Suchergebnisse

Endometriosis is currently poorly understood by the medical sciences; contemporary healthcare has been evidenced as failing to meet the diverse needs of the women who live with the condition. This study examined women's experiences of navigating knowledge and power within medical encounters for endometriosis. In-depth interviews were conducted with 26 women who have been diagnosed with endometriosis about their experiences of the condition and associated healthcare. Women valued both their own knowledge and their doctor's clinical expertise; as to which they privileged was situational, but it was essential the woman dictated which it would be. Women were wary of the social status and power of doctors to reduce their wellbeing through medical labels they did not identify with or by inhibiting their access to care. They identified the need for doctors to listen to and believe them as being essential to the provision of healthcare that meets women's needs and addresses the complexities of endometriosis. Our findings suggest that medical education needs to equip doctors with the skills to acknowledge and incorporate women's knowledge of their bodies within the medical encounter, and to understand how their practice affects women's social and economic participation.

Endometriosis, a common disease characterised as a "gynaecological disorder" in the medical literature, has attracted the attention of feminist scholars as a metaphorical meeting point for gender, knowledge and power. Based on interviews conducted with general practitioners and gynaecologists, we examined the language clinicians use to construct Medicine and women with endometriosis. We sought to identify whether these constructions endorsed or challenged historical discourses, and any implications for women with endometriosis. Clinicians endorsed Medicine as the authoritative knowledge on women and their bodies, and constructed Medicine as being about providing answers on, and doing things to, the body. Women with endometriosis were constructed as reproductive bodies with hysterical tendencies. The historical hysteria discourse was most often endorsed when discussing "difficult" women, referring to those for whom treatment was not helpful or who held a perception of their disease alternative to their clinician. The findings of our study are consistent with previous social analyses of medical literature on endometriosis and with women's reported experiences, suggesting these discourses to be prevalent in contemporary healthcare for endometriosis. Medical education needs to address the historical androcentric bias of medical knowledge and equip clinicians with the skills to address women's diverse needs.

Little is known about filicide from the perspective of women convicted of the offence. The lack of research is partly attributable to the many difficulties entailed in researching socially marginalised and incarcerated people. Research on filicide engages with socially, culturally, and politically sensitive matters, including gendered social structures and behaviours, legal and ethical complexity, emotionally arousing topics, a rare phenomenon, and hard-to-reach participants. In countries where there is poor surveillance, limited local information, and few resources or experts in filicide, researchers must find innovative ways of overcoming these problems. Here we describe the particular challenges in conducting research on women convicted of filicide in Malaysia, a predominantly Muslim country, when the researchers are based at an Australian university. The persistence, resilience, and creativity required to overcome each problem were justified by the achievement of research that contributes to knowledge and has implications for change in policy and practice.

Little is known about filicide from the perspective of women convicted of the offence. The lack of research is partly attributable to the many difficulties entailed in researching socially marginalised and incarcerated people. Research on filicide engages with socially, culturally, and politically sensitive matters, including gendered social structures and behaviours, legal and ethical complexity, emotionally arousing topics, a rare phenomenon, and hard-to-reach participants. In countries where there is poor surveillance, limited local information, and few resources or experts in filicide, researchers must find innovative ways of overcoming these problems. Here we describe the particular challenges in conducting research on women convicted of filicide in Malaysia, a predominantly Muslim country, when the researchers are based at an Australian university. The persistence, resilience, and creativity required to overcome each problem were justified by the achievement of research that contributes to knowledge and has implications for change in policy and practice.

Little is known about filicide from the perspective of women convicted of the offence. The lack of research is partly attributable to the many difficulties entailed in researching socially marginalised and incarcerated people. Research on filicide engages with socially, culturally, and politically sensitive matters, including gendered social structures and behaviours, legal and ethical complexity, emotionally arousing topics, a rare phenomenon, and hard-to-reach participants. In countries where there is poor surveillance, limited local information, and few resources or experts in filicide, researchers must find innovative ways of overcoming these problems. Here we describe the particular challenges in conducting research on women convicted of filicide in Malaysia, a predominantly Muslim country, when the researchers are based at an Australian university. The persistence, resilience, and creativity required to overcome each problem were justified by the achievement of research that contributes to knowledge and has implications for change in policy and practice.

Background: The effectiveness of interventions for people with severe mental illness delivered by informal community care providers in low and lower middle-income countries is not known. The aim was to conduct a systematic review of the impact of community-based interventions implemented by the informal sector for people with severe mental illness in these settings. Methods: Five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials) were searched for English-language publications using both keywords and MeSH terms. All study designs were included. Results: Five papers, reporting data from five studies conducted in four low and lower middle-income countries in 2017, met the inclusion criteria for the review. Of the five included studies, three had a before and after design, one was a randomized controlled trial, and one a qualitative investigation. Most interventions with a low-moderate quality of evidence used informal community care providers to deliver either self-help groups, traditional healing treatments, and/or a rehabilitation program. The investigators reported data about improvements in the outcomes of intervention participants (psychosocial functioning, psychotic symptoms, and social inclusion) and positive impacts on their families (family's knowledge and skills of mental illness management, caregiving burden, social exclusion/stigma against people with severe mental illness, and financial burden). Cost-effectiveness of the intervention (in one study) found that it had a higher financial cost but greater effectiveness than the usual standard of care. Conclusion: Although only a small number of studies were identified, the review provides promising evidence of the professionally developed interventions for people with severe mental illness, delivered by the informal community workforce in low and lower middle-income settings. Training and supportive supervision for informal community care providers are crucial components of effective interventions.

Psychologists receive several years of specialized study on the brain, behavior, and mental health, but despite the fact that over half ultimately end up in administrative or managerial roles, they receive no formalized training in the skills necessary to be successful in these roles. This book is the first of its kind to target the managerial and administrative skills necessary for the mental health professional. The book discusses practical information such as how to deal with personnel issues, how to set budgets and allocate resources, and how to document progress and maintain schedules in

Abstract Background Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorised, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. Methods A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. Results In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group. Conclusions A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history. Trial registration ACTRN 12605000567628.