I find that one of the biggest issues with mindfulness is that there are a lot of people out there claiming to be mindfulness experts, teachers or gurus who are really just creating “McMindfulness”. It’s like the fast-food version where you know it’s been processed and doesn’t really resemble the ingredients from which it was made. Yes, it’s still “food” but you can tell that it’s not the natural and organic experience of food that you’re really looking for. Don’t get me wrong, some of these “McMindfulness” teachers have good intentions. That’s where it can become a very confusing journey.

This video here is the best I’ve ever seen on looking at what mindfulness is in a succinct way. In it, Jon Kabat-Zinn defines mindfulness as “the awareness that arises by paying attention on purpose, in the present moment, and non-judgementally.”

I think it’s the “non-judgementally” bit where it’s so easy to get caught up. It’s as though we think that if we just stopped having judgemental thoughts that we’d be “all good”. So then we try to supress those judgemental thoughts. I did this A LOT at the beginning of my mindfulness journey. I have also spoken with a great number of people on my mindfulness journey who are judging themselves for having judgements.

Where mindfulness really comes in is watching the judgements go by, and just noticing them. As in “oh look, a judgement” and letting it pass without judging it, or judging yourself for having a judgemental thought. It has nothing at all to do with the absence of judgements, as these will continue to arise and pass, arise and pass, arise and pass, on and on, forever and ever.

So how does this all relate to practice as a health professional?

The judgements we are talking about here are not the clinical judgements we as clinicians make every day. I’m talking about the stuff that happens in our interactions with patients that really aren’t helpful.

So let’s go with an example that’s close to home for me. The scenario being that I’d put on quite a bit of weight and was feeling very self-conscious about it. How is that going to play out when someone who is obese comes in for a consultation?

I have had so many experiences around this over the years, most of them in the form of judgements coming up in my mind. Anything from “how could they let themselves get like that?” to “they should go and get surgery” to “don’t they know how to look after themselves?” to “they are so ugly” and “how can they live with themselves being like that?”.

So really I was just projecting my own “stuff” onto these patients. It’s a pretty normal human thing to do, and it happens all the time. Having these judgemental thoughts made me very anxious and awkward, because they were feeding the belief that I was a horrible person and an awful health practitioner, because we’re supposed to treat everyone with respect.

However, over the course of my mindfulness journey I realised that the issue wasn’t with these thoughts themselves. It’s that I was judging myself for having these thoughts. The day I realised that was when everything really changed.

It occurred to me that maybe, just maybe, I’d be able to bring compassion to myself for having these judgemental thoughts instead of judging myself for having those judgemental thoughts. That is quite a distinction, and, I feel where many of those claiming to be “gurus” but area really just perpetuating McMindfulness get it so very wrong.

So many of these “gurus” spout ideals that we need to change our thoughts to be more positive so that we can be “happy”. However, once you really get into a deeper mindfulness practice, there is the realisation that the joy of simply being is always there, regardless of whether whatever is happening in the present moment is pleasant, unpleasant or neutral. It’s the simple joy of being alive and actually having these experience that flows like a river in experience itself.

This leads me into another way in which not only mindfulness, but the practice of meditation is often misconstrued. There seems to be this myth that it’s all going to be sunshine and lollipops. That you “should” be feeling more relaxed after you meditate.

The reality is, that when the mind is really still during meditation, sometimes the most painful memories come up with an invitation for them to be explored. At 4 of the 5 meditation retreats I’ve attended in the last 12 months, I have cried. No, wept. No, sobbed uncontrollably. Sometimes in the meditation hall when everyone else is quiet. It’s just the way in which my body lets go of stuff. When the mind has really settled it’s given me the opportunity to look at some of the experiences I’ve had in a new light, and let go of the old way of seeing them. Inevitably this process can get pretty messy.

Letting go of these old ways of seeing things has changed the way I see myself and interact with others and the world. Being in the present moment as it is, without some story about how it should be or how I want it to be is an entirely different way of practice as a health professional. In many cases it has allowed me to have a much deeper listening of what the patient is communicating during our interaction, and allows me to be a lot clearer in my communication.

So yes, meditation and mindfulness practice has helped me to find a greater sense of calmness in so many situations, but that has been the by-product, not necessarily the aim.

I hope you enjoy our Mindful May theme this month and see it as part of your exploration as to whether taking up the practice might be right for you.

Image:Photo by Deniz Altindas on Unsplash

More articles on My Health Career:

• Choosing a business coach – by Amanda Griffiths, founder MHC
• From freaking out to freaking awesome – how mindfulness transformed my practice – by Amanda Griffiths
• AMA Summit on medical workforce: Too many doctors, few training opportunities in communities that need them most

The post Is mindfulness “right” for you? Here’s how it transformed my practice – by Amanda Griffiths, founder MHC appeared first on My Health Career.

