Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0011
D. Beaumont
{"title":"Emotional Health—Te Taha Whānau","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0011","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0011","url":null,"abstract":"In the Māori model of health, Sir Mason Durie named this cornerstone of health after the family (‘whānau’ in Maori), because of the central place of the family in Māori life. Author adopts a Western approach: ‘emotional health’. Maslow (‘love needs’) and Seligman (‘relationships’) concur. Author acknowledges the importance of his own family and his childhood; examines childhood beliefs and their connection with self-esteem. Practising a different approach: asking ‘What would a person who loves themselves do?’ for 21 days. The US author Byron Katie’s concept of ‘The Work’ to understand our personal triggers. Brené Brown’s 2010 TED talk, ‘The Power of Vulnerability’, which introduces the concept of wholehearted living.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128128658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0010
D. Beaumont
{"title":"Psychological Health— Te Taha Hinengaro","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0010","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0010","url":null,"abstract":"The Māori model of health and the importance of thoughts and feelings for Māori. Maslow and the need to feel safe. The significance of adverse childhood experiences and the roots of mental ill health in adults. The Dalai Lama on love and compassion. The New Zealand Government’s 2018 Inquiry into Mental Health and Addiction and New Zealand’s suicide epidemic. The New Zealand government’s first ‘Wellbeing Budget’ (2019). The role of meditation in pain management (and the author’s personal experience thereof). Maladaptive thinking, rumination, and catastrophizing. The author’s personal experience of depression. Antidepressants, or ‘the drug, doctor’? Author’s experience of acceptance and commitment therapy (accept, choose a valued direction, and take action). Mindfulness and the daily practice of meditation. Another look at work and health, especially the notion of good work. The author’s development of a plan for ‘whole life health’ in his practice, and a patient’s testimony.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133225958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0002
D. Beaumont
{"title":"Doctor Becomes Patient","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0002","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0002","url":null,"abstract":"The author’s heart attack in his early 40s, when working as a rural general practitioner (GP) in the National Health Service (NHS). The author’s career journey: from his medical school training, working as a rural GP for the NHS, his transition to specialist training, and work as an occupational physician. The experience of doctors as patients: first from the author’s personal perspective, but also the tricky matter of treating a fellow doctor. The implications of doctors as patients. The problem of middle-aged men as patients: poor health-seeking behaviour and poor compliance. Sudden death in a patient. The author’s new focus on health and prevention, not disease and treatment. Paternalism in the doctor–patient relationship. Patients or clients? The autocratic doctor, and the concept of patient-centred care. What do patients want from their doctors? The concept of working in partnership with patients.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126285806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0008
D. Beaumont
{"title":"How to Reclaim Your Life","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0008","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0008","url":null,"abstract":"Towards a new model of medical practice: the empowerment model. The social determinants of health and the RACP’s 2019 guidance document, Employment, Poverty and Health. Subsequent work on improving health equity. Resilience and the internal locus of control. The role of childhood trauma, childhood sexual abuse, adverse childhood experiences, and chronic conditions in adulthood. Case example of fibromyalgia and chronic fatigue syndrome, yet post-viral fatigue excluded; the success of a multidisciplinary approach. The importance of self-healing. The placebo effect: in 2016, 97 per cent of GPs in the UK admitted to using placebos. The concept of healing, and the role of sleep—‘Doctors are not good at telling their patients they will get better’. How the Māori model of health works in practice. The importance of spiritual health. How the author uses Māori model of health to co-develop a Life and Health Integration Plan with clients. A case example of this approach in the words of a patient. Using Maslow’s hierarchy of needs and the process of self-actualization. The author’s concept of ‘positive medicine’.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125257558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0009
D. Beaumont
{"title":"Physical Health—Te Taha Tinana","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0009","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0009","url":null,"abstract":"The Māori model of health considers physical health as the cornerstone of Western medicine. Maslow’s understanding of homeostasis. Seligman’s PERMA model and vitality. The relationship between vitality and ageing, and the author’s experience after a heart attack: ‘You look like an old man.’ Telomeres, stress, and ageing—‘you are only as old as you feel’. Professor Elizabeth Blackburn (and her PhD student Carol Greider)’s Nobel Prize-winning research on telomerase. The concept of healthspan. Lifestyle choices and optimum health and wellbeing. Epigenetics and Dr David Sinclair’s book, Lifespan: Why We Age – and Why We Don’t Have To. Sir Harry Burns on the role of the environment and Glasgow effect. Tertiary prevention and the author’s experience. The science of nutrition and diet. The work of Professor Grant Schofield, author of What the Fat? and What the Fast?, who promotes a healthy fat, Mediterranean diet, with low carbohydrates and intermittent fasting. The science of sleep and its role in obesity.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"7 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120908256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0003
D. Beaumont
{"title":"There’s Something Wrong","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0003","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0003","url":null,"abstract":"The role of the occupational physician, and relationships with employers and insurers. New Zealand’s Accident Compensation Commission and its role as a state insurer. The need for system change in order not only to prevent health and disability but to improve people’s health. Case example showing the role of the health and safety manager and the effect of the sick note on return to work. The views of the chair of Council of the Royal College of General Practitioners (RCGP) on the relationship between GP and patient. The conflict of interest between GPs and occupational physicians. Author’s research to elucidate the problem, working with the Trades Union Congress and the Department for Work and Pensions, resulting in a consensus statement and editorial in The BMJ. Author’s work on the Policy and Advocacy Committee of the Australasian Faculty of Occupational and Environmental Medicine of the Royal Australasian College of Physicians. Launch of position statement, ‘Realising the Health Benefits of Work’, in 2010. Work with Helen Kelly, President of the New Zealand Council of Trade Unions, and the concept of ‘good work’. Dame Carol Black and the Black Review, Working for a Healthier Tomorrow. The constraint of short appointment times for GPs in the UK: RCGP’s aim to increase appointment times from the current 10 minutes to 15 minutes by 2030.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125852184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0006
