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The mental health and wellbeing of young people is increasingly a concern in schools. This study explores how English secondary school teachers perceive and engage with the concept of wellbeing. By asking teachers to reflect on their practice, we can draw out their relational experience and knowledge about wellbeing in the classroom. Twenty teachers were interviewed about their practice in the context of the COVID-19 pandemic and during the academic year 2020-21. Reflexive thematic analysis reveals the challenges experienced by teachers. Specifically, we find a perceived role conflict for teachers between giving care and purveying knowledge. We draw on recent policy research and the work of Nel Noddings to account for this conflict in terms of conceptualisations of teaching practice and purpose. We illustrate how an emphasis within schools on 'doing well' academically undermines and marginalises a more holistic sense of 'being well', which contributes to a set of strains on teachers personally, professionally and relationally in terms of their interactions with students and colleagues. We propose that 'doing well' arises out of 'being well', rather than the converse, and should hence be an educational policy priority. Finally, we offer implications for how wellbeing may be woven into school culture.

Intussusception is defined as the invagination of a proximal segment of the bowel into the adjoining or distal segment. In most adults with intussusception, there is a demonstrable lead point with a definite pathologic abnormality. The clinical features of intussusception include chronic intermittent abdominal pain, nausea and vomiting, constipation, and a palpable abdominal mass. The present case report describes a 62-year-old woman with a 2-week history of abdominal pain and 9-day history of vomiting. Clinical, imaging, and histologic evaluations revealed a jejunojejunal intussusception with a gastrointestinal stromal tumor as the lead point. A gastrointestinal stromal tumor should be considered as a possible lead point in adult patients with intussusception. The implication of reducing the intussusception prior to tumor resection requires further evaluation in view of the risk of venous embolism, including direct spread of malignant cells, in cases involving a large polypoid mass with a necrotic surface that extends to the serosa as shown by intraoperative examination. Accordingly, the rationale for adjuvant therapy with imatinib also requires further evaluation.

BackgroundDespite strong and growing interest in ending the ongoing opioid health crisis, there has been limited success in reducing the prevalence of opioid addiction and the number of deaths associated with opioid overdoses. Further, 1 explanation for this is that existing interventions target those who are opiate-dependent but do not prevent opioid-naïve patients from becoming addicted. ObjectiveLeveraging behavioral economics at the patient level could help patients successfully use, discontinue, and dispose of their opioid medications in an acute pain setting. The primary goal of this project is to evaluate the effect of the 3 versions of the Opioid Management for You (OPY) tool on measures of opioid use relative to the standard of care by leveraging a pragmatic randomized controlled trial (RCT). MethodsA team of researchers from the Center for Learning Health System Sciences (CLHSS) at the University of Minnesota partnered with M Health Fairview to design, build, and test the 3 versions of the OPY tool: social influence, precommitment, and testimonial version. The tool is being built using the Epic Care Companion (Epic Inc) platform and interacts with the patient through their existing MyChart (Epic Systems Corporation) personal health record account, and Epic patient portal, accessed through a phone app or the MyChart website. We have demonstrated feasibility with pilot data of the social influence version of the OPY app by targeting our pilot to a specific cohort of patients undergoing upper-extremity procedures. This study will use a group sequential RCT design to test the impact of this important health system initiative. Patients who meet OPY inclusion criteria will be stratified into low, intermediate, and high risk of opiate use based on their type of surgery. ResultsThis study is being funded and supported by the CLHSS Rapid Prospective Evaluation and Digital Technology Innovation Programs, and M Health Fairview. Support and coordination provided by CLHSS include the structure of engagement, survey development, data collection, statistical analysis, and dissemination. The project was initially started in August 2022. The pilot was launched in February 2023 and is still running, with the data last counted in August 2023. The actual RCT is planned to start by early 2024. ConclusionsThrough this RCT, we will test our hypothesis that patient opioid use and diverted prescription opioid availability can both be improved by information delivery applied through a behavioral economics lens via sending nudges directly to the opioid users through their personal health record. Trial RegistrationClinicalTrials.gov NCT06124079; https://clinicaltrials.gov/study/NCT06124079 International Registered Report Identifier (IRRID)PRR1-10.2196/52882

Although the implementation of mindfulness-based interventions (MBIs) in educational contexts appear to have demonstrated some benefits for students and teachers in research studies conducted over the last two decades, there are also those who criticize MBI's for their instrumental focus. Exploring this debate, this article offers a case for the implementation of a more holistic and integral approach to mindfulness in educational settings. It will draw upon the philosophical legacy of Martin Heidegger and other critical theorists, who contest the dominant framing of neoliberalism and encourage engagement with more systemic perspectives. During this exploration, we examine two polemics: (1) whether mindfulness should be implemented technically or holistically and, (2) whether the focus should be individual and/or collective. The article concludes that although mindfulness may be an efficient 'self-technology' to improve certain aspects of individual well-being, it is necessary to challenge this perspective as it promotes a type of 'iatrogenic effect'. Specifically, it is argued that systemic failure is reframed as individual fallibility via a simplistic focus on well-being that may contradictorily foster appeasement to exploitative conditions. As an alternative, we offer a more integrative version, drawing in particular on the work of Ken Wilber, which proposes systemic as well as individual transformation.

