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Deep nets have done well with early adopters, but the future will soon depend on crossing the chasm. The goal of this paper is to make deep nets more accessible to a broader audience including people with little or no programming skills, and people with little interest in training new models. A github is provided with simple implementations of image classification, optical character recognition, sentiment analysis, named entity recognition, question answering (QA/SQuAD), machine translation, speech to text (SST), and speech recognition (STT). The emphasis is on instant gratification. Non-programmers should be able to install these programs and use them in 15 minutes or less (per program). Programs are short (10–100 lines each) and readable by users with modest programming skills. Much of the complexity is hidden behind abstractions such as pipelines and auto classes, and pretrained models and datasets provided by hubs: PaddleHub, PaddleNLP, HuggingFaceHub, and Fairseq. Hubs have different priorities than research. Research is training models from corpora and fine-tuning them for tasks. Users are already overwhelmed with an embarrassment of riches (13k models and 1k datasets). Do they want more? We believe the broader market is more interested in inference (how to run pretrained models on novel inputs) and less interested in training (how to create even more models).
The third chapter is an account of how PKK revolutionaries are educated in the mountains, analysing how the liberation ideology is learned and lived in the everyday. Here, women find a language to talk about their oppression and learn about their responsibility: to liberate themselves, their minds, and through armed and political struggle, other women in the region. I demonstrate how this process of learning to become ‘free’ is both emancipatory and coercive, arguing that while the liberation movement opens spaces for women, women can only participate in those spaces if they learn to become soldiers for the cause. The ethnographic data of this chapter adds another layer to my concept of militant femininities by paying attention to the matrix of domination and the intersecting power structures at work and puts forward a more nuanced analysis of agency.
Nepal’s transition from highly restrictive abortion laws and high maternal mortality to liberal laws and many fewer maternal deaths provides one of the world’s most impressive examples of the relationship of the two. Nepal’s expansion of access to abortion through an emphasis on self-determination for women and incorporation of abortion training into medical and nursing training are excellent implementation models for other nations where the constraint of women’s rights and abortion services lead to injustice and early death for women. That Nepal accomplished so much for women despite political instability and only modest economic growth supports the importance of the collaboration of ministries of health and education and non-government organizations (NGOs) to progressively expand abortion training to include a wide range of urban and rural practitioners at early and later stages of their training, set standards for education and performance, and systematically evaluate effects on abortion access and safety.
The aging of the population implies a greater risk of psychopathological events; at the same time multimorbidity constitutes the rule rather than the exception in the manifestations of the health problems of the elderly. Multimorbidity involves many diagnostic-therapeutic interventions, from general practitioners to neurology, geriatrics, psychiatry but these interventions do not appear integrated with each other.
Evaluate the availability of psychogeriatrics training programs to increase the interest and skills of the medical profession on the multimorbidity of the elderly.
We have conducted a review of the scientific literature on integrated training programs in the field of psychogeriatrics over the past decade on pubmed, comparing the different training models proposed.
A still limited amount of articles on integrated psychogeriatric training have been published although the demand for psychogeriatric care continues to increse. The frail elderly seems to have a connotation in terms of costs rather in terms of care; moreover, everything concerning the elderly is reduced to the organic dimension alone, neglecting psychopathology.
The feasibility of integrated training programs between primary care and specialists such as neurologists, geriatricians, psychiatrists is a priority in the field of psychogeriatrics in consideration of the relevant multimorbidity. It is appropriate both to update knowledge and to review the organizational models of care so that the frailty of the elderly with multimorbidity does not quickly translate into disabilities with high social welfare needs. It is also necessary for generalist psychiatry to return to the value of psychopathology of the elderly.
Stigma, stereotypes, and preconceptions have meant psychiatry has been subject to poor engagement from medical students when compared to other specialties. Whilst efforts have been made to understand reasons for this and formulate strategies to build interest, the problem still exists.
