In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research.

ABSTRACT This paper is offered as a thought piece rather than an academic paper. It will summarise some key points from the previous piece written jointly with Andrew Tyson in 2010, reflect on some of the specific assertions in that paper, and introduce a range of broader musings that seem relevant developed since that time. To put these in context, after a short note on terminology, I begin by summarising my work in social care and other roles.

ObjectiveTibial stress injuries are challenging in terms of early diagnosis, management strategy, and safe return-to-play. In the present study, pain production associated with the application of therapeutic ultrasound (TUS) was used as a primary diagnostic tool to assess tibial bone stress injuries, and the sensitivity of this procedure was compared with Magnetic Resonance Imaging (MRI). Subject and methodsThe study was designed as a retrospective analysis of prospectively collected data on tibial bone stress injuries in elite Track and field athletes attending the National Track and Field Athletics Centre in Thessaloniki, Greece, in the period 1995–2007. All patients underwent evaluation by TUS, and the sensitivity of the procedure was compared with MRI. ResultsFour of 29 athletes showed a positive TUS examination for stress injury while MRI showed normal findings. Additionally, 5 athletes evidenced MRI findings typical of a tibial bone stress injury, while TUS evaluation was negative. Using MRI as the standard, TUS displayed a sensitivity of 79.2%. ConclusionTherapeutic ultrasound is a reproducible modality with satisfactory reliability and sensitivity related to MRI, and could represent a useful tool for clinicians to primarily assess suspected tibial bone stress injuries in high qualification Track and Field athletes.

As Artificial Intelligence (AI) becomes more and more pervasive in our everyday life, new questions arise about its ethical and social impacts. Such issues concern all stakeholders involved in or committed to the design, implementation, deployment, and use of the technology. The present document addresses these preoccupations by introducing and discussing a set of practical obligations and recommendations for the development of applications and systems based on AI techniques. With this work we hope to contribute to spreading awareness on the many social challenges posed by AI and encouraging the establishment of good practices throughout the relevant social areas. As points of novelty, the paper elaborates on an integrated view that combines both human rights and ethical concepts to reap the benefits of the two approaches. Moreover, it proposes innovative recommendations, such as those on redress and governance, which add further insight to the debate. Finally, it incorporates a specific focus on the Italian Constitution, thus offering an example of how core legislations of Member States might contribute to further specify and enrich the EU normative framework on AI.

On 14th August 2021, a magnitude 7.2 earthquake struck the Tiburon Peninsula in the Caribbean nation of Haiti, approximately 150 km west of the capital Port-au-Prince. Aftershocks up to moment magnitude 5.7 followed and over 1,000 landslides were triggered. These events led to over 2,000 fatalities, 15,000 injuries and more than 137,000 structural failures. The economic impact is of the order of US$1.6 billion. The on-going Covid pandemic and a complex political and security situation in Haiti meant that deploying earthquake engineers from the UK to assess structural damage and identify lessons for future building construction was impractical. Instead, the Earthquake Engineering Field Investigation Team (EEFIT) carried out a hybrid mission, modelled on the previous EEFIT Aegean Mission of 2020. The objectives were: to use open-source information, particularly remote sensing data such as InSAR and Optical/Multispectral imagery, to characterise the earthquake and associated hazards; to understand the observed strong ground motions and compare these to existing seismic codes; to undertake remote structural damage assessments, and to evaluate the applicability of the techniques used for future post-disaster assessments. Remote structural damage assessments were conducted in collaboration with the Structural Extreme Events Reconnaissance (StEER) team, who mobilised a group of local non-experts to rapidly record building damage. The EEFIT team undertook damage assessment for over 2,000 buildings comprising schools, hospitals, churches and housing to investigate the impact of the earthquake on building typologies in Haiti. This paper summarises the mission setup and findings, and discusses the benefits, and difficulties, encountered during this hybrid reconnaissance mission.

BackgroundSymptomatic muscle herniae are an uncommon cause of chronic exercise induced leg pain. The most common site for muscle hernia is the tibialis anterior muscle. This study evaluates the outcome of a minimal incision fasciotomy in patients with a symptomatic muscle hernia of the tibialis anterior muscle, and their return to normal daily activities including sport. MethodsThe study reports mid-term results in a series of 22 consecutive patients (17 males and 5 females, median age: 22 years) with a unilateral tibialis anterior MH who had undergone minimally invasive fasciotomy between 2008 and 2019. Clinical outcomes were assessed with SF-36 and European Quality of Life-5 Dimensions scale (EQ-5D). The ability to participate in sport before and after surgery, and the time to return to training (RTT) and to sport (RTS) were recorded. ResultsAt a median follow up after surgery of 23 months, both questionnaires showed a statistically significant improvement (P < 0.005). At the latest follow up, 16 of patients (73%) had returned to pre-injury or higher levels of sport/activity. The median time to return to training and to return to sport was 7 and 11 weeks respectively. No severe complications and no recurrence of symptoms were recorded. ConclusionMinimally invasive fasciotomy is effective and safe for patients suffering from muscle hernia of the tibialis anterior muscle with good results in the mid-term. Level of EvidenceIV.

PurposeThis paper examines the challenges associated with rural women entrepreneurs in Oman. The study is based on women living in rural and highland areas who aim to move beyond their traditional roles in the family seeking avenues for growth and development. It identifies several problems encountered by rural women entrepreneurs and the impact on their future business opportunities.Design/methodology/approachA mixed research approach involving quantitative and qualitative elements was adopted for the study. The research is based on 183 survey responses and personal interviews with 8 rural women entrepreneurs. Partial least squares structural equation modeling (PLS-SEM) was adopted to analyse the quantitative responses and depict a model featuring the intensity of the problems affecting business opportunities. Seven short cases based upon the interviews with rural women entrepreneurs are also detailed.FindingsSeveral problems experienced by rural women entrepreneurs were identified hampering their business ventures, linked to personality, family, educational, socio-cultural, facilities, legal, financial and economic, organizational and geographical, out of which household, organizational and geographical linked problems were most significant. Entrepreneurial opportunities for rural women entrepreneurs are discussed.Practical implicationsThe research suggests that the policymakers should holistically consider how the rural women engaged in informal business for various means can be better supported and sustained by overcoming associated problems, can achieve business opportunities and contribute to regional socio-economic development.Originality/valueThere is a limited literature available on rural women entrepreneurship in an Arab context. The study provides an overview of the challenges and problems experienced by these women and the support areas required to overcome them for their sustainability in this region.