Cultivating Compassion through analysis of online patient narratives

Compassion is at the forefront of national and international healthcare policy, practice and educational debates as a result of a series of recent reports (Mid Staffordshire NHS Foundation Trust Inquiry, 2010, Lown et al 2011, Mannion, 2014). Arguably, this emphasis on compassion is in juxtaposition to an increasingly complex technological healthcare system focused upon outcomes, efficiency, productivity and competence. Within this fast paced and time pressured environment innovative strategies are required to cultivate and sustain compassion among healthcare professionals.

Understanding the person’s experience of illness and making an emotional connection are key processes in cultivating compassion (Dewar, 2013). The exponential growth in unsolicited patient narratives has the potential to provide invaluable insight into what matters to patients and their experience of illness. For many patients these stories ‘reclaim’ their illnesses from the traditional biomedical model of disease and reveal otherwise hidden aspects of their experience. The content though freely accessible, is however unedited and lacks safeguards in relation to the quality or accuracy of the information provided. Despite these concerns, healthcare professionals are now challenged to pay attention to these unsolicited patient stories and to consider how they can inform and improve patient care.

This paper discusses the use of online patient narratives in undergraduate nurse education to cultivate compassion. Critical analysis of online patient narratives is advocated as a potential educational strategy to cultivate compassion among future health care professionals.

References
Dewar,B. (2013) Cultivating compassionate care Nursing Standard 27, (34) 48-55

Lown B, Rosen J, Martilla J.(2011) An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Affairs (Millwood) 30, 1772–8.
Mannion,R. (2014) Enabling compassionate healthcare: perils, prospects and perspectives International Journal of Health Policy and Management 2, 115-7
Mid Staffordshire NHS Foundation Trust Inquiry (2010). Independent Inquiry into care provided by Mid Staffordshire NHS Foundation London: Stationery Office.

Online health information - what the newspapers tell their readers: a systematic content analysis

Background: This study investigated the nature of newspaper reporting about online health information in the UK and US. Internet users frequently search for health information online, although the accuracy of the information retrieved varies greatly and can be misleading. Newspapers have the potential to influence public health behaviours, but information has been lacking in relation to how newspapers portray online health information to their readers.

Methods: The newspaper database Nexis (R) UK was searched for articles published from 2003 - 2012 relating to online health information. Systematic content analysis of articles published in the highest circulation newspapers in the UK and US was performed. A second researcher coded a 10% sample to establish inter-rater reliability of coding.

Results: In total, 161 newspaper articles were included in the analysis. Publication was most frequent in 2003, 2008 and 2009, which coincided with global threats to public health. UK broadsheet newspapers were significantly more likely to cover online health information than UK tabloid newspapers (p = 0.04) and only one article was identified in US tabloid newspapers. Articles most frequently appeared in health sections. Among the 79 articles that linked online health information to specific diseases or health topics, diabetes was the most frequently mentioned disease, cancer the commonest group of diseases and sexual health the most frequent health topic. Articles portrayed benefits of obtaining online health information more frequently than risks. Quotations from health professionals portrayed mixed opinions regarding public access to online health information. 108 (67.1%) articles directed readers to specific health-related web sites. 135 (83.9%) articles were rated as having balanced judgement and 76 (47.2%) were judged as having excellent quality reporting. No difference was found in the quality of reporting between UK and US articles.

Conclusions: Newspaper coverage of online health information was low during the 10-year period 2003 to 2012. Journalists tended to emphasise the benefits and understate the risks of online health information and the quality of reporting varied considerably. Newspapers directed readers to sources of online health information during global epidemics although, as most articles appeared in the health sections of broadsheet newspapers, coverage was limited to a relatively small readership.

