Friday, 20 July 2012

elderly in my words-poem by me

being elderly does not feel so good
i dont feel the way i thought i would
served my country,worked all my life
some years ago i lost my wife
i do not need or ask for a lot
but not all happy with what ive got
someoe to talk to for an hour a day
we still love you to hear anyone say
to my sons and daughters im just a pest
please dear lord lay me down to rest

memories of a child-a true account

memories of a child-a true account

20/07/2012 16:25
sometimes it is strange how you think about the past,but recently i have-so i thought i would blog some memories.
as a child i had a loving but very strong mother and an alcoholic father but i have no regrets apart from maybe the odd cuts and bruises.
my parents eventually split which i guess was inevitable in so many ways and i remember one xmas day my dad came to visit us,but as usual he was drunk and he started his idiotic behavior and he ended up fighting with mam and a xmas present of mine got broken.
it was something that most of you would not even remember a reel to reel tape recorder-it was not new and mam saved to buy it from a second hand shop but to me it was the best ever xmas present and he broke it through alcohol.i dont think it was just my present that was broken on that xmas day but a piece of my heart too.

memories of a child-a true account

memories of a child-a true account


sometimes it is strange how you think about the past,but recently i have-so i thought i would blog some memories.
as a child i had a loving but very strong mother and an alcoholic father but i have no regrets apart from maybe the odd cuts and bruises.
my parents eventually split which i guess was inevitable in so many ways and i remember one xmas day my dad came to visit us,but as usual he was drunk and he started his idiotic behavior and he ended up fighting with mam and a xmas present of mine got broken.
it was something that most of you would not even remember a reel to reel tape recorder-it was not new and mam saved to buy it from a second hand shop but to me it was the best ever xmas present and he broke it through alcohol.i dont think it was just my present that was broken on that xmas day but a piece of my heart too.

20/07/2012 16:25

Thursday, 19 July 2012

THE TWIITER LYNCH MOB

twitter sometimes reminds me of the old wild west with its lynch mobs and always a person who runs the town(twiitertown) if you like westerns you will hve seen it loads of time,get everyone worked up into a frenzy against someone who has the cheek and nerve to challange them,they think they can post what they want about who or what the want.
one out of this bunch i believe to be  professional and then in my oppinion the others are wannabe,s-they all like to hear how great they are and have huge egos but little substance and some do suffer from mental issues but that should not be held against them because in fairness a lot on twitter have disorders and should be admired for thier bravery of talking about it.
i am not asking anyone else to become involved that is thier sneaky way,i am not the only one who as been singled out by this group of people who seem to get a real buzz out of basically trying to regulate twitter in thier lynch mob rule.
me  could not give a stuff about these morons but i thought i would warn the rest of you to be carefull because they will turn on you.i would happily leave twitter but at the moment i would not give the mindless word thugs the satisfaction

Claire OT @claireOT I'm an occupational therapist. I talk about health, mental health recovery, disability, social justice, busy organising


@BPDFFS Campaigning and Training for People with Borderline Personality Disorder
 
 
The Care Guy @StuartSorensen British trainer & speaker. Interested in mental health, social care, human rights. I work throughout UK
Workington, UK ·
 Gill_Sorensen @Gill_Sorensen mum, wiccan, wife, some times silly, some times serious but most of the time a complete flake. I live with 1 bloke 2 boys and 5 cats.
Cumbria
 Amanda O @Trying to do my bit to make a difference in mental health matters. My blog can be found at
 
 
 and then the followers of these morons who are more like sheep than people who will do as they are told by idiots-if you want to reply please use my blog .
amanda_stand
BPD FFS sue sibbald

questions and answers-just for fun

earlier today  i asked two questions
the first one got no answers the second one was what is all bran and below is a very good if somewhat not very informative reply-but i liked it though.
 it's a breakfast cereal made only out of bran ;)

this was just an execise in how difficult it can be to answer a question without cutting and pasting if you want it to be evidence based.

below is a more indepth answer using a source which is shown,this was just in the sense of fun but i think it proves to an extent how difficult answering questions can be without using sources.

All Bran Cereal
All bran cereal is cereal which features the benefit of maximizing the grams of fiber per each serving. This is a benefit because of how it affects your sense of feeling sated. Eating all bran cereal will make you feel more full, not only in the short term, but also extending to a couple of hours thereafter. This longer state of feeling sated may just have something to do with all bran cereal's lower glycemic index. The benefits of all bran cereal don't end just at making you feel more full. All bran cereal has also been found to reduce the likelihood of weight gain for both men over 40 as well as women in the age range of 38 to 63. The aforementioned cereal that contains refined-grain has the tendency of causing weight gain in people who eat it regularly.
Comparison
The choice of whole grain cereal versus all bran cereal largely comes down to what your priorities and preferences are. If you value a cereal that puts an emphasis on reducing your risk for noxious diseases like diabetes and heart disease, you should choose whole grain cereal. If, on the other hand, you mainly value the possibility of weight loss or reducing the likelihood that you will gain weight, you should opt to eat all bran cereal. You must remember that both kinds of cereals are a lot healthier than refined-grain cereal, which you ought to avoid.

