Clinical Psychologist, 4 years’ experience, UK

2020 ◽  
pp. 260-263
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Epileptic Seizures ◽  
Second Opinion ◽  
Clinical Psychologist ◽  
Medical Professionals ◽  
Medical Settings ◽  
Inappropriate Care ◽  
Wide Range ◽  
Negative Interactions

This chapter addresses the experience of a Clinical Psychologist who has worked in acute medical settings and on inpatient wards for several years, and has encountered people with a wide range of symptoms and presentations. Unfortunately, in acute medical settings, people who experience Non-Epileptic Seizures (NES) often receive substandard or inappropriate care and have negative interactions with staff as a result of stigma. When someone presents with NES, the situation can be difficult for medical professionals to understand. They can be just as frightened, confused, and unsure about what to do as the person experiencing the seizures. Moreover, it can be difficult for doctors to admit that they do not know what is happening. They can feel under pressure to do or say something—maybe to refer for a test that is not really needed, to prescribe unnecessary medication, or to refer to another specialist for a second opinion. As such, people often go through a seemingly never-ending journey of uncertainty, anxiety, and rejection as they try to find some understanding about what is causing the seizures they cannot predict or explain.

Neurologist, 13 years’ experience, Australia

2020 ◽  
pp. 204-206
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Emergency Department ◽  
Behavioral Therapy ◽  
Epileptic Seizures ◽  
Clinical Psychologist ◽  
Eeg Monitoring ◽  
Patient Reported ◽  
History Of ◽  
Convulsive Seizures ◽  
One Year ◽  
Video Eeg

This chapter discusses the experience of a Neurologist with a patient who presented with a history of three bilateral convulsive seizures over a period of several months. The Neurologist started him on an adjunct antiepileptic therapy and he became seizure free. However, the situation changed dramatically after a stable period of twelve months. He started having seizures again and his mother was able to recognize that these seizures were different from those he had had one year earlier. Prolonged video-EEG monitoring confirmed the diagnosis of Non-Epileptic Seizures (NES). The Neurologist then referred the patient to a Clinical Psychologist, who used Cognitive Behavioral Therapy and taught him some techniques to cope with the condition. Eventually, the patient and his family were able to manage the NES better with the help of the psychologist. The patient reported a significant improvement clinically with less frequent NES and they learned how to manage the situation without visiting the Emergency Department.

Clinical Psychologist, 2 years’ experience, UK

2020 ◽  
pp. 97-97
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Clinical Practice ◽  
Patient Group ◽  
Patient Population ◽  
Epileptic Seizures ◽  
The Body ◽  
Clinical Psychologist

This chapter studies the experience of a Clinical Psychologist who has conducted some research with patients with Psychogenic Non-Epileptic Seizures (PNES) but has not worked therapeutically with this patient group. What struck the psychologist was the lack of understanding about the condition, among both patients and clinicians. Anxiety goes hand in hand with uncertainty. As a Psychologist, it can feel overwhelming to identify, make sense of, and address the underlying trauma and difficulties of an illness presenting so physically and so strongly within the body. Hopefully, the continued developments in research and clinical practice will help this patient population receive the help and support that is necessary for their recovery.

Clinical Psychologist, 3 years’ experience, UK

2020 ◽  
pp. 89-90
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Epileptic Seizures ◽  
Final Diagnosis ◽  
Clinical Psychologist ◽  
Not Given ◽  
Perceived Injustice ◽  
The People ◽  
High Incidence ◽  
Universal Truth ◽  
And Training ◽  
Conscious Control

This chapter assesses the idea that patients with Non-Epileptic Seizures (NES) are “difficult.” Anger is an emotion that people feel in the context of perceived injustice: if something is taken from someone, if someone is treated differently, or if someone is not given what he or she deserves. Often, individuals with NES have been treated badly by the people who should have shown them care. This is not a universal truth by any stretch, but research has shown there to be a high incidence of trauma within NES populations. Experiencing symptoms affecting movement and awareness that are outside of conscious control often means that people with NES miss out on opportunities and lose their jobs and driving licenses as well as their independence. Unfortunately, for someone who experiences NES, the journey to a final diagnosis could take years. As such, patients’ anger is not simply attributable to an interaction with one professional or to an explanation that people with NES are inherently difficult. Instead, it is important to look beyond the clinic room to acknowledge that the system as a whole is not meeting the needs of people who experience NES and that this is not fair. One way to make a difference, then, is to provide access to information and training for healthcare professionals.

scholarly journals Wearable Potentiometric Sensors for Medical Applications

Sensors ◽  
2019 ◽  
Vol 19 (2) ◽  
pp. 363 ◽  
Author(s):  
María Cuartero ◽  
Marc Parrilla ◽  
Gaston Crespo
Keyword(s):  
Sport Performance ◽  
Medical Utilization ◽  
Potentiometric Sensors ◽  
Sensor Calibration ◽  
Medical Applications ◽  
Sample Collection ◽  
Medical Settings ◽  
Wide Range ◽  
The Individual

