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About ac97dmc

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  2. Please excuse my misanthropic parenthesis to the topic of charity in capitalism:
  3. Don't be a maverick! Be standard, tedious, even boring in your decisions! (quote Tony Zigmond AC approval course)
  4. Thank You! I am sure we can talk about the principles of beneficence, necessity and proportionality in all kinds of treatment and more so for treatments/interventions/therapies which are covert, coercive, confound effects or conflate damages. But could we stick to the topic Please, as it sounds more absorbing.......
  5. Copied from Wikipedia: Job burnout is characterized by exhaustion, cynicism, and reduced professional efficacy within the workplace.[1] More accurately defined, exhaustion refers to the depletion or draining of emotional resources, cynicism refers to the indifference or distant attitude of work, and reduced professional efficacy refers to the lack of satisfaction with past/present expectations.[2] Occupational burnout is typically and particularly found within the human service professions. Such jobs that naturally experience high amounts of occupational burnout include: social workers, nurses, teachers, lawyers, physicians, and police officers.[3] The reason why burnout is so prevalent in the human service professions is due in part to the high stress environment, emotional involvedness, and outcomes that are independent of the effort exerted by the working individual. The individuals who are most vulnerable to occupational burnout are ones who are strongly motivated, dedicated, and involved in the work in which they partake.[4] As work for these individuals is a source of importance in which they derive meaning in life, it is significant that they find meaning by achieving their goals and expectations. Therefore, the process of burning out is the realization and reflection of the failure to find meaning and growth in life.[4] Occupational burnout is associated with increased work experience, increased workload, absences and time missed from work, impaired empathy and cynical attitudes toward clientele, and thoughts of quitting.[5] ......good references.
  6. ......well! ECT certainly works better than CBT in severe depression!
  7. it was 25% for this patient.
  8. Not aware of the local guidelines, if any, but earlier this year I did get a chance to observe an ECT session at a tertiary care (multi-speciality) hospital in north India. Their inpatient psychiatric facility has about 50 patients, and possibly see a similar number in the outpatients every morning. Anyways, the ECT experience and the practicalities - - indication - young patient had a acute onset/rapid progressing illness of a hysterical psychotic/dissociative nature. family perplexed and looking for rapid resolution. - notes said pt. quite agitated at admission 1.5 weeks ago but had settled after 2 sessions of ECT in the last week (i observed 3rd session). oral meds (Olanzapine) continued. - plan to carry on 2-4 more sessions - takes place in one of the minor OT of the hospital. - manned by surgical staff, SR anaesthesia (post MD), Res Psychiatry (final year) - npo overnight etc, psych res well versed with pro and anti-convulsive effects of drugs - thiopentone sod & succinyl choline i/v - Odd practice of inflating the BP cuff wrapped around arm to over arterial systolic just prior to administration of ms relaxant! To be removed by psych reg as soon as 25 sec seizure observed on the arm. (i did notice that the toes twitch for same duration as the arm, just that the arm twitches a bit more frantically!) - sticky electrodes to B/L temporal position (didn't do any others) - similarly calibrated Thymatron - showed dose, coulombs and resistance ohms, No EEG output, visible seizure for >25 sec suggested treatment completion at that level (if okay, carry on same level. if not, rotate the Thyma dial to next treatment level) - recovery in surgical recovery unit i.e. all resus and suction equipment in vicinity - psych reg notes in psych file and on surgical recovery notes - patient back to psych ward after recovery - lunch/tea with family consent and mental health legislation - that's another story! a different context and different benchmarks! i assume everyone must have agreed in the spirits of health, family, well-being, responsibility and 'good for you' principles - joys of living in a collectivistic culture!
  9. .......i am sure you'll have come across this already.............quote Steve Jobs (MHRIP) - "Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary." and I also wish you "Stay hungry. Stay foolish".
  10. SAS usually have more study funds than STs/CTs etc. Find other interesting things e.g. health management, special interest sessions, psychotherapy, mental health law.....whatever you fancy. Being a permanent SAS you would be contributing to the Trust, so build your expertise accordingl.
  11. Option A: Get a job that you enjoy doing. Option B: Get a job that gets you the money to do things that you enjoy doing. I am equally comfortable with both.....“You have your way. I have my way. As for the right way, the correct way, and the only way, it does not exist.”
  12. "Common sense is the collection of prejudices acquired by age eighteen." - Albert Einstien
  13. surely it is better than the worst outcome for them - a life of ostracisation, neglect, dysfunction, vulnerability, becoming a target for the malevolent types in society, subject of ridicule from prejudiced youngsters, being depicted as zombies in movies etc etc... Therefore, I think, it is the society's problem and hence should we not be treating the society?? brings us back to the agents of social establishment argument... .....operating on the fringes of society and medicine, and that is quite literally - looking at the location of majority psychiatric hospitals, hostels etc.; .....responding to anxieties of the system - own anxiety, CPN's anxiety, social worker's anxiety, family's anxiety, GP's anxiety (and last of list patient's anxiety) using chemicals that cling to neurons and work in more ways than I can comprehend or the manufacturer understand.
  14. The uncinate fasciculus is a white matter tract in the human brain that connects parts of the limbic system such as the hippocampus and amygdala in the temporal lobe with frontal ones such as the orbitofrontal cortex.