Learning to assist women born with atypical genitalia: journey through ignorance,taboo and dilemma

This aim of this article is to increase awareness of the psychological aspects of a range of conditions associated with atypical development of the reproductive-genital system. In highlighting some of clients’ experiences with how atypical genitalia is managed, useful parallels can be drawn for other services.

Many clients report being distressed by previous non-disclosure of crucial aspects of their condition by medical practitioners or non-discussion of the implications. Current concerns often relate to having to discuss atypical genitalia with sexual partners. Psychological formulation of the women's difficulties must take account of dominant ways of conceptualizing sex and sexuality in our society. Within a feminist-discursive framework, psychotherapeutic interventions can be helpful in a number of ways. Psycho-educational efforts can help to further increase clients’ expertise about their conditions and, thereby, increase control of decisions relating to treatment and to disclosure. However, information delivery would need to draw on alternative and subordinated discourses. Psychological therapy offers opportunities to further explore meanings of different aspects of the condition and to challenge notions of normalcy. Where such support is offered in a group format, it provides additional opportunities for making available different interpretations and solutions, and for reducing isolation.

Far from being an obscure area in medicine, management of conditions associated with atypical genitalia starkly exposes pervasive notions of ‘normal’ sexuality that underpin research and practice in many areas of health and illness, and as such should concern health professionals in general.     

Community Member and Faith Leader Perspectives on the Process of Building Trusting Relationships between Communities and Researchers

In the first phase of this research, we conducted, audio‐recorded, and transcribed seven focus groups with more than 50 English‐ or Spanish‐speaking women of childbearing age. Qualitative analysis revealed the following themes: (1) expectation that participation would involve relationships based on trust that is built over time and impacted by cultural factors; (2) perceived characteristics of research staff that would help facilitate the development of trusting relationships; (3) perceptions about the location of the visits that may affect trust; (4) perceptions of a research study and trust for the institution conducting the study may affect trust; (5) connecting the study to larger communities, including faith communities, could affect trust and willingness to participate. In the second phase of this research, we conducted, recorded, transcribed, and analyzed interviews with leaders from diverse faith communities to explore the potential for research partnerships between researchers and faith communities. In addition to confirming themes identified in focus groups, faith leaders described an openness to research partnerships between the university and faith communities and considerations for the formation of these partnerships. Faith leaders noted the importance of finding common ground with researchers, establishing and maintaining trusting relationships, and committing to open, bidirectional communication.     

本体心理学在精神分裂症临床诊断与治疗中的应用

精神分裂症至今仍被认为是世界范围内广泛存在的最神秘的精神疾病.本体心理学流派经过对来自不同文化背景的患者40年成功的临床实践,第一个也是唯一一个证明了它能够运用有效方法 来治愈精神分裂症.文章描述了心身疾病和精神分裂症的病因,并从本体心理学的三个发现,即:偏差屏、语义场和本体自在分析了疾病生成过程,从而澄清和解决了许多有分歧的观点,并围绕着疾病的一些悬而未决的问题,以本体心理学的方法 进行了深入、详细的阐述.     

中职生人际信任、社交焦虑现状及其关系

目的探讨中职生人际信任与社交焦虑现状及其关系。方法用人际信任量表(ITS)和社交焦虑量表(IAS)调查了南京江宁中等专业学校392名中职生。结果中职生的社交焦虑得分为(43.52±8.40),高于常模,总体上较为严重;人际信任得分(80.79±8.28),中等偏上。其中中二年级的人际信任水平最高;中一年级的社交焦虑显著高于其他年级,中职女生、非班干部的社交焦虑情况相对严重。结论提高人际信任水平有助于缓解社交焦虑,而降低社交焦虑也能提高人际信任水平。     

Unexpected Challenges Faced by Psychotherapy Trainees

Abstract

Clinical supervision of school psychology candidates at the pre-internship level is an essential component of professional training and acculturation of new practitioners into the field. However, limited attention has been paid to issues regarding the clinical supervision of school psychologists at this level. Indeed, there appears to be a dearth of information in the literature addressing the supervision of school psychologists at the pre- and post-graduate levels. While this area remains largely unexamined, clinical supervision of school psychologists is an important component in the development of the profession at all levels. This article discusses supervision in the context of a competency-based model for training school psychology candidates at the pre-internship level.     

Expert for Whom? Court-Appointed Versus Party-Appointed Experts

We investigated differences in judges' attitudes between court-appointed and party-appointed forensic psychiatric expert evidence, including who commissioned the report and how this impacted on the judges' perception of the evidence presented. We also investigated the experts' views on being either a party-appointed or court-appointed expert. This survey has no explicit preconceptions. It sought to gather information empirically. The attitudes towards the experts are seen both from the legal professionals' view and from that of the experts themselves. Two groups, one of 107 forensic psychiatric experts (39 psychologists, 65 psychiatrists and three non-specialist medical doctors), and one of 157 legal professionals (44 judges, 74 attorneys and 39 prosecutors) responded to an online survey. We found that 88% of the experts had been appointed by the court and of these, 73% preferred to be court-appointed. Fifty-one per cent had also been party-appointed and the most common principal was the defence attorney (46%). Sixty-two per cent of the judges who had an opinion stated that the party-appointed experts did not assist the court. This indicates that the judges clearly preferred independent court-appointed experts.     

护患情境会话

正文化差异问题Probiem with Culture Difference点评语言是人类交流的载体,所以交谈是交流的主要形式。为了达到交流的有效目的,在交谈过程中护理人员首先应在语词中表达出真诚、热忱的服务态度。如黄护士的     

Rosacea – global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group

Background The absence of specific histological or serological markers, the gaps in understanding the aetiology and pathophysiology of rosacea, and the broad diversity in its clinical manifestations has made it difficult to reach international consensus on therapy guidelines. Objectives The main objective was to highlight the global diversity in current thinking about rosacea pathophysiology, classification and medical features, under particular consideration of the relevance of the findings to optimization of therapy. Methods The article presents findings, proposals and conclusions reached by the ROSacea International Expert group (ROSIE), comprising European and US rosacea experts. Results New findings on pathogenesis provide a rationale for the development of novel therapies. Thus, recent findings suggest a central role of the antimicrobial peptide cathelicidin and its activator kallikrein‐5 by eliciting an exacerbated response of the innate immune system. Cathelicidin/kallikrein‐5 also provide a rationale for the effect of tetracyclines and azelaic acid against rosacea. Clinically, the ROSIE group emphasized the need for a comprehensive therapy strategy – the triad of rosacea care – that integrates patient education including psychological and social aspects, skin care with dermo‐cosmetics as well as drug‐ and physical therapies. Classification of rosacea into stages or subgroups, with or without progression, remained controversial. However, the ROSIE group proposed that therapy decision making should be in accordance with a treatment algorithm based on the signs and symptoms of rosacea rather than on a prior classification. Conclusion The ROSIE group reviewed rosacea pathophysiology and medical features and the impact on patients and treatment options. The group suggested a rational, evidence‐based approach to treatment for the various symptoms of the condition. In daily practice this approach might be more easily handled than prior subtype classification, in particular since patients often may show clinical features of more than one subtype at the same time.