The Relationship between Terminology Preferences, Empowerment and Internalised Stigma in Mental Health.

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. However, people who are empowered may actively challenge stigma by engaging in meaningful opportunities, furthering their self-worth as they achieve control within their lives. People who are empowered through active treatment participation are more likely to reach recovery goals and experience the benefits of evidence-based practices. Hence, empowerment can be viewed as essential to the recovery and well-being of people with a mental illness. Participants in this quantitative study (N = 173) were diagnosed with a mental illness and were recruited via convenience sampling from mental health support groups in Australia. Internalised stigma was less common and empowerment more prevalent in this study than was found in previous studies. However high internalised stigma and low empowerment were present. The terms 'individual' and 'person with lived experience' which have been identified as the preferred terms in a previous study were highlighted as both empowering and recovery focussed.

Terminology Preferences in Mental Health.

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. Avoiding the use of stigmatising language and using terminology that does not exclude the positive characteristics of the individual may play an important role in challenging stigma. This study involved a mixed method approach to identify the terminology preferences of people with a mental illness in Australia. N = 173 participants were recruited via convenience sampling. The humanistic terms 'individual' and 'person with lived experience' were identified as the preferred terms. Qualitatively there was a wide variation in how the terms made the respondents think or feel, with only one of the terms - 'survivor,' having solely negative themes. When contrasting the two most commonly used clinical terms, 'client' was significantly preferred to 'patient'. The term 'consumer' was one of the least preferred terms. This suggests that the use of this term, which is in regular use in Australia, should be reconsidered.

Staff and client perspectives of the Open Borders programme for people with borderline personality disorder.

In recent years, there has been a move away from the medical model of care for people with borderline personality disorder, as hospital admission comes with a number of risks and potential adverse consequences. Although long-term outpatient-based therapy is successful, this may not be an option for those whose condition is in need of stabilisation. Brief admission for crisis intervention has been successful and is now widely used; however, research that examines both the staff and clients' perceptions of a dedicated programme is lacking. Open Borders is a residential recovery-oriented programme that provides brief admission, respite, and phone coaching for people with borderline personality disorder who are heavy users of the public mental health system. In this paper, the authors report the perspectives of clients and staff of the Open Borders programme obtained through semi-structured interviews. Thematic analysis of client and staff perspectives identified four common themes: 'Benefits of the programme', 'Enhanced client outcomes', 'Impact of the physical environment', and 'Ways of enhancing service delivery'. In addition, analysis of the staff perspectives included the theme 'Emotional impact on staff'. Benefits of the programme included the small supportive team approach, flexibility of the staff to spend time with the clients to tailor care, and the relaxed, welcoming environment. Enhanced client outcomes included a reduction in self-harming and hospitalization and an increase in self-efficacy. These results support the move away from the medical model and the empowerment of clients to self-manage their symptoms while fostering hope and self-determination.

A cross-sectional study of the association between anxiety and temporomandibular disorder in Australian chiropractic students.

OBJECTIVE: This study examined the association between anxiety and temporomandibular disorder (TMD) in Australian chiropractic students, particularly its effect on quality of life. METHODS: Chiropractic students (n = 185) completed online surveys, including the Oral Health Impact Profile for TMDs (OHIP-TMD) and the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. The OHIP-TMD psychometric properties were assessed using principal component analysis. Linear regression models were used to examine demographic predictors for anxiety and TMD. A general linear model assessed the association between anxiety and the psychosocial and function scales identified through analysis of the OHIP-TMD questionnaire. RESULTS: The mean value for the OHIP-TMD and PROMIS was 1.3 (SD = 0.7) and 9.5 (SD = 4.1), respectively. Women reported significantly lower quality of life (QoL) related to TMD symptoms (p = 0.006) and that QoL related to TMD symptoms increased significantly as students progressed through the course (p = .025). Lower levels of anxiety were significantly associated with male gender (p = .000), employment (p = .008), higher program levels (p = .003), and having children (p = .005). General linear model analysis revealed that increased anxiety was significantly associated with higher levels of oral physical function impairment (p = .003) and elevated psychosocial distress (p = .0001). CONCLUSION: Anxiety was significantly associated with psychosocial distress and oral physical function impairment in university chiropractic students. In addition to impacting on oral health-related QoL, anxiety also affects students' engagement with learning and academic performance. It would therefore be beneficial to implement strategies that mitigate students' anxiety levels.

Can a stress management programme reduce stress and improve quality of life in people diagnosed with multiple sclerosis?

BACKGROUND: Despite evidence of perceived stress as a risk factor for multiple sclerosis activity, the evidence for managing stress is limited.Objective To evaluate a stress management programme on perceived stress and quality of life, over 6 months. METHODS: One hundred people with multiple sclerosis were randomly assigned to either a stress management programme of mindfulness, meditation and progressive muscle relaxation, or wait list. Perceived stress and quality of life were assessed at three intervals across 6 months. Salivary cortisol levels were assessed at two intervals: baseline and first follow-up. RESULTS: The stress management programme did not significantly reduce perceived stress, when comparing mean scores. Secondary analysis using median scores found a significant improvement for quality of life, favouring the intervention group. CONCLUSION: Stress management had no significant effect on the primary outcome of perceived stress but did improve quality of life in a secondary analysis of median scores.

