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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 2-month history of progressive lower-extremity edema, weight loss, and fatigue. Medical history is significant for recreational use of inhaled cocaine; he denies injection drug use. He has no other known medical issues and takes […]

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The devastating opioid epidemic is one of the largest public health problems facing the U.S. Over 2.5 million people in the U.S. suffer from opioid use disorder. Four in five new heroin users started out misusing prescription painkillers. A 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to […]

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When I was a cardiology fellow back in the 1980s, I learned about a variety of early tools for evaluating heart health that had been displaced by the modern standards of electrocardiography (ECG, or EKG for the Deutschephiles) and echocardiography. One such technique – ballistocardiography – stuck with me, and may be making a comeback. […]

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Without doubt, the future of medicine will include mandatory education for physicians on their conscious and unconscious biases. The politically and culturally progressive nature of medical education and graduate medical education almost ensure that this will eventually be a deeply-ingrained part of our training and our continuing certification. I’m sure that as our culture purports […]

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Doing a simple internet search, you can find a plethora of information about well-being and health. Being happy and well is a goal everyone should aim to achieve. However, I  find many of the tips out there are simply unattainable. It may be that I am just a fail at true inner peace and that […]

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People with disrupted 24-hour cycles of rest and activity more likely to have mood disorders, research suggests

People who experience disrupted 24-hour cycles of rest and activity are more likely to have mood disorders, lower levels of happiness and greater feelings of loneliness, research suggests.

While the study does not reveal whether disruptions to circadian rhythms are a cause of mental health problems, a result of them or some mixture of the two, the authors say the findings highlight the importance of how we balance rest and activity.

Related: Nobel prize for medicine awarded for insights into internal biological clock

Related: Late risers more likely to die early? Wake me up from this nightmare | Andy Dawson

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Raising awareness of mental health problems should be the start of the process of tackling them, not the end

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

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I’ve used my experiences over the last 20 years to develop Swirl, an accessible guide to managing anxiety

I have struggled with anxiety, particularly overthinking, for a number of years. I’ve had cognitive behavioural therapy (CBT) and taken medication – and I’ve collected a lot of self-help literature.

I’ve found most of this material dull and lengthy, and if you have mental health issues, you might struggle with the motivation and concentration to read it. As a mental health nurse, I also noticed there were few resources for service users that were empowering or pleasing to the eye. There was a lot of stereotyping, with pictures of clouds, people frowning or sitting with their head in their hands. I wanted to create something that could take on those associations.

If you wake up in the middle of the night with your mind swirling with thoughts, my hope is that you can pick up Swirl and that it will soothe you

Related: I'm reinventing mental health care by putting patients in charge

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The UK’s abundant woodland has proven health benefits. That’s why Network Rail’s destructive scheme must be opposed

In 2001 there were 1.3bn trees in England. That’s 25 for every person in the country, the highest numbers since the first world war. One article predicted that in 2020 there would be more trees in England than in 1086, when 15% of the country was cloaked in woodland. Part of the reason for this buoyant outlook was the country’s response to the great storm of 1987. We mourned for our ancient yews and the beeches of Chanctonbury Ring. Petitions were drafted, many thousands of saplings were planted. We rebuilt our woods with solemn and impassioned dedication.

The predictions will not fall short. Across the UK, the number of trees has sharply increased. In 2015 there were 3bn trees, the equivalent of 47, a sizeable copse, for every person, around twice as many as in 2001. These statistics might evoke a bosky eden where the wild wood is reclaiming the land, yet recent years have also seen a return of large-scale felling, with Network Rail’s plans to cut down millions more trees the latest example.

Related: Revealed: Network Rail's new £800m scheme to remove all 'leaf...

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Six-week checkup would help the 50% of UK mothers with mental health problems

New mothers should receive a mental health checkup six weeks after giving birth to help tackle possible postnatal depression and other problems related to having a baby, ministers have been told.

