title: Developing a recovery ethos for psychiatric  services in New Zealand

authors: Smith, Mark Andrew

subjects: Philosophy

abstract: This thesis is about developing a recovery ethos for psychiatric services in New Zealand. The argument of the thesis is that  currently a procedural ethos is dominant in psychiatric services in New Zealand, based on eclectic ways of facilitating recovery. Recovery from mental illness, is based on the criteria of symptom reduction and functioning and can be further refined to   have a client and professional perspective. Rather than using an eclectic approach to facilitating recovery the thesis argues for a pluralistic approach, where the virtues, the relationship with professionals, client narrative and the psychiatric community become central to decision making, rather than principle based procedures.
  The thesis is an argued, applied philosophical thesis in terms of methodology. The scope of the thesis is psychiatric services and the focus is broadly ethical decision making. There are three main divisions to the thesis. Part 1 is concerned with clarification of the main terms used in the thesis. This involves exploring the  historical background to the concept of recovery, clarifying the concept of recovery itself and providing an argument for giving greater prominence to the term mental illness over the term mental disorder. Part 2  identifies the main problem of the thesis, namely the procedural ethos, and the problems it is causing clients suffering from mental illness in facilitating their recovery. Part 3  shows what is involved in developing a recovery ethos for psychiatric services in New Zealand.

text: Developing a recovery ethos for psychiatric  services in New Zealand This thesis is about developing a recovery ethos for psychiatric services in New Zealand. The argument of the thesis is that  currently a procedural ethos is dominant in psychiatric services in New Zealand, based on eclectic ways of facilitating recovery. Recovery from mental illness, is based on the criteria of symptom reduction and functioning and can be further refined to   have a client and professional perspective. Rather than using an eclectic approach to facilitating recovery the thesis argues for a pluralistic approach, where the virtues, the relationship with professionals, client narrative and the psychiatric community become central to decision making, rather than principle based procedures.
  The thesis is an argued, applied philosophical thesis in terms of methodology. The scope of the thesis is psychiatric services and the focus is broadly ethical decision making. There are three main divisions to the thesis. Part 1 is concerned with clarification of the main terms used in the thesis. This involves exploring the  historical background to the concept of recovery, clarifying the concept of recovery itself and providing an argument for giving greater prominence to the term mental illness over the term mental disorder. Part 2  identifies the main problem of the thesis, namely the procedural ethos, and the problems it is causing clients suffering from mental illness in facilitating their recovery. Part 3  shows what is involved in developing a recovery ethos for psychiatric services in New Zealand.

year: 2007

title: EEG slow-wave coherence changes in propofol-induced general anesthesia: experiment and theory.

authors: Wang, Kaier

subjects: Turing–Hopf instabilities

abstract: The electroencephalogram (EEG) patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying brain state, and provide insight into the mechanisms of general anesthesia. Although cellular-based mechanisms have been proposed, the origin of the slow oscillation has not yet been unambiguously established. A recent theoretical study by Steyn-Ross et al. (2013) proposes that the slow oscillation is a network, rather than cellular phenomenon. Modeling anesthesia as a moderate reduction in gap-junction interneuronal coupling, they predict an unconscious state signposted by emergent low-frequency oscillations with chaotic dynamics in space and time. They suggest that anesthetic slow-waves arise from a competitive interaction between symmetry-breaking instabilities in space (Turing) and time (Hopf), modulated by gap-junction coupling strength. A significant prediction of their model is that EEG phase coherence will decrease as the cortex transits from Turing-Hopf balance (wake) to Hopf-dominated chaotic slow-waves (unconsciousness). Here, we investigate changes in phase coherence during induction of general anesthesia. After examining 128-channel EEG traces recorded from five volunteers undergoing propofol anesthesia, we report a significant drop in sub-delta band (0.05-1.5 Hz) slow-wave coherence between frontal, occipital, and frontal-occipital electrode pairs, with the most pronounced wake-vs.-unconscious coherence changes occurring at the frontal cortex.

