Measuring Health: A Guide to Rating Scales and Questionnaires

Disparities in health outcomes are a well documented and worrisome part of our health care system. These disparities persist in spite of, and are occasionally exacerbated by, new technologies that are intended to improve health care. This results in a “digital divide” in which populations that have poorer health outcomes continue to have poorer health outcomes despite technological improvements. In many ways, the digitical divide is already shrinking via improved access to internet and technology/process improvements. For example, people with schizophrenia, PTSD, and bipolar disorder have had their care successfully augmented by new technology. However, problems persist- being impoverished, female, and black all correlate with decreased probability of completing a telehealth visit, and millions of americans have insufficient internet access to complete telehealth visits. We must continue to utilize new technology in health care to improve outcomes, but we must also be wary to ensure those outcomes are equitable across different populations.

/pdf/disparities-in-health-care-and-the-digital-divide-10mqg2f5rw.pdf

Disparities in Health Care and the Digital Divide.

The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions.To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions.We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care.Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence.Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions. 

https://jmir.org/api/download?alt_name=mental_v9i5e35159_app1.pdf&filename=cd4004d811673868640bdcd90872738e.pdf

Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review

In current consequence of haematology, blood cancer i.e. acute lymphoblastic leukemia is very frequently founded in medical practice, which is characterized by over activation and functional abnormality of bone marrow. The abnormality is identified through physical examination with a screening of blood smears. However, this method is error prone and labor intensive task for haematologist. Hence, haematologist needs a specific computer aided diagnostic system (CAD) that can deal with these limitations of prior systems and capable of discriminating immature leukemic cells from mature healthy cells. Thus, this work addresses the problem of segmenting a microscopic blood image into different regions, and then further analyzes those regions for localization of the immature lymphoblast cell. Further, it investigates the use of different geometrical, chromatic and statistical textures features for nucleus as well as cytoplasm and pattern recognition techniques for sub typing immature acute lymphoblasts as per FAB (French--- American --- British) classification. This can facilitate haematologist for acquiring essential information about prognosis and for an appropriate cure for leukemia. The exhaustive experiments have been conducted on 260 microscopic blood images (i.e. 130 normal and 130 cancerous cells) taken from ALL-IDB database. The proposed techniques consisting of the segmentation module used for segmenting the nucleus and cytoplasm of each leukocyte cell, feature extraction module, feature dimensionality reduction module that uses principal component analysis (PCA) to mapped the higher feature space to lower feature space and classification module that employs the standard classifiers, like support vector machines, smooth support vector machines, k-nearest neighbour, probabilistic neural network and adaptive neuro fuzzy inference system.

Classification of acute lymphoblastic leukaemia using hybrid hierarchical classifiers

This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of treatment yields a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research. 

Treatment of Posttraumatic Stress Disorder: a State-of-the-art Review

Stres merupakan suatu fenomena respon tubuh yang terjadi dalam kehidupan sehari-hari yang dapat memberikan dampak positif ( eustress ) maupun negatif ( distress ). Stres dapat menjadi salah satu faktor yang mempengaruhi prestasi akademik seseorang. Penelitian dilakukan di sekolah SMA Diakonia dengan subjek siswa/siswi tahun ajaran 2013/2014. Tujuan penelitian untuk mengetahui hubungan antara stres dengan prestasi akademik, sehingga dampak negatif dari stres dapat diturunkan dan meningkatkan dampak positifnya. Desain studi yang digunakan pada penelitian ini dengan penggunaan kuesioner DASS 42 pada bulan Desember 2013 yaitu cross sectional yang memiliki subjek sebanyak 76 siswa dilakukan pengambilan sampel secara consecutive non random sampling . Dari hasil uji statistik yang didapatkan sebanyak 27 siswa (35.52%) mengalami stres, 49 siswa (64.47%) tidak mengalami stres. Prestasi akademik siswa yang mengalami stres dengan nilai rata-rata kurang dari 75 sebanyak 5 siswa dan 22 siswa mengalami stres dengan nilai rata-rata lebih dari 75. Terdapat hubungan yang bermakna antara stres dengan prestasi akademik dengan nilai p value =0.019 (p < 0.05), memiliki resiko 9.25 kali lebih besar untuk mendapatkan nilai rata-rata kurang dari 75. Disarankan untuk penelitian selanjutnya dapat dilakukan dengan faktor resiko lain.

Hubungan stres dengan prestasi akademik di SMA Diakonia Jakarta

A leukocyte recognition system, as part of a differential blood counter system, is very important in hematology field. In this paper, the propose system aims to automatically classify the white blood cells (leukocytes) on a given microscopic image. The classifications of leukocytes are performed based on the combination of color and texture features of the blood cell images. The developed system classifies the leukocytes in one of the five categories (neutrophils, eosinophils, basophils, lymphocytes, and monocytes). In the preprocessing stage, the system starts with converting the microscopic images from Red Green Blue (RGB) color space to Hue Saturation Value (HSV) color space. Next, the system splits the Hue and Saturation features from the Value feature. For both Hue and Saturation features, the system processes their color information using the Feature Selection method and the Window Cropping method; while the Value feature is processed by its texture information using the Co-occurrence matrix method. The final recognition stage is performed using the Euclidean distance method. The combination of the Feature Selection and Co-occurrence Matrix methods gives the best overall recognition accuracies for classifying leukocyte images.

