needing to be extracted and these are expressed in hugely variable and idiosyncratic language used in research reports to convey information makes developing algorithms to extract all the information with near perfect accuracy impractical. However, statistical matching algorithms combined with advanced machine learning approaches created reasonably accurate outcome predictions from incomplete data. Conclusions AI holds promise for achieving the goal of predicting outcomes of behavior change interventions, based on information that is automatically extracted from intervention evaluation reports. This information can be used to train knowledge systems using machine learning and reasoning algorithms.

scholarly journals Challenges and solutions to returning to clinical training after research: a multidisciplinary survey of integrated academic trainees in West Yorkshire, United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. L. Downey ◽  
J. Bentley ◽  
H. Pandit
Keyword(s):  
United Kingdom ◽  
Clinical Training ◽  
Clinical Work ◽  
Survey Study ◽  
Full Time ◽  
Clinical Supervisors ◽  
Research Activities ◽  
Time Out ◽  
Rapid Transition ◽  
The University

Abstract Background Time out of clinical training can impact medical trainees’ skills, competence and confidence. Periods of Out of Programme for Research (OOPR) are often much longer than other approved mechanisms for time of out training. The aim of this survey study was to explore the challenges of returning to clinical training following OOPR, and determine potential solutions. Methods All current integrated academic training (IAT) doctors at the University of Leeds (United Kingdom) and previous IAT trainees undertaking OOPR in the local region (West Yorkshire, United Kingdom)(n = 53) were invited to complete a multidisciplinary survey. Results The survey was completed by 33 participants (62% response rate). The most relevant challenges identified were completing the thesis whilst transitioning back to clinical work, the rapid transition between full-time research and clinical practice, a diminished confidence in clinical abilities and isolation from colleagues. Potential solutions included dedicated funds allocated for the renewal of lapsed skills, adequate notice of the clinical rotation to which trainees return, informing clinical supervisors about the OOPR trainee returning to practice and a mandatory return to standard clinical days. Conclusions Addressing these issues has the potential to improve the trainee experience and encourage future trainees to take time out of training for research activities.

scholarly journals Managing Clinical Trials for Alzheimer’s Disease During the COVID-19 Crisis: Experience at Fundació ACE in Barcelona, Spain

2020 ◽  
Vol 77 (4) ◽  
pp. 1805-1813
Author(s):  
Carla Abdelnour ◽  
Ester Esteban de Antonio ◽  
Alba Pérez-Cordón ◽  
Asunción Lafuente ◽  
Mar Buendía ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Ad Hoc ◽  
Strategic Plan ◽  
Lessons Learned ◽  
Drop Out ◽  
Rt Pcr ◽  
Serological Tests ◽  
Clinical Trial Research ◽  
Research Activities ◽  
The Impact

Background: The COVID-19 pandemic has brought great disruption to health systems worldwide. This affected ongoing clinical research, particularly among those most vulnerable to the pandemic, like dementia patients. Fundació ACE is a research center and memory clinic based in Barcelona, Spain, one of the hardest-hit countries. Objective: To describe the ad-hoc strategic plan developed to cope with this crisis and to share its outcomes. Methods: We describe participants’ clinical and demographic features. Additionally, we explain our strategic plan aimed at minimizing the impact on clinical trial research activities, which included SARS-CoV-2 RT-PCR and IgG serological tests to all participants and personnel. The outcomes of the plan are described in terms of observed safety events and drop-outs during the study period. Results: A total of 130 patients were participating in 16 active clinical trials in Fundació ACE when the lockdown was established. During the confinement, we performed 1018 calls to the participants, which led to identify adverse events in 26 and COVID-19 symptoms in 6. A total of 83 patients (64%) could restart on-site visits as early as May 11, 2020. All SARS-CoV-2 RT-PCR diagnostic tests performed before on-site visits were negative and only three IgG serological tests were positive. Throughout the study period, we only observed one drop-out, due to an adverse event unrelated to COVID-19. Discussion: The plan implemented by Fundació ACE was able to preserve safety and integrity of ongoing clinical trials. We must use the lessons learned from the pandemic and design crisis-proof protocols for clinical trials.

