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Forensic mental health services in the United Kingdom and Ireland
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Pamela J Taylor, Jackie Craissati, Pamela J Taylor, Lindsay Thomson, Fred Browne, Harry Kennedy, Damian Mohan, John Basson, Adrian Grounds, John Gunn, Pete Snowden, Pamela J Taylor
If seclusion is anything other than a means of emergency containment, it is probably the reduction in general stimulation coupled with limited but individualized attention which is beneficial for some patients. When secluded, however, patients are usually deprived of everything except clothes and bedding, and, for these, especially nondescript, toughened articles may be provided. The walls are bare, lighting is generally under staff control and the only means of external distraction is staff observation and evaluation. This is close to sensory deprivation, which is well documented as having adverse effects. It is likely that some of the so-called prison psychoses, documented around the turn of the last century (Nitsche and Williams, 1913), were secondary to the sensory deprivation of solitary confinement, and Grassian (1983) documented the onset of similar, apparently environmentally dependent disorders in a latter day American prison. No one any longer expects seclusion to be therapeutic for the mentally normal, or even for people with neurotic or personality disorders. Insofar as there may be a small positive effect for people with schizophrenia, with a possible reduction in hallucinatory experiences (Harris, 1959), improvement in body image and boundary (Reitman and Cleveland, 1964), and lowered symptoms for those who prefer withdrawal as a coping strategy (Mehl and Cromwell, 1969), such advantages might be achieved with reduction of sensory input way short of the harshness of locked away isolation.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
11 Dietrich JE, Whedon GD, Shon E. Effects of immobilization upon various metabolic and physiologic functions of normal men. Am J Med 1948; 4: 3. 12 Hyatt KH, Kamenetsky LG, Smith WM. Extravascular dehydration as an etiologic factor in post-recumbency orthostasis. Aerosp Med 1969; 40: 644-650.13 Taylor HL, Henschel A, Brozek J et al. Effects of bedrest on cardiovascular function and work performance. JAppl Physiol 1949; 2: 223 . - 14 Bolin RH. Sensory deprivation: An overview. Nurs Forum 1974;13 : 241-258.15 Allman RM, Laprade CA, Noel LB et al. Pressure sores among hospitalized patients. Ann Intern Med 1986; 105: 337-342.16 Posner JB. Intracranial Metastases in Neurologic Complications of Cancer. Philadelphia, PA: FA Davis, 1995; pp. 77-110.17 Rozenthal JM. Nervous system complications in cancer in current therapy. In: Earlen P, Brain M, eds. Hematology/Oncology, Vol. 3. New York: BC Decker, 1998; pp. 314-319.18 Cairncross JG, Kim J-H, Posner JB. Radiation therapy for brain metastases. Ann Neurol 1980; 7: 529-541.19 Young DF, Posner JP, Chu F et al. Rapid course radiation therapy of cerebral metastases: Results and complications. Cancer 1974;4 : 1069-1076.20 Huang ME, Cifer DX, Marcus LK. Functional outcome following brain tumor and acute stroke: A comparative analysis. Arch Phys Med Rehabil 1998; 79: 1386-1390.O'Dell MS, Barr K, Spanier P, Warnick R. Functional outcome of inpatient rehabilitation in persons with brain tumors. Arch Phys Med Rehabil 1998; 79: 1530-1534.Sherer M, Meyers CA, Bergloff P. Efficacy of post acute brain injury rehabilitation for patients with primary malignant brain tumors. Cancer 2001; 92(4 Suppl): 1049-1052.23 Posner J. Neurologic Complications of Cancer. Philadelphia, PA: FA Davis, 1995: p. 118. 24 Cheville A. Rehabilitation of patients with advanced cancer. Cancer 2001; 92(4 Suppl): 1039-1048.25 Santiago-Palma J, Payne R. Palliative care and rehabilitation. Cancer 2001; 92(4 Suppl): 1049-1052.
Responses to stimuli in the ‘snoezelen’ room in unresponsive wakefulness or in minimally responsive state
Published in Brain Injury, 2022
Hiela Lehrer, Ilil Dayan, Keren Elkayam, Adi Kfir, Uri Bierman, Lilach Front, Amiram Catz, Elena Aidinoff
The care of patients with MCS and UWS customarily includes medical, physical, and stimulatory interventions (4,5). Sensory stimulation, which is also used to identify signs of awareness and music therapy have been used as part of the routine treatment of these patients (6). Sensory stimulation programs include unimodal stimulation, through any of the five senses, or multimodal stimulation (5,7–12). Some studies have suggested that sensory stimulation can stimulate affected neural networks, accelerate brain plasticity, and avoid sensory deprivation that could slow down the patient’s recovery (12). Some have emphasized the importance of stimuli, which are pleasant or familiar to the patient (1). Others have noted the importance of emotional, structured, and meaningful stimulation, and recommend avoiding overstimulation that may cause habituation (13). Irrespective of their effectiveness, sensory stimulations encourage friends and family to participate in treatment, and are recommended by the British Royal College of Physicians (1).
How Does Our Brain Generate Sexual Pleasure?
Published in International Journal of Sexual Health, 2021
Barry R. Komisaruk, Maria Cruz Rodriguez del Cerro
Extrapolating this principle, sensory stimulation is of fundamental importance for the function of the nervous system, and consequently for our existence. Kaufman (1960, p. 321) made the following insightful observation: “Most gratifications are in fact derived from stimulation, not the lack of it.…Freud said that the child sought this experience (nursing) again for the pleasurable state it produced, which it should be noted is a state of stimulation.” Under conditions of severe sensory deprivation, our brain generates neuronal activation in the form of hallucinations (Mason & Brady, 2009). We crave sensory stimulation. In the absence or perceived inadequate level of stimulation from our environment, physical or social, we seek it. An actual hug or its myriad physical stimulation equivalents (idiosyncratic) or social symbolic or metaphorical equivalents (e.g. phone call from a loved one) can provide the sensory stimulation or the related cognitive neuronal activity (excitation). If we can’t get that, we give it to ourselves.
Pediatric cochlear implantation: A quarter century in review
Published in Cochlear Implants International, 2019
Holly F.B. Teagle, Lisa R. Park, Kevin D. Brown, Carlton Zdanski, Harold C. Pillsbury
Cochlear implantation has become the standard of care for children who are born with or acquire significant hearing loss and receive limited benefit from hearing aids. In the relatively short history of the field, technology and evolving clinical practices have transformed the lives of thousands of children. Over the past 30 years, the knowledge base related to pediatric cochlear implantation has grown in breadth and depth. In the US, the first multi-channel cochlear implants (CI) for children were introduced via Food and Drug Administration (FDA) clinical trials in 1987. Pediatric cochlear implant use has expanded considerably since then, and clinical centers around the world have explored this treatment and its impact on children with a broad range of characteristics and histories (for review see Eisenberg, 2017). Cochlear implant clinical outcomes and related research have enabled insight into our understanding of the development of childhood neurocognitive processes, such as executive function (Beer, Kronenberger & Pisoni, 2011), and theory of mind (Macaulay & Ford, 2006). Further, findings have supplemented our understanding of the development of sensory systems and how restored sensory deprivation impacts many aspects of human development (Sharma, Nash & Dorman, 2009; Lazard, et.al, 2012; Kral & Sharma, 2012; Stropahl, Chen & Debener, 2017).