/pdf/a-combination-of-feature-selection-and-co-occurrence-matrix-3lcreg2djs.pdf

A Combination of Feature Selection and Co-occurrence Matrix Methods for Leukocyte Recognition System

Dalam kehidupan sehari-hari, mahasiswa pasti akan mengalami kecemasan dalam berbagai situasi lingkungan akademik. Mahasiswa kedokteran khususnya, memiliki kecenderungan tingkat kecemasan yang lebih tinggi dibandingkan dengan mahasiswa lainnya dalam rentang umur sebaya. Tingkat kecemasan ini dapat memberikan efek negatif bila tidak tertangani dengan baik, terutama terhadap performa akademik mahasiswa. Tujuan penelitian ini adalah mengetahui perbandingan nilai praktikum Histologi mahasiswa berdasarkan tingkat kecemasan mahasiswa. Diharapkan, hasil penelitian ini dapat digunakan untuk mengurangi tingkat kecemasan mahasiswa kedokteran dalam menjalani pendidikannya sebagai calon dokter. Metode yang digunakan adalah desain kuantitatif dengan membandingkan tingkat kecemasan terhadap hasil ujian mahasiswa. Instrumen yang digunakan adalah kuesioner Beck Anxiety Inventory (BAI) dan tes akademik. Responden terdiri dari 88 orang mahasiswa yang dipilih dengan cara purposive non-random sampling. Data yang didapatkan dianalisis dengan menggunakan perangkat lunak SPSS versi 22 menggunakan one-way ANOVA. Hasil penelitian menunjukkan, bahwa rata-rata nilai ujian praktikum Histologi pada mahasiswa dengan tingkat kecemasan rendah (mean=80.95 ± 8.78) lebih tinggi daripada kelompok mahasiswa dengan tingkat kecemasan sedang (mean=72.87 ± 12.03) dan tinggi (mean=77.00 ± 10.81). Hasil uji homogenitas variansi dengan Levene Statistic adalah 0.651 dengan nilai kemaknaan sebesar 0.524 (p>0.05) yang berarti variansi dari ketiga ujian sama. Hasil uji statistik dengan one-way ANOVA menunjukkan nilai F hitung adalah 5.362 dengan nilai kemaknaan sebesar 0.006 (p<0.05) yang berarti terdapat perbedaan nilai ujian praktikum histologi mahasiswa terhadap tingkat kecemasan. Kesimpulan hasil penelitian menunjukkan bahwa perbandingan rata-rata nilai ujian praktikum Histologi lebih tinggi pada mahasiswa dengan tingkat kecemasan rendah dibandingkan dengan mahasiswa yang memiliki tingkat kecemasan sedang dan tinggi. Kata kunci : pendidikan kedokteran, histologi, kesehatan mental, kecemasan, BAI

/pdf/perbandingan-nilai-praktikum-histologi-berdasarkan-tingkat-1q44n1d37f.pdf

Perbandingan nilai praktikum histologi berdasarkan tingkat kecemasan pada mahasiswa kedokteran

This paper presents the development of software for virtually teaching of medical laboratory skills based on instructional model. This initial study focuses on the assessment models developed by Borg and Gall; Dick, Carey, and Carey. The sample of this study is 887 students of the 2007 to 2011 academic year. The surveys were conducted by requiring all participants to complete the questionnaire that has been prepared. The data were analyzed using descriptive statistics. The findings of this survey are: (1) From 34 medical skills, hematology laboratory skills is the most difficult (19,73%), (2) Twenty-seven medical skills are indicated as moderate skills to learn (0.11-17.25%) (3) Six skills which include glucometer, catheter, Ear-Nose-Throat examination, Visus examination and Thyroid examination are categorized as simple skills to learn. Based on the findings, a software application for virtual teaching of hematology laboratory skills for medical students is developed.

Software Development for Virtual Teaching of Medical Laboratory Skills

Perkembangan teknologi yang sangat pesat telah membantu dunia medis untuk mendiagnosis kondisi kesehatan seseorang. Salah satu cara untuk melakukan diagnosis medis yang paling utama yaitu melalui pemeriksaan sel darah. Darah terdiri dari eritrosit, leukosit, dan plasma darah. Salah satu komponen darah yang sering dianalisis untuk mengetahui kondisi tubuh adalah leukosit. Analisis dapat dilakukan dengan melakukan perhitungan terhadap jumlah leukosit yang ada dalam tubuh. Tahap awal dari proses perhitungan sel darah adalah dengan melakukan pendeteksian terhadap lokasi sel darah melalui citra digital preparat sel darah. Pada penelitian ini, pendeteksian dilakukan secara otomatis menggunakan teknik Region Proposal Network dengan mengaplikasikan metode Faster R-CNN. Proses utama pendeteksian leukosit terdiri dari tahap pre-processing dan tahap pendeteksian area leukosit menggunakan metode Faster R-CNN. Target dari sistem yang diusulkan adalah untuk mendapatkan area leukosit dan menandainya secara otomatis. Eksperimen dilakukan terhadap citra preparat sel darah yang diwarnai dengan cairan Wright, maupun citra preparat sel darah yang tidak diwarnai. Hasil eksperimen menunjukkan tingkat akurasi pendeteksian area leukosit sebesar 99,54% untuk citra leukosit dengan pewarnaan dan akurasi pendeteksian sebesar 93,21% untuk citra leukosit tanpa pewarnaan.

Pendeteksian Leukosit Secara Otomatis Melalui Citra Preparat Berbasis Region Proposal Network

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