Fictitious Case Research Articles

The psychodynamics of self-harm

SUMMARY This article examines the complex phenomenon of self-harm, exploring its motivations, theoretical underpinnings and the intricate transference and countertransference reactions that arise in clinical settings. It aims to integrate psychiatric understanding with contemporary theories of the impact of trauma on both the body and the mind, to deepen the knowledge of self-harm and increase the effectiveness of treatment approaches. The article argues for a nuanced view of self-harm and emphasises the need for compassionate, well-informed care. By addressing the psychodynamics of self-harm, the article seeks to improve therapeutic outcomes and foster an empathetic and effective clinical response. Fictitious case studies are used to illustrate these concepts, demonstrating the critical role of early attachment experiences and the challenges faced by healthcare providers in management.

ETHICAL DILEMMAS IN MEDICAL CARE FOR WOMEN IN SITUATIONS OF SOCIAL VULNERABILITY: EXPANDING THE DEBATE ON MARGINALIZED POPULATIONS IN EDUCATION

This paper addresses reflections and discussions on the female figure in the context of social marginalization, linked to threats to human rights, with a focus on access to health care and quality longitudinal monitoring. This debate analyzes the historical process of marginalization and oppression amplified when women are inserted as street dwellers, enhancing the weaknesses of helplessness and substance abuse, thus aggravating violence and stigma. This is a narrative review of literature, of a reflective nature, associated with a report of an educational experience in the construction of a teaching methodology based on a fictitious case that triggers discussion and resolution of problems linked to human rights violations of marginalized women, in the light of philosophies of law and the study of public policies for undergraduate medical students. The development of the work shows the importance of expanding studies on this topic, focusing on historically invisible people, in a problematizing narrative, using the construction of clinical cases containing not only health needs for a resolution of medicalization, based strictly on biological diagnoses, but that challenge the reflective thinking of social medicine, directing the debate towards human rights lines, in a context of interprofessional dialogues and studies of public policies, as essential in the training of doctors committed to guaranteeing equity and access to the most neglected population segments in Brazil.

Understanding of premenstrual dysphoric disorder and premenstrual syndrome among professionals in Japanese university health services: A survey with simulated cases

ObjectivesPremenstrual dysphoric disorder (PMDD) and severe premenstrual syndrome (PMS) exert profoundly adverse effects on quality of life. We surveyed psychiatrists and clinical psychologists in Japan to determine their understanding and practice of diagnosing PMDD/PMS. MethodsWe targeted psychiatrists and clinical psychologists working at health administration facilities of universities in Japan who treat female patients with depressive symptoms in their late teens and 20 s—when PMDD/PMS is likely to develop. We presented a fictitious clinical case of a 23-year-old female and investigated whether the participants considered PMDD/PMS as a potential diagnosis. We also investigated the practitioners’ basic understanding of PMDD/PMS. ResultsWe analyzed survey responses from 26 psychiatrists and 140 clinical psychologists. Comparatively few respondents considered PMDD/PMS a possible diagnosis or routinely inquired about a patient’s menstruation. When practitioners were provided with information linking observed symptoms to the menstrual cycle, most considered PMDD and PMS possible diagnoses. Recognizing and considering PMDD/PMS was related to the respondents’ attributes. ConclusionsClinicians should consider PMDD/PMS when treating women with depressive symptoms.

The Adoptee Consciousness Model: Integration with Family Counseling Theory and Practice

Transracial adult adoptee storylines are increasingly represented across media platforms, yet counseling practice guidelines for the population remain limited. The authors provide updated counseling strategies by applying the Adoptee Consciousness Model (ACM). Via a fictitious case study of one adult transracial adoptee, the authors integrate the ACM with three family systems theories. Recommendations for individual, couple, and family counselors and therapists are provided.

Dimensional models of personality and a multidimensional framework for treating personality pathology

SUMMARY The categorisation of personality pathology into discrete disorders has been an enduring standard. However, dimensional models of personality are becoming increasingly prominent, in part owing to their superior validity and clinical utility. We contend that dimensional models also offer a unique advantage in treating mental illness. Namely, psychotherapy approaches and the components of dimensional models of personality can both be arranged hierarchically, from general to specific factors, and aligning these hierarchies provides a sensible framework for planning and implementing treatment. This article begins with a brief review of dimensional models of personality and their supporting literature. We then outline a multidimensional framework for treatment and present an illustrative fictitious clinical case before ending with recommendations for future directions in the field.