Wearable potentiometric sensors have received considerable attention owing to their great potential in a wide range of physiological and clinical applications, particularly involving ion detection in sweat. Despite the significant progress in the manner that potentiometric sensors are integrated in wearable devices, in terms of materials and fabrication approaches, there is yet plenty of room for improvement in the strategy adopted for the sample collection. Essentially, this involves a fluidic sampling cell for continuous sweat analysis during sport performance or sweat accumulation via iontophoresis induction for one-spot measurements in medical settings. Even though the majority of the reported papers from the last five years describe on-body tests of wearable potentiometric sensors while the individual is practicing a physical activity, the medical utilization of these devices has been demonstrated on very few occasions and only in the context of cystic fibrosis diagnosis. In this sense, it may be important to explore the implementation of wearable potentiometric sensors into the analysis of other biofluids, such as saliva, tears and urine, as herein discussed. While the fabrication and uses of wearable potentiometric sensors vary widely, there are many common issues related to the analytical characterization of such devices that must be consciously addressed, especially in terms of sensor calibration and the validation of on-body measurements. After the assessment of key wearable potentiometric sensors reported over the last five years, with particular attention paid to those for medical applications, the present review offers tentative guidance regarding the characterization of analytical performance as well as analytical and clinical validations, thereby aiming at generating debate in the scientific community to allow for the establishment of well-conceived protocols.

scholarly journals Designing Patient-Specific Optimal Neurostimulation Patterns for Seizure Suppression

2018 ◽  
Vol 30 (5) ◽  
pp. 1180-1208 ◽  
Author(s):  
Roman A. Sandler ◽  
Kunling Geng ◽  
Dong Song ◽  
Robert E. Hampson ◽  
Mark R. Witcher ◽  
...  
Keyword(s):  
Global Optimization ◽  
Closed Loop ◽  
Epileptic Seizures ◽  
Patient Specific ◽  
Spontaneous Seizure ◽  
Global Optimization Algorithm ◽  
Neuron Network ◽  
Seizure State ◽  
Wide Range ◽  
Stimulation Pattern

Neurostimulation is a promising therapy for abating epileptic seizures. However, it is extremely difficult to identify optimal stimulation patterns experimentally. In this study, human recordings are used to develop a functional 24 neuron network statistical model of hippocampal connectivity and dynamics. Spontaneous seizure-like activity is induced in silico in this reconstructed neuronal network. The network is then used as a testbed to design and validate a wide range of neurostimulation patterns. Commonly used periodic trains were not able to permanently abate seizures at any frequency. A simulated annealing global optimization algorithm was then used to identify an optimal stimulation pattern, which successfully abated 92% of seizures. Finally, in a fully responsive, or closed-loop, neurostimulation paradigm, the optimal stimulation successfully prevented the network from entering the seizure state. We propose that the framework presented here for algorithmically identifying patient-specific neurostimulation patterns can greatly increase the efficacy of neurostimulation devices for seizures.

Dynamics and Motion Control of a 6-DOF Robot Manipulator

2012 ◽  
Author(s):  
Carlos Mondragon ◽  
Reza Fotouhi
Keyword(s):  
Free Path ◽  
Robot Manipulator ◽  
Research Work ◽  
Robotic Arm ◽  
Medical Settings ◽  
Wide Range ◽  
Pick And Place ◽  
Stationary Objects ◽  
Simulation Results ◽  
Six Degree Of Freedom

This research work is to control motion of a manipulator attached to a mobile robot for pick-and-place operations; this is part of a bigger project in developing a robotic-assisted nursing to be used in medical settings. In this paper a strategy to accomplish pick-and-place operations, using a six degree-of-freedom robotic arm, is presented. Such operations are completed by creating a collision-free path to move an object from an initial to a final position. The collision-free path is planned by considering the entire workspace of the manipulator. The workspace is defined as the subtraction of the stationary objects and the robot volumes from all of the possible reachable points of the robotic arm. Once the path is planned, the kinematics of the manipulator is considered. Although this project can be applied into a wide range of applications, it is mainly intended to be used for medical robotic assistance. Simulation results for several different paths are presented. The simulation results were verified with experimental results, although not shown here.

The Age of Chemicals in the 21st Century

2017 ◽  
Author(s):  
Carol F. Kwiatkowski
Keyword(s):  
Public Health ◽  
Human Exposure ◽  
Flame Retardants ◽  
Endocrine System ◽  
Daily Basis ◽  
Medical Professionals ◽  
Low Concentrations ◽  
Wide Range ◽  
Exposure Routes

Chapter 1 profiles the history, exposure routes, and health effects of chemicals in categories such as pesticides, solvents, flame retardants, plastics, and antimicrobials. Human exposure to low concentrations of chemicals, prenatal and childhood exposures, and effects on the endocrine system are highlighted. The goal is to raise awareness about the wide range of chemicals humans encounter on a daily basis. Medical professionals are urged to use this information to educate patients, and governments are called on to adopt new regulatory approaches to protect public health.

