New Developments in Electroconvulsive Therapy and Magnetic Seizure Therapy

CNS Spectrums ◽  
2003 ◽  
Vol 8 (7) ◽  
pp. 529-536 ◽  
Author(s):  
Sarah H. Lisanby ◽  
Oscar Morales ◽  
Nancy Payne ◽  
Edward Kwon ◽  
Linda Fitzsimons ◽  
...  
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Early Stage ◽  
Electrical Stimulus ◽  
Treatment Technique ◽  
Clinical Value ◽  
Convulsive Therapy ◽  
Magnetic Seizure Therapy ◽  
Stage Of Development ◽  
New Findings

ABSTRACTNew findings regarding the mechanisms of action of electroconvulsive therapy (ECT) have led to novel developments in treatment technique to further improve this highly effective treatment for major depression. These new approaches include novel electrode placements, optimization of electrical stimulus parameters, and new methods for inducing more targeted seizures (eg, magnetic seizure therapy [MST]). MST is the use of transcranial magnetic stimulation to induce a seizure. Magnetic fields pass through tissue unimpeded, providing more control over the site and extent of stimulation than can be achieved with ECT. This enhanced control represents a means of focusing the treatment on target cortical structures thought to be essential to antidepressant response and reducing spread to medial temporal regions implicated in the cognitive side effects of ECT. MST is at an early stage of development. Preliminary results suggest that MST may have some advantages over ECT in terms of subjective side effects and acute cognitive functioning. Studies designed to address the antidepressant efficacy of MST are underway. As with all attempts to improve convulsive therapy technique, the clinical value of MST will need to be established through controlled clinical trials. This article reviews the experience to date with MST, and places this work in the broader context of other means of optimizing convulsive therapy in the treatment of depression.

Methodology of constructive technology assessment in health care

2007 ◽  
Vol 23 (2) ◽  
pp. 162-168 ◽  
Author(s):  
Kirsten F. L. Douma ◽  
Kim Karsenberg ◽  
Marjan J. M. Hummel ◽  
Jolien M. Bueno-de-Mesquita ◽  
Wim H. van Harten
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Technology Assessment ◽  
Early Stage ◽  
New Technology ◽  
Genetic Research ◽  
Practical Implementation ◽  
Stage Of Development ◽  
New Findings ◽  
Constructive Technology Assessment

Objectives: Technologies in health care are evolving quickly, with new findings in the area of biotechnological and genetic research being published regularly. A health technology assessment (HTA) is often used to answer the question of whether the new technology should be implemented into clinical practice. International evidence confirms that the results of HTA research sometimes have limited impact on practical implementation and on coverage decisions; the study design is commonly based on the paradigm of stability of both the technology and the environment, which is often not the case. Constructive technology assessment (CTA) was first described in the 1980s. In addition to the traditional HTA elements, this approach also takes into account the technology dynamics by emphasizing sociodynamic processes. With a CTA approach, comprehensive assessment can be combined with an intentional influence in a favorable direction to improve quality.Methods: In this study, the methodological aspects mainly concerning the diagnostic use of CTA are explained. The methodology will be illustrated using the controlled introduction of a new technology, called microarray analysis, into the clinical practice of breast cancer treatment as a case study. Attention is paid to the operationalization of the phases of development and implementation and the research methods most appropriate for CTA.Conclusions: In addition to HTA, CTA can be used as a complementary approach, especially in technologies that are introduced in an early stage of development in a controlled way.

scholarly journals To What Extent are Healthcare Professionals Immune from Liability for Professional Negligence? A Review of the Cases of Bolam and Bolitho

2021 ◽  
Author(s):  
ABBA AMSAMI ELGUJJA
Keyword(s):  
Healthcare Professionals ◽  
Early Stage ◽  
Medical Profession ◽  
Standards Of Care ◽  
Medical Negligence ◽  
Convulsive Therapy ◽  
Medical Opinion ◽  
Stage Of Development ◽  
Electro Convulsive Therapy ◽  
Risk Benefit Analysis

