ORCID Profile
0000-0002-1636-0807
Current Organisations
The University of Newcastle
,
University of Newcastle Australia
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Publisher: SAGE Publications
Date: 10-08-2023
DOI: 10.1177/10398562231191662
Abstract: The aim is to increase the understanding of non-sexual boundary challenges and potential personal and professional impacts on doctors and medical students. We examined peer-reviewed and grey literature and published commentary and cases from Australian health practitioner boards and medico-legal insurance companies. Key ideas relating to the objective of our study were subsequently framed into a narrative. Compared to ‘sexual’ boundary crossings, the literature examining ‘non-sexual’ boundaries is scanty, fragmented, and difficult to find. There are gaps in knowledge around the prevalence and consequences of non-sexual boundary challenges and crossings, although the safety and wellbeing of health professionals and patients are of concern. Non-sexual boundary crossings may represent a ‘slippery slope’ to boundary violations. Opportunities for doctors and medical students to access relevant training appear limited. We identified several categories of boundary challenges based on context, the nature of the existing relationship, and the type of behaviour. Non-sexual boundary challenges may be related to stress, burnout, and risk for future boundary violations. Future research to investigate the impacts on doctors and medical students in maintaining professional boundaries in their relationships with patients and colleagues, their specific training needs, and the effectiveness of training in reducing work-related stress and burnout is needed.
Publisher: Springer International Publishing
Date: 2019
Publisher: Royal College of Psychiatrists
Date: 06-2022
DOI: 10.1192/J.EURPSY.2022.951
Abstract: The magnitude and exceptional opportunity to research the psychological distress of shelter in place resulted in a publication frenzy on a smorgasbord of research studies of variable scientific robustness. Confinement, fear of contagion, social isolation, financial hardship, etc. equated to stratospheric stress levels. The decline in protective factors as a function of quarantine anecdotally reflected historic rates of anxiety and depression. In this study, we combined 12 variegate datasets and developed an algorithm to build a model to identify key predictors of pandemic-related stress with high accuracy and generalizability. This study reports on existing published data. We first describe the International (Adamson et al., 2020) and then the Italian dataset (Flesia et al., 2020). The time-frame (first wave of lockdown), method (survey), measurement tool (Perceived Stress Scale), and outcome measures were extremely similar to enable consolidation of datasets (see Figure1). The Flesia et al., (2020) data set was integrated into the Adamson et al., (2020) dataset as the first step towards data validation construction of the ML predictive model. We aim to demonstrate the strength of combining cross-cultural datasets, and the applicability of ML algorithms to facilitate the process and generate a predictive model that identifies and validates key predictors of pandemic-related stress and accommodates for interaction with demographic, cultural, and other mitigating factors while concurrently having high generalizability. We believe our model provides clinicians, researchers, and decision-makers with evidence to investigate the moderators and mediators of stress, and introduce novel interventions to mitigate the long-term effects of the COVID-19 pandemic. No significant relationships.
Publisher: Wiley
Date: 16-04-2013
DOI: 10.1111/ACPS.12119
Publisher: MDPI AG
Date: 12-2021
DOI: 10.3390/COVID1040058
Abstract: The scale and duration of the worldwide SARS-COVID-2 virus-related quarantine measures presented the global scientific community with a unique opportunity to study the accompanying psychological stress. Since March 2020, numerous publications have reported similar findings from erse international studies on psychological stress, depression, and anxiety, which have increased during this pandemic. However, there remains a gap in interpreting the results from one country to another despite the global rise in mental health problems. The objective of our study was to identify global indicators of pandemic-related stress that traverse geographic and cultural boundaries. We amalgamated data from two independent global surveys across twelve countries and spanning four continents collected during the first wave of the mandated public health measures aimed at mitigating COVID-19. We applied machine learning (ML) modelling to these data, and the results revealed a significant positive correlation between PSS-10 scores and gender, relationship status, and groups. Confinement, fear of contagion, social isolation, financial hardship, etc., may be some reasons reported being the cause of the drastic increase in mental health problems worldwide. The decline of the typical protective factors (e.g., sleep, exercise, meditation) may have lified existing vulnerabilities/co-morbidities (e.g., psychiatric history, age, gender). Our results further show that ML is an apropos tool to elucidate the underlying predictive factors in large, complex, heterogeneous datasets without invalidating the model assumptions. We believe our model provides clinicians, researchers, and decision-makers with evidence to investigate the moderators and mediators of stress and introduce novel interventions to mitigate the long-term effects of the COVID-19 pandemic.