This qualitative study presents an analysis of the experiences of a teacher who had recently left working in an England state funded primary school. Using reflective lifeworld methodology, this study explored the teacher's struggle to be authentic in the context of state funded education. Three prominent themes were identified as: (1) enhancement of every learner; (2) systemic oppression; and (3) tensions in being a teacher. The study concludes that being authentic as a teacher was experienced as being incompatible with the current educational system.

The Barrett-Lennard Relationship Inventory was designed to assess the extent to which a person experiences unconditional positive regard, empathic understanding, and genuineness in a relationship. This study (N = 1,286) investigated measurement invariance between English, Chinese, and Spanish language versions of the inventory and partial scalar invariance was established.

Self-compassion offers profound benefits to well-being and healthy psychological functioning. Surprisingly however, the relationship assumed between compassion for self and others has been questioned by recent research findings and is at best inconsistently correlated. The aim of this study is to throw further light on this debate by testing whether the association between self-compassion and compassion for others is moderated by authenticity amongst 530 participants who completed the Authenticity Scale, the Self-Compassion Scale, and the Compassion Scale. The results show that authenticity has a moderation effect on the association between self-compassion and the kindness, common humanity, mindfulness, and indifference subscales of the Compassion Scale. These results offer some initial insight into understanding the association between compassion for self and others and establish a case for researching the role of authenticity more thoroughly. The findings of this investigation call for further empirical attention to socially constructive aspects of authenticity and the development of new authenticity measurements that may better assess the interaction effect., Author(s): Aydan Bayir-Toper [sup.1] , Edward Sellman [sup.1] , Stephen Joseph [sup.1] Author Affiliations: (1) grid.4563.4, 0000 0004 1936 8868, School of Education, Centre for Research in Human Flourishing, University [...]

Mindfulness-based interventions (MBIs) can result in positive "side effects," such as concentration and individual well-being, highly desirable to schools operating within a neoliberalist agenda emphasizing performativity. However, employing a critical literature review, we argue that adverse side effects also occur, though under-researched. We engage critical and systems theories, within a broader complexity paradigm, to show how MBIs manifest as a form of "iatrogenesis," whereby a "sleight of hand" occurs, offsetting systemic fallibility as individual culpability. Iatrogenesis provides both "cancer" and "cure," the source of much stress and the means to cope, leaving systems under-critiqued whilst the individual is expected to adjust to this logic. Guised like this, MBIs may do more harm than good, obfuscating deeper transformation of self and society. We conclude by uniting with those who argue the need to embrace more authentic and holistic versions of mindfulness for individual and social transformation to occur.

Over the past decade or so within this journal, there have been critical debates concerning the role of mindfulness within education, the influence of neoliberalism on education in general and well-being interventions specifically, and the relevance of the philosophy of Martin Heidegger for critiquing modernity including the nature and purpose afforded education. In this article, we propose that these debates are sufficiently interrelated to develop a more unified argument. We will show how a Heideggerian perspective is conceptually rich, in both its heritage, as it draws upon both East-Asian wisdom and western thinking, and its engagement, as it confronts the implications of what Heidegger called a 'technical-era', for offering such a unified critique. The focus of this critique is on instrumental forms of mindfulness (mindfulness 'in' education), which when framed by neoliberalism has rather narrow goals concerning individual well-being and performance. In contrast, more critical and integral forms of mindfulness (mindfulness 'as' education) offer the potential for more holistic and authentic learning. Throughout the article, we discuss how Heideggerian philosophy offers a number of useful concepts (e.g., enframing, Dasein, authenticity, meditative thinking), which are able to both critique the instrumentalisation of approaches like mindfulness by neoliberalism and speak to more holistic education oriented toward more authentic being in the world.

This article examines the potentiality, acceptability and ethical considerations of a mindfulness-based intervention (MBI) for supporting pupils' mental well-being in a junior school. To date, research has predominantly focused on the psychological or behavioural benefits of MBIs rather than broader and more philosophical issues of implementation. The findings reported in this article are positioned alongside recent debates critiquing the neoliberal agenda of 'privatising' well-being and downplaying the role of the institution and its cultural context. The study synthesises the perspectives of pupils and teachers to provide more in-depth insights into the everyday realities of MBIs in educational contexts. The study highlights and critically examines the inherent ethical dilemmas of implementing MBIs in contexts that include vulnerable and conscripted audiences in particular. As such, this article argues the case for those individuals involved in developing, administering and/or advocating MBIs to acknowledge these ethical dilemmas with greater transparency and integrity and consider the aims of MBIs in relation to their potential instrumental or holistic possibilities and processes of 'schoolification'.

The aim was to investigate the association between experiencing a therapeutic relationship and subsequent authenticity. Forty-six clients completed the Barrett-Lennard Relationship Inventory (B-LRI), Relational Depth Inventory (RDI), a measure of the therapeutic alliance (ARM-5) and the Authenticity Scale (AS) at intervals over 10 therapy sessions. Higher scores on the B-LRI at sessions 3, 5 and 10 were associated with an increase in authenticity over the 10 sessions. These results provide some initial evidence in support of Rogers's (1957) theory that it is the conditions of the therapeutic relationship that lead to greater authenticity.