Integration

Integration
  • 文章类型: Journal Article
    心理治疗领域具有整合以提高治疗有效性的悠久历史。一种类型,同化融合,为家庭治疗提供创新的机会,以纳入不同方法的临床和研究贡献。本文通过探索如何将眼动脱敏和再处理(EMDR)同化为住院精神病治疗青年的基于依恋的家庭治疗(ABFT),为整合文献做出了贡献。ABFT旨在通过要求青少年和年轻人讨论依恋破裂来提高对父母形象的依恋安全性。这个过程,专为内化障碍患者设计,会引起焦虑,特别是对于通常有创伤史和不良生活经历的患者群体。EMDR是创伤后应激障碍的一线疗法,有可能有效治疗各种其他精神健康状况。当由于孩子和父母之间的信任破裂而导致患者情绪退缩或失调时,EMDR可以帮助脱敏相关的记忆和支持家庭治疗过程。作者提供了这两种模型的概述,和一个详细的案例研究作为例子。本文最后讨论了其含义,整合努力,和限制。
    The psychotherapy field has a long history of integration to improve treatment effectiveness. One type, assimilative integration, offers innovative opportunities to family therapy to incorporate the clinical and research contributions of different approaches. This paper contributes to the literature on integration by exploring how Eye Movement Desensitization and Reprocessing (EMDR) can be assimilated into Attachment-Based Family Therapy (ABFT) for youth in residential psychiatric treatment. ABFT seeks to improve attachment security to parental figures by asking adolescents and young adults to discuss attachment ruptures. This process, specially designed for patients with internalizing disorders, can provoke anxiety, particularly for a patient population that commonly has a history of trauma and adverse life experiences. EMDR is a first-line therapy for post-traumatic stress disorder and has the potential to be effective in treating various other mental health conditions. When patient emotional withdrawal or dysregulation due to breaches in trust between child and parent emerges in ABFT, EMDR may help desensitize associated memories and bolster the family therapy process. The authors provide an overview of both models, and a detailed case study as an example. The paper concludes with a discussion on implications, integration efforts, and limitations.
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  • 文章类型: Journal Article
    这篇文章是对Kaldybekov和他的同事的回应,2024年福柯权力理论论文。我认为,如果不研究福柯的知识生活和经历,很难理解他的权力理论,尤其是他的战争经历.我研究的目的是证明福柯关于权力的想法和他自己的生活之间存在联系,尽管他似乎受到马克思主义理论的影响,但他一直对极权主义理论持批评态度,在他职业生涯的早期。在这篇论文中,我展示了他如何通过将尼采的一些思想融入他的思想中来处理这个困境。为了说明福柯的生活和他的权力理论之间的联系,我在福柯1970年代关于精神病学权力的系列讲座和意大利记者Trombadori进行的采访中提出了一个特别的出发点。
    The article is a response to Kaldybekov and his colleague\'s, 2024 paper about Foucault\'s theory on power. I argue that it is difficult to understand Foucault\'s theory of power without looking into his intellectual life and experiences, especially his war experiences. The objective of my study is to show that there is a connection between Foucault\'s ideas about power and his own lived life, and that he always has been critical of totalitarian theories although he seems influenced by Marxist theories, early in his career. In the paper I show how he deals with this dilemma by incorporating some of Nietzsche\'s ideas into his thinking. To illustrate the connection between Foucault\'s lived life and his theories about power, I take a particular point of departure in Foucault\'s lecture series on psychiatric power in the 1970s and an interview conducted by the Italian journalist Trombadori.
