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الإرشاد الجمعي : التدخل والفنيات
يتحدث الكتاب عن الإرشاد الجمعي حيث يتناول الأساليب والمهارات القيادية في الارشاد الجمعي والمراحل والعملة والقوى العلاجية في الإرشاد الجمعي وأهمية الهدف في الإرشاد الجمعي وخطط لمجموعتك وخطط لجلستك والشروع في العمل مرحلة البدء وحالة البدءويتناول الكتاب ايضا أساليب أساسية في القيادة الجماعية والتركيز على المجموعة وأساليب أساسية المقاطعة والأغراء في الكلام واستخدام الجولات والثنائيات واستخدام التمارين في الإرشاد الجمعي.
BOOK
Pulsed field ablation in medicine: irreversible electroporation and electropermeabilization theory and applications
Focal ablation techniques are integral in the surgical intervention of diseased tissue, where it is necessary to minimize damage to the surrounding parenchyma and critical structures. Irreversible electroporation (IRE) and high-frequency IRE (H-FIRE), colloquially called pulsed-field ablation (PFA), utilize high-amplitude, low-energy pulsed electric fields (PEFs) to nonthermally ablate soft tissue. PEFs induce cell death through permeabilization of the cellular membrane, leading to loss of homeostasis. The unique nonthermal nature of PFA allows for selective cell death while minimally affecting surrounding proteinaceous structures, permitting treatment near sensitive anatomy where thermal ablation or surgical resection is contraindicated. Further, PFA is being used to treat tissue when tumor margins are not expected after surgical resection, termed margin accentuation. This review explores both the theoretical foundations of PFA, detailing how PEFs induce cell membrane destabilization and selective tissue ablation, the outcomes following treatment, and its clinical implications across oncology and cardiology.
Clinical experience is still progressing, but reports have demonstrated that PFA reduces complications often seen with thermal ablation techniques. Mounting oncology data also support that PFA produces a robust immune response that may prevent local recurrences and attenuate metastatic disease. Despite promising outcomes, challenges such as optimizing field delivery and addressing variations in tissue response require further investigation. Future directions include refining PFA protocols and expanding its application to other therapeutic areas like benign tissue hyperplasia and chronic bronchitis.
Journal Article
“Aristotle and the Zoon Politkon”: A Response to Abbate
Cheryl Abbate’s (2016) article in this journal makes the case that many nonhuman animals are “political” in the Aristotelian sense (Politics; Nicomachean Ethics). Moreover, Abbate rejects the claim that anthrôpos (Homo sapiens) is the most political of animals. While the aim to deflate often overexaggerated distinctions between us and other animals is laudable, in the following I suggest that Abbate’s evidence from cognitive ethology, and her application of evolutionary principles, fall short of demonstrating other animals to be as political as anthrôpos.
Journal Article
UK medical students’ self-reported knowledge and harm assessment of psychedelics and their application in clinical research: a cross-sectional study
ObjectiveTo capture UK medical students’ self-reported knowledge and harm assessment of psychedelics and to explore the factors associated with support for changing the legal status of psychedelics to facilitate further clinical research.DesignCross-sectional, anonymous online survey of UK medical students using a non-random sampling method.SettingUK medical schools recognised by the General Medical Council.Participants132 medical students who had spent an average of 3.8 years (SD=1.4; range: 1–6) in medical school.ResultsMost students (83%) reported that they were aware of psychedelic research and only four participants (3%) said that they were not interested in learning more about this type of research. Although medical students’ harm assessment of psychedelics closely aligned with that of experts, only 17% of students felt well-educated on psychedelic research. Teachings on psychedelics were only rarely encountered in their curriculum (psilocybin: 14.1 (SD=19.9), scale: 0 (never) to 100 (very often)). Time spent at medical schools was not associated with more knowledge about psychedelics (r=0.12, p=0.129). On average, this sample of medical students showed strong support for changing the legal status of psychedelics to facilitate further research into their potential clinical applications (psilocybin: 80.2 (SD=24.8), scale: 0 (strongly oppose) to 100 (strongly support)). Regression modelling indicated that greater knowledge of psychedelics (p<0.001), lower estimated harm scores (p<0.001), more time spent in medical school (p=0.024) and lower perceived effectiveness of non-pharmacological mental health treatments (p=0.044) were associated with greater support for legal status change.ConclusionsOur findings reveal a significant interest among UK medical students to learn more about psychedelic research and a strong support for further psychedelic research. Future studies are needed to examine how medical education could be refined to adequately prepare medical students for a changing healthcare landscape in which psychedelic-assisted therapy could soon be implemented in clinical practice.