A cross-party group of 60 MPs and peers have written to Steve Brine, the minister for public health and primary care, demanding that all mothers in England have an assessment of their emotional and mental health carried out by a GP, practice nurse or health visitor.

Related: How to survive the mental pressures of being a new mother

The maternal check is often either not done at all or is done in a hurry at the end of the baby check appointment

Related: Our health system is failing new mothers | Maggie Gordon-Walker

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Tessa Jowell was a member of the Mental Health Act Commission set up in 1983 to safeguard the interests of patients formally detained in mental hospitals, which included visiting and monitoring their care.

Already an expert in the field, she wore her learning lightly. A team player, she combined penetrating questions with a compassion for the patients and the staff caring for them. Distressing though the work sometimes was, she was always vivacious and full of good humour.

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I am one of the women who has felt overwhelmed. And this isn’t due to hormones, or any of the other explanations that are used to blame women

Like every other age known to humankind, these are hard times to be a woman. According to the UK’s biggest survey into the impact of stress, 81% say they have felt overwhelmed or unable to cope in the past year (compared with 67% of men). The other 19% were probably too damn busy, or perhaps just drained by being paid less than the man sitting next to them, to respond.

Related: Three in four Britons felt overwhelmed by stress, survey reveals

Women are twice as likely to experience anxiety as men

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Stress almost drove me out of the profession. But a change in leadership has helped me fall back in love with education

  • Read more from the Secret Teacher

Not so long ago, I was ready to quit teaching. Now, I’ve got my sights on leadership. The difference is my headteacher.

Under my previous head, I got the point where I couldn’t go on. I was signed off work with anxiety and stress. At school, we’d been under intense pressure to get more children to expected levels to show the school was improving – and were always on edge thanks to drop-in observations. As a member of the school leadership team, the headteacher expected me to remain distant from the rest of the staff, meaning I was isolated from my colleagues.

Related: Teachers are at breaking point. It's time to push wellbeing up the agenda

When staff sought support, they were made to feel it was their fault – and their responsibility alone to deal with it

Related: Every school needs a staff wellbeing team – here’s how to start one

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Governments can do more; so can social media companies. We parents might stop projecting our anxieties too

Poor Twiglet the dog. Her short-lived career as a comfort animal for anxious Cambridge university students ended prematurely this week, after unprecedented demand to take her out for soothing walks left her feeling rather overanxious herself. At her peak, the jack russell was being booked out for eight hours a day, which says something about stress levels approaching finals.

Related: The new GCSE exams pile on pressure and kill off passion for learning | Keza MacDonald

What are the biggest changes to GCSEs?

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The all-consuming new system is causing stress-induced illnesses and has little relevance outside of school

Reading teachers’ and students’ accounts of the immense stress and mental health issues caused by the introduction of the new GCSE exams this year is heartbreaking. “The new GCSEs have broken my best students, left some with serious stress-induced illnesses, and isolated the majority, leaving them completely apathetic towards their own learning,” said one teacher. A student reports: “I have seen the mentally toughest people crack and it’s painful to watch. People crying over being unable to do a maths question. Is this what we want as a nation, to be put under this mental stress?”

Exams are not exactly known for making teenagers happy, but the misery should at least lead to something useful at the end of it. GCSEs as they previously stood were so forgiving that their usefulness was often called into question – but instead of reforming them, former secretary of state for education Michael Gove decided to take them back to the days of the O-level. The new GCSEs emphasise tough, stressful end-of-year examinations over coursework and regular testing: teacher friends tell me...

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Residents in Geel have been taking in mentally ill strangers for hundreds of years. Now academics are looking to the small Flemish town for social care ideas

Maria Lenaerts was seven years old when she came home from school one day to find a stranger at the kitchen table. It was September 1942 in Nazi-occupied Belgium.

The young man looked afraid. He did not say a word to her. “He was sitting at the table like this,” she recalls, hiding her head in her arms. “He didn’t understand anything.”

A tradition from the age of Chaucer has survived and evolved into part of Flanders’ state healthcare system

Related: Safe, happy and free: does Finland have all the answers?

