Ono Academic College

Cystic fibrosis (CF) is a severe genetic disorder historically associated with low life expectancy. The introduction of CF transmembrane conductance regulator (CFTR) modulator drugs like Trikafta has dramatically improved health outcomes for many people with CF (pwCF), shifting their lived experiences in unexpected ways. This qualitative study explores the psychological and social consequences of such improvements, focusing specifically on identity disruption and emotional adaptation. Utilizing a phenomenological approach, in-depth interviews were conducted with CF patients who had used Trikafta for at least 2 years, alongside an analysis of publicly available blog narratives. The findings reveal two central themes: identity disruption and ambivalent loss. Participants described profound challenges in adjusting to their new health status, including difficulties in redefining their identity after years of viewing themselves as chronically ill. Additionally, they reported a paradoxical sense of loss, grieving aspects of their previous illness experience, such as a sense of urgency in life decisions and strong connections within the CF community. While participants also shared hopeful and forward-looking narratives, this study centers on the less-explored emotional complexities that emerge when long-standing illness-based identities are disrupted. The findings underscore the need for comprehensive psychological support systems to help PwCF process identity shifts and sustain a sense of continuity in their lives.

This study examined psychological performance determinants in 48 adult wheelchair basketball players, focusing on self-efficacy, sport-confidence, and goal orientation. Participants (38 male and 10 female) were analyzed by classification, sex, etiology, experience, and age. Outcome measures included the Basketball Self-Efficacy Scale, Task and Ego Orientation in Sport Questionnaire (TEOSQ), and the Trait Sport-Confidence Inventory. T tests were performed to explore differences between groups. Results revealed significant differences in TEOSQ scores between classifications: High pointers (International Wheelchair Basketball Federation [IWBF]4-4.5) had higher ego-orientation scores than low pointers (IWBF 1-1.5). Males had higher self-efficacy scores than females. Less-experienced athletes showed higher task-orientation scores. Pearson correlation tests revealed a strong negative correlation between TEOSQ and age and a moderate negative correlation between TEOSQ and experience. The findings provide insights into psychological performance determinants in wheelchair basketball players, offering a foundation for targeted coaching practices aimed at enhancing athletic performance.

IntroductionThis study explored the use of the Virtual Reality Joint Painting Procedure (VR-JPP) to examine the relationship dynamics between mother-daughter dyads in middle childhood (ages 9 to 12). The research focused on art-based interventions conducted in the virtual reality space.MethodsInterviews were conducted with 16 mothers who participated in the VR-JPP.ResultsThe interviews yielded three main themes: dyadic communication in the virtual reality space, the advantages and disadvantages of three-dimensional painting in virtual reality, and the tripartite relationship between the therapist, mother, and daughter in the therapeutic space. The findings suggest that virtual reality fostered an innovative therapeutic space that encourages freer and more open interactions between mothers and daughters using avatars that enable unmediated emotional expression. The virtual space allowed the dyads to focus on emotional and creative communication and increased their grasp of relationship dynamics.DiscussionThe virtual space allowed the dyads to focus on emotional and creative communication and increased their grasp of relationship dynamics. These findings contribute to the literature on the uses of art in the virtual reality space from the perspective of mothers.

Background: Papilledema, an ophthalmic finding associated with increased intracranial pressure, is often induced by dermatological medications, including corticosteroids, isotretinoin, and tetracyclines. Early detection is crucial for preventing irreversible optic nerve damage, but access to ophthalmologic expertise is often limited in rural settings. Artificial intelligence (AI) may enable the automated and accurate detection of papilledema from fundus images, thereby supporting timely diagnosis and management. Objective: The primary objective of this study was to explore the diagnostic capability of ChatGPT-4o, a general large language model with multimodal input, in identifying papilledema from fundus photographs. For context, its performance was compared with a ResNet-based convolutional neural network (CNN) specifically fine-tuned for ophthalmic imaging, as well as with the assessments of two human ophthalmologists. The focus was on applications relevant to dermatological care in resource-limited environments. Methods: A dataset of 1094 fundus images (295 papilledema, 799 normal) was preprocessed and partitioned into a training set and a test set. The ResNet model was fine-tuned using discriminative learning rates and a one-cycle learning rate policy. GPT-4o and two human evaluators (a senior ophthalmologist and an ophthalmology resident) independently assessed the test images. Diagnostic metrics including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and Cohen's Kappa, were calculated for each evaluator. Results: GPT-4o, when applied to papilledema detection, achieved an overall accuracy of 85.9% with substantial agreement beyond chance (Cohen's Kappa = 0.72), but lower specificity (78.9%) and positive predictive value (73.7%) compared to benchmark models. For context, the ResNet model, fine-tuned for ophthalmic imaging, reached near-perfect accuracy (99.5%, Kappa = 0.99), while two human ophthalmologists achieved accuracies of 96.0% (Kappa ≈ 0.92). Conclusions: This study explored the capability of GPT-4o, a large language model with multimodal input, for detecting papilledema from fundus photographs. GPT-4o achieved moderate diagnostic accuracy and substantial agreement with the ground truth, but it underperformed compared to both a domain-specific ResNet model and human ophthalmologists. These findings underscore the distinction between generalist large language models and specialized diagnostic AI: while GPT-4o is not optimized for ophthalmic imaging, its accessibility, adaptability, and rapid evolution highlight its potential as a future adjunct in clinical screening, particularly in underserved settings. These findings also underscore the need for validation on external datasets and real-world clinical environments before such tools can be broadly implemented.