http://www.fitday.com/

final answer-please read and decide for yourself

this really is my last response to this issue-best interest is for people without capacity-
i do hope that this will clear this up once and for all-the mental capacity act is clear
Sory @MikeGargett but this is misleading. Part 5 MCA is clear: decision-makers are expected to be reasonable, not expert. -for a person who lacks capacityView conversation Hide conversation Reply RetweetedRetweet Delete FavoritedFavorite 3h The Care Guy ?@StuartSorensen
@MikeGargett @claireOT @SocialWorkKent Not particularly but if you want to go ahead.
on Reply RetweetedRetweet Delete FavoritedFavorite 19h The Care Guy ?@StuartSorensen
@MikeGargett @nicolejade6 @dementia_tch1 If you mean me thst's unfair. I commented on the MCA, not you.
The Care Guy ?@StuartSorensen
@cal_ann @lavinialady Thankyou. Problem is it's too wasy to look like a bulky when all I realky want to do is challenge misleading myths
-there are no misleading myths just the factsThe Care Guy ?@StuartSorensen
@dementia_tch @lavinialady I spend too much time dispelling these dangerous myths to let such go unchallenged on
The Care Guy ?@StuartSorensen
@dementia_tch @lavinialady And there are those who object to dangerous misrepresentation by psuedo experts. That affects practice -
no misrepresentation only what is stated by the mca clearlyThe Care Guy ?@StuartSorensen
@MikeGargett Including A&E Dr
23h The Care Guy ?@StuartSorensen
@MikeGargett @stuartsanderso2 @maggsy2000 @MentalHealthCop @Ermintrude2
 
Read chapter 6 CoP. Clearly states NOT just medical. Principles of the ActThe Act is underpinned by five key principles:without capacity must be in their best interests. Home > Professional Reference > Mental Capacity ActPrint this page Send to a friend Mental Capacity Act This PatientPlus article is written for healthcare professionals so the language may be more technical than the
See separate articles
condition leaflets. You may find the abbreviations list helpful.Consent To Treatment (Mental Capacity and Mental Health Legislation), Consent To Treatment In Children (Mental Capacity and Mental Health Legislation) and Compulsory Hospitalisation.

The Mental Capacity Act (2005) provides a statutory framework to empower and protect vulnerable people who are not able to make their own decisions. It makes it clear who can take decisions, in which situations, and how they should go about this. It enables people to plan ahead for a time when they may lose capacity. The Act replaces previous statutory schemes for Enduring Powers of Attorney and Court of Protection Receivers with reformed and updated schemes. The Mental Capacity Act applies to people aged 16 and over.
On this page
Principles of the Act Purposes of the Act Deprivation of liberty safeguards Document references Internet and further reading



A presumption of capacity
The right for individuals to be supported to make their own decisions
That individuals must retain the right to make what might be seen as eccentric or unwise decisions.
Best interests
Least restrictive intervention: anything done for or on behalf of people without capacity should be the least restrictive of their basic rights and freedoms.
: anything done for or on behalf of people
: people must be given all appropriate help before anyone concludes that they cannot make their own decisions.
: every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise.
Assessment of mental capacity is specific for each individual decision at any particular time. People are considered to lack capacity if they have an impairment that causes them to be unable to make a specific decision. The person should be able to understand, retain and weigh the information provided and communicate their decision.

Independent mental capacity advocates should be appointed to represent people who lack capacity and face serious decisions with no one to be an advocate for them. The possible causes of incapacity are wide ranging and include dementia, acute confusion, depression, psychotic illness, distress or emotional disturbance. No specific diagnosis should be assumed to imply incapacity.
 

Principles of the ActThe Act is underpinned by five key principles:
A presumption of capacity
The right for individuals to be supported to make their own decisions
That individuals must retain the right to make what might be seen as eccentric or unwise decisions.
Best interests:
: people must be given all appropriate help before anyone concludes that they cannot make their own decisions.
: every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise.
Assessment of mental capacity is specific for each individual decision at any particular time. People are considered to lack capacity if they have an impairment that causes them to be unable to make a specific decision. The person should be able to understand, retain and weigh the information provided and communicate their decision.

