About Dr Shock
Posts by Walter van den Broek:
This courageous young woman Rachel Star (on twitter) tells about the negative an positive aspects of ECT, a year later. Very impressive story from someone who has been there and is getting along.
A kind of sequel of a video at the beginning of this year just before and during the course of ECT on this blog: Hands on experience on video about electroshock therapy.
A young woman and her mother on this video about ECT. Very impressive story about having ECT, side-effects and how she improved on ECT.
Publish or Perish sums up the urgency for scientists to publish in top journals. Scientists work in competitive environments in which publishing is essential to their careers, reputation and research funding. Journal editors and peer reviewers are the ones to judge the manuscripts for quality and safeguard the interests of the readership of the journal.
The editors have different tasks to preform in order to prevent conflict of interests and ensuring the readers of read worthy publications. The first one being the prevention of duplicate publications. This is also called the “Ingelfinger rule”. But what constitutes duplication?
Duplicate publication can take a number of forms, ranging from splitting data into the “minimal publishable unit” (MPU) described by Bill Parmley, to publishing in symposia or proceedings as well as in journals, to submitting virtually the same data to two or more journals in the same language. The issue is receiving heightened attention recently due to the dissemination of new research findings in virtually complete form on the internet and in non-subscription medical periodicals shortly following oral presentations.
If one of the people in the audience publishes a post on his blog with the results and probably a video of the event, can this be called a duplication? Should editors not only use PubMed or Medline to exclude duplication of manuscripts but also Google? Editors of the Annals of Neurology also use Google Scholar to screen for prior use of key phrases or paragraphs in a submission under review.
Another important task is the peer review. The use of peers to evaluate the work of fellow scientists is assumed to raise the quality of the submitted manuscript. There has been some research to the effect of peer review but from a systematic review of nine studies it was concluded that
Editorial peer review, although widely used, is largely untested and its effects are uncertain.
There is always an ongoing discussion whether peer review should be double blind. The argument being that if editors know the identity of the authors they may be more vulnerable to biases. Unfortunately a large study done by seven medical journals indicated that neither authors nor editors found significant difference in the quality of comments when both reviewers and authors were blinded. Moreover, reviewers could identify at least one of the authors on about 40% of the papers.
Last but not least is the disclosure of financial conflicts of interests. A new disclosure form that has been adopted by all journals that are members of the International Committee of Medical Journal Editors (ICMJE) was recently published in all journals member of the ICMJE. They encourage all other journals to adopt this form.
I tried the form, it’s very exhaustive, they ask authors to disclose four types of interest. In the accompanying editorial very convenient information about the time frames for the possible conflicts of interests are defined.
Disclosure of four types of interests:
- the commercial entities that provided support for the work reported in the manuscript (life span of the research)
- commercial entities having a possible interest in the area of the manuscript (36 months before submission time frame)
- similar financial association involving their spouse or their children under 18 years
- non financial associations that may be relevant to the submitted manuscript.
There’s also a completed sample form.
Drazen, J., Van Der Weyden, M., Sahni, P., Rosenberg, J., Marusic, A., Laine, C., Kotzin, S., Horton, R., Hebert, P., Haug, C., Godlee, F., Frizelle, F., de Leeuw, P., & DeAngelis, C. (2009). Uniform Format for Disclosure of Competing Interests in ICMJE Journals New England Journal of Medicine DOI: 10.1056/nejme0909052
Jefferson, T. (2002). Effects of Editorial Peer Review: A Systematic Review JAMA: The Journal of the American Medical Association, 287 (21), 2784-2786 DOI: 10.1001/jama.287.21.2784
DeMaria, A. (2003). Duplicate publication: insights into the essence of a medical journal Journal of the American College of Cardiology, 41 (3), 516-517 DOI: 10.1016/S0735-1097(03)00002-0
In a recent online publication about another form of brain stimulation in treatment resistant depression showed promising results. The electrodes are placed on the brain instead of in the brain as with Deep Brain Stimulation (DBS):
A new neurosurgical procedure may prove helpful for patients with treatment-resistant depression. Bilateral epidural prefrontal cortical stimulation (EpCS) was found generally safe and provided significant improvement of depressive symptoms in a small group of patients
The location for Brain Stimulation in EpCS targets electrical stimulation to the anterior frontal poles and the lateral prefrontal cortex. Two different places on both hemispheres, resulting in four separate paddle leads which are connected to two small generators surgically implanted in the upper chest area of the patient. The leads are placed through a burr hole in the skull but above the dura mater and thus remain separated from the underlying cortical region by the arachnoid space. ECS is more direct than transcranial magnetic stimulation (TMS) and or vagus nerve stimulation (VNS) and potentially safer than deep brain stimulation (DBS), which involves passing the electrodes through brain tissue.
Of five patients three reached remission. Overall after seven months, the average improvement was 54.9 percent based on the Hamilton Rating Scare for Depression.
Advantages according to the team:
“Cortical stimulation has several advantages provided that it shows efficacy in treating depression. It is reversible, non-destructive and potentially safer than other forms of invasive brain stimulation since the stimulating paddles don’t come in direct contact with the brain.”
Deep Brain Stimulation is a neuro-surgical procedure used in mostly neurological and psychiatric disorders. In this procedure electrodes are placed in the brain, not on the brain. A great step forward, patients don’t have to be awake during the procedure. This post has a video showing a clear description of the old and new procedure for deep brain stimulation (DBS).