Confronting Fake News Through Collective Intelligence in Adolescents

Adolescents are vulnerable to the exponential increase in fake news spread. Collective judgment on the quality of news has been an effective intervention. Collective Learning platform makes it possible to apply collective intelligence through simultaneous interaction in a large group, similar to social networks. The objective of this article is to analyze whether this platform effectively improves how adolescents confront fake news. 360 Spanish students aged 15–16 years old participated in the experiment confronting a fictitious case of fake news. The quantitative analysis using ANOVA demonstrated that there were significant positive changes for addressing fake news, both overall as well as in each of the participants. We discuss how these results confirm that collective intelligence improves digital literacy in the Internet challenges.

Testamentary capacity

SUMMARY To make a valid will, a person should be able to understand the nature and consequences of doing so, the extent of their estate and the claims others may have on it. No disorder of mind should be present that would affect their testamentary decisions, and clinicians are therefore often asked to give an opinion on whether a person has testamentary capacity. This article discusses the legal issues involved, with reference to UK case law (in particular, the legal test of Banks v Goodfellow (1870)), and outlines the requirements of testamentary capacity assessment (including retrospective assessments), the clinician's responsibilities when requested by a solicitor to make an assessment of capacity (‘the golden rule’) and what they might expect if appearing in court to give expert witness regarding testamentary capacity. Fictitious case studies are presented illustrating certain points in testamentary capacity assessment.

Optimizing Forest Surveillance: A Hybrid Algorithm Combining ACO and ABC

This work introduces a potential Hybrid Algorithm for the complex field of forest monitoring, integrating Artificial Bee Colony Optimisation (ABC) and Ant Colony Optimisation (ACO). The performance indicators of the algorithm were carefully assessed in a fictitious use case. Its effectiveness was demonstrated by a shorter drone path, a shorter flight duration, and less energy usage, making it an affordable surveillance option. In addition, the algorithm demonstrated a great rate of mission coverage, quick convergence, and consistently good quality of solutions. Its usefulness in dynamic forest habitats was highlighted by its capacity to adjust to changing weather conditions and scale to accommodate more waypoints. Its cost-effectiveness is increased by efficient resource utilisation, which is demonstrated by low CPU and memory consumption. Taken together, these results highlight how the algorithm may transform forest surveillance by increasing operational effectiveness, cutting expenses, and satisfying the changing requirements of intricate monitoring scenarios. To fully realise the algorithm's potential for environmental monitoring applications, this research advocates for more real-world testing and optimisation.

Agile governance practices by aligning CMMI V2.0 with portfolio SAFe 5.0

Agile is now a mainstream approach used by developer teams at software organizations. However, many of these organizations still employ traditional governance methods, negatively impacting agile team performance, quality and morale. To address this issue, we applied the Design Science Research Framework to develop Agile governance guidelines by harmonizing CMMI V2.0 and SAFe 5.0. Specifically, we matched CMMI V2.0 governance practices to SAFe 5.0 roles, practices and artefacts. The resulting guidelines were validated, first by means of a survey and then through interviews with process improvement practitioners and agile experts who worked on a fictitious case study. The survey participants, especially those more familiar with SAFe practices, stated that the proposed harmonization was meaningful. Agile experts participating in the case study confirmed that the proposed guidelines were practical and comprehensive, as well as consistent and complete. Pending further empirical validation, these guidelines constitute a crucial step towards Agile governance.

Lung cancer MDT quality assessment: A nationwide study.