Independent mental capacity advocates should be appointed to represent people who lack capacity and face serious decisions with no one to be an advocate for them. The possible causes of incapacity are wide ranging and include dementia, acute confusion, depression, psychotic illness, distress or emotional disturbance. No specific diagnosis should be assumed to imply incapacity.
anything done for or on behalf of people without capacity must be in their best interests. Least restrictive interventionPurposes of the ActThe Act deals with the assessment of a person's capacity and
Assessing lack of capacity
acts by carers of those who lack capacity.The Act sets out a single clear test for assessing whether a person lacks capacity to take a particular decision at a particular time.
It is a 'decision-specific' test.
No one can be labelled 'incapable' as a result of a particular medical condition or diagnosis. A lack of capacity cannot be established merely by reference to a person's age, appearance, or any condition or aspect of a person's behaviour which might lead others to make unjustified assumptions about capacity.
To test if the person has capacity:
Does the person have an impairment of the mind or brain, or a disturbance of mental function?
If so, does that impairment or disturbance mean that the person is unable to make the decision in question at the time it needs to be made?
To have capacity to make a decision, someone must be able to:
Understand the information relevant to the decision.
Retain the information.
Use that information as part of the process of making the decision.
Communicate his/her decision either by talking, signing, or any other means.
Best interests
Everything that is done for or on behalf of a person
The Act provides a checklist of factors that decision-makers must work through in deciding what is in a person's best interests.
A person can put his/her wishes and feelings into a written statement if they so wish, which the person making the determination must consider.
Carers and family members have a right to be consulted.
All decisions must be made in the best interest of that person:
Involve the person who lacks capacity.
Be aware of the person's wishes and feelings.
Consult with others who are involved in the care of the person.
Do not make assumptions based solely on the person's age, appearance, condition or behaviour.
Consider whether the person is likely to regain capacity to make the decision in the future.
who lacks capacity must be in that person's best interests. Acts in connection with care or treatment
Section 5 of the Act clarifies that where a person is providing care or treatment for someone
This covers actions that would otherwise result in a civil wrong or crime if someone has to interfere with the person's body or property in the ordinary course of caring. For example, by giving an injection or by using the person's money to buy items for them.
The Bill introduces a new criminal offence of ill treatment or neglect of a person who lacks capacity. A person found guilty of such an offence may be liable to imprisonment for a term of up to five years.
who lacks capacity then the person can provide the care without incurring legal liability. The key will be proper assessment of capacity and best interests. Restraint or deprivation of liberty
Section 6 of the Act defines restraint as the use or threat of force where an incapacitated person resists, and any restriction of liberty or movement whether or not the person resists.
Restraint is only permitted if the person using it reasonably believes it is necessary to prevent harm to the incapacitated person, and if the restraint used is proportionate to the likelihood and seriousness of the harm.
Section 6(5) makes it clear that an act depriving a person of his or her liberty cannot be an act to which section 5 provides any protection.
Advance decisions
The Mental Capacity Act introduces
Advance decisions replace 'advance directives', which were made prior to the Mental Capacity Act. Advance directives may still be valid and applicable under the Mental Capacity Act but no new advance directives can now be made.
Advance decisions can only be made by people 18 years old or older and considered to have mental capacity.
Under advance decisions, any treatment can be refused, except for those actions needed to keep a person comfortable, eg. warmth, shelter, and offering food or water by mouth.
Wishes to have certain treatments may be expressed in advance which must be taken into account, but do not have to be followed.
An advance decision carries the same weight as decisions made by a person with capacity and must be followed. Therefore best interests do not apply.
Advance decisions may be verbal, except those about life-sustaining treatment which must be in writing and signed by the patient and a witness, and include a statement that the decision is to apply even if life is at risk.
The advance decision becomes invalid if the decision is withdrawn or amended when the person still had capacity (or even if there have been any actions suggesting they changed their mind after making the advance decision), or if there are 'lasting powers of attorney' with powers to make the same decision after the advance decision was made.
The advance decision must apply to the specific circumstance in question.
Going against a valid and applicable advance decision can result in claims for battery or criminal charges of assault.
advance decisions giving a person the right to make a decision to refuse healthcare treatment in advance, even if it results in their death. Lasting powers of attorney
The Act allows a person to appoint an attorney to act on their behalf if they should lose capacity in the future.
The Act allows people to let an attorney make financial, property, health and welfare decisions.
The designated attorney must be aged 18 years or older.
The lasting powers of attorney only come into force once the person has lost capacity and the lasting powers of attorney must be registered with the Office of the Public Guardian (see link at end of article).
The person making the lasting powers of attorney must have capacity when they sign a written document confirming the powers and limitations of the powers of attorney.
Independent Mental Capacity Advocate (IMCA)
An IMCA is someone appointed to support a person who lacks capacity but has no one to speak for them. The IMCA makes representations about the person's wishes, feelings, beliefs and values at the same time as bringing to the attention of the decision-maker all factors that are relevant to the decision. The IMCA can challenge the decision-maker on behalf of the person lacking capacity if necessary.
An IMCA must be involved in the following situations and where the person lacks capacity and has no relative, friend or unpaid carer:
An NHS body is proposing:
Serious medical treatment.
A stay of more than 28 days in hospital or eight weeks in a care home.
Change to a person's accommodation to another hospital for more than 28 days or more than eight weeks in a care home.
A local authority is proposing:
To change or to provide residential or supported accommodation for more than eight weeks.
An IMCA may also be involved in:
Accommodation reviews where there are concerns about the suitability of the placement, where the Local Authority or NHS has arranged the original accommodation, the person lacks capacity, and there is no other person appropriate to consult. Involvement of an IMCA is not necessary:
If any treatment needs to be provided as a matter of urgency.
If the person lacking capacity would be made homeless unless they were admitted to a care home.
In accommodation reviews or adult protection cases where there is already appropriate family support or where an advocate is currently involved.
Adult protection cases where protective measures are being put in place in relation to the protection of a vulnerable adult from abuse, and where the person lacks capacity. Where the person who lacks capacity is abusing another person.Parameters for research
Research involving, or in relation to, a person lacking capacity may be lawfully carried out if an 'appropriate body' (normally a Research Ethics Committee) agrees that the research is safe, relates to the person's condition and cannot be done as effectively using people who have mental capacity. The research must produce a benefit to the person that outweighs any risk or burden.
Alternatively, if it is to derive new scientific knowledge, it must be of minimal risk to the person and be carried out with minimal intrusion or interference with their rights.
Carers or nominated third parties must be consulted and agree that the person would want to join an approved research project. If the person shows any signs of resistance or indicates in any way that he or she does not wish to take part, the person must be withdrawn from the project immediately.
Transitional regulations will cover research started before the Act where the person originally had capacity to consent, but later lost capacity before the end of the project.
Court appointed deputies
The Act provides for a system of court appointed deputies to replace the previous system of receivership in the Court of Protection.
Deputies will be able to take decisions on welfare, healthcare and financial matters as authorised by the Court but will not be able to refuse consent to life-sustaining treatment. They will only be appointed if the Court cannot make a one-off decision to resolve the issues.
The Act creates two new public bodies to support the statutory framework, both of which will be designed around the needs of those who lack capacity.
A new Court of Protection
The new Court will have jurisdiction relating to the whole Act and will be the final arbiter for capacity matters. It will have its own procedures and nominated judges.
A new Public Guardian: the Public Guardian and his/her staff supervise deputies appointed by the Court and provide information to help the Court make decisions. They also work together with other agencies, such as the police and social services, to respond to any concerns raised about the way in which an attorney or deputy is operating.
A Public Guardian Board scrutinises and reviews the way in which the Public Guardian discharges his/her functions. The Public Guardian is required to produce an Annual Report about the discharge of his/her functions.
Deprivation of liberty safeguards
The aim of the deprivation of liberty safeguards is to provide legal protection for those vulnerable adults who are not detained under the amended Mental Health Act 1983, but are restricted in their freedom due to their inability to consent to care or accept treatment.
The deprivation of liberty safeguards (an amendment of the Mental Capacity Act 2005) came into effect on 1 April 2009 and cover mentally incapacitated adults in hospitals, as well as those in care homes registered under the Care Standards Act 2000.
The safeguards apply to anyone aged 18 and over:
who suffers from a mental disorder or disability of the mind, e.g. dementia or a profound learning disability,
who lacks the capacity to give informed consent to the arrangements made for their care and/or treatment, and
for whom deprivation of liberty is considered after an independent assessment to be necessary in their best interests to protect them from harm.
Whenever a hospital or care home identifies that a person
When a person is in a care home, the supervisory body will be the relevant Local Authority.
When the person is in a hospital, this will be the relevant Primary Care Trust (PCT).
The Mental Capacity Act 2005
who lacks capacity is being, or risks being, deprived of their liberty, they must apply to a 'supervisory body' for authorisation of deprivation of liberty: will not permit someone being deprived of their liberty without such an authorisation (unless it is a consequence of following a decision of the Court of Protection on a personal welfare question). Doctors are eligible to undertake a mental health assessment as part of these procedures provided they are three years post-registration and they must have undertaken the deprivation of liberty safeguards Mental Health Assessors training programme made available by the Royal College of Psychiatrists.
This work is not part of Essential Services for GPs and the British Medical Association's (BMA) Professional Fees Committee advises doctors to undertake this work only if they have agreed the level and payment arrangements for the work in advance.
Responsibility for payment lies with the PCT or Local Social Services Authority (LSSA) according to whether the person is in hospital or a Registered Home at the time of the assessment.
 
