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Future Healthcare Journal Nov 2022Recruitment and retention of medical practitioners is a challenging contemporary issue for rural and remote areas. In this paper, we explore the importance of what it is...
Recruitment and retention of medical practitioners is a challenging contemporary issue for rural and remote areas. In this paper, we explore the importance of what it is that doctors value in rural and remote places from their own personal, organisational, social and spatial lives. We do this by drawing on original research from Scotland that explored doctors' decisions on choosing, or not, to work in remote and rural locations. Three themes are explored: moving and staying, using place to think holistically about places beyond the language of work that recruitment and retention implies; how doctors' professional values and their capacity to enact those values change with time; and how policy landscapes interact and shape rural and remote locations as valued places for doctors to live and work. We end the paper by reiterating the World Health Organization findings that a whole-of-society approach is required to support rural and remote communities to flourish, thus, encouraging doctors and their families to value such places and, ultimately, .
PubMed: 36561806
DOI: 10.7861/fhj.2022-0089 -
JDR Clinical and Translational Research Jan 2022A European Union amalgam phase-down has recently been implemented. Publicly funded health care predominates in the United Kingdom with the system favoring amalgam use....
INTRODUCTION
A European Union amalgam phase-down has recently been implemented. Publicly funded health care predominates in the United Kingdom with the system favoring amalgam use. The current use of amalgam and its alternatives has not been fully investigated in the United Kingdom.
OBJECTIVES
The study aimed to identify direct posterior restorative techniques, material use, and reported postoperative complication incidence experienced by primary care clinicians and differences between clinician groups.
METHODS
A cross-sectional survey was distributed to primary care clinicians through British dentist and therapist associations (11,092 invitations). The questionnaire sought information on current provision of direct posterior restorations and perceived issues with the different materials. Descriptive statistical and hypothesis testing was performed.
RESULTS
Dentists' response rate was 14% and therapists' estimated minimum response rate was 6% (total = 1,513). The most commonly used restorative material was amalgam in molar teeth and composite in premolars. When placing a direct posterior mesio-occluso-distal restoration, clinicians booked on average 45% more time and charged 45% more when placing composite compared to amalgam ( < 0.0001). The reported incidences of food packing and sensitivity following the placement of direct restorations were much higher with composite than amalgam ( < 0.0001). Widely recommended techniques, such as sectional metal matrix use for posterior composites, were associated with reduced food packing ( < 0.0001) but increased time booked ( = 0.002).
CONCLUSION
Amalgam use is currently high in the publicly funded sector of UK primary care. Composite is the most used alternative, but it takes longer to place and is more costly. Composite also has a higher reported incidence of postoperative complications than amalgam, but time-consuming techniques, such as sectional matrix use, can mitigate against food packing, but their use is low. Therefore, major changes in health service structure and funding and posterior composite education are required in the United Kingdom and other countries where amalgam use is prevalent, as the amalgam phase-down continues.
KNOWLEDGE TRANSFER STATEMENT
This study presents data on the current provision of amalgam for posterior tooth restoration and its directly placed alternatives by primary care clinicians in the United Kingdom, where publicly funded health care with copayment provision predominates. The information is important to manage and plan the UK phase-down and proposed phase-out of amalgam and will be of interest to other, primarily developing countries where amalgam provision predominates in understanding some of the challenges faced.
Topics: Composite Resins; Cross-Sectional Studies; Dental Amalgam; Dental Materials; Dental Restoration, Permanent
PubMed: 33300416
DOI: 10.1177/2380084420978653 -
Science Robotics May 2023Place recognition is an essential spatial intelligence capability for robots to understand and navigate the world. However, recognizing places in natural environments...
Place recognition is an essential spatial intelligence capability for robots to understand and navigate the world. However, recognizing places in natural environments remains a challenging task for robots because of resource limitations and changing environments. In contrast, humans and animals can robustly and efficiently recognize hundreds of thousands of places in different conditions. Here, we report a brain-inspired general place recognition system, dubbed NeuroGPR, that enables robots to recognize places by mimicking the neural mechanism of multimodal sensing, encoding, and computing through a continuum of space and time. Our system consists of a multimodal hybrid neural network (MHNN) that encodes and integrates multimodal cues from both conventional and neuromorphic sensors. Specifically, to encode different sensory cues, we built various neural networks of spatial view cells, place cells, head direction cells, and time cells. To integrate these cues, we designed a multiscale liquid state machine that can process and fuse multimodal information effectively and asynchronously using diverse neuronal dynamics and bioinspired inhibitory circuits. We deployed the MHNN on Tianjic, a hybrid neuromorphic chip, and integrated it into a quadruped robot. Our results show that NeuroGPR achieves better performance compared with conventional and existing biologically inspired approaches, exhibiting robustness to diverse environmental uncertainty, including perceptual aliasing, motion blur, light, or weather changes. Running NeuroGPR as an overall multi-neural network workload on Tianjic showcases its advantages with 10.5 times lower latency and 43.6% lower power consumption than the commonly used mobile robot processor Jetson Xavier NX.