Listening to patients’ voices: Linguistic indicators related to diabetes self-management

2013 ◽  
Vol 9 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Ulla Connor ◽  
Marta Antón ◽  
Elizabeth Goering ◽  
Kathryn Lauten ◽  
Paris Roach ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Self Management ◽  
Medical Professionals ◽  
Patient Interview ◽  
Coding Systems ◽  
Wide Range ◽  
Control Orientation ◽  
Linguistic Coding ◽  
Depth Interviews

A great deal of research in health care has examined a wide range of variables to better understand the degree to which patients follow the advice of medical professionals in managing their health, known as adherence. This paper explains the development of the linguistic systems to describe and evaluate two psychosocial constructs (i.e. control orientation and agency) that have been found to be related to adherence in previous research for subjects with diabetes (Trento et al. 2007; Wangberg 2007; O’Hea et al. 2009). The present data came from 43 semi-structured in-depth interviews of subjects with Type 2 diabetes. One-on-one interviews with open-ended questions elicited subjects’ ‘stories’ about living with diabetes, and the transcribed interviews were analyzed to develop the linguistic systems of control orientation and agency. The resultant systems were applied to the 43 interviews by raters with high inter-rater reliability. The results showed demarcations of clearly identified codings of patient types. The paper presents the linguistic coding systems developed in the study, the results of their application to the patient interview data, and recommendations for improved communication with patients.

scholarly journals Multiple Vulnerabilities in Medical Settings: Invisible Suffering of Doctors

Societies ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Daria Litvina ◽  
Anastasia Novkunskaya ◽  
Anna Temkina
Keyword(s):  
Maternity Care ◽  
Social Group ◽  
Emotional Responses ◽  
Vulnerable Groups ◽  
Medical Professionals ◽  
Medical Settings ◽  
Neoliberal Reforms ◽  
Sensitive Topics ◽  
Perinatal Center ◽  
Multiple Challenges

While there is a substantive amount of literature on vulnerability of different kinds of patients in different settings, medical professionals are usually considered as the ones who possess power and gain a privileged position. In this paper, we aim to demonstrate that in a certain context physicians—a social group which is usually referred to as “powerful”—consider themselves vulnerable, and this positioning may influence patients in turn. This perspective highlights the complexity of interactions within medical organizations and contributes to the studies of sensitive topics and vulnerable groups. We conceptualize vulnerability of doctors and discuss what can be problematic in powerful doctors’ position. We describe some features of the post-Soviet context of Russian healthcare system and maternity care, both of which can be conceptualized as a hybrid of legacy of Soviet paternalism and new neoliberal reforms, managerialism and marketization. Empirical research is based on the ethnographic evidence from the study of a Russian perinatal center. In this article, we explore specific “existential” and “moral” vulnerabilities of medical professionals who routinely have to cope with multiple challenges, such as complicated clinical tasks, rigid control of different state bodies and emotional responses of suffering patients. We argue that there is a bond between the vulnerability of doctors and that of patients, whose position becomes more problematic as professionals become more vulnerable. At the end, we discuss methodological and theoretical implications of our research.

scholarly journals What is the Responsibility of Australian Medical Professionals Whose Patients Travel Abroad for Assisted Reproduction?

2019 ◽  
Vol 27 (3) ◽  
pp. 365-389
Author(s):  
Jenni Millbank
Keyword(s):  
Legal Regulation ◽  
Egg Donation ◽  
Medical Professionals ◽  
Patient Reports ◽  
Information Giving ◽  
Wide Range ◽  
Ethical Guidance ◽  
Before And After ◽  
Travel Abroad ◽  
Key Aspects

Abstract Australian medical professionals whose patients undertake assisted reproductive treatment abroad face a conflict: to try to provide optimal and on-going care for their patient at the same time as ensuring compliance with Australian legal, ethical, and professional rules which proscribe as unsafe or unethical key aspects of such treatment. A major suggestion from literature on medical travel is that risks to the patient can be mitigated through the involvement of the local professional. However, the force of legal regulation and ethical guidance in Australia strenuously directs clinicians away from involvement in overseas reproductive treatment. This article reports on 37 interviews with Australians travelling abroad for surrogacy, egg donation, and embryo donation, reflecting on patients’ experiences with Australian medical professionals both before and after they travelled. Patient reports demonstrate a fragmented and bewildering medical landscape in Australia, in which the ability to access domestic care and expertise varied markedly depending upon the kind of treatment patients were seeking abroad, and the mode of practice of the Australian doctor. Doctors practicing within licensed IVF clinics were notably more constrained than those outside such a setting. Patients seeking egg donation were offered information and received a wide range of diagnostic and preparatory treatments, while those seeking surrogacy were shunned, chided and offered limited (and sometimes covert) assistance. While recent changes to national ethical guidance improve clarity on information giving, the ethical and legal propriety of Australian medical professionals providing diagnostic or preparatory treatment for cross border reproduction remains uncertain.

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