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The Social Cure
A growing body of research shows that social networks and identities have a profound impact on mental and physical health. With such mounting evidence of the importance of social relationships in protecting health the challenge we face is explaining why this should be the case. What is it that social groups offer that appears to be just as beneficial as a daily dose of vitamin C or regular exercise?
This edited book brings together the latest research on how group memberships and the social identities associated with them determine people's health and well-being. The volume provides a variety of perspectives from clinical social organisational and applied fields that offer theoretical and empirical insights into these processes and their consequences. The contributions present a rich and novel analysis of core theoretical issues relating to the ways in which social identities and factors associated with them (such as social support and a sense of community) can bolster individuals' sense of self and contribute to physical and mental health. In this way it is shown how social identities constitute a 'social cure' capable of promoting adjustment coping and well-being for individuals dealing with a range of illnesses injuries trauma and stressors. In addition these theories provide a platform for practical strategies that can maintain and enhance well-being particularly among vulnerable populations.
Contributors to the book are at the forefront of these developments and the book's strength derives from its analysis of factors that shape the health and well-being of a broad range of groups. It presents powerful insights which have important implications for health clinical social and organisational psychology and a range of cognate fields.
eBook
Technical support
Describes different careers in the technical support field, along with salary and education requirements.
Book
Social Support and Physical Health
This state-of-the-art book examines the effect of social relationships on physical health. It surveys and assesses the research that shows not only that supportive relationships protect us from a multitude of mental health problems but also that the absence of supportive relationships increases the risk of dying from various diseases.Bert N. Uchino discusses the links between social support and mortality from cardiovascular disease, cancer, and HIV/AIDS. He investigates whether social support is more effective for some individuals and within certain cultures. After evaluating existing conceptual models linking social support to health outcomes, he offers his own broader perspective on the issue. And he suggests the implications for intervention and for future research in this area.
eBook
Beyond PTSD
Impulsivity, poor judgment, moodiness, risky behavior. \"You don't understand.\" \"I don't care.\" \"Whatever, bro.\" Engaging and working with teenagers is tough. Typically, we attribute this to the storms of adolescence. But what if some of the particularly problematic behaviors we see in teens -- self-destructive behaviors, academic issues, substance abuse, reluctance to engage in therapy or treatment -- point to unspoken trauma?
Teens nationwide struggle with traumatic stress related to poverty, abuse, neglect, bullying, traumatic loss, and interpersonal or community violence. But youth are also generally reluctant to disclose or discuss experiences of traumatic stress, and adults working with these youth may not immediately perceive the connection between prior trauma and the teen's current risky or concerning behavior. Beyond PTSD: Helping and Healing Teens Exposed to Trauma helps adults recognize and understand traumatized youth, and provides concrete strategies for talking to and engaging the teen, overcoming resistance, and finding the most appropriate evidence-based treatment approach for them.
Nearly twenty contributors pull from their extensive and varied experience working in schools and hospitals to child welfare programs, juvenile justice facilities, pediatric offices, and with families to provide concrete tips to manage the challenges and opportunities of working with trauma-exposed adolescents. Chapters present trauma-informed approaches to youth with aggression, suicide and self-injury, psychosis, and school refusal; youth with physical or developmental disabilities or medical comorbidities, those in juvenile justice or child welfare; teen parents; and LGBTQ youth, among others.
Throughout the text, tables compare different types of trauma therapies and provide information about how treatments might be adapted to fit a specific teen or setting. Readers will also find \"real life\" case vignettes and concrete, specific clinical pearls -- even examples of language to use -- to demonstrate how to work effectively with difficult-to-engage teens with complex symptoms and behaviors.
Written to be practical and accessible for clinicians, social workers, pediatricians, school counselors, and even parents, with the information, context, and strategies they need to help the teen in front of them.
eBook
Explainability for artificial intelligence in healthcare: a multidisciplinary perspective
Background
Explainability is one of the most heavily debated topics when it comes to the application of artificial intelligence (AI) in healthcare. Even though AI-driven systems have been shown to outperform humans in certain analytical tasks, the lack of explainability continues to spark criticism. Yet, explainability is not a purely technological issue, instead it invokes a host of medical, legal, ethical, and societal questions that require thorough exploration. This paper provides a comprehensive assessment of the role of explainability in medical AI and makes an ethical evaluation of what explainability means for the adoption of AI-driven tools into clinical practice.
Methods
Taking AI-based clinical decision support systems as a case in point, we adopted a multidisciplinary approach to analyze the relevance of explainability for medical AI from the technological, legal, medical, and patient perspectives. Drawing on the findings of this conceptual analysis, we then conducted an ethical assessment using the “Principles of Biomedical Ethics” by Beauchamp and Childress (autonomy, beneficence, nonmaleficence, and justice) as an analytical framework to determine the need for explainability in medical AI.
Results
Each of the domains highlights a different set of core considerations and values that are relevant for understanding the role of explainability in clinical practice. From the technological point of view, explainability has to be considered both in terms how it can be achieved and what is beneficial from a development perspective. When looking at the legal perspective we identified informed consent, certification and approval as medical devices, and liability as core touchpoints for explainability. Both the medical and patient perspectives emphasize the importance of considering the interplay between human actors and medical AI. We conclude that omitting explainability in clinical decision support systems poses a threat to core ethical values in medicine and may have detrimental consequences for individual and public health.
Conclusions
To ensure that medical AI lives up to its promises, there is a need to sensitize developers, healthcare professionals, and legislators to the challenges and limitations of opaque algorithms in medical AI and to foster multidisciplinary collaboration moving forward.
Journal Article
Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV
Background
Prolonged controlled mechanical ventilation depresses diaphragmatic efficiency. Assisted modes of ventilation should improve it. We assessed the impact of pressure support ventilation
versus
neurally adjusted ventilator assist on diaphragmatic efficiency.
Method
Patients previously ventilated with controlled mechanical ventilation for 72 hours or more were randomized to be ventilated for 48 hours with pressure support ventilation (n =12) or neurally adjusted ventilatory assist (n = 13). Neuro-ventilatory efficiency (tidal volume/diaphragmatic electrical activity) and neuro-mechanical efficiency (pressure generated against the occluded airways/diaphragmatic electrical activity) were measured during three spontaneous breathing trials (0, 24 and 48 hours). Breathing pattern, diaphragmatic electrical activity and pressure time product of the diaphragm were assessed every 4 hours.
Results
In patients randomized to neurally adjusted ventilator assist, neuro-ventilatory efficiency increased from 27 ± 19 ml/μV at baseline to 62 ± 30 ml/μV at 48 hours (p <0.0001) and neuro-mechanical efficiency increased from 1 ± 0.6 to 2.6 ± 1.1 cmH
2
O/μV (p = 0.033). In patients randomized to pressure support ventilation, these did not change. Electrical activity of the diaphragm, neural inspiratory time, pressure time product of the diaphragm and variability of the breathing pattern were significantly higher in patients ventilated with neurally adjusted ventilatory assist. The asynchrony index was 9.48 [6.38– 21.73] in patients ventilated with pressure support ventilation and 5.39 [3.78– 8.36] in patients ventilated with neurally adjusted ventilatory assist (p = 0.04).
Conclusion
After prolonged controlled mechanical ventilation, neurally adjusted ventilator assist improves diaphragm efficiency whereas pressure support ventilation does not.
Trial registration
ClinicalTrials.gov study registration:
NCT0247317
, 06/11/2015.
Journal Article