Quantitative analysis of anxiety levels of nursing students studying bioscience in Australia.

Nursing students traditionally find bioscience difficult and anxiety provoking. This has important ramifications, as anxiety can hinder comprehension and lead to poor exam performance. The aim of the present study was to assess whether there was any difference between the anxiety levels of nursing students during their bioscience laboratory classes compared to their clinical laboratory classes. Students were recruited from a first year Bachelor of Nursing program. The self-report State-Trait Anxiety Inventory (short form) was administered at the start of all classes throughout the semester. Anxiety scores of students between the units were compared using paired t-tests, and repeated-measures analysis of variance was used to measure anxiety scores within units over time. There were no significant differences in anxiety scores in the bioscience and clinical classes; however, the students were significantly more anxious in the theory classes. These findings suggest that nursing students do not find the subject of bioscience any more anxiety provoking than other nursing subjects. Bioscience educators should continue to focus on the integration of bioscience with nursing practice, while broader anxiety-reduction strategies throughout the curriculum should be implemented.

The nursification of a bioscience unit and its impact on student satisfaction and learning in an undergraduate nursing degree.

Undergraduate nursing students traditionally find bioscience difficult, which can be compounded by an inability to relate bioscience theory to nursing practice. Subsequently, many registered nurses feel they lack knowledge in this area. Several studies have identified this problem and focused on the importance of linking bioscience theory in undergraduate nursing curricula to clinical practice. The aim of this study was to assess whether nursification (the active association of a subject with nursing theory and practice) of the bioscience content of a first year, first semester unit impacts on the students' learning experience. The study compared two student groups' perceptions of their learning experience; one group enrolled before the bioscience unit was linked to nursing practice (pre-nursification) and the other group enrolled after the content was linked to nursing practice (post-nursification). Retrospective, quantitative analysis of the mean scores of the student feedback surveys found no significant difference between the pre and post-nursification responses with respect to the students' overall satisfaction of the unit or their ability to achieve their learning objectives, however the students in the post-nursification group reported significantly higher mean scores with respect to their motivation and inspiration to learn, and to learn effectively. The findings in this study suggest that integration of nursing practice within a bioscience unit can improve the learning experience of undergraduate nursing students.

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

A single tube, quantitative real-time RT-PCR assay that detects four potato viruses simultaneously.

A high throughput, real-time multiplex, single tube RT-PCR assay was developed for simultaneous detection of Potato leafroll virus (PLRV), Potato virus X (PVX) and Potato virus S (PVS) in potato leaves and tubers, and Tomato spotted wilt virus (TSWV) in potato tubers and tomato leaves. The test uses four different fluorescently labelled TaqMan probes. Limits of detection sensitivity were established using a range of virus transcript copy numbers (8 x 10(1) to 8 x 10(9) copies of PVX and PVS, 1 x 10(2) to 1 x 10(10) copies of PLRV and 1 x 10(3) to 1 x 10(10) copies of TSWV). For each individual assay, the inter-assay reproducibility was high, with a coefficient of variation of the combined assays of <2%. Total RNA was extracted rapidly and efficiently from bulked samples equivalent to 300 dormant tubers to detect single infections of PLRV, PVX, PVS and TSWV simultaneously in a single assay. The multiplexed assay was validated in blind studies with leaves and tubers. This high-throughput test is accurate and sensitive, and provides seed potato industries with a cost-effective diagnostic tool to detect viruses reliably in bulked samples of dormant potato tubers.

Penicillin resistance in the intestinal spirochaete Brachyspira pilosicoli associated with OXA-136 and OXA-137, two new variants of the class D beta-lactamase OXA-63.

Penicillin resistance mediated by beta-lactamase activity has been reported previously in the anaerobic intestinal spirochaete Brachyspira pilosicoli, and a novel class D beta-lactamase (OXA-63) hydrolysing oxacillin was described recently in a resistant human strain from France. In the current study, 18 B. pilosicoli strains from Australia and Papua New Guinea were tested for ampicillin and oxacillin susceptibility, and investigated for the presence of the class D beta-lactamase gene blaOXA-63 using PCR. PCR products were amplified from seven human and four porcine strains that were penicillin resistant, but not from seven penicillin-sensitive strains. Sequence analysis of the whole gene amplified from seven of the resistant strains from humans and pigs revealed only minor nucleotide differences among them, but there were significant differences compared with blaOXA-63. The predicted amino acid sequence of the enzyme from all seven strains had the same key structural motifs as the previously reported OXA-63, but two variants with 94-95% identity with OXA-63 were identified. OXA-136 had an additional amino acid and 12 other consistent amino acid substitutions compared with OXA-63. OXA-137 had the same differences compared with OXA-63 as OXA-136, but had an additional amino acid substitution at position 16. No structures consistent with integrons or transposons were found in the nucleotide sequences in the vicinity of blaOXA-136 in partially sequenced B. pilosicoli strain 95/1000, and the GC content (25.2 mol%) of the gene was similar to that of the whole genome. The gene encoding OXA-136 from B. pilosicoli strain Cof-10 conferred penicillin resistance on Escherichia coli. This study shows that penicillin resistance in human and porcine B. pilosicoli strains from Australia is associated with the production of two variants of OXA-63, and that susceptible strains lack the genes encoding OXA-63 or the variants.