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Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.
Second primary breast cancers are among the most common risks to female patients who have received radiotherapy for mediastinal lymphoma.
This study aims to audit breast dose in women who received mediastinal radiotherapy for lymphoma and compare the combined dose parameter values measured to those in the literature.
Methods:
Twenty-three patient datasets from 2017 to 2021 were obtained. Inclusion criteria, such as female gender and 30Gy prescription dose, were applied. Target volumes were delineated using involved site radiotherapy and planned on Eclipse (Varian, Palo Alto, CA) using either fixed field or VMAT. Breast contours were retrospectively outlined according to RTOG/EORTC guidance and descriptive statistics were used to compare findings to those from the literature.
Results:
Differences were found in V4gy, V5Gy and mean dose compared to the literature with mean dose being 2Gy in the literature and 4Gy in this audit.
Conclusions:
Breast dose parameter values between patients in this study vary due to multiple factors. These include the treatment delivery method used and the position of the treatment field in relation to the location of breast tissue. Mean dose and V4% and V5% to breast tissue found in this study differ from that found in the literature. This study highlights the importance of accurate contouring and optimising breast tissue when possible.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Training is the most common and perhaps the most useful role for a global volunteer at this stage in the development of global mental health. Once initial agreements with hosts have been confirmed, it will be time to firm up details of agreed objectives, what training package or materials would be helpful, who will be involved, details of timetabling, as well as how best to deliver the training requested by the host. Special consideration of psychosocial interventions needs to be given to any training in mental health, as these therapeutic interventions are an integral part of the management of all people with mental health conditions.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
People volunteer at different stages of their careers, from student days to post retirement. The reasons are varied, but common motivations include altruism and the desire to ‘give something back’. Many readers may wish to contribute to the welfare of people overseas with mental illness, alongside some who feel a deep desire to do what they can for those who have little access to mental health care. For people from a diaspora background, there may be a desire to help ‘back home’. For others, it is motivated by a need for refreshment and to gain new perspectives away from the usual daily professional ways of working. Some may feel the desire to contribute to colleagues’ development or make an impact on trainees and the next generation. Other volunteers may crave ethical travel, and some mention the increasing appeal of learning from colleagues in varied and low resource settings. Whatever the reason(s), careful reflection is indeed needed as outlined in Chapters 3 and 4 on ethical considerations.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
The overarching principle of ethical volunteering is to ‘do no harm’. Volunteers need to think carefully about how to behave, and what to teach and how to discuss ideas. There have been examples in the media of volunteers in charitable positions behaving inappropriately, including sexual exploitation of vulnerable people, and these cause huge suffering, trauma and humiliation to individuals and organisations. Nowadays organisations have strict safeguarding rules. It is critical to stay professional at all times.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
This chapter explores the practicalities of arrival in another country, settling in and co-working with hosts in final planning and preparation for programme delivery. The importance of spending time getting to know the people with whom you will be working as well as the flavours of the world they live in will help shape a meaningful collaborative experience. Self-care and care for the team remain a constant theme and an important point of emphasis.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Global volunteering provides an opportunity to learn, support and work with individuals, communities and colleagues around the world. It can be a hugely rewarding endeavour for all stakeholders if it is undertaken with adequate preparation, developed with host partners and is focused on sustainability. The principles and experiences outlined in this book have sought to provide you with an opportunity to approach the global volunteering placements in mental health with the necessary knowledge, confidence and humility. At the same time, it is important to recognise that much of this book considers how best to navigate the voluntary context as it is here and now. In this chapter, likely changes in the areas of global mental health are presented.
Edited by
Sophie Thomson, World Psychiatric Association,Peter Hughes, Springfield University Hospital, London,Sam Gnanapragasam, South London and Maudsley NHS Foundation Trust
Making diagnoses and understanding the appropriate use of medication in treating mental disorders is just one part of mental health care. The other part is psychosocial treatments. In global volunteering it is important to be skilled in the principles and use of these psychological treatments as well as medication. Some aspects of medication are included here as there is so much interplay of psychosocial and prescribing.