This paper reviewed the extent to which Bolam provided healthcare professionals with immunity from claims based on negligence in the past, and whether Bolitho was able to resolve that issue.During the early 1950s, when the NHS was in its golden era, the medical profession was still “unregulated and paternalistic” in approach. Consequently, the medical profession had enjoyed unreserved obedience from patients and was treated with great reverence by society. John Hector Bolam was a patient who sustained fractures because the defendants applied unmodified electro-convulsive therapy on him. So, his suit for negligence provided the much-needed opportunity for grounding the principles of medical negligence which was still in its early stage of development. The issue was unprecedented, and therefore the dictum of Lord President Clyde in the Scottish case of Hunter and Hanley became handy. The ruling gave doctors the latitude to set standards of care and justify their actions by simply having their peers support them. It placed the onus of proving “Wednesbury unreasonableness” on the patients in order to succeed in medical negligence litigation against a doctor. That was very difficult to prove. This attracted criticisms against Bolam that it provided excessive immunity to doctors and difficulties to the patients. Several cases had been decided in favor of the doctors and allied healthcare professionals.A similar opportunity arose in 1984 when the Bolitho rule was propounded which empowered the courts to intervene and determine if a body of medical opinion is indeed responsible, by subjecting their evidence to the logicality and risk/benefit analysis tests.Issues for consideration include, to what extent did Bolam provide immunity to healthcare professionals and, post-Bolitho, if the issues have now been resolved. To accomplish that, the author will examine the various court decisions pre-and post- Bolitho with a view to coming up with the answer(s) to the issues raised

scholarly journals Anaesthesia for electroconvulsive therapy: a role for etomidate

2002 ◽  
Vol 26 (9) ◽  
pp. 351-353 ◽  
Author(s):  
Susan M. Benbow ◽  
Priti Shah ◽  
Joe Crentsil
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Cardiac Disease ◽  
Maximum Level ◽  
Electrical Stimulus ◽  
Induction Agent ◽  
Clinical Implications ◽  
Anaesthetic Drug ◽  
The Individual ◽  
Severe Cardiac Disease

Aims and MethodThree cases are described to illustrate the elective use of etomidate in electroconvulsive therapy (ECT) anaesthesia.ResultsUse of etomidate is described in an individual who was treated with an electrical stimulus at the maximum level for the ECT machine in use; in a person who had severe side-effects with an alternative induction agent; and in a person with severe cardiac disease.Clinical ImplicationsThe anaesthetic drug should be tailored to the individual needs of the person being treated with ECT. Clinics should involve local anaesthetic departments in reviewing their anaesthetic practice.

The Application of UX Research in New Energy Vehicle Innovation

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Menghan TAO ◽  
Ning XIAO ◽  
Xingfu ZHAO ◽  
Wenbin LIU
Keyword(s):  
Early Stage ◽  
Rapid Expansion ◽  
The Other ◽  
Innovative Product ◽  
Stage Of Development ◽  
New Energy ◽  
New Energy Vehicle ◽  
The One ◽  
New Energy Vehicles ◽  
Degree Of Innovation

New energy vehicles(NEV) as a new thing for sustainable development, in China, on the one hand has faced the rapid expansion of the market; the other hand, for the new NEV users, the current NEVs cannot keep up with the degree of innovation. This paper demonstrates the reasons for the existence of this systematic challenge, and puts forward the method of UX research which is different from the traditional petrol vehicles research in the early stage of development, which studies from the user's essence level, to form the innovative product programs which meet the needs of users and being real attractive.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

scholarly journals Learning health systems in primary care: a systematic scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Danielle M. Nash ◽  
Zohra Bhimani ◽  
Jennifer Rayner ◽  
Merrick Zwarenstein
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Health Systems ◽  
Scoping Review ◽  
Early Stage ◽  
Point Of Care ◽  
The United States ◽  
Stage Of Development ◽  
Integrated Health ◽  
Google Search

Abstract Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.

scholarly journals Open Research Data and Open Peer Review: Perceptions of a Medical and Health Sciences Community in Greece

Publications ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 14
Author(s):  
Eirini Delikoura ◽  
Dimitrios Kouis
Keyword(s):  
Peer Review ◽  
Evaluation System ◽  
Early Stage ◽  
Open Science ◽  
Health Sciences ◽  
Research Data ◽  
Stage Of Development ◽  
Open Research ◽  
Proper Training ◽  
To Receive

Recently significant initiatives have been launched for the dissemination of Open Access as part of the Open Science movement. Nevertheless, two other major pillars of Open Science such as Open Research Data (ORD) and Open Peer Review (OPR) are still in an early stage of development among the communities of researchers and stakeholders. The present study sought to unveil the perceptions of a medical and health sciences community about these issues. Through the investigation of researchers` attitudes, valuable conclusions can be drawn, especially in the field of medicine and health sciences, where an explosive growth of scientific publishing exists. A quantitative survey was conducted based on a structured questionnaire, with 179 valid responses. The participants in the survey agreed with the Open Peer Review principles. However, they ignored basic terms like FAIR (Findable, Accessible, Interoperable, and Reusable) and appeared incentivized to permit the exploitation of their data. Regarding Open Peer Review (OPR), participants expressed their agreement, implying their support for a trustworthy evaluation system. Conclusively, researchers need to receive proper training for both Open Research Data principles and Open Peer Review processes which combined with a reformed evaluation system will enable them to take full advantage of the opportunities that arise from the new scholarly publishing and communication landscape.

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