Document references

 
The Mental Capacity Act Deprivation of Liberty Safeguards, Dept of HealthInternet and further reading




Mental Capacity Act 2005 Code of Practice, Ministry of Justice Consent guidance: patients and doctors making decisions together, General Medical Council, 2008 The Mental Capacity Act 2005, Dept of Health The Mental Capacity Act 2005: Guidance for health professionals, British Medical Association Mental Capacity Act Tool Kit, British Medical Association, September 2008 Consent tool kit - fifth edition, British Medical Association, December 2009 Advance decisions and proxy decision-making in medical treatment and research, British Medical Association, November 2007 The Office of the Public Guardian
1
: anything done for or on behalf of people without capacity should be the least restrictive of their basic rights and freedoms.

Friday, 6 July 2012

Home > Professional Reference > Ehlers-Danlos Syndrome


Epidemiology

  • Ehlers-Danlos syndrome (EDS) affects approximately 1 in 5,000 live births.1
  • Inheritance is usually autosomal dominant.

Presentation

Abnormalities of collagen production result in:
  • Bruising, bleeding from the gastrointestinal tract.
  • Dissecting aortic aneurysm at an early age.
  • Wide scars.
  • Laxity of joints.
  • Herniae.
  • Hyperelasticity of skin.
The first presentation may be premature rupture of the membranes.
EHLER'S DANLOS (OM1375a.jpg)

Types of Ehlers-Danlos syndrome

There are many types of Ehlers-Danlos syndrome (EDS) based on different gene mutations affecting the structure or assembly of different collagens. All share common features of fragile skin and laxity of joints and ligaments. The Villefranche classification of EDS substituted descriptions for earlier types numbered with Roman numerals:2
  • Classic (formerly known as Type I and II):
    • Classical features of EDS (soft, doughy, hyperelastic skin) with atrophic scars.
    • Multiple bruises, especially on the legs.
    • Easy skin-splitting shows in childhood over the forehead, elbows, knees and chin.
    • Other features are epicanthic folds, blue sclerae, fibrous nodules over knees and ankles.
  • Hypermobile type (formally known as Type III):
    • Most common and often not diagnosed.
    • Characterised by tall stature, blue sclerae and ready bruising.
    • Shows marked joint hypermobility but moderate skin elasticity and no scarring.
  • Vascular type (formally known as Type IV):3
    • Appears as thin skin with venous patterns readily visible, ecchymoses over the knees and shins, premature ageing of the skin on the dorsum of the hands, feet and shins with a 'Madonna' face with large eyes, nasal thinning and small ear lobes.
    • The main problem is spontaneous rupture of medium/large arteries at any age from mid-adolescence to late adult life. Arterial aneurysms are also common.
    • Death results from arterial rupture but rupture of the sigmoid colon is also common.
    • Recent studies showed that 15% of women who became pregnant died due to complications during pregnancy.
    • Overall median lifespan is reduced to 48 years.
  • Kyphoscoliosis type (formally known as Type VI):
    • Severe main features with early progressive fibrosis and severe motor delay.
  • Arthrochalasia type (formally known as Types VII A and B):
  • Dermatosparaxis type (formally known as Type VII C):
    • Main features are variable, early tooth loss with severe periodontitis.

Differential diagnosis

Investigations

  • Diagnosis is normally made on the clinical presentation.
  • Subcutaneous calcified spherules can be confirmed on X-rays.

Management

  • There is no specific treatment.
  • Celiprolol, a beta1-adrenoceptor antagonist with a beta2-adrenoceptor agonist action, has been used to prevent arterial dissections and ruptures.5
  • Trauma should be minimised, and protective clothing and padding may help.
  • Genetic counselling should be provided.