This piece explores whether giving those with a passion for psychiatry a platform to share this could gradually but positively influence their peers and thus, be a potential way to drive engagement in psychiatry as a career.
Advanced literature searches explored items such as engagement in psychiatry and benefits of peer-to-peer education. CASP checklists facilitated selection and appraisal of literature for use in this discussion. Key themes were identified and used to formulate suggestions for the use of peer-to-peer teaching in building interest in psychiatry.
Thematic analysis of the data found 4 main themes relating to engagement in psychiatry. Current strategies to improve this have varying impact and include clinical exposure, using patients with lived experience in learning and enrichment activities, whilst the main negative influence is a long-standing stigma and stereotype around psychiatry. Three themes regarding the relevant benefits of peer-to-peer teaching were found, being peer-to-peer connection, peer influence and means to overcome stigma.
Three key strategies for the use of peer to peer learning are suggested. These are ‘learning from students with lived experience’, ‘peer-teaching from passionate students prior to clinical exposure’ and ‘using peer learning to initially introduce topics in psychiatry in a relatable manor’.
Important changes have been done in economic status of residents in 2018. The impact of these measures in changing opinion was checked.
The prioritization exercises of main factors related with psychiatric residents’ decision to emigrate could be a starting point of elaboration of a strategy of reforms.
The study was cross sectional evaluation at national level on a randomized selected sample of Romanian psychiatric residents’ opinion on factors which influence decision of migration in EU countries in two time points: 2015 and 2020.
38% of residents intend to work abroad comparing with 78% before the economic changes (25.84% versus 71.66% for a limited period of time and 15.73% versus 28.33% intend to emigrate) and 2% versus 5% intend to leave the speciality. The most important factors for decision to emigrate changed from “Better working conditions” (15.73 versus 37.31% residents) to “Better training” 20.25% residents and the factor “respect and appreciation by colleagues” remained important for 19.10% versus 17.91%. “Lack of working place for partner” was considered by 26.96% of responders as an important disadvantage of working abroad. “Being far from family members” which was considered 5 years ago by 64.18% of responders as an important disadvantage of working abroad, nowadays concerns only 6.74%, probably because it seems easier to go abroad together with the family members.
The factors (better training in psychiatry and psychotherapy, better supervision, more involvement in research) which influence the residents’ decision to emigrate represent the starting points on futures reforms in educational and medical system in psychiatry.
Some of the most vulnerable psychiatry patients are children under 18, as they can’t protect themselves and their rights from unethical behaviour of mental health professionals. There is a gap between theoretical knowledge and application of ethics at the workplace. Continuous education in ethics is necessary to address this gap.
The objective of the study was to compare various forms of education in ethics and develop training for mental health practitioners.
The study had 2 groups (356 participants, aged 23 to 67, average age – 41.3) – staff of the main and oldest children’s mental health clinic in Moscow, Russia. The control group (124 participants) of mental health professionals received written materials on ethics (such as ethical codes and ethical decision-making protocols). The test group (232 people) participated in a several trainings on ethics. The trainings included 3 parts – discussing the code of ethics, creating examples of potential ethical challenges and role-plays. Participants reported that the topics on the quality of care, common ethical dilemmas and relationships between the practitioners, young patients and legal guardians, were the most helpful for them.
The survey was conducted to evaluate the results. 70.8% of staff members that participated in training shared that they feel confident about applying the Code and the decision-making protocols in unclear cases. Only 32.6% from the control group reported the same level of confidence.
Hands-on training in ethics for continuing education has shown to be more beneficial, as compared to theoretical instructions
Mental disorders linked with the menstrual cycle, childbirth and the menopause are unique to women and have their specific requirements for identification, assessment, treatment and service provision as well as appropriately trained staff. Mental disorders that are linked to domestic violence, sexual abuse or victimisation and affect more women than men, also have their own specific requirements. This is increasingly being recognized by policy makers and health care planners. In the case of perinatal mental health some countries have set up specialised inpatient and community services. In the UK this was followed by the development of National competencies for different professional groups and National training programmes. This project and the current clinical training in perinatal mental health for psychiatric trainees will be described. Nationally recognized qualifications are currently being developed. Developments in other areas of women’s mental health appear less advanced. The presentation will discuss current guidelines and opportunities for training that are being offered in the UK and what we can learn from perinatal mental health for further development in these areas.