8594 Background: This observational study evaluates concordance between lung cancer multi-disciplinary team (MDT) meetings, focusing on diagnosis, staging, and treatment recommendations, especially for curative options. Assessing MDT decisions aims to identify factors potentially affecting survival rates, promoting equal treatment access for patients nationwide. Methods: In Norway, patients with lung cancer are discussed at local MDT (without a thoracic surgeon present) and at university hospital MDT (with a thoracic surgeon present). All hospitals received 35 fictitious case reports of patients with inoperable non-small cell (NSCLC) and small cell lung cancer (SCLC) with anonymized CT and PET images for discussion at the ordinary MDT meetings. Of the 12 participating hospitals, 5 were university hospitals. Results: Of the 35 patient’s cases, 12 were assessed as having stage III NSCLC. For 10 of the 12 there were differences in stage assessment, from stage IIIA-B-C to IV, and in recommended treatment (Table). For each case, curative treatment was recommended by a varying number of MDTs, from zero to nine of 12. Treatment suggestions for the four SCLC patients were identical except for one patient with stage IV, performance status (PS) score 2-3 and stroke, for whom the recommended treatment ranged from best supportive care (BSC) to triple therapy. There was generally good consensus between recommending treatment with a tyrosine kinase inhibitor (TKI) in patients with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) translocation positivity. We found that factors leading to discrepancies in MDT decisions were patients age >75-80 years, comorbidities, PS 2 or lack of a stated PS, PD-L1 more than 50-75% in stage IV and large cell neuroendocrine carcinoma (LNEC). Conclusions: MDT-recommendations regarding treatment varied between MDT sites, and this may have the greatest consequences for patients in stage III. MDT treatment recommendations varied between the sites, confirming that treatment choice can be challenging in certain type of cases like elderly, poor PS or LNEC. Shared decision-making (SDM) with patients was often recommended. As an important outcome of the study, we found no difference in treatment choice between local and university hospital MDTs. [Table: see text]

Detrimental effects of scene manipulations on temperature-based time since death estimation

In forensic casework, time since death (TSD) estimations may play a crucial role to establish chains of events as well as for alibi assessment in homicide cases. Classical TSD estimation relies on reasonably stable ambient temperatures and a correct documentation of ambient and rectal temperatures. This constancy is in some cases disturbed by post-discovery alterations of the crime scene, e.g. opening a window. In order to develop a better understanding of this alteration-based detrimental impact on TSD estimation as well as to identify feasible recommendations for casework, the present pilot study examined ambient temperature effects of different window opening scenarios regarding various time intervals (5 to 360 min) in a furnished 10 m2 apartment during winter. In this context, in addition to the ambient temperature and thus the cooling rate of the room, re-approximation to initial room temperature, potential influences on a nomogram-based time since death estimation using a fictitious case, and the impact of the measurement height above the ground were investigated. Our data indicate a significant reduction of the mean temperature decrease rate after 15 min regardless of the remaining opening time and a correlation with the size of the respective opening surfaces. Re-approximation to initial room temperatures was observed with up to three times longer than the initial opening time. There was no evidence of a substantial advantage of temperature measurements above the level of the corpse (> 0.1 m). The limitations of the study and its applicability for forensic casework are critically reviewed.

The Indirect Costs of Avoidance in Food Allergy Management: A Scoping Review

Background: Food allergy management requires avoidance of allergenic food. While the direct costs of food allergy management have been described, avoidance may also contribute to time and opportunity costs. We aimed to conduct a scoping review of the peer-reviewed literature on the indirect costs of food allergy, and to characterise these costs through a series of fictitious case studies. Methods: We performed a scoping review, guided by Arskey and O’Malley’s methodological framework, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews. Eligible studies included original, peer-reviewed, English language literature with no lower limits to publication dates, which addressed the indirect costs of food allergy, including time and opportunity costs. A search strategy was developed by content experts with experience performing multi-database scoping reviews. The search was performed on 10 July 2023, managed using Rayyan (Cambridge, USA), and screened for eligibility. Results: Searches yielded 104 articles. After deduplication, 96 articles were screened at the title and abstract level; 12 articles were included following full-text screening. Of these, three studies were performed on adults with food allergy, eight studies were based on data collected from caregivers of children with food allergy, and one study made use of data reflecting adults and caregivers of children with food allergy. Collectively, indirect costs were identified as higher amongst those with vs. without food allergy. The few studies on age and food allergy differences (e.g., type and number of food allergies, history of reaction) are equivocal. Conclusions: The limited body of peer-reviewed literature supports that food allergy commonly carries substantial indirect costs across diverse measurement tools, albeit with age-group differences.