Complications

  • Pregnancy may be very dangerous. Obstetric complications include risk of uterine rupture during labour, damage to the vagina and perineum, bleeding and rupture of blood vessels and the colon during the puerperium.6
  • Abnormal bleeding may cause extreme difficulty with any surgical operation.

Prognosis

  • Lifespan is usually normal unless there is marked vascular fragility.
  • A high prevalence of severe complications occurs in a minority of families

scizophrenia



scizophrenia Treatment

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments.
Antipsychotic medications
Antipsychotic medications have been available since the mid-1950's. The older types are called conventional or "typical" antipsychotics. Some of the more commonly used typical medications include:

Schizophrenia facts


  • Schizophrenia is a chronic, severe, debilitating mental illness that affects about 1% of the population, more than 2 million people in the United States alone.
  • With the sudden onset of severe psychotic symptoms, the individual is said to be experiencing acute schizophrenia. Psychotic means out of touch with reality or unable to separate real from unreal experiences.
  • There is no known single cause of schizophrenia. As discussed later, it appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals.
  • There are a number of various treatments for schizophrenia. Given the complexity of schizophrenia, the major questions about this disorder (its cause or causes, prevention, and treatment) are unlikely to be resolved in the near future. The public should beware of those offering "the cure" for (or "the cause" of) schizophrenia.
  • Schizophrenia is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems.
  • Symptoms of schizophrenia may include delusions, hallucinations, catatonia, negative symptoms, and disorganized speech or behavior.
  • There are five types of schizophrenia based on the kind of symptoms the person has at the time of assessment: paranoid, disorganized, catatonic, undifferentiated, and residual.
  • Children as young as 6 years of age can be found to have all the symptoms of schizophrenia as their adult counterparts and to continue to have those symptoms into adulthood.
  • Although the term schizophrenia has only been in used since 1911, its symptoms have been described throughout written history.
  • Schizophrenia is considered to be the result of a complex group of genetic, psychological, and environmental factors.
  • Health-care practitioners diagnose schizophrenia by gathering comprehensive medical, family, mental-health, and social/cultural information.
  • The practitioner will also either perform a physical examination or request that the individual's primary-care doctor perform one. The medical examination will usually include lab tests.
  • In addition to providing treatment that is appropriate to the diagnosis, professionals attempt to determine the presence of mental illnesses that may co-occur.
  • People with schizophrenia are at increased risk of having a number of other mental-health conditions, committing suicide, and otherwise dying earlier than people without this disorder.
  • Medications that have been found to be most effective in treating the positive symptoms of schizophrenia are first- and second-generation antipsychotics.
  • Psychosocial interventions for schizophrenia include education of family members, assertive community treatment, substance-abuse treatment, social-skills training, supported employment, cognitive behavioral therapy, and weight management.
  • Cognitive remediation, peer-to-peer treatment, and weight-management interventions remain the focus topics for research.

What is schizophrenia?


Schizophrenia is a chronic, severe, debilitating mental illness that affects about 1% of the population, corresponding to more than 2 million people in the United States alone. Other statistics about schizophrenia include that it affects men about one and a half times more commonly than women. It is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. The thought problems associated with schizophrenia are described as psychosis, in that the person's thinking is completely out of touch with reality at times. For example, the sufferer may hear voices or see people that are in no way present or feel like bugs are crawling on their skin when there are none. The individual with this disorder may also have disorganized speech, disorganized behavior, physically rigid or lax behavior (catatonia), significantly decreased behaviors or feelings, as well as delusions, which are ideas about themselves or others that have no basis in reality (for example, the individual might experience paranoia, in that he or she thinks others are plotting against them when they are not).

What are the different types of schizophrenia?


There are five types of schizophrenia, each based on the kind of symptoms the person has at the time of assessment.
  • Paranoid schizophrenia: The individual is preoccupied with one or more delusions or many auditory hallucinations but does not have symptoms of disorganized schizophrenia.


  • Disorganized schizophrenia: Prominent symptoms are disorganized speech and behavior, as well as flat or inappropriate affect. The person does not have enough symptoms to be characterized as suffering from catatonic schizophrenia.


  • Catatonic schizophrenia: The person with this type of schizophrenia primarily has at least two of the following symptoms: difficulty moving, resistance to moving, excessive movement, abnormal movements, and/or repeating what others say or do.


  • Undifferentiated schizophrenia: This is characterized by episodes of two or more of the following symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic type of schizophrenia.


  • Residual schizophrenia: While the full-blown characteristic positive symptoms of schizophrenia (those that involve an excess of normal behavior, such as delusions, paranoia, or heightened sensitivity) are absent, the sufferer has a less severe form of the disorder or has only negative symptoms (symptoms characterized by a decrease in function, such as withdrawal, disinterest, and not speaking).