Related: 'Moneysupermarket for mental health': could the future of treatment be digital?

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What did I find when I joined a university? Poor mental health, huge workloads, ego-driven professors and rampant plagiarism

Not for the first time, I watched as one of our PhD students was loaded into an ambulance and taken to hospital. He had collapsed in one of the university research labs about 20 minutes earlier.

A few hours later we received word from the hospital that the student was now alert and all tests were normal. Just as I had seen previously, the student had fainted as a result of stress, anxiety and fatigue.

Related: Student mental health is suffering as universities burst at the seams | Anonymous academic

Related: We must stop universities exploiting the unpaid labour of PhD students | Anonymous academic

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Group criticises counselling services cut when Manus refugees have one of highest mental illness rates in world

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The Australian government is trying to walk away from the human rights crisis it created on Manus Island, winding back health services while refugees and asylum seekers are still in its care, Amnesty International has said.

A report by the organisation, released on Friday, criticised the termination of mental health services despite the 700-strong refugee population on Manus having one of the highest rates of mental illness in the world, according to the UN.

Related: The gay, transgender and bisexual men on Manus are forced into silence | Behrouz Boochani

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The GCSE is 30 – and it’s suddenly much tougher, causing extraordinary anxiety for teachers and pupils. So should it be scrapped?

On Monday morning, what may be the most dreaded and feared set of public exams England’s teenagers have ever sat began in school assembly halls up and down the country.

It is 30 years since GCSEs (General Certificate for Secondary Education) were first introduced under Margaret Thatcher, replacing O-levels and CSEs. The new exam was designed to cover a broad spectrum of ability rather than dividing pupils between high achievers, who sat O-levels, and lower-ability students, who took CSEs. Now, three decades later, following claims of grade inflation and dumbing down, GCSEs have been revised and re-formed and a brand new set of exams is being rolled out.

These students are under more pressure than at any point in living memory

Related: Secret Teacher: I fear for the wellbeing of students under pressure to perform

I have never, in over 20 years of teaching, seen pupils suffer so much anxiety and other symptoms of poor mental health

The school leaving age is 18, in effect. Education goes on from four to 18. So what are you testing people at 16 for?

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Sussex NHS trust ‘unreservedly’ sorry in case of Janet Müller, 21, who died after absconding from mental health ward

A health trust has apologised “unreservedly” for failings in the case of a 21-year-old student whose body was found in a burnt-out car after she absconded from a mental health ward.

How Janet Müller, a German national in her final year at Brighton University, ended up in the boot of a torched Volkswagen Jetta is a mystery. She died from inhalation of fire fumes within hours of going missing. Christopher Jeffrey-Shaw, 27, was convicted of manslaughter and imprisoned for 17 years.

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Greater Manchester mental health trust’s outgoing chief executive on seven years of austerity and her fears for the health service’s future

Mental health has a hell of a lot to teach the acute sector,” says Bev Humphrey, the outgoing chief executive of the Greater Manchester mental health NHS foundation trust. “It needs to sit up and listen.”

Humphrey believes that truly integrated mental health teams – involving psychiatrists, psychologists, mental health nurses, social workers, speech therapists, occupational therapists and dietitians – that provide services around the clock are the way forward across the NHS. “We have crisis intervention teams working 24/7, helping to reduce the pressure on inpatient beds. If you had that for older people, you would have fewer emergency admissions to hospital.”

