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Diagnosing pain in neonates is difficult but critical. Although approximately thirty manual pain instruments have been developed for neonatal pain diagnosis, most are complex, multifactorial, and geared toward research. The goals of this work are twofold: 1) to develop a new video dataset for automatic neonatal pain detection called iCOPEvid (infant Classification Of Pain Expressions videos), and 2) to present a classification system that sets a challenging comparison performance on this dataset. The iCOPEvid dataset contains 234 videos of 49 neonates experiencing a set of noxious stimuli, a period of rest, and an acute pain stimulus. From these videos 20 s segments are extracted and grouped into two classes: pain (49) and nopain (185), with the nopain video segments handpicked to produce a highly challenging dataset. An ensemble of twelve global and local descriptors with a Bag-of-Features approach is utilized to improve the performance of some new descriptors based on Gaussian of Local Descriptors (GOLD). The basic classifier used in the ensembles is the Support Vector Machine, and decisions are combined by sum rule. These results are compared with standard methods, some deep learning approaches, and 185 human assessments. Our best machine learning methods are shown to outperform the human judges.

Vibration arthrometry is a new non‐invasive technique which detects, records and analyses vibrations elicited during clinical examination of human joints. In congenital dislocation of the hip, the computer‐based method has been developed to achieve a more objective and earlier diagnosis than is otherwise available. This is a condition of 0.2 per cent incidence with which a child may be born or which can develop shortly after birth. If a diagnosis is achieved soon after birth, the treatment is simple, cheap and effective. However, if the disease is not diagnosed until the child is walking, treatment is complicated and expensive and the child will need lengthy hospitalisation with a poor prognosis. An evaluation was made of three options: existing screening system, higher level screening and use of the Belfast Hip Screener.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

Purpose: Miscarriage is commonly understood as an involuntary, grieve-able pregnancy outcome. Abortion is commonly understood as a voluntary, if stigmatized, pregnancy outcome that people do not typically grieve. This chapter examines a nexus of the involuntary and voluntary: how people who chose abortion following observation of a serious fetal health issue make sense of their experience and process associated emotions.

Design: The author draws on semi-structured interviews with cisgender women who had an observed serious fetal health issue and chose to terminate their pregnancy.

Findings: Findings highlight an initial prioritization of medical knowledge in pregnancy decision-making giving way, in the face of the inherent limits of medical knowability, to a focus on personal and familial values. Abortion represented a way to lessen the prospective suffering of their fetus, for many, and felt like an explicitly moral decision. Respondents felt relief after the abortion as well as a sense of loss. They processed their post-abortion emotions, including grief, in multiple ways, including through viewing – or intentionally not viewing – the remains, community rituals, private actions, and no formalized activity. Throughout respondents’ experiences, the stigmatization of abortion negatively affected their ability to obtain the care they desired and, for some, to emotionally process the overall experience.

Originality/Value: This chapter offers insight into the understudied experience of how people make sense of a serious fetal health issue and illustrates an additional facet of the stigmatization of abortion, namely how stigmatization may complicate people’s pregnancy decision-making process and their post-abortion processing.

The purpose of this paper is to investigate an idea of producing an assistive and augmentative communication (AAC) tool that uses natural human computer interfacing to accommodate the disabilities of children with cerebral palsy (CP) and assist them in their daily communication.

The authors developed a prototype that recognizes the real time detected emotions display on the face and send alerts to the caretakers through Short Messaging System (SMS) or loud speaker.

The evaluation result shows that the proposed prototype recognizes real time facial expressions from the children with CP with an average of 79.4 per cent, and a maximum of 88.3 per cent (standard deviation of 7.4 per cent) on ten children with CP. Evaluations were also conducted to investigate the effectiveness of the prototype to deliver critical expression messages to their caretakers. The result showed that 98.5 per cent of SMS was sent successfully to the caretakers (pre‐defined mobile phone number) with an average waiting time of 8.3 seconds.

The paper demonstrates the potential of the proposed prototype to assist children with CP to communicate with their caretakers in real time.

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

This study contributes to the understanding of the health effects of pesticides exposure and of how pesticides have been and should be regulated.

This study presents literature reviews for the period 2000–2013 on (i) the health effects of pesticides and on (ii) preference valuation of health risks related to pesticides, as well as a discussion of the role of benefit-cost analysis applied to pesticide regulatory measures.