It’s a very common question asked by both high school students and those looking to study nutrition as a second degree.

I’ve collated my top 5 tips to assist you in selecting the right nutrition degree for you:

1. Understand the difference between a Dietitian and a Nutritionist

Nutrition and healthy eating are hot topics on social media and people are increasingly interested in making a career of it. However, not all nutrition courses will get you the same qualification. Understanding the different job roles of a ‘Dietitian’ versus a ‘Nutritionist’ will go a long way to help you decide which program is best for you.

A ‘Dietitian’ is someone who has trained at University to be skilled at providing dietary advice to any person who has a medical health condition or for general health and wellness.

• A dietitian might work in a hospital, community health centre, aged care facility, with athletes or run their own private practice clinic.
• The term Accredited Practising Dietitian (APD) is a credential recognised in Australia. An APD is both a dietitian and nutritionist and can work in a range of different roles. If a community member sees an APD for dietary advice, they can be assured the dietitian has completed an accredited course, is up to date with new and evolving evidence, and has the necessary skills to help them. Community members are also able to claim back through Medicare and/or their private health fund if they’re seeing a dietitian in a private practice.

The term ‘Nutritionist’, is not regulated and this makes it a bit tricky for the general public to know the level of training any particular ‘Nutritionist’ has undertaken. For example, you could complete a 3-month online course about nutrition or a 3-year nutrition university degree and both would allow you to work as a Nutritionist.

• If you complete a shorter online, college nutrition course or university nutrition degree you’ll likely have the skills to provide general health and wellness advice to community members. If you wish to work in a role where you can provide advice for specific health conditions, you may not have the knowledge and skills if the course did not include dietetics and medical nutrition therapy training. Community members are generally unable to claim rebates through Medicare or private health insurance if they are seeing someone with this kind of training.
• If you complete a University degree with a focus on nutrition (and not dietetics), you are likely to work at a population level to help communities change their eating and improve their health. Examples of this kind of work includes research projects or health promotion work in rural Aboriginal and Torres Strait Islander communities (for example), projects in schools and within non-government organisations such as Diabetes Australia, The Heart Foundation and Oz Harvest. If the degree also includes ‘dietetics’, you would still have these options open to you but would gain the added qualification of being an APD.

2. Know the pre-requisites of the program

If you are thinking of studying nutrition, you’ll need to be passionate about (or willing to learn about) science. Understanding chemistry and the human body is the foundation for learning about how nutrition affects our health.

If you are in high school, I would recommend studying biology and chemistry. If you are undertaking an undergraduate degree already, ensure you are studying chemistry, biochemistry, physiology and anatomy. Every University will differ with the pre-requisite requirements for entry into their nutrition program. Therefore, have a chat to your preferred University prior to making your decision. If you have not studied the required subjects at school or in your current degree, you might be able to undertake what is called a ‘bridging course’ prior to commencing the nutrition program.

3. Postgraduate? Or Undergraduate?

In Australia, nutrition degrees can be undertaken as an undergraduate bachelor’s program or a postgraduate master’s program. Generally speaking, most bachelor’s degrees are 3-4 years full time and most master’s degrees are two years. As expected, there are pros and cons for both types of programs:

• The benefit of a bachelor’s degree:
  • You are able to study nutrition straight away after high school. In some circumstances you’ll gain a dietetics or nutritionist qualification quicker.

• The benefits of a master’s degree:
  • You will gain a more solid foundation knowledge and life experiences from completing two degrees
  • You will have a higher level of University study which can aid in the competitive job market. Additionally, in some states, your starting salary will be higher if you’ve completed a master’s degree.

4. Get inquisitive

The actual subjects in nutrition and dietetic university degrees do vary slightly. Although you may get a similar qualification following the completion of your program, knowing and understanding the unique aspects of each program will help you decide which program is right for you.

Here’s some questions to ask:

• The practical workplace placements – Find out where students are commonly placed and if there are any hidden costs. For example, will you have to travel? What are the associated costs for these travels?
• What nutrition research are the University staff involved with? – As part of the degree, you may conduct a research project. The research topics staff routinely conduct in their own job, will often influence the nutrition topics you will be able to work on in your degree.
• The program focus – Do they focus on producing graduates aimed at working in any particular area? This might be hospital work, public health, food service, research or media. For example, within our program at Bond University, we have focus areas on research, international nutrition, clinical skills and entrepreneurship.
• Extra-curricular activities – Do they offer volunteering opportunities in your areas of interest?

