Addressing psychiatric care in conflict zones: recommendations for the Arab region.
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ABSTRACT:
SUBMITTER: El-Khoury J
PROVIDER: S-EPMC8274416 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: Not available
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Project description:In this paper, I will discuss a children's rights-based argument for the duty of states, as a joint effort, to establish an effective program to help bring children out of conflict zones, such as parts of Syria, and to a safe haven. Children are among the most vulnerable subjects in violent conflicts who suffer greatly and have their human rights brutally violated as a consequence. Furthermore, children are also a group whose capacities to protect themselves are very limited, while their chance to flee is most often only slim. I will then discuss three counterarguments: the first counterargument would be that, instead of getting the children out of a particular country, it would be better to improve their situation in their home countries. A second counterargument could be that those states, which have such a duty to bring children to a safe haven, would be overburdened by it. Finally, the third counterargument I want to discuss states that such a duty would also demand a military intervention, which could worsen the situation even further.
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Project description:Many post-disaster and post-conflict regions do not have sufficient data on their transportation infrastructure assets, hindering both mobility and reconstruction. In particular, as the number of ageing and deteriorating bridges increases, it is necessary to quantify their load characteristics in order to inform maintenance and asset databases. The load carrying capacity and the design load are considered as the main aspects of any civil structures. Human examination can be costly and slow when expertise is lacking in challenging scenarios. In this paper, we propose to employ deep learning as a method to estimate the load carrying capacity from crowdsourced images. A convolutional neural network architecture is trained on data from over 6000 bridges, which will benefit future research and applications. We observe significant variations in the dataset (e.g. class interval, image completion, image colour) and quantify their impact on the prediction accuracy, precision, recall and F1 score. Finally, practical optimization is performed by converting multiclass classification into binary classification to achieve a promising field use performance.
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Project description:Objective: To determine if the use of a simple self-administered Postpartum Questionnaire for Mothers (PQM) at the well-baby visit (WBV) increased the proportion of women who received health care and contraception by 6 months postpartum (PP). Methods: This was a single-site, system-level, intervention. Women were recruited from the pediatric clinic when presenting with their infants for a 2-month WBV. During phase 1 of the study, a control group was enrolled, followed by an 8-week washout period; then enrollment of the intervention group (phase 2). During phase 2, the PQM was administered and reviewed by the pediatrician during the infant's visit; the tool prompted the pediatrician to make a referral for the mother's primary or contraceptive care as needed. Data were collected at baseline and at 6 months PP, and additional data were extracted from the electronic medical record. Results: We found that PP women exposed to the PQM during their infant's WBV were more likely to have had a health care visit for themselves between 2 and 6 months PP, compared with the control group (relative risk [RR] 1.66, [confidence interval (CI) 0.91-3.03]). In addition, at 6 months PP, women in the intervention group were more likely to identify a primary care provider (RR 1.84, [CI 0.98-3.46]), and more likely to report use of long-acting reversible contraception (LARC) (RR 1.24, [CI 0.99-1.58]), compared with women in the control group. Conclusion: A simple self-administered PQM resulted in an increase in women's receipt of health care and use of LARC by 6 months PP. Clinical Trial Registration: Use of a reproductive life planning tool at the pediatric well-baby visit with postpartum women, NCT03448289.
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Project description:The behavioural variant of frontotemporal dementia (bvFTD) is a frequent cause of early-onset dementia. The diagnosis of bvFTD remains challenging because of the limited accuracy of neuroimaging in the early disease stages and the absence of molecular biomarkers, and therefore relies predominantly on clinical assessment. BvFTD shows significant symptomatic overlap with non-degenerative primary psychiatric disorders including major depressive disorder, bipolar disorder, schizophrenia, obsessive-compulsive disorder, autism spectrum disorders and even personality disorders. To date, ∼50% of patients with bvFTD receive a prior psychiatric diagnosis, and average diagnostic delay is up to 5-6 years from symptom onset. It is also not uncommon for patients with primary psychiatric disorders to be wrongly diagnosed with bvFTD. The Neuropsychiatric International Consortium for Frontotemporal Dementia was recently established to determine the current best clinical practice and set up an international collaboration to share a common dataset for future research. The goal of the present paper was to review the existing literature on the diagnosis of bvFTD and its differential diagnosis with primary psychiatric disorders to provide consensus recommendations on the clinical assessment. A systematic literature search with a narrative review was performed to determine all bvFTD-related diagnostic evidence for the following topics: bvFTD history taking, psychiatric assessment, clinical scales, physical and neurological examination, bedside cognitive tests, neuropsychological assessment, social cognition, structural neuroimaging, functional neuroimaging, CSF and genetic testing. For each topic, responsible team members proposed a set of minimal requirements, optimal clinical recommendations, and tools requiring further research or those that should be developed. Recommendations were listed if they reached a ≥ 85% expert consensus based on an online survey among all consortium participants. New recommendations include performing at least one formal social cognition test in the standard neuropsychological battery for bvFTD. We emphasize the importance of 3D-T1 brain MRI with a standardized review protocol including validated visual atrophy rating scales, and to consider volumetric analyses if available. We clarify the role of 18F-fluorodeoxyglucose PET for the exclusion of bvFTD when normal, whereas non-specific regional metabolism abnormalities should not be over-interpreted in the case of a psychiatric differential diagnosis. We highlight the potential role of serum or CSF neurofilament light chain to differentiate bvFTD from primary psychiatric disorders. Finally, based on the increasing literature and clinical experience, the consortium determined that screening for C9orf72 mutation should be performed in all possible/probable bvFTD cases or suspected cases with strong psychiatric features.
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