Step-by-step one-way ANOVA analysis with the Jamovi program

ANOVA is the acronym for Analysis of Variance, which stands for Analysis of Variance, and is used to establish statistically significant differences between the means of two groups. Currently there are several programs that synthesize this work allowing us to analyse statistical data in a simpler way. In this manuscript we will address a one-way or one-factor analysis of variance, which means that we must have an explanatory variable, also known as an independent variable, which must have two or more categories, we must also have a dependent or response variable of the type quantitatively discrete, in a fictitious case we will observe with this method how the independent variables shifted to the dependent variable, using the JAMOVI program, which is a free and easy-to-install advanced calculation program that allows the creation of complex statistical calculations efficiently. for manipulation, filtering, selection and combination of data.

Testing the interrater reliability of integrated interpretations using a problem-solving model.

[Purpose] A method for evaluating integrated interpretation skills, which is an important educational goal in clinical practice, is yet to be established. This study examined the interrater reliability of a problem-solving model that was developed as a novel assessment method. [Participants and Methods] Three students created problem-solving models using fictitious case data. Ten clinical practice supervisors with at least 3 years of experience were asked to score the models, and the intraclass correlation coefficient (2, 1) was calculated. [Results] The intraclass correlation coefficient was 0.88, which indicates a good result. [Conclusion] Good interrater reliability was obtained using the problem-solving model, which suggests that this model may be used to assess integrated interpretation skills in clinical practice.

Welfare regimes and social workers' conceptions of social problems and professional roles

This article compares social work in countries representing four different welfare regimes: Chile, the Republic of Ireland (refer to elsewhere as ‘Ireland’), Lithuania and Sweden. The aim is to examine how social workers in different contexts refer to families’ complex needs, how contextual factors influence social workers’ positions and actions, and how they make sense of their work. Social workers in 15 focus groups, 4 per country except for Chile with 3, were interviewed about their conceptions of ‘family’, ‘families with complex needs’, and reasoning about interventions in relation to a fictitious complex case vignette. The understanding of complex needs appears relatively individualized in Chile and Lithuania, while contextual factors were more pronounced in the Irish and Swedish material. Chile, exemplifying a familialized family policy regime, reflects a poverty-compensatory social worker role that also supports familial reproduction; Ireland, a partly de-familialized regime, reflects a supportive and risk-reactive role; Lithuania, a re-familialized regime reflects a patriarchal risk-reducing role and Sweden, a de-familialized policy regime, reflects a rights-oriented and technocratic role. Welfare regimes shape different social work practice contexts. However, to some extent, social workers around the world share a common work ethos in how they, for the best interest of the people they work with, deal with the cross-pressure from social problems and political-ideological priorities.

THE ELIMINATION OF STATE ADMINISTRATIVE COURT’S AUTHORITY TO DECIDE POSITIVE FICTITIOUS DECISIONS AFTER THE AMENDMENT TO LAW NUMBER 30 OF 2014 CONNECTED WITH THE GENERAL PRINCIPLES OF GOOD GOVERNANCE

Government agencies and/or officials carry out the task of administering the state using legal instruments, one of which is decisions. If within the allotted time a government official does not respond to the request filed against him, his silence is equated with a fictitious decision. The fictitious decisions that apply in Indonesia are positive fictitious decisions, implicitly contained in Article 53 paragraph (3) of Law Number 30 of 2014, namely the government's silence means a form of acceptance. A positive fictitious decision needs to be submitted to the Administrative Court to get an acceptance decision. After the UUCK, PTUN's authority to decide on positive fictitious decisions was abolished, so what are the legal consequences and whether this is in accordance with the AUPB. The research method uses normative juridical with statutory, case, and conceptual approaches. The results of the research show that PTUN does not have the authority to decide on a positive fictitious decision request due to the abolition of Article 53 paragraph (4) in UUCK, so that the settlement lies with government agencies. However, there is a disparity in the judge's decision regarding the authority of PTUN to decide on a positive fictitious decision request caused by two approaches, namely legalistic positivism and action. It is possible to enter a positive fictitious case by filing a lawsuit for unlawful acts by government agencies and/or officials. The abolition of PTUN's authority is not in accordance with AUPB, especially the principles of legal certainty, expediency, accuracy, and fairness.