Deep Brain Stimulation (DBS) is mostly used for Parkinson’s Disease. DBS for Obsessive Compulsive Disorder and Depression is just starting to be used. It is unclear how DBS works for Parkinson’s Disease.
It is used for treatment resistant depression. When other treatments fail, deep-brain stimulation (DBS) may offer hope to patients suffering from chronic and severe depression. In recent published research about deep brain stimulation for treatment resistant depression, six months after surgery, 60% of patients were responders and 35% met criteria for remission, benefits that were largely maintained at 12 months.
The most appropriate target, optimal stimulation parameters, and long-term effects and efficacy remain uncertain. The targets for deep brain stimulation in treatment resistant depression has 6 options available.
Nahas, Z., Anderson, B., Borckardt, J., Arana, A., George, M., Reeves, S., & Takacs, I. (2009). Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression Biological Psychiatry DOI: 10.1016/j.biopsych.2009.08.021
Social Capital Divide between the young and the elderly
A social capital divide between elderly and younger people on the Internet is best described as a difference in resources that are created in social networks and relationships between people and that have a certain value or benefit for individuals participating in this network/relationships. Social capital can be created with participating in online networks such as Myspace. Age differences in online networking in Myspace exist. Elderly have fewer friends and mostly from age groups outside their own age compared to teenagers. Older people tend to be more careful and selective when choosing their friends on MySpace and only want to add to their friends list people that they know very well. Older people tend to represent themselves in a more formal and official way compared to teenagers. They tend to use less videos, music and the exchange of comments.
Learning computer skills
Another problem with the elderly can be a lack of computer skills. Despite the advantages of the Internet and advances in electronic communication, utilization of the Internet among older adults is relatively low. Improving computer skills of the elderly can enable them to access health information on the Internet and improve their health knowledge. Courses such as e-health programs can enhance the use of computers for improving knowledge of online health information. Your never to old to learn computer skills. Moreover, experience with technology, and not age, accounts for observed lifelong changes in digital literacy skills. Digital literacy improves with training in all age groups, the adult group improved significantly more than the younger participants.
A digital generational divide is developing
This indicates a gap between digitally literate users and the elderly. This has disadvantages especially for the elderly since new media and co-creation have the potential to increase individuals’ flexibility, expand opportunities for information retrieval and learning, and compensate for functional limitations such as reduced mobility, vision, hearing, and cognitive abilities. If you want to read more about how the elderly differ from the young in Internet use please read The Generational Divide in Internet use. Why this is important? These points should be kept in mind when creating a social network for the elderly. If you want to speed up the process of changing the elderly peoples’ use of computers and online communities think about these findings, and don’t forget about the In home care services that can help elderly be introduced to these new trends in the world, while also taking well care of their health
Henry Markram says the mysteries of the mind can be solved — soon. Mental illness, memory, perception: they’re made of neurons and electric signals, and he plans to find them with a supercomputer that models all the brain’s 100,000,000,000,000 synapses.
How can we make a brain from a super computer. In this video a theory is explained how to do it. All based on the universe. The universe has evolved to “see” itself in the brain. Interesting theory. The design secret of the brain is diversity. And other important principles to understand the brain.
Creating a good patient experience is the focus and mandate of the Chief Experience Officer at the Cleveland Clinic, one of the world’s top-rated medical facilities. In this talk, Bridget Duffy shows the theory and practice of patient-centered care, including an on-stage demo of an innovative patient gown.
Gel Health will explore the patient experience in a variety of organizations and companies. They’re having a conference Gel Health. It will be held on Thursday and Friday, October 22 and 23, 2009 at Scandinavia House, Park Avenue and 38th Street in Manhattan, New York. Check out their website for further information
- a growth of nearly 9 million Americans creating blogs between 2004 and 2005, a shift from 1.1 million to 10 million bloggers.
- In 2006, 39% of all U.S. Internet users were accessing blogs.
- More than 70% of blogs were classified as personal journals, recording the individuals’ daily life events, thoughts, and feelings.
- Bloggers present accurate portrayals of themselves in their blogs.
- Studies indicate that young adults and adolescents are more likely than other age groups to create blogs.
- Men are somewhat more likely than women to create blogs.
- Age and sex are said to have little bearing on the content of blogs.
- Men create blogs for information purposes, whereas women are more interested in self-expression.
- Females are said to be more likely to present themselves as ‘‘friendly,’’ whereas males present themselves more often as ‘‘confident.’’
- Motivations for blogging: self-expression, networking, identity management, preserve and augment existing relationships.
But how is that on MySpace?
Results suggest that MySpace blogs are not dissimilar from other forms of blogging because they provide an important outlet for emotion and self-expression.
Fullwood, C., Sheehan, N., & Nicholls, W. (2009). Blog Function Revisited: A Content Analysis of MySpace Blogs CyberPsychology & Behavior DOI: 10.1089/cpb.2009.0138
MEDLIB’s ’spooktacular’ round 1.7 is up at Alisha764’s Blog: A solo medical librarian’s ramblings. A blog carnival of “excellent posts in the field of medical librarianship.”
Amongst excellent topics also the long awaited PubMed redesign was previewed this week. Another highly anticipated preview was Google Wave. You could argue both previews have brought to light issues with the new products; however, each holds promise for changing the medical library field. The discussion about H1N1 flu and vaccination is another topic leading to several excellent posts.
Check it out at Alisha764’s Blog: A solo medical librarian’s ramblings