Gender, religion, and sociopolitical issues in cross-cultural online education

Cross-cultural education is thought to develop critical consciousness of how unequal distributions of power and privilege affect people’s health. Learners in different sociopolitical settings can join together in developing critical consciousness – awareness of power and privilege dynamics in society – by means of communication technology. The aim of this research was to define strengths and limitations of existing cross-cultural discussions in generating critical consciousness. The setting was the FAIMER international fellowship program for mid-career interdisciplinary health faculty, whose goal is to foster global advancement of health professions education. Fellows take part in participant-led, online, written, task-focused discussions on topics like professionalism, community health, and leadership. We reflexively identified text that brought sociopolitical topics into the online environment during the years 2011 and 2012 and used a discourse analysis toolset to make our content analysis relevant to critical consciousness. While references to participants’ cultures and backgrounds were infrequent, narratives of political-, gender-, religion-, and other culture-related topics did emerge. When participants gave accounts of their experiences and exchanged cross-cultural stories, they were more likely to develop ad hoc networks to support one another in facing those issues than explore issues relating to the development of critical consciousness. We suggest that cross-cultural discussions need to be facilitated actively to transform learners’ frames of reference, create critical consciousness, and develop cultural competence. Further research is needed into how to provide a safe environment for such learning and provide faculty development for the skills needed to facilitate these exchanges.

An iterative longest matching segment approach to speech enhancement with additive noise and channel distortion

This paper presents a new approach to speech enhancement from single-channel measurements involving both noise and channel distortion (i.e., convolutional noise), and demonstrates its applications for robust speech recognition and for improving noisy speech quality. The approach is based on finding longest matching segments (LMS) from a corpus of clean, wideband speech. The approach adds three novel developments to our previous LMS research. First, we address the problem of channel distortion as well as additive noise. Second, we present an improved method for modeling noise for speech estimation. Third, we present an iterative algorithm which updates the noise and channel estimates of the corpus data model. In experiments using speech recognition as a test with the Aurora 4 database, the use of our enhancement approach as a preprocessor for feature extraction significantly improved the performance of a baseline recognition system. In another comparison against conventional enhancement algorithms, both the PESQ and the segmental SNR ratings of the LMS algorithm were superior to the other methods for noisy speech enhancement.

Design and results of a dual-gas Quasi-Phase matching (QPM) foil target

Quasi-phase matching (QPM) can be used to increase the conversion efficiency of the high harmonic generation (HHG) process. We observed QPM with an improved dual-gas foil target with a 1 kHz, 10 mJ, 30 fs laser system. Phase tuning and enhancement were possible within a spectral range from 17 nm to 30 nm. Furthermore analytical calculations and numerical simulations were carried out to distinguish QPM from other effects, such as the influence of adjacent jets on each other or the laser gas interaction. The simulations were performed with a 3 dimensional code to investigate the phase matching of the short and long trajectories individually over a large spectral range.

Spectacles of military urbanism in online representations of the Elite Squad of the military police of Rio de Janeiro: a multimodal approach

This paper presents a multimodal analysis of online self-representations of the Elite Squad of the military police of Rio de Janeiro, the Special Police Operations Battalion BOPE. The analysis is placed within the wider context of a “new military urbanism”, which is evidenced in the ongoing “Pacification” of many of the city’s favelas, in which BOPE plays an active interventionist as well as a symbolic role, and is a kind of solution which clearly fails to address the root causes of violence which lie in poverty and social inequality. The paper first provides a sociocultural account of BOPE’s role in Rio’s public security and then looks at some of the mainly visual mediated discourses the Squad employs in constructing a public image of itself as a modern and efficient, yet at the same time “magical” police force.

Speaking Out Online:The Benefits and Risks of Speaking About Sexual Violence for Young People

Speaking out about sexual violence has been a fundamental part of feminist politics since the 1970s. The practice of narrating experiences of violence, either publicly or to friends and family aims to combat the culture of silence and stigmatisation that surrounds sexual violence while also helping individuals to gain a sense of empowerment and connect with other survivors. However, speaking out also contains inherent risks, especially for young people. Survivors may meet with stigmatising or disbelieving responses, and they may lose control over who knows their story and the way in which it is told and retold.
These risks and benefits are altered, and potentially exacerbated, in an online environment. While social media may increase survivors’ ability to contact and connect with others with similar experiences it also makes it harder to control when and how their story is shared. The disjuncture between online and offline environments may also increase feelings of stigmatisation and isolation.
There is a need to explore the specific risks and benefits of speaking out online given both young people’s extensive use of social media for social interactions and the increasing tendency for support and educational services targeted at young people to make use of social media and online environments. This paper draws on literature and some preliminary research to consider both risks and benefits of speaking out online and to open a conversation about the creation of supportive spaces and mechanisms for young people to speak about sexual violence in online environments.

