Depression at Work, Authenticity in Question: Experiencing, Concealing and Revealing

Australia and the UK have both introduced policies to protect employees who experience mental illness, including depression. However, a better understanding of the issues workers face (e.g. sense of moral failure) is needed for the provision of appropriate and beneficial support. We analysed 73 interviews from the UK and Australia where narratives of depression and work intersected. Participants encountered difficulties in being (and performing as if) ‘authentic’ at work, with depression contributing to confusions about the self. The diffuse post-1960s imperative to ‘be yourself’ is experienced in conflicting ways: While some participants sought support from managers and colleagues (e.g. sick leave, back to work plans), many others put on a façade in an attempt to perform the ‘well’ and ‘authentic’ employee. We outline the contradictory forces at play for participants when authenticity and visibility are expected, yet moral imperatives to be good (healthy) employees are normative

ACR appropriateness criteria® nasal cavity and paranasal sinus cancers

The American College of Radiology (ACR) Appropriateness Criteria are evidence‐based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer‐reviewed journals and the application of well‐established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Here, we present the Appropriateness Criteria for cancers arising in the nasal cavity and paranasal sinuses (maxillary, sphenoid, and ethmoid sinuses). This includes clinical presentation, prognostic factors, principles of management, and treatment outcomes. Controversies regarding management of cervical lymph nodes are discussed. Rare and unusual nasal cavity cancers, such as esthesioneuroblastoma and sinonasal undifferentiated carcinomas, are included. © 2016 American College of Radiology. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 39: 407–418, 2017Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136245/1/hed24639.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136245/2/hed24639_am.pd

Exploring men's and women's experiences of depression and engagement with health professionals: more similarities than differences? A qualitative interview study

<p>Abstract</p> <p>Background</p> <p>It is argued that the ways in which women express emotional distress mean that they are more likely to be diagnosed with depression, while men's relative lack of articulacy means their depression is hidden. This may have consequences for communicating with health professionals. The purpose of this analysis was to explore how men and women with depression articulate their emotional distress, and examine whether there are gender differences or similarities in the strategies that respondents found useful when engaging with health professionals.</p> <p>Methods</p> <p>In-depth qualitative interviews with 22 women and 16 men in the UK who identified themselves as having had depression, recruited through general practitioners, psychiatrists and support groups.</p> <p>Results</p> <p>We found gender similarities and gender differences in our sample. Both men and women found it difficult to recognise and articulate mental health problems and this had consequences for their ability to communicate with health professionals. Key gender differences noted were that men tended to value skills which helped them to talk while women valued listening skills in health professionals, and that men emphasised the importance of getting practical results from talking therapies in their narratives, as opposed to other forms of therapy which they conceptualised as 'just talking'. We also found diversity among women and among men; some respondents valued a close personal relationship with health professionals, while others felt that this personal relationship was a barrier to communication and preferred 'talking to a stranger'.</p> <p>Conclusion</p> <p>Our findings suggest that there is not a straightforward relationship between gender and engagement with health professionals for people with depression. Health professionals need to be sensitive to patients who have difficulties in expressing emotional distress and critical of gender stereotypes which suggest that women invariably find it easy to express emotional distress and men invariably find it difficult. In addition it is important to recognise that, for a minority of patients, a personal relationship with health professionals can act as a barrier to the disclosure of emotional distress.</p

Development and Validation of Nomograms Predictive of Overall and Progression-Free Survival in Patients With Oropharyngeal Cancer

Purpose Treatment of oropharyngeal squamous cell carcinoma (OPSCC) is evolving toward risk-based modification of therapeutic intensity, which requires patient-specific estimates of overall survival (OS) and progression-free survival (PFS). Methods To develop and validate nomograms for OS and PFS, we used a derivation cohort of 493 patients with OPSCC with known p16 tumor status (surrogate of human papillomavirus) and cigarette smoking history (pack-years) randomly assigned to clinical trials using platinum-based chemoradiotherapy (NRG Oncology Radiation Therapy Oncology Group [RTOG] 0129 and 0522). Nomograms were created from Cox models and internally validated by use of bootstrap and cross-validation. Model discrimination was measured by calibration plots and the concordance index. Nomograms were externally validated in a cohort of 153 patients with OPSCC randomly assigned to a third trial, NRG Oncology RTOG 9003. Results Both models included age, Zubrod performance status, pack-years, education, p16 status, and T and N stage; the OS model also included anemia and age × pack-years interaction; and the PFS model also included marital status, weight loss, and p16 × Zubrod interaction. Predictions correlated well with observed 2-year and 5-year outcomes. The uncorrected concordance index was 0.76 (95% CI, 0.72 to 0.80) for OS and 0.70 (95% CI, 0.66 to 0.74) for PFS, and bias-corrected indices were similar. In the validation set, OS and PFS models were well calibrated, and OS and PFS were significantly different across tertiles of nomogram scores (log-rank P = .003;\u3c .001). Conclusion The validated nomograms provided useful prediction of OS and PFS for patients with OPSCC treated with primary radiation-based therapy