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  • 文章类型: Journal Article
    背景:人口结构变化,人口老龄化,医疗保健需求的增加导致了全球医疗保健工作者的短缺。通过从中低收入国家(LMICs)向高收入国家(HICs)寻求更好的机会,移民卫生保健工作者(MHCWs)是减少这种短缺的关键贡献者。经济因素和卫生劳动力需求推动他们的迁移,但他们也面临着适应新国家和新工作环境的挑战。为了有效应对这些挑战,建立基于证据的政策至关重要。如果不这样做,可能会导致移民医疗工作者(MHCW)离开东道国,从而加剧了医护人员的短缺。
    目标:回顾和综合MHCW在适应新国家和新的国外工作环境时遇到的障碍。
    方法:我们遵循了PRISMA指南,并在PubMed和Embase数据库中进行了搜索。我们纳入了2000年后发表的横断面研究,涉及从LMIC国家迁移到高收入国家的MHCW,并以英文出版。我们建立了数据提取工具,并使用横断面研究评估工具(AXIS)根据预定类别评估文章质量。
    结果:通过有针对性的搜索,我们确定了14篇文章。这些文章涵盖了来自中低收入国家的11,025个MHCWS,专注于欧洲,美国,加拿大,澳大利亚,新西兰,和以色列。参与者和受访者的比率各不相同,从12%到90%不等。研究涵盖了各种医疗保健角色和年龄范围,主要是25-45年,一个重要的女性存在。与会者平均在东道国居住3-10年。结果根据河滨文化适应压力清单(RASI)进行分类,并扩展到包括官僚和就业障碍,性别差异,原住民vs.非本地人,和定向计划。
    结论:研究结果强调了文化能力培训和量身定制的支持对MHCW整合和工作满意度的重要性。在新的医疗保健环境中花费的时间和定向计划的影响是塑造他们留下或离开意图的关键因素。尽管有局限性,这些研究提供了有价值的见解,强调持续需要采取整体战略以促进成功整合,最终有利于医疗保健系统和所有利益相关者的福祉。
    BACKGROUND: Shifting demographics, an aging population, and increased healthcare needs contribute to the global healthcare worker shortage. Migrant Health Care Workers (MHCWs) are crucial contributors to reducing this shortage by moving from low-and middle-income countries (LMICs) to high-income countries (HICs) for better opportunities. Economic factors and health workforce demand drive their migration, but they also face challenges adapting to a new country and new working environments. To effectively address these challenges, it is crucial to establish evidence-based policies. Failure to do so may result in the departure of Migrant Healthcare Workers (MHCWs) from host countries, thereby worsening the shortage of healthcare workers.
    OBJECTIVE: To review and synthesize the barriers experienced by MHCWs as they adjust to a new country and their new foreign working environments.
    METHODS: We followed the PRISMA guidelines and conducted a search in the PubMed and Embase databases. We included cross-sectional studies published after the year 2000, addressing MHCWs from LMIC countries migrating to high-income countries, and published in English. We established a data extraction tool and used the Appraisal tool for Cross-Sectional Studies (AXIS) to assess article quality based on predetermined categories.
    RESULTS: Through a targeted search, we identified fourteen articles. These articles covered 11,025 MHCWS from low- to medium-income countries, focusing on Europe, the USA, Canada, Australia, New Zealand, and Israel. Participants and respondents\' rates were diverse ranging from 12% to 90%. Studies encompassed various healthcare roles and age ranges, mainly 25-45 years, with a significant female presence. Participants resided in host countries for 3-10 years on average. Results are categorized based on the Riverside Acculturation Stress Inventory (RASI) and expanded to include bureaucratic and employment barriers, Gender differences, Natives vs. non-natives, and orientation programs.
    CONCLUSIONS: The findings emphasize the importance of cultural competence training and tailored support for MHCWs integration and job satisfaction. Time spent in the new healthcare setting and the influence of orientation programs are key factors in shaping their intentions to stay or leave. Despite limitations, these studies provide valuable insights, emphasizing the ongoing need for holistic strategies to facilitate successful integration, ultimately benefiting healthcare systems and well-being for all stakeholders.
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  • 文章类型: Journal Article
    背景:空间转录组学(ST)正在促进我们对复杂组织和生物体的理解。然而,构建稳健的聚类算法以在单个组织切片中定义空间相干区域,并对齐或整合源自不同来源的多个组织切片以进行必要的下游分析仍然具有挑战性。众多的集群,对齐,集成方法是通过利用ST数据的空间信息专门为ST数据设计的。缺乏全面的基准研究使方法的选择和未来的方法开发变得复杂。
    结果:在这项研究中,我们系统地对各种最先进的算法进行基准测试,使用各种大小不同的真实和模拟数据集,技术,物种,和复杂性。我们使用不同的定量和定性指标和分析来分析每种方法的优缺点,包括空间聚类准确性和连续性的八个指标,均匀流形逼近和投影可视化,逐层和逐点对准精度,和三维重建,旨在评估方法性能和数据质量。用于评估的代码可在我们的GitHub上找到。此外,我们提供在线笔记本教程和文档,以促进所有基准测试结果的复制,并支持新方法和新数据集的研究。
    结论:我们的分析得出了涵盖多个方面的全面建议,帮助用户为他们的特定需求选择最佳工具,并指导未来的方法开发。
    BACKGROUND: Spatial transcriptomics (ST) is advancing our understanding of complex tissues and organisms. However, building a robust clustering algorithm to define spatially coherent regions in a single tissue slice and aligning or integrating multiple tissue slices originating from diverse sources for essential downstream analyses remains challenging. Numerous clustering, alignment, and integration methods have been specifically designed for ST data by leveraging its spatial information. The absence of comprehensive benchmark studies complicates the selection of methods and future method development.
