Voz y discurso en salud mental: esquemas diagnósticos en conflicto en un análisis de caso

In this article we present a case of misdiagnosis in mental health that started in the admission interview and lasted for a year of treatment. To interpret the causes of this error, and based on a collaborative process with the mental health team, we use two theoretical categories: “discourse” (understood as the set of semiotic and semantic regularities that correspond to a social field, as in “medical discourse”, etc.) and “voice” (understood as the singular product of the articulation between multiple discourses throughout the biographical trajectory of a person). Methodologically, we use the descriptive tools of conversation analysis in a heterogeneous corpus that goes through the different stages of diagnosis and treatment. The analysis shows the effect of psychoanalytic discourse, which selects some aspects of the patient’s voice while ignoring others, arriving at a diagnosis of conversion disorder (“hysteria”) and preventing another, of progressive aphasia. In the end, the potential of interaction studies for the diagnostic process and some implications of the case for the field of discourse analysis are discussed.En este trabajo presentamos un caso de error de diagnóstico en salud mental que, iniciado en la entrevista de admisión, se prolongó durante un año de tratamiento. Para interpretar las causas de dicho error, y basados en un proceso colaborativo con el equipo de salud mental, utilizamos dos categorías teóricas: “discurso” (entendido como el conjunto de regularidades semióticas y semánticas que se corresponden con un campo social, como en “discurso médico”, etc.) y “voz” (entendida como el producto singular de la articulación entre múltiples discursos a lo largo de la trayectoria biográfica de una persona). Metodológicamente, empleamos las herramientas descriptivas del análisis de la conversación en un corpus heterogéneo que atraviesa las diferentes etapas del diagnóstico y el tratamiento. El análisis muestra el efecto del discurso psicoanalítico, que selecciona algunos aspectos de la voz de la paciente ignorando otros, arribando a un diagnóstico de trastorno de conversión (“histeria”) e impidiendo otro, de afasia progresiva. En el final, se discute el potencial de los estudios de la interacción para el proceso diagnóstico y algunas implicancias del caso para el campo del análisis del discurso

Test beam performance measurements for the Phase I upgrade of the CMS pixel detector

A new pixel detector for the CMS experiment was built in order to cope with the instantaneous luminosities anticipated for the Phase I Upgrade of the LHC. The new CMS pixel detector provides four-hit tracking with a reduced material budget as well as new cooling and powering schemes. A new front-end readout chip mitigates buffering and bandwidth limitations, and allows operation at low comparator thresholds. In this paper, comprehensive test beam studies are presented, which have been conducted to verify the design and to quantify the performance of the new detector assemblies in terms of tracking efficiency and spatial resolution. Under optimal conditions, the tracking efficiency is (99.95 ± 0.05) %, while the intrinsic spatial resolutions are (4.80 ± 0.25) μm and (7.99 ± 0.21) μm along the 100 μm and 150 μm pixel pitch, respectively. The findings are compared to a detailed Monte Carlo simulation of the pixel detector and good agreement is found.Peer reviewe

Velocity-space sensitivity of the time-of-flight neutron spectrometer at JET

The velocity-space sensitivities of fast-ion diagnostics are often described by so-called weight functions. Recently, we formulated weight functions showing the velocity-space sensitivity of the often dominant beam-target part of neutron energy spectra. These weight functions for neutron emission spectrometry (NES) are independent of the particular NES diagnostic. Here we apply these NES weight functions to the time-of-flight spectrometer TOFOR at JET. By taking the instrumental response function of TOFOR into account, we calculate time-of-flight NES weight functions that enable us to directly determine the velocity-space sensitivity of a given part of a measured time-of-flight spectrum from TOFOR

Relationship of edge localized mode burst times with divertor flux loop signal phase in JET

A phase relationship is identified between sequential edge localized modes (ELMs) occurrence times in a set of H-mode tokamak plasmas to the voltage measured in full flux azimuthal loops in the divertor region. We focus on plasmas in the Joint European Torus where a steady H-mode is sustained over several seconds, during which ELMs are observed in the Be II emission at the divertor. The ELMs analysed arise from intrinsic ELMing, in that there is no deliberate intent to control the ELMing process by external means. We use ELM timings derived from the Be II signal to perform direct time domain analysis of the full flux loop VLD2 and VLD3 signals, which provide a high cadence global measurement proportional to the voltage induced by changes in poloidal magnetic flux. Specifically, we examine how the time interval between pairs of successive ELMs is linked to the time-evolving phase of the full flux loop signals. Each ELM produces a clear early pulse in the full flux loop signals, whose peak time is used to condition our analysis. The arrival time of the following ELM, relative to this pulse, is found to fall into one of two categories: (i) prompt ELMs, which are directly paced by the initial response seen in the flux loop signals; and (ii) all other ELMs, which occur after the initial response of the full flux loop signals has decayed in amplitude. The times at which ELMs in category (ii) occur, relative to the first ELM of the pair, are clustered at times when the instantaneous phase of the full flux loop signal is close to its value at the time of the first ELM