Media wall

The artwork combines a mural with ticker displays and a bank of plasma screens housed in a three dimensional lacquered frame. The screens are web linked to local and international webcams, bringing the outside world into the hospital: the electronic ticker boxes convey both information and poetry

Artworks for radiology department at Northwick Park Hospital

A series of digital photographs/X-Rays created in the radiology department

From the Outside in – Navigating the Hospital 2005

This was a collaborative commission with poet John Davies (aka ‘Shedman’) at Eastbourne General Hospital and The Conquest Hospital Hastings. The research and artistic outcomes provided findings for an Environmental Strategy for East Sussex Hospitals NHS Trust, which is being developed by Arts in Healthcare in partnership with the Trust Estates Department. It is hoped that in the future artists and designers will be regularly involved at the early stages of environmental planning for refurbishment and new build schemes. We were asked to examine the physical, psychological and emotional responses of patients and staff to the issues of navigation around the sites, with a focus on arrival, waiting and departure. The brief required us to navigate the sites, observe activity, interact with staff and patients and to reflect on, and suggest creative solutions to, the issues and problems encountered. We created a ‘headquarters’ in a garden shed erected in the main entrances of Eastbourne and Conquest Hospitals. From these vantage points, visitors, staff and patients were invited to share their experiences and ideas for improvement. We gave an initial presentation about the work to staff from outpatient areas. The subsequent outcome of the research was an exhibit of the visual and written material collated by the artists, and were shown at both hospitals. These were displayed as light boxes and digital prints. The wider public consisting of staff, patients and visitors were invited to comment on the artists’ responses by completing forms that were available in hard copy and through the staff intranet. Staff were kept informed of the project, where to see the exhibition and how to communicate their views, through articles in ‘Connect’ and on the Trust’s intranet. The public were kept informed through posters in public waiting areas, and by the volunteer staff who welcome visitors

Out there

In ‘Out There’, I will reflect on some recent projects which took place in public (educational) institutions: a primary school, two NHS teaching hospitals, and a local history museum. The role the artist was given varied (from ‘lead artist’ in the NHS hospitals to ‘creative practitioner’ in the school): all of them involve a considered relationship with the public or, in the case of the school, the children, and an embedding in the institution, its strata of expert workers (or ‘officers’) and its spatial divisions: (‘units’, clinics, classes). The artworks all emerged from cross‐disciplinary collaborations, and a contingent and evolving response to place. • Set in Lauriston School, Hackney, Ghost School (2007-8) was an unfolding work (with architect Julia Dwyer and poet John Davies) which responded to an invitation by the school to explore the qualities of the existing school with the children and involve them in generating ideas for their new school. It culminated in the making of an archival box (an ark) and brought together ex students, a parent/filmmaker and the children in a public event. • Outside in (Eastbourne and Hastings NHS Hospitals, 2005), a public interactive mapping of hospital journeys followed an invitation by the hospital to work with John Davies to investigate the arrival/departure spaces in both sites. The last in a series of works over three years as ‘lead artist,’ Our Storeys (North Middlesex University Hospital, 2008 ‐ : with John Davies) is a four storey ‘poetry wall’ which gathers stories and histories provided by hospital workers/local people, and combines them with images, text and poems. • Digitate (2003‐4) (with Julia Dwyer) responded to an invitation by Enfield Council to participate in the year‐long ‘Cultural Mapping’ of Enfield alongside other artist/architect teams. Our focus was on Forty Hall, a council owned Jacobean manor which houses a local history museum. The ensuing works including a temporary street–sited piece and artefacts now installed in Forty Hall and Enfield’s Civic Centre