text: EEG slow-wave coherence changes in propofol-induced general anesthesia: experiment and theory. The electroencephalogram (EEG) patterns recorded during general anesthetic-induced coma are closely similar to those seen during slow-wave sleep, the deepest stage of natural sleep; both states show patterns dominated by large amplitude slow waves. Slow oscillations are believed to be important for memory consolidation during natural sleep. Tracking the emergence of slow-wave oscillations during transition to unconsciousness may help us to identify drug-induced alterations of the underlying brain state, and provide insight into the mechanisms of general anesthesia. Although cellular-based mechanisms have been proposed, the origin of the slow oscillation has not yet been unambiguously established. A recent theoretical study by Steyn-Ross et al. (2013) proposes that the slow oscillation is a network, rather than cellular phenomenon. Modeling anesthesia as a moderate reduction in gap-junction interneuronal coupling, they predict an unconscious state signposted by emergent low-frequency oscillations with chaotic dynamics in space and time. They suggest that anesthetic slow-waves arise from a competitive interaction between symmetry-breaking instabilities in space (Turing) and time (Hopf), modulated by gap-junction coupling strength. A significant prediction of their model is that EEG phase coherence will decrease as the cortex transits from Turing-Hopf balance (wake) to Hopf-dominated chaotic slow-waves (unconsciousness). Here, we investigate changes in phase coherence during induction of general anesthesia. After examining 128-channel EEG traces recorded from five volunteers undergoing propofol anesthesia, we report a significant drop in sub-delta band (0.05-1.5 Hz) slow-wave coherence between frontal, occipital, and frontal-occipital electrode pairs, with the most pronounced wake-vs.-unconscious coherence changes occurring at the frontal cortex.

year: 2014

title: Disabled Māori and disability support options

authors: Nikora, Linda Waimarie

subjects: Maori

abstract: The goal of this research project was to provide information to enhance the development and implementation of an effective model of disability support service provision to Maori with disabilities. This was done by identifying and documenting the needs expressed by disabled Maori and their carers living in the Midland area, and by considering the experiences and observations of a key informant group. From our reading of the literature and the feedback we received from participants, a proposed model of disability support service provision has been proposed.

In five sections, this report begins by defining disability, and also by defining the act of caring for the disabled. Focussing on the Maori experience, obstacles, access to existing support services, cultural barriers, and health policies are discussed. In the second chapter, the research methodology is described, along with how the information was gathered. Following this is the third section which presents the opinions and reflections of Maori with disabilities. It concludes strategically with a view of the ideal community, suggesting possible resolutions, by exposing current flaws and inadequacies. Chapter four records the views and perspectives of key informant/whanau carers who participated in the project. They offer an insightful account of the often unrecognised side of the disability experience. Considering the preceding discussions, the final section develops a model of service provision for Maori with disabilities, and proposes this for effective service delivery.

text: Disabled Māori and disability support options The goal of this research project was to provide information to enhance the development and implementation of an effective model of disability support service provision to Maori with disabilities. This was done by identifying and documenting the needs expressed by disabled Maori and their carers living in the Midland area, and by considering the experiences and observations of a key informant group. From our reading of the literature and the feedback we received from participants, a proposed model of disability support service provision has been proposed.

In five sections, this report begins by defining disability, and also by defining the act of caring for the disabled. Focussing on the Maori experience, obstacles, access to existing support services, cultural barriers, and health policies are discussed. In the second chapter, the research methodology is described, along with how the information was gathered. Following this is the third section which presents the opinions and reflections of Maori with disabilities. It concludes strategically with a view of the ideal community, suggesting possible resolutions, by exposing current flaws and inadequacies. Chapter four records the views and perspectives of key informant/whanau carers who participated in the project. They offer an insightful account of the often unrecognised side of the disability experience. Considering the preceding discussions, the final section develops a model of service provision for Maori with disabilities, and proposes this for effective service delivery.

year: 2004-01-01