Gynaecological care of women with chronic pelvic pain: Patient perspectives and care preferences.

OBJECTIVE: To explore the experiences and care preferences of women with chronic pelvic pain, with or without a history of sexual trauma, seeking gynaecological care. DESIGN: Qualitative study. SETTING: Ambulatory endometriosis centre. POPULATION OR SAMPLE: Women aged 18-55 years with chronic pelvic pain. METHODS: Baseline demographics and sexual trauma history were obtained, and participants were assigned to focus groups according to a positive (four groups, 13 participants) or negative (two groups, nine participants) screen for a history of sexual trauma. The focus groups were led by a clinical psychologist and a gynaecological surgeon and consisted of semi-structured interviews. The interviews were audio-recorded and transcribed, and the transcripts were coded in NVivo 12. MAIN OUTCOME MEASURES: Content analysis was used to derive themes according to the participants' own words. RESULTS: Participants with chronic pelvic pain, with or without a history of sexual trauma, experienced delay in diagnosis and repetitive dismissals by clinicians. Participants' experiences of dismissals included: clinicians not listening, insufficient allocation of time to appointments and perceived redundant medical testing (i.e. sexually transmitted infection testing, urine cultures, ultrasounds). Participants identified clinician interactions as pivotal in coping with both pelvic pain and sexual abuse. Participants also provided feedback regarding trauma-informed practices and care delivery specific to patients with chronic pelvic pain. CONCLUSION: Patients with chronic pelvic pain, with or without a history of sexual trauma, report negative experiences when interacting with the healthcare system. They have clear needs and preferences regarding gynaecological care and provide feasible suggestions for improving care delivery.

Association of Non-Pharmaceutical Interventions to Reduce the Spread of SARS-CoV-2 With Anxiety and Depressive Symptoms: A Multi-National Study of 43 Countries.

Objectives: To examine the association of non-pharmaceutical interventions (NPIs) with anxiety and depressive symptoms among adults and determine if these associations varied by gender and age. Methods: We combined survey data from 16,177,184 adults from 43 countries who participated in the daily COVID-19 Trends and Impact Survey via Facebook with time-varying NPI data from the Oxford COVID-19 Government Response Tracker between 24 April 2020 and 20 December 2020. Using logistic regression models, we examined the association of [1] overall NPI stringency and [2] seven individual NPIs (school closures, workplace closures, cancellation of public events, restrictions on the size of gatherings, stay-at-home requirements, restrictions on internal movement, and international travel controls) with anxiety and depressive symptoms. Results: More stringent implementation of NPIs was associated with a higher odds of anxiety and depressive symptoms, albeit with very small effect sizes. Individual NPIs had heterogeneous associations with anxiety and depressive symptoms by gender and age. Conclusion: Governments worldwide should be prepared to address the possible mental health consequences of stringent NPI implementation with both universal and targeted interventions for vulnerable groups.

Characterizing Research About Interprofessional Education Within Pharmacy.

Objective. To determine how interprofessional education (IPE) in pharmacy has been studied, namely which disciplines have engaged in IPE research initiatives, the research methodologies that have been used, and what journals have published in this area.Findings. In the 145 IPE studies included in the review, the authors represented 13 different disciplines (3.2±1.5 disciplines per study). Pharmacy authors most commonly published with co-authors from nursing, medicine, and health management and support and most frequently served as first author or last author. The IPE activities involved 4.0 student disciplines (SD = 1.9) and 211.8 students (SD = 280.1), and most commonly included nursing (n = 104, 71.7%), medicine (n = 102, 70.3%), and health management and support students (n = 50, 34.5%). Most studies did not include an author from each student discipline involved in the IPE (n = 88, 60.7%). Further, a majority of studies used nonrandomized groupings (n = 103, 71.0%) with quantitative data (n = 74, 51.0%) and most were published in an interprofessional journal (n = 65, 44.8%) or pharmacy-specific journal (n = 45, 31.0%).Summary. Pharmacists have increased their engagement in IPE research as demonstrated by the number of articles published and authorship order position. However, mismatches between student disciplines and author disciplines on published papers elucidate opportunities to foster collaborations that position students for success within a collaborative healthcare environment.

