Considerations for Clinicians When Working Cross-Culturally: A Review

Communication between cultural groups, termed intercultural communication, is often difficult or not successful within a mental health setting. It is important to gain a greater understanding of intercultural communication, in order to provide appropriate treatment and care. This literature review first defines what is meant by intercultural communication, before examining the literature on the intercultural dynamics that must be considered when working cross-culturally within a mental health setting. Particular focus is given to the clinical interview, as it is the key mode of communication within therapeutic practice. Intercultural communication is a dynamic process, and to be effective many socio-cultural factors must be considered. Theoretical models of effective intercultural communication within a health context highlight the need for clinicians to possess cultural knowledge and communication skills; however, the utility of such models is yet to be assessed. The research suggests that cultural competency training is one method to promote more effective intercultural communication within a mental health setting, with cultural adaptations to therapies and assessment tools shown to increase communication effectiveness

S.M.A.R.T Technologies for Students who are Deaf with Disabilities

In 2017, Drs. Guardino, Cannon and Mr. Logan Silverman presented the different types of technology that may assist professionals when working with students with disabilities. Last year, in November 2018, Dr. Guardino gave a keynote presentation at the Florida Educators of the Deaf and hard of hearing annual conference addressing the various strategies professionals use when serving students who are deaf with disabilities (i.e., autism, learning disabilities, attention deficit disorder). Within the presentation, a live poll was taken to ascertain and share the exact strategies used. Interestingly, many of the professionals responded to the poll by offering their use of different technologies (apps, software, devices). Although these technologies were named, there was not enough time to demonstrate their use. This year, Mr. Logan Silverman and I will analyze the poll results from last year and demonstrate the most frequently selected technological strategies as well as others (e.g., Sign2TXT, do2learn, carolgraysocialstories.com, ECT, PECS/cough drop app, gonoodle, Class Dojo, OneNote)

A Systematic Review of Effective Intercultural Communication in Mental Health

Purpose of the Research: Effective intercultural communication between patients and clinicians is essential for the delivery of high quality health care. To date, there has been no systematic assessment of empirical literature on effective communication within a mental health context, despite theoretical models purporting certain criteria make health communications more effective. The current research aims to determine factors which aid or hinder communication effectiveness in such a context, and to see whether the literature supports Teal and Street’s (2009) theoretical model specifically. Additionally, the review considered the role of language disparity between patients and clinicians within the mental health context. Method: Electronic databases Medline, Psych Info and Web of Science were searched using an optomised search strategy in June 2014. Studies were considered where intercultural communication between a clinician and patient was a primary focus. To meet inclusion the papers needed to be empirical in nature, written in English, peer-reviewed and of sound quality. Data relating to the study type and analysis used, characteristics of participants (both patients and clinicians), cultural and communication information were extracted.Results: Eight papers were included in the final review. The results largely support Teal and Street’s model and highlight that nonverbal and verbal behaviour skill, recognition of cultural differences, incorporating cultural knowledge, alongside negotiation and collaboration with patients and family members, all aid in effective communication. Additionally, language barriers were found to pose a significant barrier to communication. The quantity of current literature investigating the effectiveness of intercultural communication specifically within a mental health setting is limited, highlighting the need for further investigation.

Anti-Psychiatry And The Biomedical Model: From Delusion To Disorder

Psychiatry as it functions today is largely guided by the biomedical model of mental illness, which rests upon the notion that deviations in mental functioning are biological in nature. This thesis seeks to critique this understanding of psychological distress through the lens of the philosophical tradition of anti-psychiatry, drawing primarily from the works of Thomas Szasz and Michel Foucault. Szasz places emphasis on the diagnostic disparities between physiological and psychological illness, arguing that the experiences and behaviors that psychiatrists class as mental diseases are actually communicative strategies utilized by individuals who lack the tools to properly address the stressors in their lives. In contrast, Foucault approaches the issue from a historico-political context, considering the power dynamics involved in the psychiatric encounter by giving an account of its evolution since the days of the asylum. Drawing from the description of the biomedical model given by investigative journalist Robert Whitaker, I will consider how the philosophies of Szasz and Foucault relate to the modern psychiatric climate. Ultimately, I will argue that it is Foucault’s perspective that best equips us to critique the biomedical model, as its origins are inevitably intertwined with economic and political power

Dependent infrastructure system modeling: A case study of the St. Kitts power and water distribution systems

Critical infrastructure systems underlie the economy, national security, and health of modern society. These infrastructures have become increasingly dependent on each other, which poses challenges when modeling these systems. Although a number of methods have been developed for this problem, few case studies that model real-world dependent infrastructures have been conducted. In this paper, we aim to provide another example of such a case study by modeling a real-world water distribution system dependent on a power system. Unlike in the limited previous case studies, our case study is in a developing nation context. This makes the availability of data about the infrastructure systems in this case study very limited, which is a common characteristic of real-world studies in many settings. Thus, a main contribution of the paper is to show how one can still develop representative, useful models for systems in the context of limited data. To demonstrate the utility of these types of models, two examples of different analyses are performed, where the results provide information about the most vulnerable parts of the infrastructures and critical linkages between the power and water distribution systems.publishedVersio

Segmentation of Exercise Repetitions Enabling Real-Time Patient Analysis and Feedback Using a Single Exemplar