Related: Three in four Britons felt overwhelmed by stress, survey reveals

Related: Mental health referrals in English schools rise sharply

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Recently, I attended a conference on social media. The conference was geared towards health care professionals who had a product they wanted to perfect and promote. In speaking with some of these participants, many of whom were physicians, I realized they had no clear marketing plan.  Although a clear and concise marketing plan would help […]

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She said her insurance wouldn’t cover her oxygen. I didn’t believe her. She needed it. She had an irreversible lung disease that made walking a block feel like a hundred-yard sprint. It was no trouble showing she needed it– her blood oxygen levels would drop below 85 percent with any activity (normal levels are between […]

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated in follow-up after a diagnosis of ulcerative colitis. Ten days ago he was started on prednisone, 60 mg/d, but his symptoms have not improved. He has six to nine bloody bowel movements per day and moderate […]

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The release of new Star Wars movies has inspired extensive peer-reviewed commentary from economics to medicine, including the use of movies’ characters as examples for psychopathology teaching. But its true value as a primer for medical education may have been overlooked.   Just a few of the many parallels include: Simulation.  Aboard the Millennium Falcon, Luke […]

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Why don’t doctors advocate for themselves? Or young doctors, at least. Maybe it’s because we’re bombarded with patient care, never ending-educational opportunities or the mountain of electronic medical records that still need signed. Maybe it’s because it’s too overwhelming. Understanding and conquering the health care behemoth that organizations, third-party payers, and the government have created […]

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A recent article and accompanying commentary in the journal Pediatrics describe what we currently know about children who have died from influenza over the past decade or more. The Centers for Disease Control (CDC) has collected information about this since the 2003-2004 influenza season. In that first report, there were 153 deaths. Since then there have been at least 100 influenza […]

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About 30 miles east of LA, on the quiet tree-lined campus of Claremont Graduate University, sunlight pierces the ornately covered windows of a lower-level classroom in Harper Hall. A glow is cast upon the 25 students of Dr. Debbie Freund’s health policy course; PhD candidates and practicing physicians among them. Many of these bright young scholars will […]

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As a new mum, I know loneliness cuts deep – and the lack of services for parent and child plays a large part in this

It is the strange lot of young mothers to be never alone, but often lonely. You may have a baby stuck limpet-like to your breast, hip or lap, but for many women, particularly those heroic superbeings we call single mothers, loneliness stalks the days like a tiger.

Related: Our health system is failing new mothers | Maggie Gordon-Walker

Motherhood can be lonely for everyone – but for the millions on low incomes the situation is desperate

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I failed twice to get a nursing degree, but I’ve seen how my experience of mental health problems can help others

Working as a nurse was not something I ever saw myself doing while I was growing up. The possibilities seemed endless and I dreamed of being everything from an archaeologist to a vet. However, at the age of 15 I received a life-changing diagnosis and the world I knew fell apart. Overnight my life changed from that of a normal teenager to one punctuated with unrelenting rounds of in-patient psychiatric treatment and a near-fatal battle with anorexia.

My own journey, and the healthcare professionals who had influenced it – both good and not so good – had a profound effect on me and I began to consider nursing as a career. I wondered if I would be able to use my experience to help others in similar positions, and felt a strong desire to give something back.

Related: I had psychosis and was sectioned. Nurses saved me from the brink

Related: To be human to another human – this is why we nurse

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In the 1950s and 60s, a Montreal hospital subjected psychiatric patients to electroshocks, drug-induced sleep and huge doses of LSD. Families are still grappling with the effects

Sarah Anne Johnson had always known the broad strokes of her maternal grandmother’s story. In 1956, Velma Orlikow checked herself into a renowned Canadian psychiatric hospital, the Allan Memorial Institute in Montreal, hoping for help with postpartum depression.

She was in and out of the clinic for three years, but instead of improving, her condition deteriorated – and her personality underwent jarring changes.

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Research suggests MDMA could reduce symptoms when combined with talking therapies

MDMA, the main ingredient of the party drug ecstasy, could help reduce symptoms among those living with post-traumatic stress disorder, research suggests.

Post-traumatic stress disorder is commonly treated with drugs, psychotherapies or both. However, some find little benefit, with certain talking therapies linked to high dropout rates.

Related: Power of psychedelic drugs to lift mental distress shown in trials

Related: MDMA approved for final trials to treat PTSD before possible legalization

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At Lloyds, where I’m CEO, we’ve seen how a change in attitudes has helped staff – and our business – to thrive

British society has made huge strides in recent years in its willingness to acknowledge, confront and treat mental health, but the workplace remains an area where we continue to struggle with its impacts: and the costs are devastating.

