Biomedical imaging research opportunities workshop IV: A white paper

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134967/1/mp5838.pd

Medical teleconsultation in the care of children with suspected rare diseases: a pilot study in Brazil during the COVID-19 pandemic

Objective: To evaluate teleinterconsultation in medical genetics for cases of children with suspected rare diseases. Methods: Prospective study of qualitative and quantitative survey that evaluated the use and satisfaction with asynchronous teleinterconsultation for physicians from public hospitals in a city in the northern macro-region of the state of Minas Gerais. Results: A total of 21 teleinterconsultations were performed from September 29, 2020, to January 07, 2021. Eleven (52.4%) of them were able to establish the probable diagnosis in the first evaluation, and the others were within the protocols of rare disease investigation. Of the 12 requesting physicians, 11 (91.6%) were female, seven (58.2%) were paediatric residents, and five (41.7%) were paediatricians. Seven of the requesting physicians had never used telemedicine before. There was 100% satisfaction with the teleinterconsultation with the specialist geneticist. Conclusion: Teleinterconsultation in medical genetics for children with rare diseases met expectations, modified the conduct of non-specialist physicians in a city lacking a geneticist, and guided diagnosis and conduct in all cases

Neuroendoscopy Adapter Module Development for Better Brain Tumor Image Visualization

The issue of brain magnetic resonance image exploration together with classification receives a significant awareness in recent years. Indeed, various computer-aided-diagnosis solutions were suggested to support radiologist in decision-making. In this circumstance, adequate image classification is extremely required as it is the most common critical brain tumors which often develop from subdural hematoma cells, which might be common type in adults. In healthcare milieu, brain MRIs are intended for identification of tumor. In this regard, various computerized diagnosis systems were suggested to help medical professionals in clinical decision-making. As per recent problems, Neuroendoscopy is the gold standard intended for discovering brain tumors; nevertheless, typical Neuroendoscopy can certainly overlook ripped growths. Neuroendoscopy is a minimally-invasive surgical procedure in which the neurosurgeon removes the tumor through small holes in the skull or through the mouth or nose. Neuroendoscopy enables neurosurgeons to access areas of the brain that cannot be reached with traditional surgery to remove the tumor without cutting or harming other parts of the skull. We focused on finding out whether or not visual images of tumor ripped lesions ended up being much better by auto fluorescence image resolution as well as narrow-band image resolution graphic evaluation jointly with the latest neuroendoscopy technique. Also, within the last several years, pathology labs began to proceed in the direction of an entirely digital workflow, using the electronic slides currently being the key element of this technique. Besides lots of benefits regarding storage as well as exploring capabilities with the image information, among the benefits of electronic slides is that they can help the application of image analysis approaches which seek to develop quantitative attributes to assist pathologists in their work. However, systems also have some difficulties in execution and handling. Hence, such conventional method needs automation. We developed and employed to look for the targeted importance along with uncovering the best-focused graphic position by way of aliasing search method incorporated with new Neuroendoscopy Adapter Module (NAM) technique

A retrospective audit of the clinical value of routine chest radiographs in the first 24 hours after cardiac surgery using medical records

Routine postoperative chest radiography after cardiac surgery is a common practice, although studies, both prospective and retrospective, conducted in their majority outside Africa, have shown that these chest radiographs are of low clinical value, mainly due to limited impact on patient management. Following cardiac surgery and admission to ICU, chest radiographs are obtained in order to ensure proper position of all invasive devices such as endotracheal tubes, invasive catheters as well as nasograstric tubes, and to exclude possibility of a pneumothorax, atelectasis, infiltrates, and other potential respiratory complications associated with ventilatory support. Following cardiac surgery, there are other elements that require assessment: mediastinum (for widening due to bleeding), pleural space (for presence of fluid or air) and cardiovascular system (for presence of signs of failure). Specific to cardiac surgery is the post-operative pulmonary dysfunction (PPD), where systemic inflammatory response due to cardiopulmonary bypass is the main culprit [Milot J et al, 2001] - leading to acute lung injury. Over and above the usual cardiovascular diseases that require surgical intervention, in Sub-Saharan Africa, inflammatory and infective conditions such as pulmonary tuberculosis, pulmonary hydatid disease, and pulmonary complications of HIV infection, are very prevalent. These pre-existing lung pathologies predispose patients to postoperative pulmonary complications after cardiac surgery. This audit investigates the role and importance of bedside chest X-rays in post operative care of cardiac surgery patients that come from a population group where lung pathology is quite prevalent

Development of services for symptomatic breast disease: report of the Sub-group to the National Cancer Forum / Bernadette O'Keefe, Niall O'Higgens, Ann O'Doherty.