BORDERLINE pd-nothing borderline about bpd

People with borderline personality disorder, are often anxious, depressed, self‐harm, in crisis and are difficult to engage in treatment. In this review of the talking/behavioural therapies for people with borderline personality disorder, we identified seven studies involving 262 people, over five separate comparisons. Dialectical behaviour therapy (DBT) included treatment components such as prioritising a hierarchy of target behaviours, telephone coaching, groups skills training, behavioural skill training, contingency management, cognitive modification, exposure to emotional cues, reflection, empathy and acceptance. DBT seemed to be helpful on a wide range of outcomes, such as admission to hospital or incarceration in prison, but the small size of included studies limit confidence in their results.
Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.
Version: 2009
Many people with borderline personality disorder (BPD) receive medical treatment. However, there are no drugs available for BPD treatment specifically. A certain drug is most often chosen because of its known properties in the treatment of associated disorders, or BPD symptoms that are also known to be present in other conditions, such as depressive, psychotic, or anxious disorders. BPD itself is characterised by a pervasive pattern of instability in affect regulation (with symptoms such as inappropriate anger, chronic feelings of emptiness, and affective instability), impulse control (symptoms: self‐mutilating or suicidal behaviour, ideation, or suicidal threats to others), interpersonal problems (symptoms: frantic efforts to avoid abandonment, patterns of unstable relationships with idealization and depreciation of others), and cognitive‐perceptual problems (symptoms: identity disturbance in terms of self perception, transient paranoid thoughts or feelings of dissociation in stressful situations). This review aimed to summarise the current evidence of drug treatment effects in BPD from high‐quality randomised trials.
Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.
Version: 2010
Borderline personality disorder (BPD) is a complex and severe mental disorder that affects approximately 2% of the general population. Many people with BPD experience considerable instability in their interpersonal relationships and sense of who they are, leading to frequent crises and acts of self harm. To date, little is known about what might help people with BPD when they are experiencing an acute crisis. In this review, we wanted to examine how effective crisis interventions are for people with BPD by looking at evidence from randomised controlled trials (RCTs).
Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.
Version: 2012
Deliberate self‐harm is a major health problem associated with considerable risk of subsequent self‐harm, including completed suicide. This systematic review evaluated the effectiveness of various treatments for deliberate self‐harm patients in terms of prevention of further suicidal behaviour. From the results of 23 randomized controlled trials the reviewers concluded that more evidence is required to indicate what the most effective care is for this large patient population. Promising results were found for problem‐solving therapy, provision of a card to allow emergency contact with services, depot flupenthixol for recurrent repeaters of self‐harm and long‐term psychological therapy for female patients with borderline personality disorder and recurrent self‐harm. However, insufficient numbers of patients in nearly all trials limit the conclusions that can be reached. More evidence is required to determine the most effective treatment for deliberate self‐harm patients and larger trials are badly needed.
Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.
Version: 2009
Various medicines, which are collectively termed 'antiepileptic drugs', have been used to treat persistent aggression. This review systematically examines the evidence supporting this practice. From the evidence available, we were unable to draw any firm conclusion about using these medicines to treat aggression. Four antiepileptic drugs (valproate/divalproex, carbamazepine, oxcarbazepine and phenytoin) helped to reduce aggression in at least one study. However, for three of these drugs (valproate, carbamazepine and phenytoin) we found at least one other study where there was no significant improvement. Further research is needed to clarify which antiepileptic drugs are effective for whom. Such research is best carried out using carefully designed clinical trials. Such trials need to take account of the type of aggression displayed, the severity of the aggression, and any other disorders experienced by the participants.
Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.
Version: 2010

Alzheimers

What is Alzheimer's disease?

Alzheimer's disease is the most common cause of dementia, affecting around 496,000 people in the UK. The term 'dementia' describes a set of symptoms which can include loss of memory, mood changes, and problems with communication and reasoning. These symptoms occur when the brain is damaged by certain diseases and conditions, including Alzheimer's disease. This factsheet outlines the symptoms and risk factors for Alzheimer's disease, and describes what treatments are currently available.
Alzheimer's disease, first described by the German neurologist Alois Alzheimer, is a physical disease affecting the brain. During the course of the disease, protein 'plaques' and 'tangles' develop in the structure of the brain, leading to the death of brain cells. People with Alzheimer's also have a shortage of some important chemicals in their brain. These chemicals are involved with the transmission of messages within the brain.
Alzheimer's is a progressive disease, which means that gradually, over time, more parts of the brain are damaged. As this happens, the symptoms become more severe.

Symptoms

People in the early stages of Alzheimer's disease may experience lapses of memory and have problems finding the right words. As the disease progresses, they may:
  • become confused and frequently forget the names of people, places, appointments and recent events
  • experience mood swings, feel sad or angry, or scared and frustrated by their increasing memory loss
  • become more withdrawn, due either to a loss of confidence or to communication problems
  • have difficulty carrying out everyday activities - they may get muddled checking their change at the shops or become unsure how to work the TV remote.
As the disease progresses, people with Alzheimer's will need more support from those who care for them. Eventually, they will need help with all their daily activities.
While there are some common symptoms of Alzheimer's disease, it is important to remember that everyone is unique. No two people are likely to experience Alzheimer's disease in the same way.

chrones

Crohn's disease

Inflammatory bowel disease - Crohn's disease; Regional enteritis; Ileitis; Granulomatous ileocolitis; IBD- Crohn's disease
Last reviewed: April 16, 2012.
Crohn's disease is a form of inflammatory bowel disease (IBD). It usually affects the intestines, but may occur anywhere from the mouth to the end of the rectum (anus).

mindfull


just look


do not judge


what works


bbc thurs-dimentia care

when i grow old on thursday was showing 4 celebrities in 4 elderly care homes.
this is about the home where renowned news reporter  john simpson stayed for the programme.
john in his war correspondance days
but he found dimentia even harder to report on
it can happen to any of us
initially i got angry with him over a reply of "im not one of your patients"when asked if he knew where his room was-then tears as john got to know the residents inparticular an elderly lady who only rememberd her grown up kids as only small children and visibly upset john with her emotions and the fact the residents had to be locked in.