We present a segmentation algorithm capable of segmenting exercise repetitions in real-time. This approach uses subsequence dynamic time warping and requires only a single exemplar repetition of an exercise to correctly segment repetitions from other subjects, including those with limited mobility. This approach is invariant to low range of motion, instability in movements and sensor noise while remaining selective to different exercises. This algorithm enables responsive feedback for technology-assisted physical rehabilitation systems. We evaluated the algorithm against a publicly available dataset (CMU) and against a healthy population and stroke patient population performing rehabilitation exercises captured on a consumer-level depth sensor. We show the algorithm can consistently achieve correct segmentation in real-time

Clinicians’ use of the structured professional judgement approach for adult secure psychiatric service admission assessments: A systematic review

The structured professional judgement (SPJ) approach was initially developed to support risk assessment and management decisions. The approach is now being adapted and applied to admission assessments for adult secure services. This systematic review aims to summarise the evidence for the effectiveness and acceptability of the SPJ approach in admission assessments of this kind. A comprehensive electronic search strategy was used to identify studies indexed in PubMed, PsycInfo, Medline and Cochrane Library (January 2007 –January 2024). Two search strategies included terms (and synonyms) for psychiatric patients (quantitative) or clinicians and clinicians’ experiences (qualitative), structured professional judgement, admission, and secure services. Twelve quantitative articles (published 2007–2020) were identified. SPJ-informed guidance included were the DUNDRUM-1, DUNDRUM-2, DUNDRUM-3, DUNDRUM-4, and the HCR-20. While findings were variable, the overall pattern indicated that ratings suggestive of more problems were associated with increased likelihood of admission or movement to higher security levels. There is emerging evidence for the use of SPJ guidance to support admission decision-making. Specifically, it should be used as an adjunct to existing decision-making processes rather than as a replacement for those processes. Further research, both quantitative and qualitative, across a wider range of settings and populations is recommended

Deep sequencing of foot-and-mouth disease virus reveals RNA sequences involved in genome packaging

Non-enveloped viruses protect their genomes by packaging them into an outer shell or capsid of virus-encoded proteins. Packaging and capsid assembly in RNA viruses can involve interactions between capsid proteins and secondary structures in the viral genome as exemplified by the RNA bacteriophage MS2 and as proposed for other RNA viruses of plants, animals and human. In the picornavirus family of non-enveloped RNA viruses, the requirements for genome packaging remain poorly understood. Here we show a novel and simple approach to identify predicted RNA secondary structures involved in genome packaging in the picornavirus foot-and-mouth disease virus (FMDV). By interrogating deep sequencing data generated from both packaged and unpackaged populations of RNA we have determined multiple regions of the genome with constrained variation in the packaged population. Predicted secondary structures of these regions revealed stem loops with conservation of structure and a common motif at the loop. Disruption of these features resulted in attenuation of virus growth in cell culture due to a reduction in assembly of mature virions. This study provides evidence for the involvement of predicted RNA structures in picornavirus packaging and offers a readily transferable methodology for identifying packaging requirements in many other viruses. Importance: In order to transmit their genetic material to a new host, non-enveloped viruses must protect their genomes by packaging them into an outer shell or capsid of virus-encoded proteins. For many non-enveloped RNA viruses the requirements for this critical part of the viral life cycle remain poorly understood. We have identified RNA sequences involved in genome packaging of the picornavirus foot-and-mouth disease virus. This virus causes an economically devastating disease of livestock affecting both the developed and developing world. The experimental methods developed to carry out this work are novel, simple and transferable to the study of packaging signals in other RNA viruses. Improved understanding of RNA packaging may lead to novel vaccine approaches or targets for antiviral drugs with broad spectrum activity

The Torpid State:Recent Advances in Metabolic Adaptations and Protective Mechanisms(dagger)

Torpor and hibernation are powerful strategies enabling animals to survive periods of low resource availability. The state of torpor results from an active and drastic reduction of an individual's metabolic rate (MR) associated with a relatively pronounced decrease in body temperature. To date, several forms of torpor have been described in all three mammalian subclasses, i.e., monotremes, marsupials, and placentals, as well as in a few avian orders. This review highlights some of the characteristics, from the whole organism down to cellular and molecular aspects, associated with the torpor phenotype. The first part of this review focuses on the specific metabolic adaptations of torpor, as it is used by many species from temperate zones. This notably includes the endocrine changes involved in fat- and food-storing hibernating species, explaining biomedical implications of MR depression. We further compare adaptive mechanisms occurring in opportunistic vs. seasonal heterotherms, such as tropical and sub-tropical species. Such comparisons bring new insights into the metabolic origins of hibernation among tropical species, including resistance mechanisms to oxidative stress. The second section of this review emphasizes the mechanisms enabling heterotherms to protect their key organs against potential threats, such as reactive oxygen species, associated with the torpid state. We notably address the mechanisms of cellular rehabilitation and protection during torpor and hibernation, with an emphasis on the brain, a central organ requiring protection during torpor and recovery. Also, a special focus is given to the role of an ubiquitous and readily-diffusing molecule, hydrogen sulfide (H2S), in protecting against ischemia-reperfusion damage in various organs over the torpor-arousal cycle and during the torpid state. We conclude that (i) the flexibility of torpor use as an adaptive strategy enables different heterothermic species to substantially suppress their energy needs during periods of severely reduced food availability, (ii) the torpor phenotype implies marked metabolic adaptations from the whole organism down to cellular and molecular levels, and (iii) the torpid state is associated with highly efficient rehabilitation and protective mechanisms ensuring the continuity of proper bodily functions. Comparison of mechanisms in monotremes and marsupials is warranted for understanding the origin and evolution of mammalian torpor