    RESULTS: In this study, we systematically benchmark a variety of state-of-the-art algorithms with a wide range of real and simulated datasets of varying sizes, technologies, species, and complexity. We analyze the strengths and weaknesses of each method using diverse quantitative and qualitative metrics and analyses, including eight metrics for spatial clustering accuracy and contiguity, uniform manifold approximation and projection visualization, layer-wise and spot-to-spot alignment accuracy, and 3D reconstruction, which are designed to assess method performance as well as data quality. The code used for evaluation is available on our GitHub. Additionally, we provide online notebook tutorials and documentation to facilitate the reproduction of all benchmarking results and to support the study of new methods and new datasets.
    CONCLUSIONS: Our analyses lead to comprehensive recommendations that cover multiple aspects, helping users to select optimal tools for their specific needs and guide future method development.
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  • 文章类型: Journal Article
    虚拟护理预约在COVID-19期间迅速扩展,这是出于必要,并使许多患者能够获得和连续性的护理。虽然以前的工作已经探索了医疗保健提供者在小规模项目中使用远程医疗的经验,大流行期间广泛采用虚拟医疗为更好地理解如何加强远程医疗作为常规医疗服务提供模式的机会。对医疗保健提供者进行有效使用虚拟护理技术的培训和教育是有助于促进改善采用和使用的因素。我们描述了使用电子学习技术设计和开发认可的持续专业发展(CPD)计划的方法,以使用虚拟护理技术在医疗保健提供者中培养更好的知识和舒适度。首先,我们讨论了我们使用提供者的调查问卷进行系统需求评估研究的方法,关键线人采访,和一个病人焦点小组。接下来,我们描述了我们在与卫生系统中的主要利益相关者团体协商以及安排委员会告知计划设计和满足认证要求方面的步骤。然后深入描述电子学习模块的教学设计特点和方面,我们评估该计划的计划也得到了分享。作为CPD模式,电子学习提供了机会,可以为可能分散在农村和偏远社区的医疗保健提供者提供及时的继续专业教育。
    UNASSIGNED: Virtual care appointments expanded rapidly during COVID-19 out of necessity and to enable access and continuity of care for many patients. While previous work has explored health care providers\' experiences with telehealth usage on small-scale projects, the broad-level adoption of virtual care during the pandemic has expounded opportunities for a better understanding of how to enhance the integration of telehealth as a regular mode of health care services delivery. Training and education for health care providers on the effective use of virtual care technologies are factors that can help facilitate improved adoption and use. We describe our approach to designing and developing an accredited continuing professional development (CPD) program using e-learning technologies to foster better knowledge and comfort among health care providers with the use of virtual care technologies. First, we discuss our approach to undertaking a systematic needs assessment study using a survey questionnaire of providers, key informant interviews, and a patient focus group. Next, we describe our steps in consulting with key stakeholder groups in the health system and arranging committees to inform the design of the program and address accreditation requirements. The instructional design features and aspects of the e-learning module are then described in depth, and our plan for evaluating the program is shared as well. As a CPD modality, e-learning offers the opportunity to enhance access to timely continuing professional education for health care providers who may be geographically dispersed across rural and remote communities.
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  • 文章类型: Journal Article
    病例概念化是治疗过程成功的核心。然而,整合案例概念化研究落后于整合治疗干预技术的研究。一个成功的案例概念化提供了(A)一个动态的,上下文敏感,然而,客户功能的简约模型;(b)相关治疗目标和相关评估程序;以及(c)包括干预阶段和潜在障碍的治疗计划。案例概念化的成功是临床心理学受训人员的核心临床能力目标,甚至是专业临床医生的职业学习目标。新兴的技术趋势和对抗性协作团队的形成可能有助于研究构建良好的案例概念化的效用。
    Case conceptualization is central to the success of the therapeutic process. However, integrative case conceptualization research has lagged behind research on integrating therapeutic intervention techniques. A successful case conceptualization provides (a) a dynamic, context-sensitive, yet parsimonious model of the client\'s functioning; (b) relevant treatment targets and associated assessment procedures; and (c) a treatment plan including intervention phases and potential obstacles. Success in case conceptualization is a core clinical competency goal for trainees in clinical psychology and a career-long learning goal even for expert clinicians. Emerging technological trends and the formation of adversarial collaborative teams may assist research on the utility of well-constructed case conceptualizations.
