Managing medically unexplained illness in general practice

Provides practical management strategies that general practitioners (GPs) can use when patients present with medically unexplained symptoms. Background Patients with medically unexplained symptoms commonly present to general practice and experience significant disability. Many have a history of trauma, which complicates the therapeutic relationship between doctor and patient. Because diagnosis is an expected outcome of a medical interaction, doctors and patients can feel frustrated and lost without one. Objective This article provides practical management strategies that general practitioners (GPs) can use when patients present with medically unexplained symptoms. Discussion Three types of common presentations are discussed. Enigmatic illnesses occur when the doctor and patient believe that a bio-medical disease is likely, but a diagnosis is not forthcoming. Contested illnesses occur when a patient is committed to a diagnosis the doctor does not accept. Chaotic illnesses occur when symptoms are over-determined; there are many possible diagnoses, but none fully explain the complex web of distress the patient experiences. Common strategies for managing medically unexplained symptoms are discussed, and specific approaches to each presentation are outlined

A Small Model of the Australian Macroeconomy: An Update

Almost a decade ago David Gruen and Geoff Shuetrim constructed a small macroeconomic model of the Australian economy. A comprehensive description of this model was subsequently provided by Beechey et al (2000). Since that time, however, the model has continued to evolve. This paper provides an update on the current structure of the model and the main changes which have been made to it since Beechey et al . While the details of the model have changed, its core features have not. The model remains small, highly aggregated, empirically based, and non-monetary in nature. It also retains a well-defined long-run steady state with appropriate theoretical properties, even though its primary role is to analyse short-run macroeconomic developments.Australian economy; macroeconomic model; monetary policy

Alien Registration- Stone, Louise (Bangor, Penobscot County)

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Covering cops: Critical reporting of Indonesian police corruption

The following article analyses contemporary newspaper representations of police corruption in Indonesia’s premier English-language newspaper, The Jakarta Post. The article draws on primary data obtained from 114 articles published online between January and December 2013. The subsequent quantitative analysis found that The Jakarta Post reported on various forms of police corruption in both specific and general contexts with a majority of reports focusing on the investigation of corruption allegations where at least three people were involved. Information about suspects was also provided. Qualitative analysis indicated the following themes were frequently discussed: the extent of police corruption; causes of police corruption; fighting police corruption; the belief that police cannot be trusted to investigate internal police corruption; and that police corruption interferes with external investigations. Despite many obstacles involved in reporting police corruption, the authors argue that overall The Jakarta Post takes a critical view in its reporting of police corruption

‘Repeat abortion’, a phrase to be avoided? Qualitative insights into labelling and stigma

Background In recent years there has been growing international interest in identifying risk factors associated with ‘repeat abortion’, and developing public health initiatives that might reduce the rate. This article draws on a research study looking at young women's abortion experience in England and Wales. The study was commissioned with a specific focus on women who had undergone more than one abortion. We examine what may influence women's post-abortion reproductive behaviour, in addition to exploring abortion-related stigma, in the light of participants' own narratives. Study design Mixed-methods research study: a quantitative survey of 430 women aged 16–24 years, and in-depth qualitative interviews with 36 women who had undergone one or more abortions. This article focuses on the qualitative data from two subsets of young women: those we interviewed twice (n=17) and those who had experienced more than one unintended/unwanted pregnancy (n=15). Results The qualitative research findings demonstrate the complexity of women's contraceptive histories and reproductive lives, and thus the inherent difficulty of establishing causal patterns for more than one abortion, beyond the obvious observation that contraception was not used, or not used effectively. Women who had experienced more than one abortion did, however, express intensified abortion shame. Conclusions This article argues that categorising women who have an abortion in different ways depending on previous episodes is not helpful. It may also be damaging, and generate increased stigma, for women who have more than one abortion

SEXUAL ABUSE OF DOCTORS BY DOCTORS PROFESSIONALISM COMPLEXITY AND THE POTENTIAL FOR HEALING

Contemporary attitudes to sexual abuse are changing. The Royal Commission into Institutional Responses to Child Sexual Abuse, the response of the Australian Defence Force to allegations of sexual abuse in the military and the work of the Australian Human Rights Commission around sexual harassment in the workplace all indicate a shift in community values. They also represent a shift in our understanding of the nature and scope of professionalism. As each respected institution has its professional failures exposed, it becomes obvious that no group is immune. Existing codes of professional conduct have not protected colleagues or clients from toxic behaviour