UK Psychiatry Trainees are allocated one day per week in their final three years of training to use for “a clinical or clinically related area of service which cannot be provided within the training post but which is of direct relevance to the prospective career pathway of the trainee”. It is unclear how trainees in the East of England are using this time and what could help them optimise use of this time. We completed a survey to evaluate these areas.
To determine details of how Special interest sessions (SIS) are spent by trainees: How much support/ planning for SIS is available and if this is adequate. Whether trainees feel they are able to use their SIS for its intended purpose of providing “a clinical or clinically related area of service which cannot be provided within the training post but which is of direct relevance to the prospective career pathway of the trainee” Exploration of barriers/tensions to maximizing use of SIS. SIS Record keeping What advice would trainees give re: special interest sessions to a new SPR? What lessons can be drawn to assist trainees from other countries/ training programmes to maximise their own development.
Survey sent to all Higher trainees in the East of England via Regional Training Programme.
Awaited. Survey sent 29/09/2020
Results pending. We will feedback in detail on outcomes from the survey and subsequent discussion with Regional training programme members.
Mental health is no doubt a topical conversation at medical school. We noted that whilst many students appreciated the power in talking openly about challenges faced, it was a topic many found hard to approach. In response, we have implemented a peer-led training programme at Bristol Medical School. The aim of the programme is to improve confidence and enable students to recognise and respond to their own, a peer or patient’s distress in a more proactive, supportive and overall effective way. It utilised peer-led, discussion based workshops during the first few months of medical school to achieve this.
To evaluate the role of peer-led mental health training in undergraduate medical education.
The program was piloted in November 2019. T-tests compared 142 participating students’ baseline self-reported understanding and confidence and follow up, as measured on a likert scale (1-5). Qualitative feedback was also welcomed.
Students showed a significant improvement in their self-reported understanding (24%, P<0.05), confidence when supporting a peer (18%, P<0.05) and confidence if faced with a more acute situation (21%, P<0.05). Students expressed particular admiration for the fact that the session was peer led ‘as it emphasised the importance of mental health in…society’.
This programme may be beneficial in creating a stronger community of doctors who are equipped with the confidence and ability to better care for themselves, their colleagues, and patients. Further evaluation is required to determine whether this reduces rate or severity of mental illness in participants or the broader student population.
The COVID-19 pandemic has highlighted a need for engaging online resources to enrich psychiatry training for undergraduate medical students. Podcasting is a well-established digital communication platform utilised daily in a myriad of capacities, including education. A group of medical students were tasked with creating their own educational podcasts covering specific aspects of psychiatry.
Each pair was set a sub-topic of psychiatry and utilised software to produce educational resources. The objective of this project was to reflect upon production as well as explore the efficacy of podcasting as a tool within undergraduate training.
The medical students conducted research and contacted experts within the field to contribute to their podcasts. The majority of the students then conducted reviews of the literature surrounding podcasting within medical education, which informed the production of their own podcasts. From this, it was discussed how this project could impact future practice, and indicated that podcasts may become crucial asynchronous learning tools in medical education.
Literature review and first-hand experience of podcast production enabled the students to appreciate the advantages of podcasting and the potential for its widespread future applications. Their wider reading revealed that podcast-using study participants outperformed or matched their peers in assessments, and overwhelmingly enjoyed using podcasts over traditional teaching methods.
The use of podcasting can complement traditional psychiatry training and appeal to a generation of digital natives that prefer this learning style. Podcast production is also an excellent revision method, highlighting the advantages of peer-to-peer education in both learning and increasing engagement with psychiatry.