Bisexual Women's Invisibility in Health Care.

Invisibility of racial and ethnic inequity in clinical research means many important features of disease etiology and symptom presentation are often unaccounted for. Similarly, binary (ie, gay or straight) definitions of sexuality render bisexual women's experiences invisible, and this invisibility has 2 important consequences for minority groups' members' health, which this article considers.

Out and in Harm's Way: Sexual Minority Students' Psychological and Physical Health after Institutional Betrayal and Sexual Assault.

In a large random sample of undergraduate university students, we investigated whether sexual minority individuals (i.e., lesbian, gay, and bisexual individuals) experienced different rates of sexual violence victimization (including sexual assault and rape) and subsequent institutional betrayal compared to their heterosexual counterparts, and whether such differences may account for disparities in the psychological and physical health of sexual minorities compared to heterosexuals. In addition to differences in sexual assault victimization rates by gender and sexual orientation, we found differences in rates of institutional betrayal. When non-heterosexual women experienced sexual assault, they experienced a significantly higher rate of institutional betrayal compared to heterosexual women. Overall, greater institutional betrayal was associated with greater negative psychological and physical health outcomes in sexual minorities compared to heterosexual students. These findings reinforce the need for institutional reforms related to the climate and reporting of sexual violence on college campuses, and also identify sexual minority students as a population of particular risk for additional harm by their institutions when they need them most.

COVID-19 has united patients and providers against institutional betrayal in health care: A battle to be heard, believed, and protected.

In this commentary, researchers, health care consumers, and medical providers reflect on institutional betrayal during the COVID-19 pandemic in American and Canadian health care systems. Examples of institutional betrayal experienced by patients and their family members, as well as medical providers, are described. Although such examples may be more evident to the general public during the current pandemic, they do not represent new problems. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

When Is Advertising a Plastic Surgeon's Individual "Brand" Unethical?

Advertising a plastic surgery practice on social media is fraught with both practical and ethical challenges. We use an institutional betrayalframework to explore the range of potential harms to patient well-being while also considering the pitfalls of social media activity, especially marketing, for practitioners. We also give consideration to the relative benefits that such online patient-clinician relationships can provide. In our analysis, we draw on specific examples of plastic surgery procedures prominently featured on social media, including the Vampire Facelift®.

Collusion, torture, and inequality: Understanding the actions of the American Psychological Association as institutional betrayal.

The Hoffman Report (Hoffman et al., 2015) documented devastating information about the American Psychological Association (APA) and the profession of psychology in the United States, prompting a public apology and a formal commitment by APA to correct its mistakes (APA, 2015). In the current article, we utilize betrayal trauma theory (Freyd, 1997), including betrayal blindness (e.g., Freyd, 1996; Tang, 2015) and institutional betrayal (Smith & Freyd, 2014b), to understand and learn from APA's behaviors. We further situate this discussion in the context of inequality, both within APA and in American society generally. We detail how the impact of APA's institutional betrayals extended beyond the organization, its members, and the psychology profession, highlighting the potential for disproportionate harm to minorities, including those who were tortured; Muslims, Middle Easterners, Afghans, and non-Americans who were not tortured; and other minority individuals (Gómez, 2015d). Acknowledging, understanding, and addressing its institutional betrayals offers APA the opportunity to take meaningful corrective and preventive measures. We propose several institutional reparations, including making concrete changes with transparency and conducting self-assessments to inform further needed changes (Freyd & Birrell, 2013). By engaging in institutional courage, APA has the potential to grow into an ethical governing body that fulfills its mission to "advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives" (APA, 2016).