title: Measures of Dosage for Spinal-Cord Electrical Stimulation: Review and Proposal

authors: Single, Peter S.

abstract: This manuscript proposes an electrical definition of therapeutic dose for spinal cord systems used for the treatment of chronic pain, analogous to the pharmacological definition. Dose-response relationships are fundamental to pharmacology, radiotherapy, and other treatments, but have never been properly established for neuromodulation. This manuscript offers a robust measure of dose, pre-requisite to establishing a reliable and repeatable dose-response relationship. The new definition, enabled by the system transresistance obtained from measurement of evoked action potentials, recognizes the mechanism of action of spinal cord stimulation (SCS), and should improve acceptance of the therapy as compared to pharmacological treatments which are currently used more frequently for the treatment of chronic pain. The new definition suggests methods for personalization and standardization of the dose in SCS, and is potentially generalizable to all neuromodulation therapies in which nervous tissue is excited including sacral nerve stimulation (SNS), vagal nerve stimulation (VNS), and deep-brain stimulation (DBS). Formulas are provided, and applied using patient data. Powerful conclusions are drawn from application of the new measure.

text: Measures of Dosage for Spinal-Cord Electrical Stimulation: Review and Proposal This manuscript proposes an electrical definition of therapeutic dose for spinal cord systems used for the treatment of chronic pain, analogous to the pharmacological definition. Dose-response relationships are fundamental to pharmacology, radiotherapy, and other treatments, but have never been properly established for neuromodulation. This manuscript offers a robust measure of dose, pre-requisite to establishing a reliable and repeatable dose-response relationship. The new definition, enabled by the system transresistance obtained from measurement of evoked action potentials, recognizes the mechanism of action of spinal cord stimulation (SCS), and should improve acceptance of the therapy as compared to pharmacological treatments which are currently used more frequently for the treatment of chronic pain. The new definition suggests methods for personalization and standardization of the dose in SCS, and is potentially generalizable to all neuromodulation therapies in which nervous tissue is excited including sacral nerve stimulation (SNS), vagal nerve stimulation (VNS), and deep-brain stimulation (DBS). Formulas are provided, and applied using patient data. Powerful conclusions are drawn from application of the new measure.

year: 2023

title: Christian discipleship and interfaith engagement

authors: Douglas, Pratt

subjects: Christians

abstract: Ever since the famous 1910 Edinburgh World Mission conference Christian individuals and the Christian Church have been increasingly challenged to relate in new ways to people of other faiths. Reflecting on the relationship between Christian discipleship and interfaith engagement this article addresses three questions. Can a biblical basis for such engagement be discerned? What is the impact of the "Great Commission" at the end of Matthew's gospel (28:18-20)? How might a new understanding of mission and discipleship relate to concerns about interreligious dialogue? In other words, can Christian discipleship actively enable positive interfaith relations and engagement with adherents of other faiths? In conclusion, the article points to a number of considerations that might indeed contribute to just such an understanding of discipleship.

text: Christian discipleship and interfaith engagement Ever since the famous 1910 Edinburgh World Mission conference Christian individuals and the Christian Church have been increasingly challenged to relate in new ways to people of other faiths. Reflecting on the relationship between Christian discipleship and interfaith engagement this article addresses three questions. Can a biblical basis for such engagement be discerned? What is the impact of the "Great Commission" at the end of Matthew's gospel (28:18-20)? How might a new understanding of mission and discipleship relate to concerns about interreligious dialogue? In other words, can Christian discipleship actively enable positive interfaith relations and engagement with adherents of other faiths? In conclusion, the article points to a number of considerations that might indeed contribute to just such an understanding of discipleship.

year: 2009

title: Māori and Dementia: Māori health professionals’ perceptions of dementia, support offered and suggested improvements

authors: Townsend, Marie

subjects: dementia

abstract: E iti noa ana, nā te aroha (It is the giving that counts and not the size of the gift) The purpose of this thesis was to investigate the perceptions of Māori health professionals about Māori elders and dementia. The study aimed to describe: Māori health care providers’ understandings of dementia; traditional versus contemporary understandings; how cultural beliefs affect experience; how Māori cope with dementia; key issues relevant to Māori people with dementia; and how services can be improved to meet the needs of aged Māori. The usefulness and possible cultural adaptation of the biomedical model has been explored within the context of a Māori worldview and the perceptions of participants. Semi-structured and in-depth interviews were conducted with eight mental health professionals and one caregiver. The information gathered at interviews was recorded within verbatim transcripts, which were written and returned to the participants for feedback. A qualitative data analysis was carried out on the approved transcripts. The main findings suggest that Māori health professionals recognise that many Māori perceive dementia both from a traditional cultural perspective, associated with spirituality as well as a holistic understanding of wellness. Key issues identified by participants were: that there is fear associated with mental health facilities; the exclusion of cultural values and understandings from service providers is detrimental to the wellbeing of Māori elders; Māori do not understand the symptoms typically associated with dementia as an illness; there is a need for information and education within an appropriate frame for whānau; disjointed and multiple service providers inhibits Māori from accessing facilities offered; and that there is a real need for further services. It was considered important that mental health services are culturally appropriate, show respect for Māori values; are coordinated and sensitive; encourage and continue the development of a Māori mental health workforce; and further develop kaupapa Māori services for Māori elders. The main implication of this research is that further investigation into Māori and dementia is required. Recommendations are made with a view towards better addressing some of the mental health needs of Māori elders.

text: Māori and Dementia: Māori health professionals’ perceptions of dementia, support offered and suggested improvements E iti noa ana, nā te aroha (It is the giving that counts and not the size of the gift) The purpose of this thesis was to investigate the perceptions of Māori health professionals about Māori elders and dementia. The study aimed to describe: Māori health care providers’ understandings of dementia; traditional versus contemporary understandings; how cultural beliefs affect experience; how Māori cope with dementia; key issues relevant to Māori people with dementia; and how services can be improved to meet the needs of aged Māori. The usefulness and possible cultural adaptation of the biomedical model has been explored within the context of a Māori worldview and the perceptions of participants. Semi-structured and in-depth interviews were conducted with eight mental health professionals and one caregiver. The information gathered at interviews was recorded within verbatim transcripts, which were written and returned to the participants for feedback. A qualitative data analysis was carried out on the approved transcripts. The main findings suggest that Māori health professionals recognise that many Māori perceive dementia both from a traditional cultural perspective, associated with spirituality as well as a holistic understanding of wellness. Key issues identified by participants were: that there is fear associated with mental health facilities; the exclusion of cultural values and understandings from service providers is detrimental to the wellbeing of Māori elders; Māori do not understand the symptoms typically associated with dementia as an illness; there is a need for information and education within an appropriate frame for whānau; disjointed and multiple service providers inhibits Māori from accessing facilities offered; and that there is a real need for further services. It was considered important that mental health services are culturally appropriate, show respect for Māori values; are coordinated and sensitive; encourage and continue the development of a Māori mental health workforce; and further develop kaupapa Māori services for Māori elders. The main implication of this research is that further investigation into Māori and dementia is required. Recommendations are made with a view towards better addressing some of the mental health needs of Māori elders.

year: 2011