Lay magistrates are involved in most of the criminal cases in England and Wales. They typically sit in panels, but in minor cases they sit as single decision-makers. In both situations, they are assisted by a legal adviser. Lay magistrates also hear appeals as part of a mixed court presided over by a professional judge. Lay magistrates are more diverse in personal characteristics than professional judges, but the level of commitment required results in an overrepresentation of older, middle-class people. The lay magistrate is defined by law, professional work patterns, budget constraints, and the traditional legal culture. In addition, the architecture of the courtroom, as well as the use of video links, often impedes interaction between lay magistrates and defendants. These constraints at times threaten justice and procedural fairness. The number of lay magistrates has been declining for years. To dispose of cases more quickly, professional judges have taken a slice of the caseload. A different work pattern can be found at the youth court where magistrates engage actively with the defendant and are not confined to a narrow decision-making function.
In the medical education field, the use of highly sophisticated simulators and extended reality (XR) simulations allow training complex procedures and acquiring new knowledge and attitudes. XR is considered useful for the enhancement of healthcare education; however, several issues need further research.
The main aim of this study is to define a comprehensive method to design and optimize every kind of simulator and simulation, integrating all the relevant elements concerning the scenario design and prototype development.
A complete framework for the design of any kind of advanced clinical simulation is proposed and it has been applied to realize a mixed reality (MR) prototype for the simulation of the rachicentesis. The purpose of the MR application is to immerse the trainee in a more realistic environment and to put him/her under pressure during the simulation, as in real practice.
The application was tested with two different devices: the headset Vox Gear Plus for smartphone and the Microsoft Hololens. Eighteen students of the 6th year of Medicine and Surgery Course were enrolled in the study. Results show the comparison of user experience related to the two different devices and simulation performance using the Hololens.
Linguistic deficits attested in children with Developmental Language Disorder (DLD) have been explained in terms of limitations in working memory (WM). The goal of this research is to assess whether a tailored WM program can improve the syntactic abilities of children with DLD and those with typical development (TD). We created a novel iPad application consisting of five activities specifically designed to train the components of WM that have been shown to be the most predictive of performance on tests assessing complex syntax. Thirty-two children with DLD (M = 9;0) and 18 with TD (M = 8;5) followed the WM training (lasting 12 hours). Results show significant improvement in verbal WM (direct effects) in both TD and DLD groups, and in sentence repetition (transfer effects) in the DLD group, with the most pronounced improvements observed for complex syntactic structures. This progression is not observed for 38 age-matched children of the same age who followed an alternative, global scholastic training (20 DLD, 18 TD), which proves the specific efficacy of our WM training. The logical next step will be to incorporate the training into the therapy of children with DLD in order to reinforce the potential benefit of their interventions.
The aim was to to establish core components of spiritual care training for healthcare professionals in Australia.
This study used the Delphi technique to undertake a consensus exercise with spiritual care experts in the field of healthcare. Participant opinion was sought on (i) the most important components of spiritual care training; (ii) preferred teaching methods; (iii) clinical scenarios to address in spiritual care training; and (iv) current spiritual assessment and referral procedures.
Of the 107 participants who responded in the first round, 67 (62.6%) were female, 55 (51.4%) worked in pastoral care, and 84 (78.5%) selected Christian as their religious affiliation. The most highly ranked components of spiritual care training were “relationship between health and spirituality,” followed by “definitions of spirituality and spiritual care.” Consensus was not achieved on the item “comparative religions study/alternative spiritual beliefs.” Preferred teaching methods include case studies, group discussion, role-plays and/or simulated learning, videos of personal stories, and self-directed learning. The most highly ranked clinical scenario to be addressed in spiritual care training was “screening for spiritual concerns for any patient or resident.” When asked who should conduct an initial spiritual review with patients, consensus was achieved regarding all members of the healthcare team, with most nominating a chaplain or “whoever the patient feels comfortable with.” It was considered important for spiritual care training to address one's own spirituality and self-care. Consensus was not achieved on which spiritual care assessment tools to incorporate in training.
