Personal constructs of mind-body identity in people who experience medically unexplained symptoms (MUS)

"Medically unexplained symptoms" (MUS) refers to chronic physical symptoms without a clear medical cause, which produce significant levels of distress and functional impairment. This project modified the repertory grid technique to explore how twenty participants experiencing MUS construed self and others in bodily and psychological ways. Findings suggested that symptoms are well integrated within participants' wider mind–body construct systems. Increased distance between how self in general is construed compared to self when symptoms are worst was associated with reduced anxiety. Measuring intrapersonal and interpersonal implicative dilemmas suggested that moral and relational construing of identity is affected by MUS.Peer reviewe

ADHD: ‘Because You’re Worth It’: The Marketisation of ADHD to Adult Women

Drawing on the traditions of discursive psychology and critical discourse analysis this study examined the marketisation of ‘Attention-deficit/hyperactivity disorder’ (ADHD) to women in a small sample of online YouTube videos. Of specific interest was the constructed and constructive nature of discourse at a ‘micro’ level, with a particular focus on the reification and commodification of the ‘ADHD-product’; and the discursive strategies used to persuade women of the potential benefits of ‘ADHD’ diagnosis and ‘treatment’. The video material analysed represented a combination of first person testimonies from the ‘sufferer’, and the sharing of ‘expertise’ by ‘professionals’, and comprised of both verbal and visual aspects. The analytic categories generated told a ‘story’ of the construction and commodification of the ‘ADHD-product’, unproblematically positioned within the biomedical discourse; followed by the active promotion of ‘ADHD’ to women, with strong endorsements for the use of stimulant medication to ‘enhance performance’ and ‘increase one’s potential’. Attention was also paid to the possibility that this diagnosis might threaten women’s selfhood and undermine personal authenticity. Implications for research and professional practice are discussed in light of the analysis

A problem-based approach to clinical education in dietetics

Developing the clinical skills and knowledge of dietetic students provides a challenge for both universities and health care agencies. Deakin University has recently adopted a group learning model using problem-based learning to deliver the clinical component of the Master of Nutrition and Dietetics course. This approach was designed to enhance integration of clinical theory and practice, develop closer links between on-campus and off-campus learning environments and provide students with more active learning experiences. The impact of the new approach was evaluated using student questionnaires, academic and competency outcomes, and a focus group convened with hospital supervisors. The evaluation indicated that students generally thought that this method of learning had helped to integrate their basic knowledge with dietetic case management. There was no difference in academic scores from the previous year and an apparent reduction in the number of students requiring additional placement time to mee t competency standards. Hospital supervisors were supportive of the changes, although they had some reservations regarding the time and structure of clinical placements. As a result of this evaluation, recommendations for future development of the program include introducing problem-based learning to students earlier in their course, providing additional placement days during the block and increasing the amount of time dedicated to more complex topics. Based on the evaluation results obtained, this collaborative learning using a problem-based approach will continue to be used in the clinical education program at Deakin University. <br /

Direct patient contacts of dietetic students during their final clinical placement

Direct student-patient contacts, during the professional clinical placement of a Master of Nutrition and Dietetics course, were collected and analysed for the first time using a computerised method. In the final eight-week hospital placement, 26 dietetic students submitted data on direct patient contacts which included: dietetic activities (e.g. assessing, counselling and reviewing); the primary nutritional condition of the patient (e.g. type 2 diabetes and liver disease); and the time spent in contact with patients. The most common dietetic activities were reviews, followed by collection of dietary information and counselling. The most common nutritional condition encountered by students was an inadequate nutrient intake, followed by patients receiving enteral nutrition. Contact time with patients increased over the placement, with proportionately more time spent by students seeing patients independently than when being observed by supervising dietitians. The data collected provided valuable informa tion on the amount of time spent by students in direct patient contacts, the range of dietetic activities undertaken and the amount of time student activities were directly observed. This information will be useful in the development of benchmarks for clinical skill development, hospital and university staff planning and the assessment of the impact of any changes to the format of student placement experience in the clinical setting.<br /

Psychosocial peer mediation as sustainable method for conflict prevention and management among refugee communities in Germany

Following the arrival of over 1.2 million refugees and asylum seekers since the 2015 European refugee crisis, Germany has faced enormous humanitarian and societal challenges, with direct implications for participatory peace-building efforts at the local community level. A multitude of postmigration stressors and high prevalence of mental health conditions among refugees contribute to the substantial burden of daily conflicts in refugee shelters and communities. Ongoing exposure to a conflict-prone environment, psychological distress and stigmatization among community members can severely impair the quality of life and aggravate existing health-related, socio-economic and integrational challenges. Previous research has demonstrated the feasibility of individual alternative dispute resolution (ADR) and mental health literacy (MHL) interventions in refugee settings. As interpersonal conflict and psychological well-being constitute mutually interdependent phenomena, integrated methodologies combining ADR with MHL may offer unique value to affected vulnerable populations. However, systemic implementation of such mechanisms in refugee shelters has remained largely unexplored. In recognition of this unmet need and as part of the nonprofit organization R3SOLUTE, we have developed a tailored educational curriculum directed at equipping refugees in shelters and their local neighbor citizens with peer mediation-based ADR and MHL skills. In this multidisciplinary bottom-up approach, termed psychosocial peer mediation (PPM), participants learn to effectively manage and prevent conflicts in their own communities. Based on our field experience with implementing PPM in numerous refugee shelters across Germany between 2018 and 2021, we here provide relevant practical insights and discuss best practices, with a focus on addressing existing challenges and opportunities in the field

Factors associated with cytomegalovirus serostatus in young people in England:A cross-sectional study

BACKGROUND: Human cytomegalovirus (CMV) is a common herpesvirus which is estimated to infect 83% of the global population. Whilst many infections are asymptomatic, it is an important cause of morbidity and mortality, particularly for immunocompromised people and for infants who are congenitally infected. A vaccine against CMV has been stated as a public health priority, but there are gaps in our understanding of CMV epidemiology. To guide potential future vaccination strategies, our aim was to examine risk factors for CMV seropositivity in young people in England. METHODS: The Health Survey for England (HSE) is an annual, cross-sectional representative survey of households in England during which data are collected through questionnaires, and blood samples are taken. We randomly selected individuals who participated in the HSE 2002, aiming for 25 participants of each sex in each single year age group from 11 to 24 years. Stored samples were tested for CMV antibodies. We undertook descriptive and regression analyses of CMV seroprevalence and risk factors for infection. RESULTS: Demographic data and serostatus were available for 732 individuals, of whom 175 (23.7%) were CMV-seropositive. CMV seroprevalence was associated with age, with 18.3% seropositive at 11-14 years compared to 28.3% at 22-24 years. CMV serostatus was also higher in people of non-white ethnicity (adjusted odds ratio [aOR] 6.22, 95% confidence interval [CI] 3.47-11.14), and in adults who were seropositive for EBV (aOR 2.08 [1.06-4.09]). There was no evidence that smoking status, occupation, body mass index and region of England were associated with CMV serostatus. CONCLUSIONS: CMV seroprevalence is strongly associated with ethnicity, and modestly increases with age in 11-24-year-olds. A greater understanding of the transmission dynamics of CMV, and the impact of this on CMV-associated morbidity and mortality, is necessary to inform effective vaccination strategies when a vaccine for CMV becomes available