Does a self-referral counselling program reach doctors in need of help? A comparison with the general Norwegian doctor workforce

BACKGROUND: Doctors have a relatively high degree of emotional distress, but seek help to a lesser degree and at a later stage than other academic groups. This can be deleterious for themselves and for their patients. Prevention programs have therefore been developed but it is unclear to what extent they reach doctors in need of help. This study describes doctors who participated in a self-referrral, easily accessible, stress relieving, counselling program in Norway, and compares them with a nationwide sample of Norwegian doctors. METHODS: Two hundred and twenty seven (94%) of the doctors, 117 women and 110 men, who came to the resort centre Villa Sana, Modum, Norway, between August 2003 and July 2005, agreed to participate in the study. Socio-demographic data, reasons for and ways of help-seeking, sick-leave, symptoms of depression and anxiety, job stress and burnout were assessed by self-reporting questionnaires. RESULTS: Forty-nine percent of the Sana doctors were emotionally exhausted (Maslach) compared with 25% of all Norwegian doctors. However, they did not differ on empathy and working capacity, the other two dimensions in Maslach's burnout inventory. Seventy-three percent of the Sana doctors could be in need of treatment for depression or anxiety based on their symptom distress scores, compared with 14% of men and 18% of women doctors in Norway. Twenty-one percent of the Sana doctors had a history of suicidal thoughts, including how to commit the act, as compared to 10% of Norwegian doctors in general. CONCLUSION: Sana doctors displayed a higher degree of emotional exhaustion, symptoms of depression and anxiety as well as job related stress, compared with all Norwegian doctors. This may indicate that the program at Villa Sana to a large extent reaches doctors in need of help. The counselling intervention can help doctors to evaluate their professional and private situation, and, when necessary, enhance motivation for seeking adequate treatment

Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204]

BACKGROUND: Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. METHODS/DESIGN: A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and < 39 weeks gestation, planning a vaginal birth, not in active labour, with a singleton, viable fetus of vertex presentation, are eligible to participate. Allocation concealment is achieved using telephone randomisation. Participants assigned to hypnosis groups commence hypnosis training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia – the primary endpoint. We estimate that approximately 5–10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants have been recruited. All participant data will be analysed, by a researcher blinded to treatment allocation, according to the "Intention to treat" principle with comprehensive pre-planned cost- benefit and subgroup analyses. DISCUSSION: If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice

Narrative Functions of Clause Linkage in Garrwa: a perpective analysis

Clause linkage has long been associated with the cohesive narrative functions of temporal organisation and participant tracking (eg. Givon 1983a, Myhill & Hibiya 1988). In this paper I use data from Garrwa, a language of Northern Australia, to show that in addition to these functions, clause linkage also contributes to the interpretation of narrative perspective. The results of this investigation illustrate the range of functions that can be associated with clause linkage, contributing to the analysis of clause linkage cross-linguistically, as well as demonstrating the utility of narrative perspective as a discourse-pragmatic phenomenon motivating choices in linguistic form, and coherence in narrative structure

Post-start-up overlap and disattentiveness in talk in a Garrwa community

Overlap in conversation is a well-established area of conversation analysis research (e.g. Jefferson 1983; Schegloff 2000) which can reveal how participants orient to transition relevance places. This paper presents an analysis of overlap in the mixed (Garrwa, Kriol and English) language conversations of two indigenous Australian women as part of a larger study of turn-taking practices in indigenous conversations. Walsh (Walsh 1995) made some observations about Aboriginal conversational style, for example that they may enter a conversation without attending to the talk of others. His observational claims are empirically examined here in the context of our data.We find that the overlapping talk in our data follows many patterns similar to English speakers talk, including transition space overlap (cf. Jefferson 1983) and simultaneous starts. The most important difference we found was overlap onset occurring shortly after the closure of the transition space, reflecting disattendance by speakers to the content, but not the timing, of each others talk. Overall, however, we find that the turn-taking of these two women is overwhelmingly orderly, and deviations from orderliness can mostly be accounted for by their orientation to points of possible completion and rules of turn-taking as described by Sacks, Schegloff and Jefferson (1974)

Intonational rises and dialogue acts in the Australian English map task

C1 - Journal Articles RefereedEight map task dialogs representative of General Australian English, were coded for speaker turn, and for dialog acts using a version of SWBD-DAMSL, a dialog act annotation scheme. High, low, simple, and complex rising tunes, and any corresponding dialog act codes were then compared. Dialog acts corresponding to information requests were consistently realized as high-onset high rises ((L +)H*H-H%). However low-onset high rises (e.g., L*H-H%) corresponded to a wider range of other "forward-looking" communicative functions, such as statements and action directives, and were rarely associated with information requests. Low-range rises (L*L-H%), by contrast, were mostly associated with backward-looking functions, like acknowledgments and responses, that is they were almost always used when the speaker was referring to what had occurred previously in the discourse. Two kinds of fall-rise tunes were also examined: the low-range fall-rise (H *L-H%) and the expanded range fall-rise (H* + L H-H%). The latter shared similar dialog functions with statement high rises, and were almost never associated with yes/no questions, whereas the low-range fall-rises were associated more with backward-looking functions, such as responses or acknowledgments. The Australian English statement high rise (usually realized as a L* H-H% tune) or "uptalk," appears to be more closely related to the classic continuation rises, than to yes/no question rises of typologically-related varieties of English

Young children from three diverse cultures spontaneously and consistently prepare for alternative future possibilities

This study examined future-oriented behavior in children (3?6 years; N = 193) from three diverse societies?one industrialized Western city and two small, geographically isolated communities. Children had the opportunity to prepare for two alternative versions of an immediate future event over six trials. Some 3-year-olds from all cultures demonstrated competence, and a majority of the oldest children from each culture prepared for both future possibilities on every trial. Although there were some cultural differences in the youngest age groups that approached ceiling performance, the overall results indicate that children across these communities become able to prepare for alternative futures during early childhood. This acquisition period is therefore not contingent on Western upbringing, and may instead indicate normal cognitive maturation