Despite the fundamental changes to our working lives during the past decade – flexible working, the end of the nine-to-five working day, an “always on” culture and the rapid evolution of technology – there is one troubling constant: declining UK productivity since 2007. As far as productivity is concerned, the past decade has been the worst since the late 18th century, around the time of the industrial revolution, according to research by the Bank of England released last week.

Related: How to manage mental health at work

Related: How to manage mental health at work

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Despite warnings of a crisis, the quality of care and patient outcomes have improved. But the NHS still needs a pragmatic plan to secure its future

This year is one of anniversaries. It’s 70 years since the NHS was created and 10 years since my last review of the service, which focused on the quality of healthcare. It seems, therefore, like the perfect moment to step back and reflect on where we find ourselves today.

With this in mind, I recently launched another review, commissioned by the Institute for Public Policy Research (IPPR) and with analytical support from management consultancy Carnall Farrar. The review aims to assess the progress we have made and the challenges we face in the future. Telling the story of the last decade in the NHS, our interim findings are both interesting and important.

Related: More cash will force the NHS to address tougher questions than money | Richard Vize

Related: NHS survey reveals staff are determined to make the best of tough conditions

Related: Integrating health and social care is vital to deliver Jeremy Hunt's plan | Julia Scott

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Inquiry commissioned by Theresa May into ‘flawed’ law finds neglect and discrimination

People with serious mental illness are suffering neglect and discrimination when they have been detained for treatment, according to a report ordered by Theresa May.

Too many of those sectioned under the Mental Health Act receive a lack of dignity and respect from staff, according to the review of legislation, which has identified a series of problems with it.

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My school is working young people into the ground, and failing to give them the support they need to deal with mental health issues

  • Read more from the Secret Teacher

As exam season looms into sight, the stress is ramping up. This is nothing new, of course, but the way students are being treated at my school is a cause for concern. We’re showing a complete disregard for their mental health and wellbeing.

Related: Test anxiety can be debilitating. But schools can help students manage it

Related: Join us: sign up for the Guardian Teacher Network newsletter

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Lack of resources among local authorities is so severe that UK faces worst crisis in 150 years, says Barnardo’s

Britain is confronting a mental health crisis because resources for children are so stretched that some only receive help if they seriously self-harm or attempt suicide, Barnardo’s has warned.

Javed Khan, chief executive of Britain’s largest children’s charity, said that young people’s mental health had never been worse in the organisation’s 152-year history. Radical action was needed, he said, because funding cuts had forced charities to abandon vital services.

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Boy’s long-running detention in Australia’s offshore detention system is causing his depression, psychiatrist treating him in Taiwan says

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A psychiatrist has said an acutely unwell child held within Australia’s offshore detention regime should not be returned to Nauru because his long-running detention there is causing his mental illness.

The 17-year-old boy, who Guardian Australia will refer to as Hamid, is currently on the island of Taiwan, where he was taken, along with his mother, for health treatment.

Related: Nauru refugee caught between her son and 'high heart attack risk'

Related: Asylum seeker boy on Nauru pleads for medical help for his mother

Related: Refugees needing medical care told to leave children alone in offshore detention

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Weighing pupils and measuring their girth could push them into eating disorders. As a former anorexic, I know the dangers

In an attempt to fight obesity, the government could force schools across England to weigh and measure their students. Under a suggested policy from No 10, children would jump on the scales and have their middles taped once a year. If they qualified as overweight, they’d be subjected to extra gym classes and a school-imposed programme of weight loss.

Related: Jamie Oliver is wrong – obesity is not just about diet | Tanni Grey-Thompson

Instead of preaching calories and kilo, they should teach teenagers to feel happy, strong and informed

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Studies on young children have identified a genetic link for some such disorders, but environmental factors also have an effect

Humans have succeeded as a species in large part because of our ability to cooperate and coordinate with each other. These skills are driven by a range of “moral emotions” such as guilt and empathy, which help us to navigate the nuance of social interactions appropriately.

