'No one else understands', 'I wouldn't want to pity myself over something that's not really my problem': siblings' experiences of their adolescent brothers and sisters' inpatient treatment for mental health difficulties.

BACKGROUND: Family life is disrupted when a child experiences mental health difficulties. This can have long-standing effects on sibling relationships. This study explores the lived experiences of young people who have an adolescent sibling hospitalised for treatment of a mental health difficulty. METHOD: Semi-structured interviews of 45-60 min were conducted to explore the experiences of 10 siblings (6 sisters/4 brothers aged 13-22) of nine patients (5 sisters/4 brothers aged 15-17) receiving treatment for a mental health difficulty in a child and adolescent inpatient unit (IPU). Interpretative phenomenological analysis was used to analyse the data. RESULTS: Two superordinate themes were identified: 'Who am I if I'm not supporting them?' and 'On the fringes: actively involved but from the outside'. The interplay of these two super-ordinate themes was found to influence the five sub-ordinate themes: 'Confusion and disbelief', 'Don't worry about me, focus on them.', 'Powerless when I need to be powerful.', 'Helping or hindering- what is this place??' and 'Knowledge is power.' CONCLUSION: Siblings described experiencing conflicting and confusing emotions which may impact their attendance in IPU and engagement in siblings' treatment. Siblings of adolescents in inpatient treatment for mental health difficulties may be at increased risk of experiencing psychological distress. The mental well-being of siblings must be borne in mind by child and adolescent inpatient services supporting families in crisis.

Exploring professional issues: the psychosocial component of genetic counseling in genomic healthcare.

Aim: To determine UK genetic counselors' (UKGCs) opinion regarding 'the psychosocial component of the UKGC remit in the new genomics era'. Methods: Facilitated discussions at a national conference (2016) using interactive methodologies (58 participants). Results: UKGCs recognized the rapid rate of change emerging with advances in genomic science. Change will be required to the UKGC remit and the roles, rules, relationships and responsibilities that underpin it (29 topics identified). UKGCs supported their 'unique selling point'; integrating knowledge and the explicit focus on psychosocial aspects of genomic healthcare. By 2019, some of the aspirations have been achieved. Conclusion: UKGCs should proactively position themselves to capitalize on the challenges and opportunities of genomic healthcare to maximize patient benefit.

Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement.

BACKGROUND: Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1(st) year (compulsory) and 2(nd) year (optional) Graduate Entry Medical School students. METHODS: A mixed method pre and post study of Year 1 (n = 140) and Year 2 (n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out. RESULTS: Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) (p < .0005). Thematic analysis of year 1 student feedback identified themes including great concept, poorly executed; and less discussion, more practice. Year 2 themes included session environment and satisfaction with tutors. CONCLUSIONS: The MBSR course was associated with high levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

Efficiency of molar distalization associated with second and third molar eruption stage.

OBJECTIVE: To evaluate the efficiency of molar distalization associated with the second and third molar eruption stage. MATERIALS AND METHODS: A systematic computerized database search was conducted using several databases. Adaptations of the terms molar distalization and distalizing appliances were used. The reference lists of all the selected articles were also searched for any potential articles that might have been missed in the electronic search. The data provided in the selected publications were grouped and analyzed in terms of molar distalization with respect to various eruption stages of maxillary second and third molars. RESULTS: Out of the 13 initially identified articles only four fulfilled the final selection criteria. Three of the four studies showed no statistical significance in linear molar distalization based on the eruptive stage of the second and/or third molars, while one study found that the amount of distal movement of the first molars was significantly greater in the group with unerupted second molars. Only one study found that the amount of molar tipping that occurred as a result of distalization was related to the eruption stage of the maxillary molars. Similarly, three of the four studies found that molar distalization time was not significantly affected by eruption of the second or third molars. CONCLUSION: The effect of maxillary second and third molar eruption stage on molar distalization-both linear and angular distalization-appears to be minimal. This conclusion is only based on low-level of evidence clinical trials. The large variability in the outcomes should be considered clinically.

Implant dentistry in the undergraduate dental education program at Dalhousie University. Part 1: clinical outcomes.

PURPOSE: This study evaluated the outcome of treatments performed by students in the undergraduate implant elective program at Dalhousie University. MATERIALS AND METHODS: All patients treated with dental implants in the undergraduate elective program at the Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada, between 1994 and 2004 were identified from patient records. Brånemark implants (Nobel Biocare) were placed by experienced oral and maxillofacial surgeons or periodontists using the traditional 2-stage protocol and an intermediate healing period of 3 to 6 months. Undergraduate students in the elective implant program were responsible for the restorative part of the treatment. RESULTS: A total of 166 implants were placed in 95 patients (38 men, 57 women; mean age: 52 years, range: 18 to 84 years). Of the 166 implants, 142 had been restored at the time of the study. Ten of the implants failed: 4 were lost during healing and the remaining 6 were lost after loading, leading to an implant survival rate of 93%. A total of 64 single-implant restorations, 7 multiple-unit fixed restorations, and 33 implant overdentures were fabricated. CONCLUSION: The results indicate that the clinical outcome of implant treatments performed by undergraduate students in the implant elective program at Dalhousie University is similar to that reported by experienced clinicians/research teams. Although the implant surgery was performed by an experienced oral and maxillofacial surgeon or periodontist, the student had the main responsibility for treatment planning and performing the prosthodontic procedures. The results also suggest that implant dentistry could be implemented as part of the curriculum in the undergraduate programs of dental schools.