9.4 people out of 100.000 people have dimentia.

john honestly admitted he thought initially the residents lives where over an in effect just went into care to die.

but as the programme went on and with a brilliant care home managers input,john changed his opponion 
totally and admitted he now realised life is not over if you get dimentia-excellent programme and john simpson was   superb 


soapstars or boozestars

alcohol is everywherethe rovers in coronation street
the soaps have huge audiencesthe queen vic in eastenders

you can not escape alcoholhollyoakes

most soaps have a pub has a focul pointemmerdale

australianeighbours

all over the world-alcoholhome and away

who can forget sue ellendallas

six tips to help fight anxiety

meditation-mindfullness

water and tranquill views

exercise

laughter

having a pet

massage

25 relaxation/stress busters


1. Breathing Exercises

Take a moment to close your eyes and focus only on your breathing. Inhale slowly through your nose. Feel your diaphram move up into your ribcage and extend your belly outward as you inhale.Slowly push out your breathe as you exhale through your mouth. Feel the stress being breathed out of your body. It is no longer a part of you. Each breath should take 6 seconds to complete. Spend 3 seconds slowly inhaling through your nose and the other 3 seconds slowly exhaling through your mouth. Take 5-10 breaths like this and you’ll instantly feel more relaxed.
2. Drink Green Tea

 L-theanine is an amino acid found in tea plants. It also promotes relaxation and modifies the stimulating effects of the caffeine present in green tea.What does that mean exactly? Well L-theanine is a caffeine antagonist, meaning that it offsets the “hyper” effect of caffeine. That is why many people will have a “soothing” cup of tea and not a soothing cup of coffee. Green tea contains more theanine than the other teas. Try drinking Green Tea in the morning for a more gradual and calming wake-up boost.
3. Listen to Music

Sit back and relax to your favorite tunes. I love listening to classic rock. If you’re feeling nostalgic, put on something that will transport you to another place in time.Escape and think of nothing but the music. Try to play songs with a positive or uplifting message. Really it’s up to you. Just enjoy and have fun.
4. Take a Foot Bath

 Even if you don’t actually own a foot bath, you can fill up a large bowl with warm water and have a nice long soak.Put in some bath salts to give your feet a soft smooth feel. Add some flowers and lavender if you like to really add to the pampering quality of this experience. Put on some relaxing music and sit in a comfy chair while your soothe your cares with this moment of Zen.
5. Meditate on Gratitude

Take a few minutes to think about all the things you are grateful for. It could be as simple as feeling grateful for the food in your fridge or the way your puppy dog loves you. Take the time to appreciate all the gifts you have in life and how lucky you are to have them. When you show thanks for the good in your life, more good will attract itself to you.I spend 5 minutes every morning meditating on gratitude while I take a shower. It’s amazing how it always starts me off in such a great mood for the day.
6. Exercise

 Although Cardio Exercise like running or bike riding is more effective for relieving anxiety, weight lifting works well too. Really, just getting to the gym in general and burning off some steam is a wonderful way to feel better. Exercise doesn’t just provide a physical release. You’re also providing a mental release as well.By exercising, you counterbalance your negative thoughts with a positive feeling that you are taking steps towards improving your health. In effect, you cast aside worry and calm your mind with the natural high of working out.
7. Get Rid of the Clutter

Feng Shui is the art of creating a serene and relaxing home. Part of this study involves clearing the clutter from your environment. Clutter creates a sense of confusion and chaos. By cleaning up your home, you’re essentially clearing out the clutter from your mind.I feel so much better after doing just a little bit of housekeeping. I find it extremely relaxing to be in a clean home.I personally like getting rid of old clothes. If I haven’t worn them in a year, then they are wasteful clutter and can be given away.
8. Get a Massage

Take the time to treat yourself to a massage. You deserve it. A massage is not only relaxing, it also promotes healthy blood circulation and overall well-being.So go ahead, pamper yourself and feel good about it. Afterall, you’re not just doing something good for your mind. You’re also promoting a healthy body.
9. Go for a Walk

Nothing clears my head like a nice brisk walk. This is even better if you have beautiful backgrounds of nature to stroll through.Whenever I visit my extended family (they live in the country), I always make time for a 10 minute walk around their lake. As you walk, think about the rhythm of your body as you stride from one step to the next. It’s calming to focus on your breathing. Concentrate on each breath and empty your thoughts as you move along.
10. Aromatherapy

 Connecting certain fragrances to an emotionally uplifting situation will trigger a relaxation response. For example, try lighting some of your favorite incense or fill your home with the aroma of potpourri while you sit back and meditate your worries away. If those aromas are too strong for you, you can buy a less pungent smelling Glade air freshener. They just plug into any outlet and you can adjust the amount of fragrance that they release. I personally love using Glade plug-ins. Vanilla is my favorite. It’s a gentle scent that eases my mind.
11. Do Charity work

When you help others, you take the focus off yourself. Taking the focus off yourself is a big part of overcoming anxiety. You internalize less and simply live in the moment, taking pleasure in the world around you. Feel good about yourself for doing a positive thing for others.
12. Read

 Escape to another place and time. Live in someone elses shoes for a while and leave your troubles behind. Reading is actually another form of meditation.You leave your own thoughts and simply follow a scripted story. You’re essentially just going along for the ride and forgetting the world around you.I doesn’t matter what you read as long as it takes your thoughts elsewhere. This is a healthy break from things and will relieve anxiety within minutes.
13. Write out Your Thoughts

If you feel anxious or upset, write down your thoughts in a letter or diary. Sometimes, getting it all out on paper can feel like you’re getting out of your system. Don’t meditate on your negative thoughts. Simply spill them out in front of you. Feel the words leaving your your mind and making room for a more peaceful state of consciousness.
14. Take a Hot Bath

Let your muscles relax and sit in peace as the water calms and soothes you. Light some candles to create and even more tranquil environment. Play music to heighten the effect. There’s no rule that says you can’t turn your bathroom into a getaway spa if only for an hour.A bonus to this is buying special soaps, shaving creams or shampoos that will further your pampered “timeout”. Treat this as a special treat and really go all out.
15. Avoid Caffeine