ABSTRACT Various studies have pointed to the historical and often progressive development of educational policies. However, very few have examined how these changes have been manifested in the lived experiences of people with disabilities. Drawing on life history interviews with 38 people with physical impairments from four generational cohorts (1950s to 2000s), the current study examines how changes in legislation and social norms were reflected in the experiences of children with physical disabilities in the Israeli education system. The thematic analysis of these interviews highlights two key spheres in which such changes, or their lack, were evident: the physical and social. Regarding the former, over the years, the schools' physical environment became increasingly accessible. However, some key barriers remained, two of which are highlight in this paper: field trips and physical education. As for the social sphere, participants reported it to be the most challenging, with most recalling vividly numerous experiences of ableism, rejection, and stigma on the part of their classmates. Our findings also highlight the significant impact of accessibility barriers on the social sphere. In discussing these findings, we situate them with relation to both past and current policy and social contexts. Finally, practical educational recommendations are suggested.

traumatic autobiographical distress by meeting neuroscience-informed MR conditions. Vaisvaser discussed selfhood as constructed by predictive processing and interpersonal neural synchronization, situating the arts as a vehicle for neuroplastic reshaping of the multidimensional self. Bridging neuroscience and subjectivity, she highlighted how functional crosstalk between brain networks supports the integration of bodily experiential and narrated mental aspects of the self, their disruptions in psychopathology, and their relevance to the psychotherapeutic use of the arts. Bokoch and Hass-Cohen found that IATN research outcomes suggested improvements in brain activity and functioning, cognitive, affective, sensory, and social functioning, as well as psychological symptoms and behaviors. Changes were captured based on biophysiological measures, neuropsychological assessments, standardized psychological self-report measures, and qualitative reports (Bokoch et al.). Strang identified the current state of evidence underlying concepts in neuroscience that are regularly integrated into IATN theory and practice. She explored the current scope, ethical concerns, and methodological challenges of arts therapies and neuroscience integration and cautioned against uncritical use of mechanistic explanations of arts therapies based on neuroscience explanations. She outlined limits and opportunities for evidence-based integration.Across the manuscripts included in this special issue, our esteemed contributors joined in this endeavor, exploring how arts therapies potentially engage brain networks and physiological In summary, key insights of this special edition illustrated the potential for the validation of IATN mechanisms through neural networks, physiological systems, and neuroplasticity. IATN theories, approaches, and clinical interventions were shown by our authors to provide unique tools to express, regulate, and externalize emotions, as well as reconsolidate trauma memories beyond verbal processing. Furthermore, sensorimotor, visual, and aesthetic elements within the therapy elicited profound emotional shifts and aid in mood regulation. Relational and social processes formed another vital component, with the therapeutic alliance and social play facilitating healing, particularly in cases focused on trauma, stigma reduction, and symptoms related to aging. The empowerment and meaning making fostered by art offer autonomy, insight, and transformation, especially for chronic conditions and marginalized voices. However, the field continues to face several challenges, including the necessity for methodological rigor, diversity, and ethical sensitivity, and innovation. These aspects are crucial for advancing future IATN research and applications.

ABSTRACTBackgroundPsychiatric diagnosis often generates controversy regarding its necessity, validity and utility. While it can help determine service eligibility and guide clinical decision‐making, a formal diagnosis can also reinforce negative stereotypes and self‐stigma, particularly among adolescents and young adults in critical stages of identity formation.AimIn this article, we argue that a policy shift from a national, free‐to‐all funding to HMO‐based coverage—with mandatory diagnostic documentation—might contradict the principles of early‐intervention services for youth.MethodBetween 2016 and 2018, we collected routine data for an evaluation study of youth early‐intervention services in Israel. During this period, eligibility changed from open access to a requirement of receiving a formal DSM diagnosis.ResultsOur secondary analysis shows no significant differences in demographic characteristics, psychological distress or social and occupational functioning before and after the policy change. However, clinicians reported a significantly higher proportion of youth meeting full diagnostic criteria for DSM diagnosis and expressed greater certainty in their assessments.DiscussionThese findings underscore the potential influence of policy on clinical judgement—or at least its documentation—demonstrating a paradox: a system intended to broaden early intervention may inadvertently hinge on a stigmatising label, potentially deterring help‐seeking among youth. Financial and policy structures can challenge the low‐barrier, youth‐friendly framework that characterises early intervention in psychiatry. Further investigation is needed to understand the fragile dynamics of mental health coverage policy and the principles youth‐oriented early‐intervention services.

ABSTRACTChild protection officers (CPOs) play a critical role in protecting children at risk and make important decisions that significantly impact children and their families. These decisions are influenced by wider contexts such as family, system, organization and multiple cultural contexts. Working in the Arab community, which has different values and norms from mainstream Israeli society, requires the CPOs to consider the cultural context within their decisions. This qualitative study used the decision‐making ecology (DME) framework and the Judgement and Decision Process in Context model (JuDPiC). The study aimed to explore what factors influence Arab CPOs' intervention decisions regarding children at risk and to gain a better understanding of how the cultural context shaped their intervention decisions. This study included 30 Arab CPOs working in social services departments in Israel, and semistructured interviews were conducted. The study's results revealed several factors at the case (e.g., child's age, gender and type of maltreatment) and organizational (e.g., accessibility of community services) levels that influenced the Arab CPOs' intervention decisions. The results demonstrated how the cultural context was embedded within the Arab CPOs' decisions. CPOs should be aware of the contexts in which decisions are made and how these may impact their intervention decisions.