Topics: Humans; Animals; Robotics; Neural Networks, Computer; Brain; Algorithms; Neurons
PubMed: 37163608
DOI: 10.1126/scirobotics.abm6996 -
The Psychoanalytic Quarterly 2020The author presents some clinical sequences from two sessions in order to illustrate his thoughts about dreaming, about experiencing in analysis, and about the clinical...
The author presents some clinical sequences from two sessions in order to illustrate his thoughts about dreaming, about experiencing in analysis, and about the clinical realization of the potential space. When the dreamer's conscious and unconscious relationship with her own dream turns the latter into a living psychic object, the experience that the dreamer can have of the dream occupies an intermediate area, placing itself between the internal world and external reality. When the dreamer lets the dream-experience affect the experience of external reality, a further transformation can take place in the analysis, since this intermediate intrapsychic area can become a transitional area between the patient and the analyst. The analyst and the patient were able to create a potential space in which, in addition to the transference repetition of cumulatively traumatic situations, an experience was generated that gave rise to embryonic processes of integration between dissociated aspects of the patient.
PubMed: 35312403
DOI: 10.1080/00332828.2020.1775468 -
Journal of Interprofessional Care 2021Interprofessional education (IPE) aims to prepare health-care students to provide patient care in a collaborative team environment. However, much health-care education...
Interprofessional education (IPE) aims to prepare health-care students to provide patient care in a collaborative team environment. However, much health-care education is delivered in places and spaces which do not support interprofessional interaction. To examine the consequences of this, we explored how a relatively new health-care education center (the "space" and "place") impacted interprofessional learning. This qualitative study drew on two data sources. Documents (n = 50) related to building design and curricula plans, and focus groups with medical and physician associate students co-learning within the building to explore their experiences of the building in relation to IPE (17 participants). Data coding and analysis were inductive, using thematic analysis. A key objective for the building was to support IPE. This objective was not translated into operational detail in later documents or into practice, as indicated by student experiences. Students experienced tensions and isolation from each other and other health-care students because of the building's place (i.e. separate from other health-care programs), the learning space within the building, and the interplay between the space and timetables. This empirical study suggests that space and place can impact on interprofessional learning, emphasizing the importance of clearly conceptualizing educational spaces and places to underpin successful IPE.
Topics: Curriculum; Humans; Interprofessional Education; Interprofessional Relations; Learning; Qualitative Research
PubMed: 32917110
DOI: 10.1080/13561820.2020.1812551 -
IEEE Transactions on Neural Systems and... 2023P300 potential is important to cognitive neuroscience research, and has also been widely applied in brain-computer interfaces (BCIs). To detect P300, many neural network...
P300 potential is important to cognitive neuroscience research, and has also been widely applied in brain-computer interfaces (BCIs). To detect P300, many neural network models, including convolutional neural networks (CNNs), have achieved outstanding results. However, EEG signals are usually high-dimensional. Moreover, since collecting EEG signals is time-consuming and expensive, EEG datasets are typically small. Therefore, data-sparse regions usually exist within EEG dataset. However, most existing models compute predictions based on point-estimate. They cannot evaluate prediction uncertainty and tend to make overconfident decisions on samples located in data-sparse regions. Hence, their predictions are unreliable. To solve this problem, we propose a Bayesian convolutional neural network (BCNN) for P300 detection. The network places probability distributions over weights to capture model uncertainty. In prediction phase, a set of neural networks can be obtained by Monte Carlo sampling. Integrating the predictions of these networks implies ensembling. Therefore, the reliability of prediction can be improved. Experimental results demonstrate that BCNN can achieve better P300 detection performance than point-estimate networks. In addition, placing a prior distribution over the weight acts as a regularization technique. Experimental results show that it improves the robustness of BCNN to overfitting on small dataset. More importantly, with BCNN, both weight uncertainty and prediction uncertainty can be obtained. The weight uncertainty is then used to optimize the network through pruning, and the prediction uncertainty is applied to reject unreliable decisions so as to reduce detection error. Therefore, uncertainty modeling provides important information to further improve BCI systems.
Topics: Humans; Brain-Computer Interfaces; Electroencephalography; Bayes Theorem; Uncertainty; Reproducibility of Results; Algorithms
PubMed: 37318970
DOI: 10.1109/TNSRE.2023.3286688 -
Transcultural Psychiatry Feb 2023Refugee children's experiences are situated in specific places where they interact with significant people. They are not usually asked about their perspectives although...