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  • 文章类型: Journal Article
    这项研究探讨了将区块链技术集成到医疗物联网(IoMT)中,以解决安全和隐私挑战。区块链的透明度,保密性,和权力下放在医疗保健领域提供了显著的潜在好处。该研究检查了各种区块链组件,图层,和协议,强调他们在IoMT中的作用。它还探讨了IoMT应用程序,安全挑战,以及集成区块链增强安全性的方法。区块链集成对于保护和管理这些数据,同时保护患者隐私至关重要。它还为医疗保健开辟了新的可能性,医学研究,和数据管理。该结果为处理来自IoMT设备的大量数据提供了一种实用的方法。该策略有效地利用了数据资源碎片和加密技术。必须有明确的标准和规范,尤其是在医疗保健领域,维护安全和保护信息的机密性至关重要。这些结果表明,遵循HIPAA等标准是至关重要的,区块链技术可以帮助确保满足这些标准。此外,该研究探讨了区块链技术在增强医疗保健行业系统间通信同时保持患者隐私保护的潜在好处。结果强调了区块链的一致性和加密技术在结合身份管理和医疗保健数据保护方面的有效性。保护患者隐私和数据完整性。区块链是一个不可改变的分布式账本系统。总之,本文提供了有关区块链技术如何通过有效解决重大挑战并产生法律,从而改变医疗保健行业的重要见解。安全,和可互操作的解决方案。研究人员,医生,研究生是我们论文的听众。
    This study explores integrating blockchain technology into the Internet of Medical Things (IoMT) to address security and privacy challenges. Blockchain\'s transparency, confidentiality, and decentralization offer significant potential benefits in the healthcare domain. The research examines various blockchain components, layers, and protocols, highlighting their role in IoMT. It also explores IoMT applications, security challenges, and methods for integrating blockchain to enhance security. Blockchain integration can be vital in securing and managing this data while preserving patient privacy. It also opens up new possibilities in healthcare, medical research, and data management. The results provide a practical approach to handling a large amount of data from IoMT devices. This strategy makes effective use of data resource fragmentation and encryption techniques. It is essential to have well-defined standards and norms, especially in the healthcare sector, where upholding safety and protecting the confidentiality of information are critical. These results illustrate that it is essential to follow standards like HIPAA, and blockchain technology can help ensure these criteria are met. Furthermore, the study explores the potential benefits of blockchain technology for enhancing inter-system communication in the healthcare industry while maintaining patient privacy protection. The results highlight the effectiveness of blockchain\'s consistency and cryptographic techniques in combining identity management and healthcare data protection, protecting patient privacy and data integrity. Blockchain is an unchangeable distributed ledger system. In short, the paper provides important insights into how blockchain technology may transform the healthcare industry by effectively addressing significant challenges and generating legal, safe, and interoperable solutions. Researchers, doctors, and graduate students are the audience for our paper.
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  • 文章类型: Journal Article
    中枢神经系统(CNS)的布鲁氏菌病很少见,经常致命,经常被忽视或误诊。
    2023年4月,济南市疾病预防控制中心通过脑脊液(CSF)培养在一名54岁妇女中发现了一例CNS布鲁氏菌病。在确认布鲁氏菌病的诊断后,济南市疾控中心立即通知山东大学齐鲁医院,病人被转移到那里,她随后被追踪并成功治疗。
    成功的结果可以归因于系统的有效整合,该系统促进了公共卫生服务与临床机构之间的协调和协作行动。
    UNASSIGNED: Brucellosis of the central nervous system (CNS) is rare and frequently fatal, often being overlooked or misdiagnosed.
    UNASSIGNED: In April 2023, the Jinan CDC identified a case of CNS brucellosis in a 54-year-old woman through cerebrospinal fluid (CSF) culture. Upon confirming the diagnosis of brucellosis, the Jinan CDC immediately informed Qilu Hospital of Shandong University, to which the patient had been transferred, and she was subsequently tracked and successfully treated.