DOHC / 200

The commodification of health care in Kerala, South India: science, consumerism and markets

In India, alongside Information Technology, health care has become a leading sector in the country‘s development as a 'knowledge economy' (World Bank 2005). One of the major achievements and beacons of economic reform is the growth of some of the most technologically advanced hospitals in the world. This thesis examines the social processes shaping the expansion of the private health care system in the state of Kerala, South India, where large corporate hospitals and 'super-speciality' medicine have spread throughout urban and many rural areas. It explores the intersections between the local and the global, as the health system becomes the major driver of industrial development, unevenly linking the local health care system to the global marketplace for technologies, health care professionals and patients. It examines the three faces of the health care system in Kerala - as a knowledge industry and route to social mobility for the middle classes, in particular doctors and nurses; secondly, as a consumer economy, as people prioritise spending on health care and shop for treatment in the urban marketplace; and finally as a moral economy, as people develop high levels of dependency on doctors, hospitals and technologies in the hope of receiving good health care. The ethnography is set in Malabar, Northern Kerala, where the expansion of private health care has been financed by remittances from migration to the Arabian Gulf countries. The thesis examines the influence of migration and economic reforms on local ecologies of health and health care; the impact of the globalisation of trade in health services in the developing world; the relationship between the private health care system and the middle classes in South Asia; and the role of markets in the delivery of health services. Based on 18 months of participant observation across the urban and rural health care market with local communities of doctors and patients, it examines how doctors and patients adjust to a changing ecology and economy of health care

Training in child and adolescent mental health for nursing, occupational therapy and social work students: does it influence career intentions?

Despite increased funding in child and adolescent mental health there remains a shortage of qualified health professionals working in this area in New Zealand. This study was designed to determine whether increasing training in child and adolescent mental health would increase undergraduate nursing, occupational therapy and social work students’ interest in working in the area. An additional aim of the study was to develop a sustainable teaching resource on child and adolescent mental health in CD-Rom format. Students participating in the study were asked to complete a questionnaire before and after attending a workshop in child and adolescent mental health and again at a follow-up point, three to 16 weeks later, to establish whether or not this had influenced their stated career intentions. To assess students’ and their educator’s perceptions of the quality and acceptability of the workshop a quality of teaching questionnaire was administered after the workshop. Three-hundred-and-seventy-three students participated in 14 workshops held in seven cities around New Zealand. The workshop had a positive impact on students’ career intentions in relation to child and adolescent mental health. A repeated measures analysis showed an overall time effect (F2,546 = 16.29, p = <0.0001). Further investigation of this difference was carried out using a multiple comparison test (Scheffe test) which showed a highly significant positive increase in career intentions between pre-workshop and post-workshop ratings (p = <0.0001), which dropped between post-workshop and follow-up (p = 0.004), with no change between pre-workshop and follow-up ratings (p = 0.43). There was no differential effect by students’ professional group (p = 0.08), ethnicity (p = 0.6), gender (p = 0.75) or age (p = 0.26). The study reflected similar career intention trends found in the literature. In particular, at base-line there were differences in profession-specific career intentions. Job attributes such as job satisfaction, personal interest, a job with supports available and being able to help people were also factors influencing students’ career intentions. The present study showed that a workshop on child and adolescent mental health had a significant immediate impact on undergraduate students’ career intentions

Decision making in surgery and cancer care

Decision making in surgery and cancer care is an interesting, challenging, and yet little explored area of surgical sciences research. This research addresses that paucity. In performing this research, health outcomes research (HOR) literature was comprehensively reviewed. Health outcome measures including quality of life and health-related quality of Life were described, in addition to their measurements. Subsequently health outcome measures in relation to oncoplastic and aesthetic breast surgery were described, and health outcome measures in a number of benign breast and colorectal pathologies were studied.Decision making in surgery and cancer care was explored using a mixed methodology of quantitative and qualitative studies. To derive a more comprehensive view, different specialties were explored: breast, colorectal, and head and neck surgery. To address socio-cultural factors the qualitative focus group discussions were undertaken in England, Wales, and India. Quantitative studies included literature reviews, prospective studies, retrospective studies, and questionnaire surveys. Qualitative studies were based on focus group discussions.The results showed that raw quantitative data is only one of the factors influencing the decision making process. A number of other factors play an important role in the decision making process. These include: health outcome measures (quality of life, health-related quality of life), clinician factors (knowledge, skill, expertise, judgment), patient factors (socio-economic, education, cultural), nursing factors, translational research, and resource infrastructure.Important themes and outcomes emerged from the qualitative studies. The focus group discussions showed that decision making in surgery and cancer care varies not only between the developing and the developed world, but also within different regions in the western world. In England, a small minority of patients was driving the decision making process, compared with Wales, where joint decision making is the norm. However, in India decision making is predominantly led by the clinicians and the patient’s family members. As modern health care moves towards a patient centered care approach, evidence based patient choice and patient decision making clearly has a greater role to play, and the cultural and practical issues demonstrated in this thesis must be considered