5. Identify the employment opportunities

Obtaining a job following graduation is probably at the top of your mind, so you might like to ask your preferred nutrition program:

• What proportion of graduates are gaining employment after their particular degree? – How long after graduation are graduates securing jobs?
• Does the program offer mentoring with the job application process and your career development? – This, as well as business studies and entrepreneurship training will help ensure you are competitive for any advertised nutrition and dietetic position or skilled to build your own business in the field.

If you are interested in studying nutrition, I would suggest contacting the teaching staff at various Universities, and find out what their expertise and special interests are, and what they can offer you.

Applications for Master of Nutrition & Dietetics Practice at Bond University are taken for course commencement in May.

Christina Turner is an Accredited Practising Dietitian. She currently works as Senior Teaching Fellow and Internships Coordinator at Bond University on the Gold Coast.

    
Bond students get to interact with both real patients and patient ‘actors’ in hospital wards and ‘private practice’ settings.

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Nola Ries, University of Newcastle and Taro Sugihara, Okayama University

Many countries around the world have ageing populations and a growing prevalence of dementia. Japan, in particular, is a “super-ageing” society, with a population getting older faster than anywhere else in the world due to long life expectancy and low birth rates.

In 2015, an article in The Lancet medical journal pointed out that “Japan will be at the forefront of devising ways to tackle the social, economic, and medical challenges posed by a super-ageing society.”

A high-tech innovator, the country is producing robots for people with dementia – to provide companionship, improve safety in the home, and help with therapy. Other countries are jumping on board with initiatives to incorporate service robots into dementia care.

But we must make sure that people, especially those living with dementia, are firmly at the centre of research and development. Technology, after all, should be for and by people, not something imposed on them.

Robots for dementia care

Robotic devices can help with physical caregiving tasks, monitor behaviour and symptoms, and provide cognitive support.

They can be classified into seven major categories: power-assisted robots that transfer patients from beds and wheelchairs; assistive robots for personal mobility; toiletry assistance robots; bathing assistance robots; monitoring robots with sensor systems; social interaction robots; and therapeutic robots.

Robots in the first four categories could be widely used in aged care to assist elders with physical mobility limitations.

Those in the latter categories have particular application for people with dementia who experience difficulty with memory, thinking and communication, as well as changes in mood, behaviour and personality.

Social robots

Robots designed for social and therapeutic purposes can look like cute animals – such as PARO, a baby seal robot – or like small humanoids – such as Sato or Romeo.

For people living with memory loss, robots can remind them about things they often forget, such as prompting them to take medication and eat meals, pointing out the location of household items and helping with their use. Robots can also provide companionship and entertainment, such as engaging people in games, dancing and singing.

Robots can support people with dementia to live independently, and help reduce negative behavioural and psychological symptoms.

They can also support human caregivers by providing watchful eyes and helping hands. Robots do not experience stress and burnout and there are other practical benefits, too. Robots that look like cuddly animals can be used in place of real animals for pet therapy. A robotic cat, for instance, doesn’t need food, water or a litter box and won’t scratch if it is squeezed a bit too hard.

The downsides

The benefits of robots sound compelling, but there are downsides as well. Especially when there are potential conflicts between the interests of people with dementia and their caregivers.

Carers need support and respite, but replacing human caregiving with technology can deprive people of social interaction and worsen the problems of loneliness and isolation. What’s more, relying on robots to do home and self-care tasks can reduce the autonomy of older adults.

Indeed, there’s a fine line between using robots for beneficial therapy and infantilising older people, when robots are used as toy-like dolls or teddy bears. New technologies should help people maintain or develop skills and should respect their years of life experience. A communication robot, for instance, could interact with a person to record a life diary and help remind her of important events and relationships.

Consent and privacy issues arise if a person is unable to turn off monitoring and data tracking features. Older people may prefer to “age in place” in a home and community where they feel a sense of attachment. Well-intentioned caregivers often want to minimise risks of harm, especially for elders living on their own, but intrusive technology can make a home feel like a hospital or prison.

And technologies that draw attention to disabilities and deficits can make people feel self-conscious and stigmatised. In the way they are designed and promoted in society, robots can perpetuate stereotypes that enfeeble older people.

User-centred research and design

It’s crucial to understand the opinions and preferences of older adults and people with conditions, such as dementia. Technology developers are sometimes criticised for a mismatch between their enthusiasm for robots and other high-tech novelties, and the preferences of people living with dementia.

A recent review on the ethics of social and assistive robotics for dementia care points out the problem of a vicious cycle: when user needs do not drive technology development, new products will have low uptake, with the consequence that unmet needs persist.

The 2015 World Alzheimer Report urges that “research investment for dementia should be upscaled, proportionate to the societal cost of the disease.”