This study indicates that the health literature has focused on individuals with direct exposure to pesticides, i.e. farmers, while the literature on preference valuation has focused on those with indirect exposure, i.e. consumers. The discussion highlights the need to clarify the rationale for regulating pesticides, the role of risk perceptions in benefit-cost analysis, and the importance of inter-disciplinary research in this area.

This study relates findings of different disciplines (health, economics, public policy) regarding pesticides, and identifies gaps for future research.

Sexually transmitted infections (STIs) can be transferred from one person to another through sexual contact. STIs lead to substantial morbidity and mortality and affect many different aspects of human life, including quality of life, sexual health, reproductive health and even the health of newborns and children. Despite of high rates of STIs in prisons, there are not sufficient screening, prevention and treatment programs to control STIs transmission among prisoners in Iran. This study aims to evaluate the prevalence of STIs among incarcerated women in Iran for the first time, using the active case finding strategy.

This is a cross-sectional study conducted on 438 incarcerated women in a prison in Tehran, Iran, from 2017 to 2018. A total of 438 prisoners were screened by active case findings for STI symptoms, then evaluated by complete genital and anal examination, followed by molecular testing.

A total of 189 (43.2%) prisoners announced vaginal discharge, while 194 (44.3%) individuals had vaginal discharge in the genital examination. In the cervical examination, 137 individuals (31.3%) had abnormal findings, of which 83 (18.9%) individuals had cervicitis, 40 (9.1%) individuals had cervical erosion, 38 (8.7%) individuals had cervical prolapse and 17 (3.9%) individuals had bleeding originated from the cervix.

This study showed that it is possible to set up a system in which the diagnosis, follow-up and treatment of prisoners with STIs can be actively performed. Educating prisoners about signs and symptoms, risk behaviors and prevention routes of STIs, as much as regular screening of prisoners, and adequate treatment can help control the STIs prevalence among prisoners and in the general population.

The aim of this study is to determine what changes occur in the health status of people with autism spectrum disorder (ASD) compared to neurotypical controls.

The authors performed a comparative analysis of data collected from 72 subjects with ASD and 75 neurotypical controls aged 3–24 years using the Rochester Health Status Survey IV (RHSS-IV). A structured individual interview was conducted to compare the health status of subjects in Macedonia.

A majority of people with ASD take vitamins, supplements and use recommended drug therapies compared to the neurotypical population and experience a larger number of side effects (p = 0.000). Compared to people with neurotypical development, children with ASD have a higher prevalence of oral ulcers (31.9% vs 17.3%; p = 0.039), changes in neurological health status – epilepsy (19.4% vs 2.7%; p = 0.001) and ADD/ADHD (only persons with ASD-19.4%; p = 0.000); respiratory diseases – angina (30.5% vs 8%; p = 0.000), rhinitis and/or sinusitis (40.3% vs 17.3%; p = 0.02); changes in the gastrointestinal system – constipation (31.9% vs 10.6%; p = 0.02), intestinal inflammation (19.4% vs 8%; p = 0.043), permeable intestines (only persons with ASD – 13.9%; p = 0.000) and the presence of the fungus Candida albicans (19.4% vs 4%; p = 0.043); psychiatric disorders – sleep problems (only in people with ASD – 18%; p = 0.000) and tics (6.9% vs 2.6%; p = 0.25) and skin diseases – eczema/allergic skin rash (36.1% vs 18.7%; p = 0.02).

Many children with ASD have health problems. These findings support and complement the professional literature on their mutual causality.

Earlier in the year, during the national steel industry strike, the House of Lords overturned a judgment of Lord Denning, MR, that sections of the industry unaffected by the trade dispute could be regarded as outside the Act and its amendments and that unions could be restrained in their application of immune activities to those firms. The decision apart, their Lordships in delivering judgment reaffirmed that only Parliament had power to make the Law; it was not the function of Judges to do this, their's to interpret and apply the Law. In strict legal terms and applying to statutes and statutory instruments, this is true; but in the widest sense, judges have been making law for centuries. Otherwise, from whence cometh the Common Law, one of the wonders of the world, if not from the mouths of H.M. Judges. Much of it is now enshrined in statute form, especially Criminal Law, but initially it was all judge‐made. In most systems of human control and function, complete separation is rarely possible and when attempted the results have not been conspicuously successful.