Search results for: Clinician

Authors: Temitope O. Tokosi

Abstract:

Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: Clinician, electronic content management, hospital, perception, technology.

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Authors: Bill D. Geis, Frederick Newman

Abstract:

Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Nina Kaufmans

Abstract:

Traditional treatments for post-traumatic stress disorder (PTSD) that rely primarily on oral narratives are partially insufficient to prevent PTSD symptoms from recurrence. As a result of the global COVID-19 pandemic, war conflicts, and economic crises, a rising proportion of users of mental health services express somatically based distress in addition to their existing mental health symptoms. Furthermore, the rapid increase in demand for mental health services has resulted in substantial burnout among mental health professionals, which may further impact the quality of services provided and the sustainability of professional life-work balance. This article examines the implications of current developments and challenges in mental health services demand and subsequent responses, as well as the effects of those responses on mental health professionals. The article examines the neurobiological mechanisms underlying traumatic experiences, then discusses the premises for "bottom-up," or somatically oriented, psychotherapy approaches, and concludes with suggestions for clinical skills and interventions to be used by practitioners who work with clients diagnosed with PTSD. In addition, we examine how somatically based psychotherapy interventions performed in sessions might reduce clinician burnout and improve their well-being. We examine how incorporating somatically based therapies into counseling will boost the efficacy of mental health recovery and maintain remission while providing mental health practitioners with chances for self-care.

Keywords: Somatic psychotherapy interventions, trauma counseling, preventing and treating burnout, adults with PTSD, bottom-up skills, the effectiveness of trauma treatment.

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Authors: Petr Vcelak, Jana Kleckova

Abstract:

Our Medicine-oriented research is based on a medical data set of real patients. It is a security problem to share patient private data with peoples other than clinician or hospital staff. We have to remove person identification information from medical data. The medical data without private data are available after a de-identification process for any research purposes. In this paper, we introduce an universal automatic rule-based de-identification application to do all this stuff on an heterogeneous medical data. A patient private identification is replaced by an unique identification number, even in burnedin annotation in pixel data. The identical identification is used for all patient medical data, so it keeps relationships in a data. Hospital can take an advantage of a research feedback based on results.

Keywords: DASTA, De-identification, DICOM, Health Level Seven, Medical data, OCR, Personal data

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Authors: Mairwen K. Jones, Bethany M. Wootton, Lisa D. Vaccaro

Abstract:

While OCD is one of the most commonly occurring psychiatric conditions experienced by older adults, there is a paucity of research conducted into the treatment of older adults with OCD. This case study represents the first published investigation of a cognitive treatment for geriatric OCD. It describes the successful treatment of an 86-year old man with a 63-year history of OCD using Danger Ideation Reduction Therapy (DIRT). The client received 14 individual, 50-minute treatment sessions of DIRT over 13 weeks. Clinician-based Y-BOCS scores reduced 84% from 25 (severe) at pre-treatment, to 4 (subclinical) at 6-month post-treatment follow-up interview, demonstrating the efficacy of DIRT for this client. DIRT may have particular advantages over ERP and pharmacological approaches, however further research is required in older adults with OCD.

Keywords: Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive-Compulsive Disorder, Older adults, Psychogeriatrics

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Authors: Rajvir Kaur, Jeewani Anupama Ginige

Abstract:

With recent trends in Big Data and advancements in Information and Communication Technologies, the healthcare industry is at the stage of its transition from clinician oriented to technology oriented. Many people around the world die of cancer because the diagnosis of disease was not done at an early stage. Nowadays, the computational methods in the form of Machine Learning (ML) are used to develop automated decision support systems that can diagnose cancer with high confidence in a timely manner. This paper aims to carry out the comparative evaluation of a selected set of ML classifiers on two existing datasets: breast cancer and cervical cancer. The ML classifiers compared in this study are Decision Tree (DT), Support Vector Machine (SVM), k-Nearest Neighbor (k-NN), Logistic Regression, Ensemble (Bagged Tree) and Artificial Neural Networks (ANN). The evaluation is carried out based on standard evaluation metrics Precision (P), Recall (R), F1-score and Accuracy. The experimental results based on the evaluation metrics show that ANN showed the highest-level accuracy (99.4%) when tested with breast cancer dataset. On the other hand, when these ML classifiers are tested with the cervical cancer dataset, Ensemble (Bagged Tree) technique gave better accuracy (93.1%) in comparison to other classifiers.

Keywords: Artificial neural networks, breast cancer, cancer dataset, classifiers, cervical cancer, F-score, logistic regression, machine learning, precision, recall, support vector machine.

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Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as physiological vital signs, images and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful to influence the judgement of clinical sentiment in ICU clinical notes. This paper presents two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of a clinical transformer model that can reliably predict clinical sentiment for notes of COVID patients in ICU. We train the model on clinical notes for COVID-19 patients, ones not previously seen by Bio_ClinicalBERT or Bio_Discharge_Summary_BERT. The model which was based on Bio_ClinicalBERT achieves higher predictive accuracy than the one based on Bio_Discharge_Summary_BERT (Acc 93.33%, AUC 0.98, and Precision 0.96). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and Precision 0.92).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation.

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