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Groups of Jungian analysts, which included the present authors, met to discuss four key theoretical concepts, each of which was felt to have problematic aspects if used unquestioningly in contemporary practice. The concepts were: The Primitive, Inner and Outer Worlds, Contrasexuality and Participation Mystique. The discussions were informed by clinical material and specific papers chosen for their critical evaluation of the topic. Four recorded transcripts were made, with permission, for further consideration of the relationship between contemporary Jungian theory and practice using the research method of thematic analysis. Three main themes were identified: Work of Analysis, Frames of Reference and Power Dynamics. The authors discuss the themes in relation to the overarching theme of power, understood as operating at conscious and unconscious levels. The artwork "Cold Dark Matter: An Exploded View" by Cornelia Parker is used as a metaphor in discussing the dynamic of challenging foundational concepts. The authors suggest that power dynamics are intrinsic in both the difficulty and the benefits of critically evaluating key concepts, binding together the theoretical (what informs us) with the clinical (what we do in the consulting room) as well as blowing apart pre-conceived notions of what underpins the analyst's work., (© 2024 The Society of Analytical Psychology.)

Background: Clinical prediction rules (CPRs) developed to predict adverse outcomes of suspected pulmonary embolism (PE) and facilitate outpatient management have limitations in discriminating outcomes for ambulatory cancer patients with unsuspected PE (UPE). The HULL Score CPR uses a 5‑point scoring system incorporating performance status and self-reported new or recently evolving symptoms at UPE diagnosis. It stratifies patients into low, intermediate and high risk for proximate mortality. This study aimed to validate the HULL Score CPR in ambulatory cancer patients with UPE., Patients and Methods: 282 consecutive patients managed under the UPE-acute oncology service in Hull University Teaching Hospitals NHS Trust were included from January 2015 to March 2020. The primary end-point was all-cause mortality, and outcome measures were proximate mortality for the three risk categories of the HULL Score CPR., Results: 30-day, 90-day and 180-day mortality rates for the whole cohort were 3.4% (n=7), 21.1% (n=43) and 39.2% (n=80), respectively. The HULL Score CPR stratified patients into low-risk (n=100, 35.5%), intermediate-risk (n=95, 33.7%) and high-risk (n=81, 28.7%) categories. Correlation of the risk categories with 30-day mortality (area under the curve (AUC) 0.717, 95% CI 0.522-0.912), 90-day mortality (AUC 0.772, 95% CI 0.707-0.838), 180-day mortality (AUC 0.751, 95% CI 0.692-0.809) and overall survival (AUC 0.749, 95% CI 0.686-0.811) was consistent with the derivation cohort., Conclusion: This study validates the capacity of the HULL Score CPR to stratify proximate mortality risk in ambulatory cancer patients with UPE. The score uses immediately available clinical parameters and is easy to integrate into an acute outpatient oncology setting., Competing Interests: Conflict of interest: All authors declared that they have no competing financial or personal interests relevant to this manuscript., (Copyright ©The authors 2023.)

Little is known about how the intersection of being a forced migrant and living with HIV can contribute to the development or exacerbation of pre-existing mental conditions. This study is set in this context and it aims to explore specific risk factors affecting the mental health of refugee women living with HIV. A total of eight refugee women living with HIV took part in the study; they were individually interviewed, and their transcripts were thematically analyzed. The overall findings indicated that participants' mental health was impaired by multiple stressors associated with their conditions, such as racial discrimination, HIV-related stigma, including from health professionals, loneliness, and resettlement adversities. These all represent threats to public health, as they discourage individuals from engaging with adequate health/mental health services. Despite their situation, participants had not received psychological interventions and their healthcare was reduced to managing the physical symptoms of HIV. Participants indicated their need to take part in group interventions that could promote their mental health and social recovery. These findings are relevant to raising awareness about the specific risk factors affecting refugee women living with HIV and to provide evidence for public health interventions based on this specific population's need.

This report describes a complex structural rearrangement between chromosomes X and 1 and a 7;13 translocation (together involving six break points) in a child with multiple congenital defects. Both parents showed a normal chromosome complement, suggesting that the changes may have originated either in a gametic nucleus or at a very early stage of zygotic development.