Transgender Healthcare Teaching in the Undergraduate Medical School Curriculum

With increasing recognition of the diverse and specific needs of transgender individuals in a health care setting, lack of knowledge, poor attitudes and prejudice towards transgender patients can result in this population being afraid to access medical care. Educating medical students early in their career in a sensitive and inclusive manner could help change these attitudes. It has been shown that medical undergraduates and post-graduates often feel unprepared or uncomfortable in caring for transgender patients due to lack of training and experience2-4. The aim of this study was to address this through introduction of basic transgender healthcare education into the University of Glasgow undergraduate medical curriculum, with the goal of implementing further interactive and fully inclusive teaching

Prevention of acute malnutrition: distribution of special nutritious foods and cash, and addressing underlying causes--what to recommend when, where, for whom, and how

Acute malnutrition is associated with increased morbidity and mortality risk. When episodes are prolonged or frequent, acute malnutrition is also associated with poor growth and development, which contributes to stunting Nutrition-specific and nutrition-sensitive strategies to prevent undernutrition during the first 1,000 days from conception to 24 months of age can reduce the risks of wasting, stunting, and micronutrient deficiencies. Under circumstances that exacerbate the underlying causes of undernutrition and increase the incidence of wasting, such as food insecurity related to lean seasons or emergencies, or increased incidence of illness, such as diarrhea or measles, additional efforts are required to prevent and treat wasting. Special nutritious foods directly meet the increased nutrient requirements of children at risk for wasting; assistance to vulnerable households, in the form of cash or food, enables households to better meet the food, health, and other needs of household members and may increase resilience; water, sanitation, and hygiene (WASH) and health interventions help prevent and address illness and hence reduce wasting risk. The contributions of specific interventions to reducing the incidence of wasting are difficult to assess under emergency conditions, due to ethical constraints and to the fact that multiple strategies are implemented at the same time. However, pragmatic studies under real-life circumstances, using different designs, e.g., including a group receiving "best possible" treatment, can provide evidence about what works, to what extent, at what cost, and under which circumstances. Programs should address the most important causes in given contexts, be feasible to implement at scale, and assess implementation, coverage, and outcomes

Quantitative assessment of pain-related thermal dysfunction through clinical digital infrared thermal imaging

BACKGROUND: The skin temperature distribution of a healthy human body exhibits a contralateral symmetry. Some nociceptive and most neuropathic pain pathologies are associated with an alteration of the thermal distribution of the human body. Since the dissipation of heat through the skin occurs for the most part in the form of infrared radiation, infrared thermography is the method of choice to study the physiology of thermoregulation and the thermal dysfunction associated with pain. Assessing thermograms is a complex and subjective task that can be greatly facilitated by computerised techniques. METHODS: This paper presents techniques for automated computerised assessment of thermal images of pain, in order to facilitate the physician's decision making. First, the thermal images are pre-processed to reduce the noise introduced during the initial acquisition and to extract the irrelevant background. Then, potential regions of interest are identified using fixed dermatomal subdivisions of the body, isothermal analysis and segmentation techniques. Finally, we assess the degree of asymmetry between contralateral regions of interest using statistical computations and distance measures between comparable regions. RESULTS: The wavelet domain-based Poisson noise removal techniques compared favourably against Wiener and other wavelet-based denoising methods, when qualitative criteria were used. It was shown to improve slightly the subsequent analysis. The automated background removal technique based on thresholding and morphological operations was successful for both noisy and denoised images with a correct removal rate of 85% of the images in the database. The automation of the regions of interest (ROIs) delimitation process was achieved successfully for images with a good contralateral symmetry. Isothermal division complemented well the fixed ROIs division based on dermatomes, giving a more accurate map of potentially abnormal regions. The measure of distance between histograms of comparable ROIs allowed us to increase the sensitivity and specificity rate for the classification of 24 images of pain patients when compared to common statistical comparisons. CONCLUSIONS: We developed a complete set of automated techniques for the computerised assessment of thermal images to assess pain-related thermal dysfunction

Integration of decision support systems to improve decision support performance

Decision support system (DSS) is a well-established research and development area. Traditional isolated, stand-alone DSS has been recently facing new challenges. In order to improve the performance of DSS to meet the challenges, research has been actively carried out to develop integrated decision support systems (IDSS). This paper reviews the current research efforts with regard to the development of IDSS. The focus of the paper is on the integration aspect for IDSS through multiple perspectives, and the technologies that support this integration. More than 100 papers and software systems are discussed. Current research efforts and the development status of IDSS are explained, compared and classified. In addition, future trends and challenges in integration are outlined. The paper concludes that by addressing integration, better support will be provided to decision makers, with the expectation of both better decisions and improved decision making processes

Transgender Healthcare Teaching in the Undergraduate Medical School Curriculum

With increasing recognition of the diverse and specific needs of transgender individuals in a health care setting, lack of knowledge, poor attitudes and prejudice towards transgender patients can result in this population being afraid to access medical care. Educating medical students early in their career in a sensitive and inclusive manner could help change these attitudes. It has been shown that medical undergraduates and post-graduates often feel unprepared or uncomfortable in caring for transgender patients due to lack of training and experience2-4. The aim of this study was to address this through introduction of basic transgender healthcare education into the University of Glasgow undergraduate medical curriculum, with the goal of implementing further interactive and fully inclusive teaching

Developing an automated clinical trending tool for the neonatal intensive care unit (NICU)

The purpose of this work was to develop a clinical trending tool which tracks patient vital signs and generates alerts for deviations from a defined baseline. This work analyzes four types of patients: a stable patient, a patient who left the Neonatal Intensive Care Unit for an extended period, and two patients who experienced a clinical deterioration. By displaying visual tools which are more intuitive and user friendly for physicians and alerting for short term vital sign deviations of these different patients, we aim to identify trends which may precede clinical deterioration in patients