1,079 research outputs found

    Talking about personal recovery in bipolar disorder: Integrating health research, natural language processing, and corpus linguistics to analyse peer online support forum posts

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    Background: Personal recovery, ‘living a satisfying, hopeful and contributing lifeeven with the limitations caused by the illness’ (Anthony, 1993) is of particular value in bipolar disorder where symptoms often persist despite treatment. So far, personal recovery has only been studied in researcher-constructed environments (interviews, focus groups). Support forum posts can serve as a complementary naturalistic data source. Objective: The overarching aim of this thesis was to study personal recovery experiences that people living with bipolar disorder have shared in online support forums through integrating health research, NLP, and corpus linguistics in a mixed methods approach within a pragmatic research paradigm, while considering ethical issues and involving people with lived experience. Methods: This mixed-methods study analysed: 1) previous qualitative evidence on personal recovery in bipolar disorder from interviews and focus groups 2) who self-reports a bipolar disorder diagnosis on the online discussion platform Reddit 3) the relationship of mood and posting in mental health-specific Reddit forums (subreddits) 4) discussions of personal recovery in bipolar disorder subreddits. Results: A systematic review of qualitative evidence resulted in the first framework for personal recovery in bipolar disorder, POETIC (Purpose & meaning, Optimism & hope, Empowerment, Tensions, Identity, Connectedness). Mainly young or middle-aged US-based adults self-report a bipolar disorder diagnosis on Reddit. Of these, those experiencing more intense emotions appear to be more likely to post in mental health support subreddits. Their personal recovery-related discussions in bipolar disorder subreddits primarily focussed on three domains: Purpose & meaning (particularly reproductive decisions, work), Connectedness (romantic relationships, social support), Empowerment (self-management, personal responsibility). Support forum data highlighted personal recovery issues that exclusively or more frequently came up online compared to previous evidence from interviews and focus groups. Conclusion: This project is the first to analyse non-reactive data on personal recovery in bipolar disorder. Indicating the key areas that people focus on in personal recovery when posting freely and the language they use provides a helpful starting point for formal and informal carers to understand the concerns of people diagnosed with bipolar disorder and to consider how best to offer support

    The Factors Contributing to Patriarchy in Contemporary Rural Bangladesh

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    This study examines factors that have contributed to the persistence of patriarchy in rural Bangladesh. Patriarchy is a social structure and practice in which men have power and privilege over women, subjecting them to various forms of oppression and exploitation. Previous studies have claimed that government and NGO-led development policies promote gender equality by improving women's access to education, microfinance, employment, political representation, and legal protections. Government and NGO-led development initiatives have improved women’s socioeconomic conditions in Bangladesh. However, gender inequality and discrimination against women remain prevalent. I argue that discriminatory cultural practices such as child marriage, dowry, and domestic violence uphold patriarchy, which perpetuates gender inequality in rural Bangladesh. This study employs ethnographic research, unstructured interviews, and participant observation to examine views held by Bangladesh’s rural population regarding discriminatory cultural practices. The findings of this thesis indicate that local sociocultural contexts determine women's empowerment in Bangladesh. Patriarchal gender norms, conservative Islamic views, and social acceptance of gender-based discrimination perpetuate gender inequality in rural Bangladesh. Rural women's economic and social stability is primarily derived from patrilocal marriage, which upholds their subjugation. Moreover, conservative gender norms and discriminatory Muslim personal laws continue to govern Muslim women's family and social status, despite their rising socioeconomic participation. Since 1975, political parties have countered weak electoral legitimacy and justified their hold on political power, by cultivating ties to conservative Islamic groups and emphasising party commitment to Islam, in line with societal norms and expectations. They have sought to maintain a balance between the role of modernisers (i.e., involving women in socioeconomic activities) and the incorporation of gender discrimination into the National Women's Development Policy, family laws, and laws around child marriage and dowry prohibition. In addition, the government refuses to challenge conservative voices that promote child marriage, wedding gifts (typically dowry), and domestic violence. Profit-driven microfinance NGOs and legal system corruption further limit women's protection against such patriarchal traditions. Based on these findings, this thesis argues that locally driven development policies involving conservative Islamic groups can advance gender equality in rural Bangladesh by shifting community support towards the promotion of women's rights

    30th European Congress on Obesity (ECO 2023)

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    This is the abstract book of 30th European Congress on Obesity (ECO 2023

    “Have patients with chronic skin diseases needs been met?”:A thesis on psoriasis and eczema patient care in dermatology service