P-Type Silicon Strip Sensors for the new CMS Tracker at HL-L-HC

Abstract: The upgrade of the LHC to the High-Luminosity LHC (HL-LHC) is expected to increase the LHC design luminosity by an order of magnitude. This will require silicon tracking detectors with a significantly higher radiation hardness. The CMS Tracker Collaboration has conducted an irradiation and measurement campaign to identify suitable silicon sensor materials and strip designs for the future outer tracker at the CMS experiment. Based on these results, the collaboration has chosen to use n-in-p type silicon sensors and focus further investigations on the optimization of that sensor type

Voz y discurso en salud mental: esquemas diagnósticos en conflicto en un análisis de caso

In this article we present a case of misdiagnosis in mental health that started in the admission interview and lasted for a year of treatment. To interpret the causes of this error, and based on a collaborative process with the mental health team, we use two theoretical categories: “discourse” (understood as the set of semiotic and semantic regularities that correspond to a social field, as in “medical discourse”, etc.) and “voice” (understood as the singular product of the articulation between multiple discourses throughout the biographical trajectory of a person). Methodologically, we use the descriptive tools of conversation analysis in a heterogeneous corpus that goes through the different stages of diagnosis and treatment. The analysis shows the effect of psychoanalytic discourse, which selects some aspects of the patient’s voice while ignoring others, arriving at a diagnosis of conversion disorder (“hysteria”) and preventing another, of progressive aphasia. In the end, the potential of interaction studies for the diagnostic process and some implications of the case for the field of discourse analysis are discussed.En este trabajo presentamos un caso de error de diagnóstico en salud mental que, iniciado en la entrevista de admisión, se prolongó durante un año de tratamiento. Para interpretar las causas de dicho error, y basados en un proceso colaborativo con el equipo de salud mental, utilizamos dos categorías teóricas: “discurso” (entendido como el conjunto de regularidades semióticas y semánticas que se corresponden con un campo social, como en “discurso médico”, etc.) y “voz” (entendida como el producto singular de la articulación entre múltiples discursos a lo largo de la trayectoria biográfica de una persona). Metodológicamente, empleamos las herramientas descriptivas del análisis de la conversación en un corpus heterogéneo que atraviesa las diferentes etapas del diagnóstico y el tratamiento. El análisis muestra el efecto del discurso psicoanalítico, que selecciona algunos aspectos de la voz de la paciente ignorando otros, arribando a un diagnóstico de trastorno de conversión (“histeria”) e impidiendo otro, de afasia progresiva. En el final, se discute el potencial de los estudios de la interacción para el proceso diagnóstico y algunas implicancias del caso para el campo del análisis del discurso

To speak with the other's voice: reducing asymmetry and social distance in mental health care admission interviews

The aim of this article is to examine the case of adoption of characteristic features of the interlocutor's ‘voice’ in mental health care admission interviews at a public hospital in Buenos Aires, Argentina. We observed ethnographically that ‘speaking with the Other's voice’ is a strategy adopted by psychoanalysts to achieve clinical goals, though they overlook its wider implications and contradictions as it involves both professionals and patients. We will argue that patients adopt bureaucratic and psychiatric terms in order to decrease asymmetry and reorient the activity conducted between the professional and the client. On the other hand, professionals tend to consider social class, age, ethnicity or religion when adopting the patient's voice in an attempt to decrease social distance. These strategies are employed to accomplish different goals during the interview: to the patient, it is a way to show competence in the activity of medical consultation, indexing the highly valued voices of state institutions and psychiatric knowledge; to the professional, it is a strategy to achieve clinical goals by decreasing social distance and enhancing transference. Analysis will show the unequal distribution of voicing options for participants: while patients attempt to reduce asymmetry despite social distance, psychotherapists try to decrease social distance but maintain asymmetry. In conclusion, wider implications will be discussed for intergroup communication between professionals and clients.Fil: Bonnin, Juan Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Centro de Estudios E Investigaciones Laborales; Argentin