This may sound like a bit of a tough one. I myself used to be a bit of a caffeine addict. And guess what? This was right around the same time my anxiety was at its worst. Sound like a coincidence? Not really.It’s easy to think that caffeine heightens you mood. Afterall, it’s a stimulant. But the crash that you get from a strong caffeine high is enough to bring on extreme anxiety and depression. So do youself a favor and start weening yourself off the caffeine train.I now start every morning with Green Tea and I eat a Granny Smith apple with my breakfast. Granny Smiths have been proven to actually wake you up just as much as a cup of coffee in the morning.
16. Stretch

 Every night before bed, take 5 minutes to stretch. Even if it’s just touching your toes, every bit helps.When you stretch, you relieve tension in your back and muscles. You’ll feel calmer and more relaxed instantly. This is a great way to prepare for a fantastic night’s sleep.If you prefer not to stretch right before bed, you can stretch before going to the gym. It helps circulation and prevents injury as well. This anxiety reliever takes just minutes and it really does wonders. As a side benefit, you’ll feel so much better physically. Since I started stretching, I’ve noticed significantly less muscle cramps and soreness after a workout. I can honestly say this technique has made me feel younger and more vibrant.
17. Eat Chocolate

Chocolate releases phenylethylamine in the brain. This so called “chocolate amphetamine” causes changes in blood pressure and blood-sugar levels leading to feelings of excitement and alertness. It works like amphetamines to increase mood and decrease depression. It’s been said that chocolate creates a feeling of “being in love”. I just like the taste myself. But if you needed some extra convincing to eat a piece of chocolate, know that it’s been proven to relieve anxiety.
18. Smile

 Smile and think of a time when you were most happy. Think of a funny moment, a family member you love or a time when you dared to try something new.Smile and think positively. Throw your negative thoughts out of your head and shield them off with a broad, life-loving smile.Share your smile with others. When you smile at someone, they can’t help but smile back at you. It’s part of human nature. Smile and bring joy into the lives of others. Smile and keep that smile for as long as you want to. The choice really is yours.
19. Guided Imagery

Guided Imagery is just a fancy way of saying visualize something that calms you. When you feel anxious or stressed, close your eyes. Picture a serene setting where you’d love to escape to.For me, my visualization involves laying in a beautiful grassy field under a wise, angular tree that stretches high above me. The sky is clear, sunny and ominous with breathtaking clouds. There are no bugs in my vison and the temperature is just perfect. A cool breeze engulfs my body in a refreshing whisper. I’m barefoot and the grass cushions my body with soft feathery support. I feel as light as air and my mind drifts off into sleepy bliss.Get the idea? It’s good to make your vision as detailed as possible. Become completely emersed in the escape and leave your anxiety out of the picture.
20. Sex

 I find it impossible to feel anxiety when I am completely carried away with lovemaking. Sex is healthy, good for the mind and body.It rejuvenates you and makes you feel completely alive. This anxiety reliever should not be overlooked. When you are completely swept away by the love of your partner, you forget about all of life’s stresses.Take a vacation from the anxiety in your mind. Instead, fill your head with the thoughts of love for another. Then indulge yourselves and think of nothing but the moment.
21. Repeat a Mantra

As the Law of Attraction States, thoughts are things. So when you think negatively, negative things will come into your life. Conversely, when you think positively, positive things will come into your life. Having a Mantra is a great way to control your thought pattern and relieve anxiety.When you’re feeling anxious, have a mantra or short prayer memorized that you can repeat in the moment. Everyone’s mantra will be different and tailored to their own anxiety but my mantra is:“I am a kind, loving person. I strive everyday to be the best I can be and all good things flow to me from the universe. Any worry or stress I have now will not make a difference in the longterm of my life. My life is good and will continue to be good. I am blessed for all that I have. The only opinion that matters in life is the opinion of myself. I love myself.”You can make your mantra whatever you choose. Make it something that speaks to your mentality and comforts your soul. Repeat your mantra in times of doubt and confusion. Hold firm that it is the truth. Your mantra will be your relaxing touchstone.
22. Eat Your Favorite Food

 I’m not telling you to go out and binge eat to get over your anxiety. Obviously that’s not a healthy strategy. However, you are allowed to indulge in your favorite comfort foods when things get particularly stressful.My comfort food is sushi. I like it when it’s super fresh and the rice is still slightly warm. I add a little hot Miso soup to the mix to really make me feel cozy. This is my relaxing meal. What’s yours?
23. Go by or Near Water

This could be as simple as laying by a pool or walking along the shoreline of your favorite beach. Water naturally has a calming effect on us.The calming effect is thought to be derived from the peaceful time when we were in out mother’s womb.Some other ideas for going near water could be visiting an aquarium, watching a beautiful lightening storm from your window, taking a walk around a lake or even simply taking a hot shower.
24. Grab Your Blankie

Your “Blankie” is symbolic. It can be anything that gives you comfort. My “Blankie” is my wedding ring. In times of high anxiety, sometimes I just look at my ring. I’ll think of my husband and the love we have for one another. I am instantly soothed.Maybe you have a lucky charm as your blankie? A necklace? A favorite sweatshirt? A great pair of jeans?Your blankie can be anything. Think of it when panic arises.
25. Use the Tactics Taught in Panic Away

 When anxiety and panic hit, they can hit Hard. that’s why I like to have step by step techniques that I can implement on the spot. Panic away is the best anxiety and panic attack program I have ever found in all my years of researching on the Internet. Use their tactics to not only relieve anxiety, but extinguish it PERMANENTLY from your life. You can start the Panic Away program right now