A self-paced online emotion socialization intervention for parents of children with challenging behavior: Tuning in to Kids OnLine.

Background: Evidence-based parenting programs delivered using online technology are an important way to enhance program uptake. To date, programs that address emotion socialization processes, such as Tuning in to Kids, have always been delivered in person, via group or one-to-one delivery. This study used a randomized control design to examine the efficacy of the self-paced Tuning in to Kids OnLine (TIKOL). Method: Participants were 150 parents of children aged 4-10 years old with challenging behaviors, randomized into intervention or 10-month waitlist control. Parents and teachers completed questionnaires at baseline and 6 months after the intervention (equivalent time points for controls) measuring parent wellbeing, parent emotion socialization, parent efficacy, child behavior, and anxiety. Results: Analyses, using mixed methods multilevel modeling, showed that intervention parents reported significantly reduced emotion dismissiveness and increased emotion coaching, empathy and efficacy compared to controls who did not. Parents participating in TIKOL also reported that their children's behavior problems and anxiety were significantly improved. Greater engagement (modules watched and duration of support calls) was associated with more significant improvements. Conclusion: Findings provide preliminary support for the efficacy of TIKOL in improving parents' emotion socialization and reducing child behavior problems and anxiety, especially when efforts to support online engagement are utilized. Further evaluation using independent observations and a sample representing a wider demographic would strengthen these findings. Clinical trial registration: Australian and New Zealand Clinical Trials Registry No. ACTRN12618000310268.

The experience of disgust by nursing and midwifery students: An interpretative phenomenological approach study.

Although disgust is recognized as a common and prominent emotion in healthcare, little is known about how healthcare professionals understand, experience and conceptualize disgust. The aim of the study was to gain an in-depth understanding of how nursing and midwifery students experience, understand and cope with disgust in their clinical work. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). Six participants (all women: two nursing students, four midwifery students) from a university in the South of England were interviewed. Four superordinate themes with eight subthemes were identified. Overall, findings suggest that participants experience both moral and physical disgust; however, they find it difficult to talk about and use other terms to describe their experience. Findings are discussed through the lens of social identity theory, to understand the relevance of professional identity and how this might further maintain the disgust taboo. The strategies participants have developed in order to cope with disgust are explored and understood within the current healthcare climate. Future research should focus on ways of addressing the experience of disgust by healthcare professionals in order to improve the quality of care provided, especially in the climate of the COVID-19 crisis.

Post-exercise Cold Water Immersion Does Not Improve Subsequent 4-km Cycling Time-Trial Compared With Passive and Active Recovery in Normothermia.

Background: We investigated whether a brief cold water immersion between two cycling time trials (TT) improves the performance of the latter compared with passive and active recovery in normothermic conditions (~20°C). Methods: In Experiment 1 10 active participants (4 women) completed two 4-km TT (Ex1 and Ex2, each preceded by a 12 min moderate-intensity warm-up) separated by a 15 min recovery period consisting of: (a) passive rest (PAS) or (b) 5 min cold water immersion at 8°C (CWI-5). In Experiment 2, 13 different active males completed the same Ex1 and Ex2 bouts separated by a 15 min recovery consisting of: (a) PAS, (b) 10 min cold water immersion at 8°C (CWI-10) or (c) 15 min of moderate-intensity active recovery (ACT). Results: In both experiments, the time to complete the 4-km TT-s was not different (P > 0.05, ES = 0.1) among the trials neither in Ex1 (Experiment 1: PAS: 414 ± 39 s; CWI-5: 410 ± 39 s; Experiment 2: PAS: 402 ± 41 s; CWI-10: 404 ± 43 s; ACT: 407 ± 41 s) nor Ex2 (Experiment 1: PAS: 432 ± 43 s; CWI-5: 428 ± 47 s; Experiment 2: PAS: 418 ± 52 s; CWI-10: 416 ± 57 s; ACT: 421 ± 50 s). In addition, in all conditions, the time to complete the time trials was longer (P < 0.05, ES = 0.4) in Ex2 than Ex1. Core temperature was lower (P < 0.05) during the majority of Ex2 after CW-5 compared with passive rest (Experiment 1) and after CWI-10 compared with PAS and ACT (Experiment 2). Perceived exertion was also lower (P < 0.05) at mid-point of Ex2 after CWI-5 compared with PAS (Experiment 1) as well as overall lower during the CWI-10 compared with PAS and ACT conditions (Experiment 2). Conclusion: A post-exercise 5-10 min cold water immersion does not influence subsequent 4-km TT performance in normothermia, despite evoking reductions in thermal strain.

The experience of disgust by healthcare professionals: A literature review.