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    Background: Common chronic skin diseases such as eczema and psoriasis usually require long term medical care. They are often associated with psychological and metabolic comorbidities, which can impact on patient quality of life (QOL) and on the self-management of these diseases. Regular assessment of patient needs, comorbidities and feedback is a critical step in the development of decision-analytic models. Currently, no intervention is available to regularly assess such patients’ needs and comorbidities and support their involvement in the decision-making and self-management of their morbidity and comorbidities. The aim of this research is to involve the patients in decision making of their care and to support their self-management by the use of a paper questionnaire (study tool) at each consultation. Objective: To explore the acceptability and potential of a self-developed paper questionnaire that constituted a study tool for addressing the needs, comorbidities, and feedback of patients with psoriasis and eczema and supporting their involvement in decision making and self-management of their chronic conditions. Method: A mixed method study was conducted and included a postal survey on adult male and female patients with psoriasis and eczema, using the study tool, which is a paper questionnaire and contains the Dermatology Life Quality Index (DLQI) and seven supplementary open-ended questions to capture patients’ views, feedback, comorbidities, coping status and needs. The survey was followed by semi-structured face-to-face interviews with a sample of the patients who had participated in the survey. The aims of the interviews were two-fold: 1. to gain a deeper understanding of their experience of living with and managing their skin disease; and 2. to gather patient feedback on the service they received as well as their views on using the new study tool or any alternative intervention to address and support their self-management. The final study was a pilot which involved presenting a proposal of an online version of the study tool to a group of healthcare experts asking them to critically review the extent to which the online model responded to patients expressed needs. Results: Of the 114 patients who participated in the postal survey 108 (94.7%) of them expressed physical, metabolic and psychological comorbidities. Stress was identified as the dominant disease-triggering factor in 72 (63%) participants. Thirty-three (28.9%) of participants reported that they could not cope with their chronic illness. Eighteen (15.7%) participants suffered from anxiety, and 12 (10.5%) had depression and suicidal thoughts. Twenty-nine (25%) participants addressed their needs for support at home, and 16 (14%) of them asked for support at work. In the patient feedback section, 21 (18.4%) and 9 (7.8%) participants rated the service they received from their general practitioner (GP) and dermatologist as poor, respectively. In the interviews, all the participants 22 (100%) welcomed the use of the study tool on a regular basis to address their needs, comorbidities and feedback. Nineteen (86.3%) of them suggested that they would prefer using an online version of the tool or patient portal system as a convenient way of remote and interactive communication with the healthcare provider, particularly during the worsening of their skin condition. In the final pilot study, the healthcare experts agreed that the proposed online version of the study tool could be a convenient platform for such patients to support their self-management. They discussed the potential importance of such a tool if it provided them with access to supportive services such as patient information on skin diseases and self-management, access to local mental health service and other relevant psoriasis and eczema patients’ support groups and charities. Conclusion: This novel mixed method research identified knowledge gaps in managing patients with psoriasis and eczema. It provided a new tool that has the potential to regularly engage and assess patients’ unmet needs, comorbidities and feedback. The tool can involve patients in decision-making and offers them the autonomy to disclose heterogeneous needs that may support their self-management. All the interviewees welcomed regular use of the study tool and the majority of them suggested that they would prefer using an online version of the tool if it was available. Future research is needed to assess the impact of the study tool in filling important gaps in patient self-management and in health service improvement

    Reflective Artificial Intelligence

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    As Artificial Intelligence (AI) technology advances, we increasingly delegate mental tasks to machines. However, today's AI systems usually do these tasks with an unusual imbalance of insight and understanding: new, deeper insights are present, yet many important qualities that a human mind would have previously brought to the activity are utterly absent. Therefore, it is crucial to ask which features of minds have we replicated, which are missing, and if that matters. One core feature that humans bring to tasks, when dealing with the ambiguity, emergent knowledge, and social context presented by the world, is reflection. Yet this capability is completely missing from current mainstream AI. In this paper we ask what reflective AI might look like. Then, drawing on notions of reflection in complex systems, cognitive science, and agents, we sketch an architecture for reflective AI agents, and highlight ways forward

    Security and Privacy of Resource Constrained Devices

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    The thesis aims to present a comprehensive and holistic overview on cybersecurity and privacy & data protection aspects related to IoT resource-constrained devices. Chapter 1 introduces the current technical landscape by providing a working definition and architecture taxonomy of ‘Internet of Things’ and ‘resource-constrained devices’, coupled with a threat landscape where each specific attack is linked to a layer of the taxonomy. Chapter 2 lays down the theoretical foundations for an interdisciplinary approach and a unified, holistic vision of cybersecurity, safety and privacy justified by the ‘IoT revolution’ through the so-called infraethical perspective. Chapter 3 investigates whether and to what extent the fast-evolving European cybersecurity regulatory framework addresses the security challenges brought about by the IoT by allocating legal responsibilities to the right parties. Chapters 4 and 5 focus, on the other hand, on ‘privacy’ understood by proxy as to include EU data protection. In particular, Chapter 4 addresses three legal challenges brought about by the ubiquitous IoT data and metadata processing to EU privacy and data protection legal frameworks i.e., the ePrivacy Directive and the GDPR. Chapter 5 casts light on the risk management tool enshrined in EU data protection law, that is, Data Protection Impact Assessment (DPIA) and proposes an original DPIA methodology for connected devices, building on the CNIL (French data protection authority) model

    Predicting and preventing relapse of depression in primary care: a mixed methods study

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    BackgroundMost people with depression are managed in primary care. Relapse (reemergence of depression symptoms after improvement) is common and contributes to the burden and morbidity associated with depression. There is a lack of evidence-based approaches for risk-stratifying people according to risk of relapse and for preventing relapse in primary care.MethodsIn this mixed methods study, I initially reviewed studies looking to predict relapse of depression across all settings. I then attempted to derive and validate a prognostic model to predict relapse within 6-8 months in a primary care setting, using multilevel logistic regression analysis on individual participant data from seven studies (n=1244). Concurrently, a qualitative workstream, using thematic analysis, explored the perspectives of general practitioners (GPs) and people with lived experience of depression around relapse risk and prevention in practice.ResultsThe systematic review identified eleven models; none could currently be implemented in a primary care setting. The prognostic model developed in this study had inadequate predictive performance on internal validation (Cstatistic 0.60; calibration slope 0.81). I carried out twenty-two semi-structured interviews with GPs and twenty-three with people with lived experience of depression. People with lived experience of depression and GPs reflected that a discussion around relapse would be useful but was not routinely offered. Both participant groups felt there would be benefits to relapse prevention for depression being embedded within primary care.ConclusionsWe are currently unable to accurately predict an individual’s risk ofdepression relapse. The longer-term care of people with depression ingeneral practice could be improved by enabling continuity of care, increased consistency and clarity around follow-up arrangements, and focussed discussions around relapse risk and prevention. Scalable, brief relapse prevention interventions are needed, which would require policy change and additional resource. We need to better understand existing interventions and barriers to implementation in practice

    Design of an E-learning system using semantic information and cloud computing technologies

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    Humanity is currently suffering from many difficult problems that threaten the life and survival of the human race. It is very easy for all mankind to be affected, directly or indirectly, by these problems. Education is a key solution for most of them. In our thesis we tried to make use of current technologies to enhance and ease the learning process. We have designed an e-learning system based on semantic information and cloud computing, in addition to many other technologies that contribute to improving the educational process and raising the level of students. The design was built after much research on useful technology, its types, and examples of actual systems that were previously discussed by other researchers. In addition to the proposed design, an algorithm was implemented to identify topics found in large textual educational resources. It was tested and proved to be efficient against other methods. The algorithm has the ability of extracting the main topics from textual learning resources, linking related resources and generating interactive dynamic knowledge graphs. This algorithm accurately and efficiently accomplishes those tasks even for bigger books. We used Wikipedia Miner, TextRank, and Gensim within our algorithm. Our algorithm‘s accuracy was evaluated against Gensim, largely improving its accuracy. Augmenting the system design with the implemented algorithm will produce many useful services for improving the learning process such as: identifying main topics of big textual learning resources automatically and connecting them to other well defined concepts from Wikipedia, enriching current learning resources with semantic information from external sources, providing student with browsable dynamic interactive knowledge graphs, and making use of learning groups to encourage students to share their learning experiences and feedback with other learners.Programa de Doctorado en Ingeniería Telemática por la Universidad Carlos III de MadridPresidente: Luis Sánchez Fernández.- Secretario: Luis de la Fuente Valentín.- Vocal: Norberto Fernández Garcí

    Behavior quantification as the missing link between fields: Tools for digital psychiatry and their role in the future of neurobiology

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    The great behavioral heterogeneity observed between individuals with the same psychiatric disorder and even within one individual over time complicates both clinical practice and biomedical research. However, modern technologies are an exciting opportunity to improve behavioral characterization. Existing psychiatry methods that are qualitative or unscalable, such as patient surveys or clinical interviews, can now be collected at a greater capacity and analyzed to produce new quantitative measures. Furthermore, recent capabilities for continuous collection of passive sensor streams, such as phone GPS or smartwatch accelerometer, open avenues of novel questioning that were previously entirely unrealistic. Their temporally dense nature enables a cohesive study of real-time neural and behavioral signals. To develop comprehensive neurobiological models of psychiatric disease, it will be critical to first develop strong methods for behavioral quantification. There is huge potential in what can theoretically be captured by current technologies, but this in itself presents a large computational challenge -- one that will necessitate new data processing tools, new machine learning techniques, and ultimately a shift in how interdisciplinary work is conducted. In my thesis, I detail research projects that take different perspectives on digital psychiatry, subsequently tying ideas together with a concluding discussion on the future of the field. I also provide software infrastructure where relevant, with extensive documentation. Major contributions include scientific arguments and proof of concept results for daily free-form audio journals as an underappreciated psychiatry research datatype, as well as novel stability theorems and pilot empirical success for a proposed multi-area recurrent neural network architecture.Comment: PhD thesis cop
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