Journal Article
Real-Time Temperature Rise Estimation during Irreversible Electroporation Treatment through State-Space Modeling
To evaluate the feasibility of real-time temperature monitoring during an electroporation-based therapy procedure, a data-driven state-space model was developed. Agar phantoms mimicking low conductivity (LC) and high conductivity (HC) tissues were tested under the influences of high (HV) and low (LV) applied voltages. Real-time changes in impedance, measured by Fourier Analysis SpecTroscopy (FAST) along with the known tissue conductivity and applied voltages, were used to train the model. A theoretical finite element model was used for external validation of the model, producing model fits of 95.8, 88.4, 90.7, and 93.7% at 4 mm and 93.2, 58.9, 90.0, and 90.1% at 10 mm for the HV-HC, LV-LC, HV-LC, and LV-HC groups, respectively. The proposed model suggests that real-time temperature monitoring may be achieved with good accuracy through the use of real-time impedance monitoring.
Journal Article
Power-Driven Electroporation Is Predictive of Treatment Outcomes in a Conductivity-Independent Manner
Objective: This study characterizes the effects of external conductivity on electroporation to develop methods to overcome potential patient-to-patient variability. Impact Statement: We demonstrate that constant power pulsed electric fields (PEFs) achieve consistent treatment outcomes despite variations in conductivity, thereby improving the predictability and efficacy of electroporation-based therapies. Introduction: Electropermeabilization-based therapies typically deliver static voltages between electrodes to induce cell permeabilization. However, tissue conductivity variations introduce uncertainty in treatment outcomes, as the tissue-specific electric field thresholds that induce electroporation also depend on the extracellular conductivity. Methods: Cell-laden hydrogels were fabricated with varying extracellular conductivities and treated with constant voltage PEFs. The voltages and currents were recorded to calculate the applied powers, and the reversible and irreversible electroporation thresholds were quantified using cell-impermeant and viability assays. Homogeneous and heterogeneous multi-tissue finite element models were employed to simulate the impact of tumor conductivity variability on the outcomes of reversible and irreversible electroporation for constant applied voltage, current, and power PEFs. Additionally, an in vivo murine pancreatic tumor model assessed the correlation between PEF delivery and treatment efficacy. Results: The In vitro experiments revealed that the electric field and current density thresholds were conductivity dependent, whereas the power density thresholds remained stable under variable conductivities. Computational modeling indicated that constant power PEFs best predicted tumor coverage in both homogeneous and heterogeneous multi-tissue models. Similarly, the in vivo tumor responses were also better predicted by applied power rather than voltage or current alone. Conclusions: Applying constant power PEFs enables consistent electroporation outcomes despite variations in conductivity.
Journal Article
How to build a game for empirical bioethics research: The case of ‘Tracing Tomorrow’
It is becoming increasingly clear that the field of empirical bioethics requires methodological innovations that can keep up with the scale and pace of contemporary research in health and medicine. With that in mind, we have recently argued for Design Bioethics—the use of purpose‐built, engineered research tools that allow researchers to investigate moral decision‐making in ways that are embodied and contextualized. In this paper, we outline the development, testing and implementation of a novel prototype tool in the Design Bioethics Workshop—with each step illustrated with collected data. Titled ‘Tracing Tomorrow’ (www.tracingtomorrow.org), the tool is a narrative game to investigate young people's values and preferences in the context of digital phenotyping for mental health. The process involved (1) Working with young people to discover, validate and define the morally relevant cases or problems, (2) Building and testing the game concept in collaboration with relevant groups and game developers, (3) Developing prototypes that were tested and iterated in partnership with groups of young people and game developers and (4) Disseminating the game to young people to collect data to investigate research questions. We argue that Design Bioethics yields tools that are relevant, representative and meaningful to target populations and provide improved data for bioethics analysis. Patient or Public Contribution In planning and conducting this study, we consulted with young people from a diverse range of backgrounds, including the NeurOX Young People's Advisory Group, the What Lies Ahead Junior Researchers Team, Censuswide youth participants and young people from the Livity Youth Network.