Those who lack moral emotions are classed as having “callous-unemotional” traits: persistent personality characteristics that make negotiating social situations difficult. The combination of callous-unemotional traits and antisocial behaviour in adolescents and adults is typically diagnosed as psychopathy.

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New investigation described as a whitewash after it fails to uncover institutional abuse

An inquiry into the care of dementia patients on a troubled mental health ward in north Wales has been described as a “whitewash” after it said there was no institutional abuse.

The findings of an in-depth investigation into the treatment of patients on Tawel Fan ward at Glan Clwyd hospital in Denbighshire, contradicted those of an earlier inquiry.

Related: Welsh health board put in special measures amid human rights concerns

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When you see your doctor, you want to know what’s wrong, follow the steps to recovery and get predictable results. Sadly, this is not always possible. Medicine is an art based on science that is constantly changing and full of things we don’t know. Here are four reasons why it seems like your doctors didn’t […]

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A 76-year-old gentleman with a history of kidney failure, myasthenia gravis and recently diagnosed with esophageal cancer presented for evaluation of melena and hypotension. The patient was my first admission to the medicine team as an intern, and he was as near to an ICU admission without actually being admitted to the ICU as one […]

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On a weekend night, I received a strange phone call from an emergency room resident. “This is an emergency,” he said, adding fragments of details, “… vaginal bleeding … her heart rate is in the 150s.” It was hard to figure out what was happening and his tone was oddly calm. “Is she in an […]

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I’ve interviewed many doctors on my podcast The Doctor’s Life. They share their stories of how they came to medicine and how they developed into the physicians that they are today. There are three common themes in these “origin stories”: The first is that many of the doctors were mentored by a physician who inspired […]

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Humans need human touch Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level. However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes […]

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It is well known that smoking cigarettes negatively impacts health and leads to an increased risk of stroke, heart disease, lung cancer and death. No one debates this anymore. But it wasn’t always this way, and it didn’t come easily. In the 1940s, almost half of the population in the United States smoked, and the […]

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Couchsurfers in Brisbane twice as likely to describe their mental health as poor than those sleeping rough

Young couchsurfers report having worse mental health and greater risk of suicide and self-harm than those sleeping on the streets, a study has found.

Preliminary results from a research project involving couchsurfers in Brisbane found they were twice as likely to describe their mental health as “poor” than those sleeping rough, and reported higher rates of suicidal ideation and self-harming behaviour.

Related: 'Straight into homelessness': housing plight of mentally ill Australians revealed

Related: NDIS failing people with severe mental health issues, new report warns

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The idea of a depressed computer may seem absurd – but artificial intelligence and the human brain share a vital feature

Depression seems a uniquely human way of suffering, but surprising new ways of thinking about it are coming from the field of artificial intelligence. Worldwide, over 350 million people have depression, and rates are climbing. The success of today’s generation of AI owes much to studies of the brain. Might AI return the favour and shed light on mental illness?

The central idea of computational neuroscience is that similar issues face any intelligent agent – human or artificial – and therefore call for similar sorts of solutions. Intelligence of any form is thought to depend on building a model of the world – a map of how things work that allows its owner to make predictions, plan and take actions to achieve its goals.

Related: Brain preservation is a step closer, but how could it ever be ‘you’? | Sue Blackmore

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Around 350,000 people could soon qualify for right to select and pay for treatments through bespoke care plan

Hundreds of thousands of people with mental health conditions and physical disabilities could be given the option of a personalised NHS budget for their own care needs under government proposals.

People with learning difficulties and dementia are among around 350,000 who could have the right to select and pay for treatments that improve their health and wellbeing through a bespoke care plan agreed with medical professionals. For children and people unable to manage the money, parents or carers will be able to manage the budget.

Related: Why are personal budgets not used more in mental health?

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About this site

Mental health is a level of psychological well-being, or an absence of a mental disorder; it is the "psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment".