"People call me a nerd, that means they're saying I'm clever" Using Personal Construct Psychology to explore the self-awareness skills of pupils with a diagnosis of autism spectrum disorder

Research suggests that those with a diagnosis of autism spectrum disorder (ASD) may have increased levels of mental health difficulties (e.g. Simonoff et al, 2008), though there is a poor evidence base around how professionals might be able to support these needs (e.g. National Autistic Society, 2010).There is some suggestion that Personal Construct Psychology (PCP) might have some utility in addressing these issues (e.g. Attwood, 2007), though this lacks thorough investigation. In line with a pragmatic approach to research, I chose an action research methodology to investigate how I could use PCP to extend the self-awareness skills of pupils with a diagnosis of ASD, an area often linked to positive wellbeing. I used various PCP activities with secondary aged pupils, adapting and modifying the methods according to their responses, skills and areas of need. The data included my own reflections and observations from the sessions, transcripts and notes of session content, as well as evaluations from the pupils relating to the activities they completed. Template analysis, a matrix framework and thematic analysis were used to analyse the two cycles of data. Findings related to processes of application (practitioner skills), and use of PCP (how activities helped the pupils to make extensions to their self-awareness when made accessible). Compared to the range of comments pupils made during the first session, all pupils showed extensions to their self-awareness following PCP, though with a wide variation in the extent of complexity shown. This study therefore yields practical implications, both for my own practice as well as for the EP profession. There is a continuing need for pupils with ASD to access support towards enhancing their emotional wellbeing; this study serves as the basis for practitioners to trial PCP approaches in order to support the development of pupil self-awareness

Objects: the archaeology of medieval healing

This chapter discusses the contribution that artefactual analyses make to a cultural history of medieval medicine, and more specifically, what the study of archaeological sources can offer, drawing principally on evidence from medieval Britain

The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review.

BACKGROUND: Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. METHODS AND FINDINGS: We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990-Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72-0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47-1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77-2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. CONCLUSIONS: Text messaging interventions increased adherence to ART and smoking cessation and should be considered for inclusion in services. Although there is suggestive evidence of benefit in some other areas, high quality adequately powered trials of optimised interventions are required to evaluate effects on objective outcomes

Clinical Features and Severity of Leptospirosis Cases Reported in the Hawke's Bay Region of New Zealand

AIMS: To record demographics, symptoms, signs, and laboratory features of confirmed leptospirosis cases in the Hawke's Bay area of New Zealand to aid clinicians in diagnosis and recognition of severity. METHODS: Review of suspected leptospirosis cases referred to the reference laboratory from hospitals in the Hawke's Bay region between March 2003 and March 2012. Inclusion criteria were IgM positivity and diagnosis confirmed with either polymerase chain reaction (PCR) or microscopic agglutination test (MAT). A retrospective systematic review of case notes was completed for demographic and laboratory data. RESULTS: Forty-three cases were included. Most common presenting symptoms were pyrexia (93%), myalgia, and headache (both 86%). 93% of patients worked in the farming or meat industries. The most common biochemical abnormalities were elevated CRP (100%) and abnormal urinalysis (93%). There was no difference in disease severity between icteric and anicteric patients. Compared to other studies, patients in New Zealand have less severe disease. CONCLUSION: Contrary to popular understanding, this study has not found icteric leptospirosis to be related to more severe disease. Anicteric leptospirosis should be a differential diagnosis in patients presenting with pyrexia, myalgia, and headache who have elevated CRP and abnormal urinalysis

Defining and assessing spiritual health : a comparative study among 13- to 15-year-old pupils attending secular schools, Anglican schools, and private Christian schools in England and Wales

This article argues that the nation's commitment to young people involves proper concern for their physical health, their psychological health, and their spiritual health. In this context the notion of spiritual health is clarified by a critique of John Fisher's model of spiritual health. Fisher developed a relational model of spiritual health, which defines good spiritual health in terms of an individual's relationship to four domains: the personal, the communal, the environmental, and the transcendental. In the present analysis, we make comparisons between pupils educated in three types of schools: publicly funded schools without religious foundation, publicly funded schools with an Anglican foundation, and new independent Christian schools (not publicly funded). Our findings draw attention to significant differences in the levels of spiritual health experienced by pupils within these three types of schools