Journal Article
Tracing Tomorrow: young people’s preferences and values related to use of personal sensing to predict mental health, using a digital game methodology
BackgroundUse of personal sensing to predict mental health risk has sparked interest in adolescent psychiatry, offering a potential tool for targeted early intervention.ObjectivesWe investigated the preferences and values of UK adolescents with regard to use of digital sensing information, including social media and internet searching behaviour. We also investigated the impact of risk information on adolescents’ self-understanding.MethodsFollowing a Design Bioethics approach, we created and disseminated a purpose-built digital game (www.tracingtomorrow.org) that immersed the player-character in a fictional scenario in which they received a risk assessment for depression Data were collected through game choices across relevant scenarios, with decision-making supported through clickable information points.FindingsThe game was played by 7337 UK adolescents aged 16–18 years. Most participants were willing to personally communicate mental health risk information to their parents or best friend. The acceptability of school involvement in risk predictions based on digital traces was mixed, due mainly to privacy concerns. Most participants indicated that risk information could negatively impact their academic self-understanding. Participants overwhelmingly preferred individual face-to-face over digital options for support.ConclusionsThe potential of digital phenotyping in supporting early intervention in mental health can only be fulfilled if data are collected, communicated and actioned in ways that are trustworthy, relevant and acceptable to young people.Clinical implicationsTo minimise the risk of ethical harms in real-world applications of preventive psychiatric technologies, it is essential to investigate young people’s values and preferences as part of design and implementation processes.
Journal Article
On Minimizing Risk and Harm in the Use of Psychedelics
Objective This article outlines recommendations from 30 psychedelic researchers on how to create a better psychedelic safety net. Methods A survey of 30 psychedelic researchers asked them to identify key critical research gaps around psychedelic harm and safety. Results The critical research gaps identified by the authors included defining the main types of psychedelic harm, the predictors of those harms, and the most effective way to treat those harms. They also call for better support for those experiencing post‐psychedelic difficulties, including better online information, peer support groups, affordable therapy, and psychiatric consultation and medication. Finally, the authors call for better funding to create a psychedelic safety net, and suggest psychedelic philanthropists, investors and companies could commit 1% of their investment in psychedelics into supporting safety measures such as research and support services. Conclusions The authors identify several practical steps to create a better psychedelic safety net and call for more funding to psychedelic safety measures such as research and support services. Relevance to clinical practice The authors outline important gaps in our knowledge around the safety and risk profile of psychedelic medicines and identify practical steps forward for researchers and clinical practitioners to make this promising field safer. Highlights A consensus paper from 30 psychedelic harm researchers suggests steps to make psychedelic culture and industry safer, as rising numbers of people are taking psychedelic drugs for recreational and healing purposes. The authors identify critical research gaps to fill, including defining the main types of psychedelic harm, the predictors of those harms, and the most effective way to treat those harms. They also call for better support for those experiencing post‐psychedelic difficulties, including better online information, peer support groups, affordable therapy, and psychiatric consultation and medication. Finally, the authors call for better funding to create a psychedelic safety net, and suggest psychedelic philanthropists, investors and companies could commit 1% of their investment in psychedelics into supporting safety measures such as research and support services.
Journal Article
EEG Neurofeedback in the Treatment of Chronic Pain: A Case Series
Neurofeedback has been used to treat a variety of problems and symptoms related to central nervous system dysregulation, including chronic pain conditions. However, there is limited published work describing the application and efficacy of neurofeedback for chronic pain. This case series describes the outcomes of neurofeedback treatment of four patients with diverse diagnoses and pain symptoms. Although there was variability in patient response, all patients reported improvements in pain and other symptoms with treatment. The findings indicate that more research to (1) clarify the benefits of neurofeedback for different conditions and (2) identify the most effective protocols for individual patients is warranted.
Journal Article