BACKGROUND: Disgust is a common emotion experienced by healthcare professionals which in extreme cases can contribute to neglect and abuse of patients. However, little research has explored how healthcare professionals experience disgust and what coping strategies they use to manage it. AIM: To identify, evaluate and synthesise results from empirical papers that have explored how healthcare professionals experience, understand and manage disgust in clinical work. DESIGN: A narrative literature review. DATA SOURCES: Using the EBSCOHost interface, a range of databases were systematically searched alongside manual searches and citation chaining which yielded the 11 papers included in this review. REVIEW METHOD: Qualitative synthesis. RESULTS: Three major themes were identified: The professionals' struggle to talk about disgust; the importance of boundaries: boundary breaching and boundary building; and the role of empathy in caring. CONCLUSION: This review found that disgust is a common experience for healthcare professionals, yet it is not talked about or openly expressed. Professionals have developed ways to cope with disgust and use empathy as a main strategy to overcome it. The review suggests that healthcare professionals should consider ways of making disgust part of a wider conversation, allowing clinicians to engage with their feelings, rather than feel ashamed of them and hiding disgust away as a silent part of care.

How pupils on the autism spectrum make sense of themselves in the context of their experiences in a mainstream school setting: A qualitative metasynthesis.

Evidence that interpersonal interactions and self-appraisal in social context are crucial in developing self-understanding raises concerns about how pupils with autism spectrum disorder make sense of themselves in school settings where many experience social marginalisation. Metasynthesis was used to systematically extract and integrate findings from qualitative studies examining the mainstream school experiences of these students. Synthesised findings identified three, intermeshing, aspects of experience which contribute to many pupils with autism spectrum disorder making sense of themselves as 'different' to typical peers in a negative way: difficulties linked to autism spectrum disorder; interpersonal relationships, particularly with peers; and accessibility of the school environment. Typical pupils' attitudes and responses towards peers with autism spectrum disorder, unusual sensory reactions to the physical school environment and individual sense-making about the self are highlighted as key areas requiring further research and intervention to improve the experiences, self-esteem and well-being of pupils with autism spectrum disorder in inclusive settings and to inform educational policy and practice.

An exploration into the relationships people with dementia have with physical objects: an ethnographic study.

In recent years there has been increasing interest in how different aspects of object relations theory might apply to dementia. While attachment theory in dementia has been well studied, there have been no systematic investigations of the way in which transitional objects are used by people with dementia. This study explores the relationship people with dementia have with physical objects using a focussed ethnographic method. Twenty-one residents and the staff of a care home for people with dementia were observed over a two-month period. Observations were recorded and analysed in light of Winnicott's criteria for transitional objects and incorporated the work of other key theorists. The ethnography found evidence that people with dementia have varied relationships with objects and can employ objects in a transitional way. The paper then explores the implications of this research for understanding the function of transitional objects for people with dementia. The findings suggest that that Winnicott's theory of transitional objects can provide a framework for understanding some of the processes of dementia.

A Cross Sectional, Observational Survey to Assess Levels and Predictors of Psychological Wellbeing in Adults with Epidermolysis Bullosa.

Epidermolysis bullosa (EB) describes a cluster of genetically determined skin disorders. Symptoms can be painful, disabling and disfiguring, yet there is little research on the psychological impact of the disease. The study aim was to measure psychological wellbeing in adults with EB; and to examine the association between psychological wellbeing and self efficacy, health locus of control and adjustment to appearance in an observational, cross sectional survey. Questionnaire packs comprising the General Health Questionnaire (GHQ-12), the General Self Efficacy Scale (GSE), the Multidimensional Health Locus of Control Scale (MHLOC), and the Derriford Appearance Scale (DAS-24), were sent to approximately 385 adults with EB. The data were analysed using SPSS. Eighty-seven participants responded. Scores on the GHQ-12 showed non-problematic psychological health in 36% of the sample; levels bordering on clinical disorder in 32.1% and severe psychological distress in 31.9%. No correlations were found between demographic factors (age and sex) or clinical factors (EB type and perceived severity) and psychological well-being. Scores on the GSE, the internal locus of control sub-scale of the MHLOC and the DAS-24 showed them to be statistically significant correlates of psychological wellbeing (P<0.001; P<0.018; and P<0.001 respectively). In a regression analysis, adjustment to appearance and self efficacy accounted for 24% of the variation in psychological wellbeing. Adults with EB might be at risk of experiencing poor psychological health. Interventions designed to enhance disease self management, self efficacy and improve body image are likely to be beneficial in this clinical group.

The psychosocial impact of epidermolysis bullosa.

Epidermolysis bullosa (EB) is a disease in which the skin blisters in response to minimal friction, causing painful wounds. Despite the potentially severe nature of epidermolysis bullosa, research on the psychosocial issues is scarce. The aims of the study were to explore the psychosocial impact of epidermolysis bullosa on affected adults and to identify associated support needs. We collected data using semistructured interviews and employed inductive thematic analysis to organize and analyze them. Three main themes­beliefs about containing the impact of EB, understandings of the disease, and the disabling impact of EB­describe the ways in which living with EB influences the daily lives of participants at intraindividual, interindividual, and sociocultural levels. The associated support needs ranged in type and intensity, from a preference for brief, skills-based interventions and the facilitation of peer support through to longer-term specialist psychological support. The results highlight how the particular combination of the rarity of the disease, its lifelong and hereditary nature, and its disfiguring impact on the skin differentiate epidermolysis bullosa from other chronic conditions.