D. Beaumont
{"title":"Disability, Chronic Pain, and Medically Unexplained Symptoms","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0006","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0006","url":null,"abstract":"The concept of disability (including the WHO definition). Case example: disability cf ‘challenge’. Chronic pain, chronic fatigue, and spina bifida, Author’s keynote speech to New Zealand Disability Support Network. The experience of 100 people with different disabilities: system failure and ‘all some doctors see is my disability’. Author’s personal experience of disability resulting from osteoarthritis in both hips. Effect of aquajogging and gentle walking in easing pain, losing weight, and lifting mood. The experience of pain. Chronic pain syndrome and Professor Clifford Woolf’s (Harvard Medical School) 1983 definition of central sensitization. The role of the brain in the experience of pain. Central sensitization and case examples of carpal tunnel syndrome and low back pain. Regional pain syndrome, pain medication and the patient’s expertise with gabapentin. Number needed to treat of gabapentin is 6–8. Effectiveness of paracetamol. Medically unexplained symptoms explained, the example of fibromyalgia, irritable bowel syndrome. The concept of ‘curing’ compared with ‘healing’. The concept of homeostasis. The WHO’s ICD-11 (2018) and the new overarching concept of bodily distress disorder.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124428726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0007
D. Beaumont
{"title":"Why Should Health and Wellbeing Matter to Doctors?","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0007","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0007","url":null,"abstract":"Health and wellbeing as central to medical practice. In 2015/2016, author was president of the Australasian Faculty of Occupational and Environmental Medicine and the revamp of the RACP’s annual Congress, featuring Sir Harry Burns, who gave the closing plenary address, exploring the social determinants of health. The role of chronic stress in disease (from Aaron Antonovsky’s 1979 book, Health, Stress, and Coping). The role of adverse childhood experiences and their effect on the amygdala. The hypothalamus–pituitary–adrenal axis and the hormonal cascade. The brain’s response to stress: allostasis. The concept of allostatic load and its role in chronic inflammation, from the work of Professor Sheldon Cohen and others. The role of inflammation in type 2 diabetes. Sir Harry Burns’ concept of locus of control, and the impact of adverse childhood events on glucocorticosteroid receptors. Sir Michael Marmot and the Whitehall I and II studies. Anaesthetist Robin Youngson and compassion in palliative care. Professor Martin Seligman’s concept of learned optimism. Implications for the future of general practice. The importance of spiritual health to indigenous peoples. Māori model of health (te whare tapa whā) developed by Professor Sir Mason Durie, which incorporates spiritual health. ‘Our patients deserve to be treated as people, but doctors are people too.’","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124003642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0012
D. Beaumont
{"title":"Spiritual Health—Te Taha Wairua","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0012","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0012","url":null,"abstract":"The significance of spiritual health in the Māori model of health. Author notes resistance in secular society to the term ‘spiritual’ and broadens the term to encompass our search for meaning: why we are here, why we exist. Maslow and our esteem needs, notably an acknowledgement of our capacities, achievements, and adequacy, by others and ourselves, to gain a sense of ‘being useful in the world’. The definition of spirituality from the Oxford Textbook of Spirituality in Healthcare as ‘the way people engage with the purpose and meaning of human existence’. Using the framework from acceptance and commitment therapy, the author’s personal experience of defining his personal values. His reflection on his own personal beliefs and his personal journey to self-discovery. The concept of inner child work and its role in existential health and healing. A client’s own experience of finding his inner child. The concept of ‘best me’. Maslow’s theory of motivation. The concept of flourishing and the author’s personal self-assessment. The US psychiatrist Dr M. Scott Peck’s book The Road Less Travelled, and his insight that it takes courage to make tough life decisions. The power of the stories we tell ourselves.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116608312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Positive MedicinePub Date : 2021-07-16DOI: 10.1093/oso/9780192845184.003.0005
D. Beaumont
{"title":"What Are ‘Health and Wellbeing’?","authors":"D. Beaumont","doi":"10.1093/oso/9780192845184.003.0005","DOIUrl":"https://doi.org/10.1093/oso/9780192845184.003.0005","url":null,"abstract":"What is health? What is wellbeing? Various definitions of health explored: a common-sense definition first. The health of middle-aged men and the effectiveness (or otherwise) of health and wellbeing programmes (including smartphone apps) in the workplace. US occupational physician, Dr Ray Fabius’ finding that such programmes work only in workplaces with a culture of health. Definition of health: the WHO’s definition (‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’), rejected as an unworkable tool; and one proposed in The Lancet in 2003 as ‘the ability to adapt’. Radically, this definition sees a patient in the context of their current life; the doctor’s role is to help the patient adapt to their prevailing condition. The social determinants of health. Dr Machteld Huber’s definition in The BMJ: ‘health is the ability to adapt and self-manage’. Her subsequent research and definition of six domains in which health manifested. Patients and nurses gave all six about equal weight, but policymakers rated bodily functions as much more important. Doctors rated the spiritual/existential dimension lower than patients. Patient-centred model of medical practice proposed that gives equal weight to all six. Moving towards a positive concept of health. Maslow’s ‘hierarchy of needs’ from his 1943 paper ‘A theory of human motivation’ explained. Professor Martin Seligman, former president of the American Psychological Association, and the concept of flourishing. Seligman’s five components of wellbeing in the PERMA model. Author’s definition of positive health.","PeriodicalId":261115,"journal":{"name":"Positive Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127391111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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