Most importantly, finite research resources must be spent wisely, with meaningful involvement of those who are intended to benefit from new therapies and products.

Including citizens in science and research

There is growing enthusiasm for “democratising” science and promoting citizen engagement and participation in research. The Japanese Science and Technology Plan, for instance, calls on the “government, academia, industry and citizens” to work together on big challenges, including the country’s super-ageing population.

And there are important critiques of what citizen participation really means in health care and technology development. But elderly members of society and people with conditions such as dementia should not be sidelined.

Those funding and leading technology development can be more proactive in engaging with older people about their priorities and preferences. Citizen jury techniques can be adapted to support dialogue among older people, technology specialists, engineers, researchers, and caregivers. And prototypes of new technologies can be trialled earlier with user groups to get their feedback.

There are ethical and practical complexities in involving people with dementia in research, but they should not be automatically excluded. Supportive strategies can maximise the ability of people with cognitive impairment to have a voice on what matters to them.

Perhaps communication robots can one day help people express their views on having a robot in their life.

Nola Ries, Associate Professor and Deputy Head of School, Research, University of Newcastle and Taro Sugihara, Assistant Professor in User Research, Okayama University

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Suicide is one of the most common causes of death among Aboriginal and Torres Strait Islander peoples.

ATSISPEP report to the Minister for Indigenous Affairs identified a potential set of success factors of Indigenous suicide prevention programs. Three levels of intervention in the success factors, which are:

1. Universal interventions
   It defines universal activity and aimed at the whole and ‘well’ population. Primordial prevention addresses the upstream risk factors for suicide such as alcohol and drug use, family dysfunction, and other challenges to wellbeing. Primary prevention may include community education to support help-seeking behaviour for those who suffer with problems that affect their mental health and wellbeing.
2. Selective interventions are aimed at young people who are identified as being at higher risk of suicide
3. Indicated interventions are aimed at individuals who have been identified as at risk of suicide, or who have attempted suicide

ANTISPEP included recommendations for government and other activity pertaining to Indigenous suicide prevention, as follows:

• All future Indigenous suicide prevention activity should utilise success factors and include a commitment to the evaluation. Suicide prevention activity should include community-specific and community-led upstream programs, and also use justice reinvestment principles.
• Governments should support the training, employment and retention of Indigenous community members/people to work in suicide prevention activity. All mental health service provider staff should be required to achieve Key Performance Indicators (KPIs) in cultural competence and the delivery of trauma informed care.
• Preparatory work should commence immediately to develop suicide prevention activities specific to the needs of those who have suffered child sexual abuse. Indigenous people identifying as LGBTQI should be represented on all Australian Government and other Indigenous mental health and suicide prevention advisory forums

In addition to these general recommendations, ANTISPEP also concluded with recommendations on the implementation of the ATSI suicide prevention strategy.

The Australian Psychological Society (APS) is calling for a quick implementation of the recommendations from the report.

APS Fellow Professor Pat Dudgeon, a member of the ATSISPEP project, said, “All attempts to address suicide must also come from an understanding of the existing and ongoing trauma experienced by Aboriginal people and the institutional racism that affects the social and emotional wellbeing of Aboriginal people. This isn’t just a health issue – it is a social issue, a justice issue and an economic issue.”

Support is available for those who are experiencing suicidal thoughts or if you know someone who is:

Lifeline

• 13 11 14
• www.lifeline.org.au

Suicide Call Back Service

• 1300 659 467
• www.suicidecallbackservice.org.au

Kids Helpline

• 1800 55 1800
• www.kidshelp.com.au

More articles on My Health Career:

• Four steps in asking R U OK
• Indigenous health organisations saw around 435,000 clients in 2014-15
• Mental health research funding decrease
• Specialist in Life campaign for GPs

Photo credit: garagolo via VisualHunt.com / CC BY-NC-SA

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The profession, stakeholders and the community are invited to provide feedback and comments, including questions by Friday 9 December 2016. Submissions will be published on the National Boards’ websites to encourage discussion and inform the community and stakeholders. Before publication, the Board will remove personally-identifying information, including contact details.

There may be circumstances under which submissions may not be published, such as on special request, offensive content, defamatory comments, or outside the scope of the consultation.

Submissions can be provided in a template document which can be accessed at the board website.

More articles on My Health Career:

• The rate of diabetes in patients presenting to emergency deparments
• Revised infection prevention and control guidelines for podiatrists
• Skilled Occupations List submissions put workforce shortages and excesses in the spotlight

Image: Stuart Miles – freedigitalphotos.net

The post Podiatry Board consultation on therapeutic endorsement guidelines for podiatrists appeared first on My Health Career.