Significance of results
This Delphi study revealed that spiritual care training for Australian healthcare professionals should emphasize the understanding of the role of spirituality and spiritual care in healthcare, include a range of delivery methods, and focus upon the incorporation of spiritual screening. Further work is required to identify how spiritual care screening should be conducted within an Australian healthcare setting.
In the majority of low- and middle-income countries, mental healthcare is delivered by primary care workers. Often, they are the only contact for patients and their families. Although their knowledge base can be limited, they are expected to manage complex cases with few resources. The authors describe their experience of partnership with mental health centres set up by the Nigeria Health Care Project, and training their primary care workers based on the World Health Organization's Mental Health Gap Action Programme. Although the programme was very effective in helping to upskill their knowledge and experience, a need for continued professional development was highlighted. Based on their feedback, multiple evidence-based options are explored, including the use of remote learning and social media (increased significantly around the world because of the COVID-19 pandemic), to help primary care workers improve their knowledge base and maintain their competencies with the limited resources available.
This chapter focuses on credit as a bounded social investment in light of financial shortfalls that arise during the life course. The Danish welfare state provides strong financial support, particularly for low-income households, through comprehensive family and educational policies such as childcare services and other in-kind benefits that limit families’ financial exposures and lower households’ opportunity costs for taking time off work, sending children to childcare, and pursuing education and training programs. Middle- and high-income households are the ones that draw on credit to smooth income losses when a spouse temporarily leaves work, for example to care for children or to get training. This "investment borrowing" is more prevalent than "consumption borrowing" to cope with labor market-related risks. By contrast, many more American households, including low- and middle-income ones, borrow money to cope with the financial consequence that arise throughout the life course, including income losses due to parental leave or expenses for childcare, education, and training–which would be covered or subsidized by most European welfare states. As life course trajectories have become more fluid and flexible and the traditional single-breadwinner model has declined, Germany’s restrictive credit regime continues to make it hard for households to borrow money.
British psychiatry is almost entirely publicly funded; in the United States, a tradition of well-remunerated private practice has prevailed. Despite similar therapeutics and nosology, psychiatry in Britain and the United States has developed in strikingly different ways. Psychoanalysis once dominated US psychiatry; in a big swing of the pendulum, it has been almost entirely replaced by psychopharmacology. In Britain, the research tradition in the past was weak; in the United States, it has been fuelled by large amounts of government funding. A British hesitancy about embracing large abstract theories has no US counterpart. In terms of training, a progressive agenda has been emphasised in Britain, more defensive postures in the United States.
Cognitive behavioural therapy (CBT) is in high demand due to its strong evidence base and cost effectiveness. To ensure CBT is delivered as intended in research, training and practice, fidelity assessment is needed. Fidelity is commonly measured by assessors rating treatment sessions, using CBT competence scales (CCSs).
The current review assessed the quality of the literature examining the measurement properties of CCSs and makes recommendations for future research, training and practice.
Medline, PsychINFO, Scopus and Web of Science databases were systematically searched to identify relevant peer-reviewed, English language studies from 1980 onwards. Relevant studies were those that were primarily examining the measurement properties of CCSs used to assess adult 1:1 CBT treatment sessions. The quality of studies was assessed using a novel tool created for this study, following which a narrative synthesis is presented.
Ten studies met inclusion criteria, most of which were assessed as being ‘fair’ methodological quality, primarily due to small sample sizes. Construct validity and responsiveness definitions were applied inconsistently in the studies, leading to confusion over what was being measured.
Although CCSs are widely used, we need to pay careful attention to the quality of research exploring their measurement properties. Consistent definitions of measurement properties, consensus about adequate sample sizes and improved reporting of individual properties are required to ensure the quality of future research.