Refugee children's experiences are situated in specific places where they interact with significant people. They are not usually asked about their perspectives although they are social agents with distinctive perspectives and feelings about relationships and events. We investigated the perspectives of refugee children on their experiences of places and relations as they resettled in Australia after their families fled from violence in Syria and Iraq and transitioned through Middle Eastern countries. One hundred-and-nine children chose to work with a computer program in either English or Arabic. They sorted feelings associated with home, school, and where they lived before and rated being nurtured at home. Hierarchical cluster analysis revealed five subgroups of children with distinctive patterns in their sorting of eight feelings for three places. Three subgroups had patterns of positive feelings about home and school. Two smaller subgroups had mixed, ambivalent feelings about either school or home. One subgroup was strongly positive, and two others were negative about before settlement. Subgroups identified on their sortings of feelings differed in their experiences of being nurtured, with positive feelings of places related to higher ratings of being nurtured at home. The study points to the importance of children's perspectives and feelings in how they interpret experiences with people and places and argues against assuming that refugee children are homogeneous in their experiences or perspectives.
Topics: Humans; Child; Refugees; Syria; Iraq; Emotions; Schools
PubMed: 35938322
DOI: 10.1177/13634615221107215 -
The European Journal of Neuroscience Aug 2022Neuroimaging studies using univariate and multivariate approaches have shown that the fusiform face area (FFA) and parahippocampal place area (PPA) respond selectively...
Neuroimaging studies using univariate and multivariate approaches have shown that the fusiform face area (FFA) and parahippocampal place area (PPA) respond selectively to images of faces and places. The aim of this study was to determine the extent to which this selectivity to faces or places is based on the shape or texture properties of the images. Faces and houses were filtered to manipulate their texture properties, while preserving the shape properties (spatial envelope) of the images. In Experiment 1, multivariate pattern analysis (MVPA) showed that patterns of fMRI response to faces and houses in FFA and PPA were predicted by the shape properties, but not by the texture properties of the image. In Experiment 2, a univariate analysis (fMR-adaptation) showed that responses in the FFA and PPA were sensitive to changes in both the shape and texture properties of the image. These findings can be explained by the spatial scale of the representation of images in the FFA and PPA. At a coarser scale (revealed by MVPA), the neural selectivity to faces and houses is sensitive to variation in the shape properties of the image. However, at a finer scale (revealed by fMR-adaptation), the neural selectivity is sensitive to the texture properties of the image. By combining these neuroimaging paradigms, our results provide insights into the spatial scale of the neural representation of faces and places in the ventral-temporal cortex.
Topics: Adaptation, Physiological; Brain Mapping; Magnetic Resonance Imaging; Pattern Recognition, Visual; Photic Stimulation; Temporal Lobe; Visual Cortex
PubMed: 35703007
DOI: 10.1111/ejn.15737 -
Journal of Environmental Psychology Dec 2020The Covid-19 pandemic has prompted a reconsideration, perhaps even a fundamental shift in our relationships with place. As people worldwide have experienced 'lockdown,'...
The Covid-19 pandemic has prompted a reconsideration, perhaps even a fundamental shift in our relationships with place. As people worldwide have experienced 'lockdown,' we find ourselves emplaced in new and complex ways. In this Commentary, we draw attention to the re-working of people-place relations that the pandemic has catalysed thus far. We offer insights and suggestions for future interdisciplinary research, informed by our diverse positionalities as researchers based in different continents employing diverse approaches to people-place research. The article is structured in two sections. First, we consider theoretical aspects of our current relationships to place by proposing a framework of three interdependent axes: emplacement-displacement, inside-outside, and fixity-flow. Second, we identify six implications of these dialectics: for un-making and re-making 'home'; precarity, exclusion and non-normative experiences of place; a new politics of public space; health, wellbeing and access to 'outside' recreational spaces; re-sensing place, virtual escapes and fluid places, and methodological and ethical considerations. Across these topics, we identify 15 key questions to guide future research. We conclude by asserting that learning lessons from the global pandemic is necessarily tentative, requiring careful observation of altered life circumstances, and will be deficient without taking relationships with place into account.
PubMed: 36540651
DOI: 10.1016/j.jenvp.2020.101514 -
Applied Bionics and Biomechanics 2023This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for...
This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for orthodontic treatment and investigate the accuracy and feasibility of a 3D guide plate in clinical practice. A total of 30 microimplants were placed in 15 patients in the Department of Stomatology, Affiliated Hospital of Jiangnan University. Before surgery, DICOM data from cone-beam computed tomography (CBCT) scans and STereoLithography data from the 3D model scan were imported to 3Shape Dental System. Data fitting and matching were performed, and 3D guide plates were designed primarily focusing on the thickness of guide plates, amount of concave compensation, and dimensions of the ring. Assist implantation method was used to place the microimplants, and postoperative CBCT images were used to evaluate the position and implantation angle. The feasibility of placing microimplants and precise implantation guided by the 3D guide plate. CBCT data before and after the placement of microimplants were compared. Regarding the secure positioning of microimplants based on CBCT data, 26 implants were categorized as Grade i, four as Grade ii, and none as Grade iii. No loosening of microimplants 1 and 3 months after surgery was reported. The implantation of microimplants is more accurate under the guidance of a 3D guide plate. This technology can achieve accurate implant positioning, thus ensuring safety, stability, and improved success rates after implantation.
PubMed: 37404956
DOI: 10.1155/2023/9060046