Publisher: Springer International Publishing
Date: 2021
Publisher: Wiley
Date: 16-04-2013
DOI: 10.1111/ACPS.12122
Abstract: To be used in conjunction with 'Psychological management of unipolar depression' [L e et al. Acta Psychiatr Scand 2013 (Suppl. 443):24-37] and 'Lifestyle management of unipolar depression' [Berk et al. Acta Psychiatr Scand 2013 (Suppl. 443):38-54]. To provide clinically relevant recommendations for the use of pharmacological treatments in depression derived from a literature review. Using our previous Clinical Practice Guidelines [Malhi et al. Clinical practice recommendations for bipolar disorder. Acta Psychiatr Scand 2009 (Suppl. 439):27-46] as a foundation, these clinician guidelines target key practical considerations when prescribing pharmacotherapy. A comprehensive review of the literature was conducted using electronic database searches (PubMed, MEDLINE), and the findings have been synthesized and integrated alongside clinical experience. The pharmacotherapy of depression is an iterative process that often results in partial and non-response. Beyond the initiation of antidepressants, the options within widely used strategies, such as combining agents and switching between agents, are difficult to prescribe because of the paucity of pertinent research. However, there is some evidence for second-line strategies, and a non-prescriptive algorithm can be derived that is based broadly on principles rather than specific steps. Depression is by its very nature a heterogeneous illness that is consequently difficult to treat. Invariably, situation-specific factors often play a significant role and must be considered, especially in the case of partial and non-response. Consulting with colleagues and trialling alternate treatment paradigms are essential strategies in the management of depression.
Publisher: Frontiers Media SA
Date: 30-11-2021
DOI: 10.3389/FRVIR.2021.742290
Abstract: In Iraq and Afghanistan over 75% of the combat casualties suffered by U.S. troops have involved explosive devices. Improvements in body armor and advances in military medicine have significantly reduced the number of combat-related fatalities, but have greatly increased the number of U.S. active component personnel suffering painful trauma injuries. Unfortunately, so far, advances in pharmacologic analgesia pain medications have not kept pace with advances in survivability. For many active component personnel and Veterans, pain is a top health complaint from patients. The opioid epidemic has increased the urgency of developing powerful non-pharmacologic approaches for the management of pain. Immersive VR is proving to be a powerful non-opioid pain management technique for acute pain. However, the cost and usability limitations of pre-2016 VR clinical products resulted in limited treatment adoption rates for clinical use. In recent years, VR technology has become increasingly immersive, portable, and miniaturized, requiring minimal technical expertise to operate, and low-cost, factors that are likely contributing to the recent increase in the clinical use of VR analgesia. VR is greatly benefitting from a growing string of major technological breakthroughs and VR treatment improvements that will likely continue to increase the effectiveness and suitability of VR analgesia for military and VA patients. Regarding acute pain, we propose that the next revision to the current Tactical Combat Casualty Care guidelines consider including VR as an effective and hemodynamically safe approach to the current management of acute trauma pain in military personnel during medical procedures. With recent miniaturization and ruggedization, VR can potentially be used closer to the battlefield in the future. Beyond distraction, innovative VR therapy techniques designed to help reduce chronic pain are discussed. Recent breakthroughs in the mass production of inexpensive, highly immersive lightweight stand alone VR systems and augmented reality systems increase the potential for widespread dissemination of VR analgesia for acute and potentially for chronic pain. For ex le, the U.S. military recently purchased 22 billion dollar’s worth of Microsoft Hololens mixed reality systems (e.g., for training). Expanded research and development of VR analgesia customized for the unique needs of military and VA patients is recommended.
Publisher: Springer International Publishing
Date: 2019
Publisher: MDPI AG
Date: 20-01-2023
DOI: 10.3390/JCM12030843
Abstract: Over the past 20 years, there has been a significant reduction in the incidence of adverse events associated with sedation outside of the operating room. Non-pharmacologic techniques are increasingly being used as peri-operative adjuncts to facilitate and promote anxiolysis, analgesia and sedation, and to reduce adverse events. This narrative review will briefly explore the emerging role of immersive reality in the peri-procedural care of surgical patients. Immersive virtual reality (VR) is intended to distract patients with the illusion of “being present” inside the computer-generated world, drawing attention away from their anxiety, pain, and discomfort. VR has been described for a variety of procedures that include colonoscopies, venipuncture, dental procedures, and burn wound care. As VR technology develops and the production costs decrease, the role and application of VR in clinical practice will expand. It is important for medical professionals to understand that VR is now available for prime-time use and to be aware of the growing body in the literature that supports VR.
Publisher: Elsevier BV
Date: 03-2021
Publisher: SAGE Publications
Date: 26-09-2012
Abstract: To explore the clinical reasoning processes underpinning diagnostic and management decision-making in treating patients presenting with psychological distress in general practice. Practising GPs were invited to attend small-group workshops in which two case histories were presented. Discussion was GP-facilitated and recorded for thematic analysis. GPs provided demographic data, completed personality and attitudinal questionnaires, and answered a series of multiple-choice questions embedded in the cases. GPs recognize the possibility of psychiatric disorders early in the clinical reasoning process, but are cautious about applying definitive diagnoses. GPs perceive that patients may be resistant to a psychiatric diagnosis and instead emphasize the need to build rapport and explore and exclude physical comorbidities. GPs see patients with a broad spectrum of distress, illness and impairment, in whom the initial presentation of psychological symptoms is often poorly differentiated and somatically focused, requiring elucidation over time. GPs therefore adopt a longitudinal strategy for diagnosis rather than investing heavily in cross-sectional assessment. GPs appear cognizant of possible psychiatric disorders and management strategies, but employ diagnostic strategies and decision-making processes that, in addition to experience and expertise, likely reflect key differences between the primary care and specialist practice settings.
No related grants have been discovered for Rita Vieira Mota De Campos Hitching.