Effects of a physical exercise session on state body image: The influence of pre-experimental body dissatisfaction and concerns about weight and shape

The effects of a physical exercise session on state body image and mood were examined. In a cross-over design, participants were randomised to two groups starting either with physical exercise (PE; experimental condition) or with reading a newspaper (RN; control condition). Before and after PE and RN, participants (N = 65) rated their body dimensions using a digital photo distortion technique and indicated their attitudinal body image and mood. Participants’ judgements of their ‘felt’ body dimensions and attitudes toward their own body were affected differently by PE and RN, indicating that participants felt slightly slimmer and were more satisfied with their bodies after PE. Exercise-induced changes in body perception were greater, the higher the pre-experimental drive for thinness, body dissatisfaction and weight/shape concerns were. Especially in those participants with higher body image disturbances, physical exercise can have a reinforcing effect on immediate body image and mood improvement.     

Sourcing stereotypes: constructing and challenging simplified knowledge

The social media uproar in Fall 2017 over a nursing textbook chart that presented generalised characterisations of minority groups generated an assumption that medical training needs more Religious Studies expertise. Analysing the sources that the chart cited, we trace the authors’ assertions to studies of varying quality and identify several specific processes involved in simplifying knowledge for dissemination, as the authors disregarded the limits of each specific study and ignored counter-evidence or otherwise evaded critical scrutiny. Comparing this example to examples from world religions discourse illustrates both differences and similarities in the process of constructing simplified presentations. While both presumably developed out of good intentions, they generate significant problems in their effort to shape material to support larger arguments. Thus, scholars across disciplines should critique and complicate their own processes for generating simplified knowledge.     

Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.     

‘Wholeness,Dignity and the Ageing Self’: A Conversation Between Philosophy and Theology

SUMMARY

Winifred Wing Han Lamb: My philosophical interest straddles the areas of education, religion and theology. As a teacher involved in school philosophy programs, I have also been interested in the philosophy of childhood and particularly in the recurring notion of the ‘whole child’ in education. In considering what ‘wholeness’ could mean for children's education, I have also been led to consider what meaning it holds for the self through the ‘changing scenes’ of life, especially in the face of the challenges of ageing.

The notion of ‘wholeness’ holds an intuitive appeal and invites articulation of the deep truths of our faith with respect to persons in all ‘sorts and conditions.’ In section one of this chapter, I attempt that articulation. But this conversation needs to be complementary. Our chapter is the beginning of a dialogue between philosophy and theology in which both affirm the ageing self in the light of the human search for wholeness and dignity.

Heather Thomson: My theological research into humanity as an image of God led me to inquire about the way in which we could speak meaningfully of ageing and dying in terms of imaging God. This challenged how God-likeness was to be understood in relation to glory, honour and power, terms associated with imaging God and exerting dominion. In searching for a theological view of the self that would confer dignity on the ageing, I was led into conversation with various philosophies of the self, some very helpful for my task.

It seems to me that, if ageing people are to be counted as having dignity and worth, and not discounted, then one's theory of the human person was significant. In pondering the issue, it appeared that a conversation between philosophy and theology would be fruitful. Hence, this joint paper. We each speak from our own discipline but find resonance with each other's work. We see this as a first step in a constructive conversation.     

Transgender Primary Medical Care

SUMMARY

Transgender medical care involves addressing general medical conditions and those related specifically to transgender issues. This article summarizes existing research in transgender medicine and provides guidance for family physicians and nurses in adapting standard primary care protocols relating to health maintenance, acute illness, and chronic disease management to address trans-specific clinical oncerns. Trans-specific issues in physical examination, health history, interpretation of laboratory tests, vaccination, screening, and treatment are explored, and the role of the primary care provider in caring for patients undergoing hormonal or surgical change is discussed.     

Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students

ABSTRACT

Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.     

The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

Psychotherapy without the self–a Buddhist perspective,by Mark Epstein

This article seeks to explore how John Rolland's Family Systems Illness Model can be utilized by counselling psychologists working with individuals or families experiencing medical problems. Based on systemic theory the model provides a psychosocial typology of illness and examines how the demands of an illness over time can provide a number of hurdles to be overcome by the client and his/her family. Specific examples and techniques are described to illustrate how the application of the model can be used to guide the interventions employed in a counselling session. the model applies a biopsychosocial approach to health care, and the applicability of this within a British NHS healthcare setting is discussed with the conclusion that such an approach may be in its infancy in this country. Limitations and ideas for expansion of the model from chronic physical illness into spheres of mental health are discussed.     

Strength of faith and body image in Muslim and non-Muslim women

A questionnaire was completed by 98 Muslim and 91 non-Muslim Australian women to examine the relationship between Islam and body image. Path analyses revealed that for Muslim women (but not non-Muslim women) strength of religious faith was inversely related to body dissatisfaction, body self-objectification, and dietary restraint. These relationships were mediated by increased use of modest clothing and by reduced media consumption. These results are consistent with the proposition that adherence to Islam can indirectly protect women's body image from appearance-based public scrutiny and from exposure to Western media.     

Religious upbringing and current religiosity in Spanish nursing and medicine students

The influence of religious education in the family upon current spiritual and religious tendencies was assessed in a sample of 599 Spanish nurse and medicine students using a religiosity scale and answers to a series of belief/disbelief statements. Results showed that nursing and medicine students were equally low-religious, with no differences in religiosity total scores between participants coming from religious families; however, medical students coming from nonreligious families showed higher religiousness than the corresponding nursing trainees. This distinction appeared both across religiosity items and in a variety of responses to belief/disbelief of Christian/secular assertions. Regression analysis showed that religious family background was a consistent predictor of religious beliefs at young adulthood, and its influence was higher for medical students. In addition to establish religious upbringing as an important factor modulating enduring religiosity, these findings provide distinctions between nurse and medical trainees, and reproduce, in a Spanish mainly catholic sample, the structure of religiosity factors previously found on North American mainline protestants.