External quality assessment for detection of colorectal cancer by Septin9 DNA methylation in clinical laboratories

Background and aimsThe incidence and mortality rate of colorectal cancer (CRC) are increasing worldwide. Septin9 methylated (mSEPT9) DNA in circulation can be used as a non-invasive detection method to assist in the early diagnosis of CRC; however, the detection methods and procedures are complicated. This study aimed to evaluate the ability of clinical laboratories to detect Septin9 methylation in plasma cell-free DNA (cfDNA). Materials and methodsWe prepared a sample panel consisting of positive and negative Septin9 methylation cells and CRC cells. Three positive samples with different methylation levels, one negative sample and one duplicate sample, two samples containing interference, three different CRC cell samples, and a fictitious case report were included. The panel was distributed to 59 laboratories for mSEPT9 analysis, result comparison, and scoring. ResultsThe sample panel, validated by National Medical Products Administration (NMPA)-approved tests and targeted bisulfite sequencing, met expectations and could be used for external quality assessment (EQA). Among the 59 laboratories, 55 (93.22%) correctly reported the mSEPT9 results for all samples, while four (6.79%) reported 15 false negatives and were considered improvable. All false negatives originated from four laboratories using laboratory-developed tests (LDTs), with three failing to detect weakly positive samples, samples containing interference, and samples from different CRC cells, and one reported erroneous results on all positive samples. ConclusionOur results illustrated that the detection of mSEPT9 in cfDNA is satisfactory in China. EQA is indispensable because it can help improve the diagnostic capability and quality management of the laboratories, and provide suggestions for the problems existing in mSEPT9 detection.

Shades of grey: choice, control and capacity in alcohol-related brain damage.

Liaison psychiatrists have identified that conducting capacity assessments in general hospital patients with alcohol-related brain damage (ARBD) can be challenging. This educational article uses the fictitious case of a man with ARBD, alcohol dependence and significant self-neglect, focusing on assessment of his capacity to decide about moving into a care home on discharge. We provide an overview of clinical, legal and ethical literature relevant to decision-making and capacity assessment in individuals with ARBD, with the aim of guiding clinicians approaching complex capacity assessments.

Roman Declamation, Roman Law, and Ancient Legal Medicine: the Case of veneficium

Abstract This paper discusses the Roman legal treatment of poisoning, grounded on the lex Cornelia de sicariis et veneficis (81 BCE), through the lens of school forensic declamations (controversiae). Sections 1-4 set the context and address key methodological issues. Section 5, the core of the research, examines Pseudo-Quintilian’s Declamatio minor 350 Aqua frigida privigno data (Cold water given to stepson) – a fictitious legal case concerning a suspicious death caused by drinking cold water. It is argued that the medico-legal assumptions underlying this distinctly unique case are likely to have brought new content to the legal conceptualisation of the reckless administration of venena, and hence, to the juristic interpretation of the degree of criminal intent required in similar cases of suspected homicide. The overall objective is to provide new insights of multidisciplinary relevance into the intersections of Roman Imperial forensic rhetoric, Roman law, and Graeco-Roman medicine, by looking closer at the method of argument through which trials involving a charge of poisoning may have been conducted in actual court practice.

A Primer on Neurodiversity-Affirming Speech and Language Services for Autistic Individuals

Purpose: The purpose of this tutorial is to educate speech-language pathologists (SLPs) on the need for and positive outcomes associated with neurodiversity-affirming care. This primer will outline what neurodiversity is, why it is central to the provision of evidence-based practice and culturally responsive care, and introduce the reader to neurodiversity-affirming clinical practices. Method: This tutorial is based on a review of literature, including academic research and written works from autistic and disability activists, existence in autistic spaces, conversations within the autistic community, lived experience as autistic individuals, and clinical experience as SLPs. Discussion: SLPs specializing in developmental disabilities will provide services for children with a variety of diagnoses and co-occurring conditions. Consequently, SLPs are likely to work with autistic and otherwise neurodivergent individuals. In supporting autistic clients, SLPs may promote communication development, provide and support augmentative and alternative communication, teach executive functioning strategies, educate family members and/or other members of the support team, and more. As such, it is imperative that SLPs have an understanding of the neurodiversity paradigm, how it relates to providing culturally responsive care, and the positive outcomes associated with incorporating it into our practice. This tutorial provides descriptions of neurodiversity-affirming care principles and definitions of related terms through visuals, discussion, and fictitious case scenarios and examples. Conclusion: Clinicians may use this primer to integrate neurodiversity-affirming care principles into their practice.