    UNASSIGNED: The successful outcome can be attributed to the effective integration of a system that facilitated coordinated and collaborative actions between public health services and clinical institutions.
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  • 文章类型: Journal Article
    语音感知需要时空分离的听觉-视觉线索的结合。相应的大脑网络级信息处理可以通过两种互补机制来表征:功能隔离,指的是在整个大脑中孤立或分布式模块中进行处理的定位。以及与相关功能模块之间的合作有关的集成。这里,我们使用功能磁共振成像记录证明了多感官言语刺激的主观感知体验,真实而虚幻,以偏析-积分的差分状态表示。我们通过参数控制了虚幻/跨模态感知的主体间变异性,通过在McGurk范式中的语音的不一致听觉视觉表达中引入时间滞后。使用两种替代的计算方法捕获了隔离-积分平衡的状态。首先,使用标准化参数统计方法鉴定了定义为感知结合网络(PBN)的感觉信号的跨模态结合模块,并计算了它们与所有其他大脑区域的时间相关性.随着越来越多的虚幻感知,PBN的大部分节点显示与大脑其余部分的合作减少,反映了高度隔离但全球一体化程度降低的国家。第二,使用图论测度,对分离-整合的改变模式进行了交叉验证.
    Speech perception requires the binding of spatiotemporally disjoint auditory-visual cues. The corresponding brain network-level information processing can be characterized by two complementary mechanisms: functional segregation which refers to the localization of processing in either isolated or distributed modules across the brain, and integration which pertains to cooperation among relevant functional modules. Here, we demonstrate using functional magnetic resonance imaging recordings that subjective perceptual experience of multisensory speech stimuli, real and illusory, are represented in differential states of segregation-integration. We controlled the inter-subject variability of illusory/cross-modal perception parametrically, by introducing temporal lags in the incongruent auditory-visual articulations of speech sounds within the McGurk paradigm. The states of segregation-integration balance were captured using two alternative computational approaches. First, the module responsible for cross-modal binding of sensory signals defined as the perceptual binding network (PBN) was identified using standardized parametric statistical approaches and their temporal correlations with all other brain areas were computed. With increasing illusory perception, the majority of the nodes of PBN showed decreased cooperation with the rest of the brain, reflecting states of high segregation but reduced global integration. Second, using graph theoretic measures, the altered patterns of segregation-integration were cross-validated.
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  • 文章类型: Journal Article
    近年来,基于一维纳米结构的器件已经在各个领域得到了广泛的应用,如传感器,能量采集器,晶体管,和电极由于其特殊和独特的性能。1964年贝尔实验室R.S.Wagner博士的开创性工作介绍了气-液-固(VLS)过程,一种强大的合成方法。从那以后,众多的合成技术,包括溶胶-凝胶,热液,化学气相沉积(CVD)物理气相沉积(PVD),还有更多,已经开发了。这些方法使研究人员能够有效地控制纳米线的形状(长度和直径)和材料特性。然而,大约二十年前,纳米线开始被广泛用作功能器件的关键部件,主要是由于缺乏适当的集成方法。尽管已经开发了数十种集成技术,没有一个成为主导选择,每种方法都有自己的优点和局限性。因此,这项工作旨在根据其工作原理对这些方法进行分类,并提供其优缺点的全面总结。此外,介绍了利用一维纳米材料集成的最先进的设备。
    In recent years, 1D nanostructure-based devices have achieved widespread usage in various fields, such as sensors, energy harvesters, transistors, and electrodes owing to their exceptional and distinct properties. The pioneering work of Dr. R. S. Wagner at Bell Laboratories in 1964 introduced the vapor-liquid-solid (VLS) process, a powerful synthesis method. Since then, numerous synthesis techniques, including sol-gel, hydrothermal, chemical vapor deposition (CVD), physical vapor deposition (PVD), and more, have been developed. These methods have enabled researchers to effectively control the shape (length and diameter) and material properties of nanowires. However, it was only about two decades ago that nanowires started to be widely utilized as key components in functional devices, primarily due to the lack of proper integration methods. Although dozens of integration techniques have been developed, none have emerged as a predominant choice, with each method presenting its own set of advantages and limitations. Therefore, this work aims to categorize these methods based on their working principles and provide a comprehensive summary of their pros and cons. Additionally, state-of-the-art devices that capitalize on the integration of 1D nanomaterials are introduced.
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