Towards cloud-native simulations – lessons learned from the front-line of cloud computing

2020 ◽  
pp. 154851291989532 ◽  
Author(s):  
Nane Kratzke ◽  
Robert Siegfried
Keyword(s):  
Cloud Computing ◽  
Cost Model ◽  
Simulation Models ◽  
Lessons Learned ◽  
Fine Grained ◽  
Architectural Styles ◽  
Research Activities ◽  
Simulation Domain ◽  
Software Prototyping ◽  
Computationally Intensive

Cloud computing can be a game-changer for computationally intensive tasks like simulations. The computational power of Amazon, Google, or Microsoft is even available to a single researcher. However, the pay-as-you-go cost model of cloud computing influences how cloud-native systems are being built. We transfer these insights to the simulation domain. The major contributions of this paper are twofold: (A) we propose a cloud-native simulation stack and (B) derive expectable software engineering trends for cloud-native simulation services. Our insights are based on systematic mapping studies on cloud-native applications, a review of cloud standards, action research activities with cloud engineering practitioners, and corresponding software prototyping activities. Two major trends have dominated cloud computing over the last 10 years. The size of deployment units has been minimized and corresponding architectural styles prefer more fine-grained service decompositions of independently deployable and horizontally scalable services. We forecast similar trends for cloud-native simulation architectures. These similar trends should make cloud-native simulation services more microservice-like, which are composable but just “simulate one thing well.” However, merely transferring existing simulation models to the cloud can result in significantly higher costs. One critical insight of our (and other) research is that cloud-native systems should follow cloud-native architecture principles to leverage the most out of the pay-as-you-go cost model.

Setting-to-Work a State-of-the-Art Solid Waste Characterisation Facility at JRC Ispra

2003 ◽  
Author(s):  
Ilpo Huhtiniemi ◽  
Massimo Anselmi ◽  
Gary Vassallo ◽  
Flaviano Bruno ◽  
Giulio Panini
Keyword(s):  
State Of The Art ◽  
Selection Process ◽  
Nuclear Research ◽  
Lessons Learned ◽  
Process Automation ◽  
Contractor Selection ◽  
Industrial Environment ◽  
Research Activities ◽  
Significant Interest ◽  
Waste Characterisation

This paper reviews the experience gained when setting-to-work a state-of-the-art waste characterisation facility that will be a fundamental element in the JRC’s strategy to characterise radioactive wastes originating from four decades of nuclear research activities conducted at the Ispra Site. In a previous paper at ICEM ’01, the authors described the specifications for the principal components of a Waste Characterisation System (WCS) and the ensuing contractor selection process via a public tendering procedure. The present paper has a broader perspective by addressing the whole waste characterisation facility of which the WCS forms a part. In the opening section, the main constituents of the facility are reviewed, and their optimised integration to respect emerging Italian standards, conventional safety principles, ALARA and operational efficiency, are discussed. The second part of the paper examines the analyses required for the licensing of the waste characterisation facility. Finally, the paper concludes with a summary of the lessons learned from the setting-to-work phase of the facility. Since the facility combines a state-of-the-art NDA solution with comprehensive process automation in an industrial environment, the experience is expected to be of significant interest to the radioactive waste management community.

Medical Preparedness Against Chemical and Biological Incidents for the NATO Summit in Istanbul and Lessons Learned

2006 ◽  
Vol 21 (4) ◽  
pp. 268-271 ◽  
Author(s):  
Levent Kenar ◽  
Turan Karayilanoglu Pharm
Keyword(s):  
Lessons Learned ◽  
Extensive Experience ◽  
Counter Measures ◽  
Research Activities ◽  
Detection And Identification ◽  
Multidisciplinary Cooperation ◽  
Time Period ◽  
Set Up ◽  
Heads Of State ◽  
Medical Planning