Exploring the perceptual characteristics of voice-hallucinations in deaf people.

INTRODUCTION: Previous research has not taken account of the possibility that deaf people will show greater heterogeneity in how they experience voice-hallucinations due to individual differences in experience with language and residual hearing. This study aims to explore how deaf participants perceive voice-hallucinations and whether the perceptual characteristics reported reflect individual experience with language and sensory input. METHOD: A statement-sorting task generated data about perceptual characteristics of voice-hallucinations for exploratory factor analysis. The sample included 27 deaf participants with experience of voice-hallucinations, and a range of hearing loss and language backgrounds. RESULTS: Perceptual characteristics of voice-hallucinations map closely onto individual auditory experience. People born profoundly deaf loaded onto nonauditory factors. Deaf people with experience of hearing speech, through residual hearing, hearing aids, or predeafness experience, reported auditory features or uncertainty about mode of perception. CONCLUSIONS: This is the first study to systematically explore voice-hallucinations in deaf people and to advance a model of subvocal articulation to account for such counterintuitive phenomena.

Exploring the meaning of separation in second-generation young South Asian women in Britain.

OBJECTIVES: To explore the experiences of young second-generation South Asian women living in Britain; to try and understand their experiences, deconstruct the term cultural conflict and understand it within a psychological framework. In particular, the aim was to explore issues of separation and individuation, and the meanings attributed to these concepts. DESIGN: An interview-based study using Interpretative Phenomenological Analysis to analyse the data. METHODS: Interviews were conducted with six second-generation South Asian women aged 16-20, who had no prior contact with mental health services. RESULTS: Five main themes were identified from the analysis: differences in the meaning of adulthood, community policing, pressures and stressors, protective factors/coping and barriers to coping. CONCLUSIONS: The participants' perceived differences in the meaning of adulthood in Asian cultures in comparison with Western cultures. These differences, in conjunction with the community policing that they were exposed to, contributed to the pressures and stressors - in particular lack of control and a desire to make individual decisions. The results indicated that the differences in the meaning of adulthood in a collective culture challenged the assumptions of the separation-individuation model, and was a key element in cultural conflict. This highlighted the complexities of generalizing research findings across all social groups, and questioned the validity of applying existing psychological theory to this population. The clinical implications of coping/protective factors and barriers to coping were discussed.

Bracket creep in Australian abortion indications: when did rubella arrive?

This article highlights a common misconception about abortion law that is apparent from reading Harriton v Stephens (2006) 226 CLR 52; namely, that fetal abnormality forms a prima facie case for lawful abortion across Australia. This fallacy stems from the legacy of British law drafted in the aftermath of the thalidomide crisis of the early 1960s, and continues to shape beliefs about Australian abortion law in society and within the judiciary. The article notes the fundamental contradictions between British-style law that provides for abortion on the ground of fetal abnormality and New South Wales case law that provides for lawful abortion in regard to the health and wellbeing of the woman. The author concludes that it is misguided and erroneous to configure abortion law in terms of the fetus inconsistent with the tradition of abortion law, and New South Wales authority.

(De)constructing body image.

The reification of body image leads to unarticulated ideological and conceptual assumptions that obscure the most dynamic and productive features of the construct. These assumptions are that body image: (1) 'exists'; (2) is a socially mediated product of perception; (3) is 'internal' and 'of the individual'; (4) can be treated and measured as if real; and (5) individuals' respond to body image measures as if neutrally providing information about pre-existing images held in their heads. We argue that it is more useful to consider body imaging as a process, an activity rather than a product.

Individualization and inequalities in health: a qualitative study of class identity and health.

It has been argued that social class, if not dead, is at least a 'zombie category' in contemporary Western society. However, epidemiological evidence shows that class-based inequalities have either persisted or widened, despite overall improvements in the health of Western populations. This article presents an exploratory qualitative study of the individualization of class identity and health conducted in a southern English city. Findings are presented in consideration of two competing argumentative positions around which participants worked to negotiate class identity and health. The first of these positions denied the significance of class for identity and health and was associated with the individualised heroic and stoic narratives of working class identity. The second position acknowledged the reality of class relations and their implications for health and identity, being associated with structurally and politically orientated narratives of middle class identity. In sum, resistance to class was associated with talk about individual, private experience whereas the acceptance of class was linked to discussion of health as a wider social or political phenomenon. This evidence lends qualified support to the individualization thesis: inequalities in health existing on structural or material levels are not simply reproduced, and indeed in some contexts may even juxtapose, accounts of social identity in interview and focus group contexts. Class identity and health are negotiated in lay talk as participants shift argumentatively back and forth between competing positions, and public and private realms, in the attempt to make sense of health and illness. The promotion of greater awareness and interest in health inequalities within wider public discourse may well help support attempts to tackle these injustices.