Partial Palmprint Matching Using Invariant Local Minutiae Descriptors

In forensic investigations, it is common for forensic investigators to obtain a photograph of evidence left at the scene of crimes to aid them catch the culprit(s). Although, fingerprints are the most popular evidence that can be used, scene of crime officers claim that more than 30% of the evidence recovered from crime scenes originate from palms. Usually, palmprints evidence left at crime scenes are partial since very rarely full palmprints are obtained. In particular, partial palmprints do not exhibit a structured shape and often do not contain a reference point that can be used for their alignment to achieve efficient matching. This makes conventional matching methods based on alignment and minutiae pairing, as used in fingerprint recognition, to fail in partial palmprint recognition problems. In this paper a new partial-to-full palmprint recognition based on invariant minutiae descriptors is proposed where the partial palmprint’s minutiae are extracted and considered as the distinctive and discriminating features for each palmprint image. This is achieved by assigning to each minutiae a feature descriptor formed using the values of all the orientation histograms of the minutiae at hand. This allows for the descriptors to be rotation invariant and as such do not require any image alignment at the matching stage. The results obtained show that the proposed technique yields a recognition rate of 99.2%. The solution does give a high confidence to the judicial jury in their deliberations and decision.

Comparing Social Work Students' Perceptions of Risk Using Online Discussion Fora: Lessons Learned from a European Pilot Project

Comparisons of international child welfare systems have identified two basic orientations to practice; a ‘child protection’ orientation and a ‘child welfare’ orientation, which are founded upon fundamentally different values and assumptions regarding the family, the origins of child care problems, and the proper role of the state in relation to the family. This paper describes a project which sought to compare how undergraduate social work students from three European Universities perceive risk in referrals about the welfare of children and to explore the impact of different cultural, ideological and educational contexts on the way in which risk is constructed by students. Students from Northern Ireland, Germany and Poland examined three vignettes via ten online discussion fora each of which provided a narrative summary of their discussion. The paper presents some findings from the analysis of the qualitative data emerging from the student discussions and draws out the lessons learned in terms of how the project was designed and implemented using online discussion fora.

Wide Matching - An Approach to Improving Noise Robustness for Speech Enhancement

It is shown that under certain conditions it is possible to obtain a good speech estimate from noise without requiring noise estimation. We study an implementation of the theory, namely wide matching, for speech enhancement. The new approach performs sentence-wide joint speech segment estimation subject to maximum recognizability to gain noise robustness. Experiments have been conducted to evaluate the new approach with variable noises and SNRs from -5 dB to noise free. It is shown that the new approach, without any estimation of the noise, significantly outperformed conventional methods in the low SNR conditions while retaining comparable performance in the high SNR conditions. It is further suggested that the wide matching and deep learning approaches can be combined towards a highly robust and accurate speech estimator.

A Largest Matching Area Approach to Image Denoising

Given the success of patch-based approaches to image denoising,this paper addresses the ill-posed problem of patch size selection.Large patch sizes improve noise robustness in the presence of good matches, but can also lead to artefacts in textured regions due to the rare patch effect; smaller patch sizes reconstruct details more accurately but risk over-fitting to the noise in uniform regions. We propose to jointly optimize each matching patch’s identity and size for gray scale image denoising, and present several implementations.The new approach effectively selects the largest matching areas, subject to the constraints of the available data and noise level, to improve noise robustness. Experiments on standard test images demonstrate our approach’s ability to improve on fixed-size reconstruction, particularly at high noise levels, on smoother image regions.