AbstractIntroduction:During the 2004 North Atlantic Treaty Organization (NATO) Summit, essential counter-measures, including medical preparedness, were taken to cope with any suspected terrorist case or events including the use of chemical or biological (CB) weapons.The Summit was held in Istanbul, a city that bridges two continents, and involved the participation of many Heads of State, Prime Ministers, and Defense Ministers from 26 NATO countries.Methods:First responders, including medical Chemical, Biological, Radiological, and Nuclear (CBRN) teams, received special training. Essential equipment, including drugs, antidotes, detectors, etc., was provided and stockpiled. Medical authorities augmented the capacity for identifying and con- trolling the injuries and any emerging CB incident through the set-up of decontamination units and the procurement of medical devices, antidotes, drugs, and personal protective suits. Additionally, a small part of the recently established NATO-CBRN battalion was welcomed to the Summit and was prepared to perform detection and identification of the agent found in suspicious appearing samples.Results:Although no CB incident was reported during the Summit, extensive experience was gained with respect to medical preparedness against CB terrorism. Sampling, detection, and analysis of toxic materials were taken into account in the medical management. Much laboratory-related work was conducted in the following time period. The laboratory work involved the stan-dardization of sampling and transportation procedures, development of both mobile and reference laboratories, and performing research activities aimed to make the CB analysis more efficient.Although the training of the medical staff was advanced, training should be continuous and supported with educational programs, conferences, meetings, and tabletop and hospital medical exercises throughout the country.Conclusion:Multidisciplinary cooperation, training, and preparedness should be provided to basic medical care units and centers as part of the medical planning aimed at perfect detection and surveillance, laboratory analysis, and emergency response.

Needs of fathers and mothers of schizophrenia patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 2044-2044
Author(s):  
J. Wancata ◽  
T. Matschnig ◽  
M. Freidl ◽  
A. Unger ◽  
F. Friedrich
Keyword(s):  
Needs Assessment ◽  
Life Events ◽  
Psychiatric Symptoms ◽  
Clinical Work ◽  
Professional Support ◽  
Mothers And Fathers ◽  
Family Counselling ◽  
Care Giving ◽  
Burn Out ◽  
Schizophrenic Patients

IntroductionMost studies investigating the problems and needs of schizophrenia patients’ carers include only one care-giving relative - mostly the patients’ mothers.PurposeThe compare needs of mothers and fathers of patients with schizophrenia.Methods101 sets of parents of patients suffering from schizophrenia were included in this study. They were assessed by means of the “Carers’ Needs Assessment for Schizophrenia”.ResultsCompared to fathers, mothers reported significantly more often problems concerning stress due to earlier life events and burn-out. Mothers required some interventions such as individual psychoeducation or family counselling more than twice as often than fathers. Overall, mothers reported more problems and needs than fathers. The number of mothers’ problems was predicted by not living with a partner and a shorter duration of the patients’ illness (DUPI). The number of mothers’ needs was predicted by patients’ psychiatric symptoms, not living with a partner and a shorter DUPI. Among fathers we could not identify any predictors, neither for problems nor for needs.ConclusionsParents of schizophrenic patients have various problems handling their child's illness and therefore need professional support. Overall, mothers reported more problems and needs for interventions than fathers. The differences between mothers’ and fathers’ problems and needs indicate the importance of considering the carer's gender in clinical work.

scholarly journals Library as Research Lab

2020 ◽  
Author(s):  
Justin Schell ◽  
Meghan Sitar
Keyword(s):  
Higher Education ◽  
Information Literacy ◽  
Design Thinking ◽  
Information Science ◽  
Lessons Learned ◽  
Library Services ◽  
Research Experiences ◽  
Research Libraries ◽  
Research Activities ◽  
The University

Information literacy at the graduate level can happen at the intersection of research method education and mentorship into a disciplinary community of practice with its own traditions of inquiry, communication, and knowledge creation. Funded by the Institute for Museum and Library Services, the Library as Research Lab Project at the University of Michigan enables graduate students, academic librarians, and information science faculty to engage in a series of research activities together, illuminating tacit knowledge in information studies and librarianship, both as a discipline and as a profession. In the project, three interconnected labs pursue authentic research questions emerging from challenges faced by the Library while providing School of Information students with mentorship, new skills, and a fellowship stipend. A common curriculum across the labs includes research ethics, publishing, project management, and current issues in higher education research. Engaging with the frames of “Research as Inquiry” and “Scholarship as Conversation” from the Association of College and Research Libraries Framework for Information Literacy in Higher Education​, students also learn how to effectively discuss, iterate upon, and present their research activities to different audiences. At the end of the fellowship, students enter the profession with an understanding of complex challenges facing libraries and with new strategies for responding to ambiguity and pursuing new solutions through research. As we complete the final year of the grant, the librarians from the Design Thinking for Library Services Lab will reflect on lessons learned and share student perspectives as a way of discussing how similar initiatives might facilitate positive and critically engaged research projects at other institutions. Attendees will be able to describe strategies for developing similar environments in support of authentic research experiences and will be able to apply strategies documented in a mentoring handbook from the project in their own work.

Sign in / Sign up

Export Citation Format

Share Document