Year: 2023

Categories : Mental HealthTags :

Generic Ketamine Performs Strongly for Treatment-resistant Depression

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Photo by Sydney Sims on Unsplash

A low-cost version of ketamine to treat severe depression has performed strongly in a placebo-controlled double-blind trial. Results published in the British Journal of Psychiatry showed that more than one in five participants achieved total remission from their symptoms after a month of bi-weekly injections, while a third had their symptoms improve by at least 50%.

“For people with treatment-resistant depression – so those who have not benefitted from different modes of talk-therapy, commonly prescribed antidepressants, or electroconvulsive therapy – 20 per cent remission is actually quite good,” lead researcher Professor Colleen Loo says.

“We found that in this trial, ketamine was clearly better than the placebo – with 20 per cent reporting they no longer had clinical depression compared with only 2 per cent in the placebo group. This is a huge and very obvious difference and brings definitive evidence to the field which only had past smaller trials that compared ketamine with placebo.”

How the trial worked

The researchers, led by UNSW Sydney and the affiliated Black Dog Institute, recruited 179 people with treatment-resistant depression. All were given an injection of either a generic form of ketamine that is already widely available in Australia as a drug for anaesthesia and sedation – or placebo. Participants received two injections a week in a clinic where they were monitored for around two hours while acute dissociative and sedative effects wore off, usually within the first hour. The treatment ran for a month and participants were asked to assess their mood at the end of the trial and one month later.

In this double-blind trial, a placebo was chosen that also causes sedation, to improve treatment masking. Midazolam is a sedative normally administered before a general anaesthetic, while in many previous studies the placebo was saline.

“Because there are no subjective effects from the saline, in previous studies it became obvious which people were receiving the ketamine and which people received placebo,” Prof Loo says.

“In using midazolam – which is not a treatment for depression, but does make you feel a bit woozy and out of it – you have much less chance of knowing whether you have received ketamine, which has similar acute effects.”

Other features of the recent trial that set it apart from past studies included accepting people into the trial who had previously received electroconvulsive therapy (ECT).

“People are recommended ECT treatment for their depression when all other treatments have been ineffective,” Prof. Loo says.

“Most studies exclude people who have had ECT because it is very hard for a new treatment to work where ECT has not.”

Another difference about this trial was that the drug was delivered subcutaneously (injected into the skin) rather than by drip, thus greatly reducing time and medical complexity. The study is also the largest in the world to date that compares generic ketamine with placebo in treating severe depression.

Much more affordable

Apart from the positive results, one of the standout benefits of using generic ketamine for treatment-resistant depression is that it is much cheaper than the patented S-ketamine nasal spray currently in use in Australia. Where S-ketamine costs about AUS$800 (R9 600) per dose, the generic ketamine is a mere fraction of that, costing as little as AUS$5 (R60), depending on the supplier and whether the hospital buys it wholesale. On top of the cost for the drug, patients need to pay for the medical care they receive to ensure their experience is safe – which at Black Dog Institute clinics, comes to AUS$350 (R4200) per session.

“With the S-ketamine nasal spray, you are out of pocket by about AUS$1200 for every treatment by the time you pay for the drug and the procedure, whereas for generic ketamine, you’re paying around AUS$300-350 for the treatment including the drug cost,” Prof Loo says.

She adds that for both S-ketamine and generic ketamine treatments, the positive effects often wear off after a few days to weeks, so ongoing treatment may be required, depending on someone’s clinical situation. But the prohibitive costs of the drug and procedure make this an unsustainable proposition for most.

The researchers will next be looking at larger trials of generic ketamine over longer periods, and refining the safety monitoring of treatment.

Source: University of New South Wales

Categories : Hospitals Surgeries & ProceduresTags :

Cancellation of Operations at the Charlotte Maxeke Johannesburg Academic Hospital

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The Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) would like to dismiss the misleading information shared by Mr Jack Bloom regarding cancelled operations.

CMJAH would like to put it on record that there were no “more than 50 elective cases cancelled due to the cold weather conditions”. The statement by Mr Bloom creates the impression that all elective cases were cancelled, which is not true.

There were 53 operations scheduled for Monday, 10 July 2023, and 26 cases were done, while only 15 were cancelled due to low temperatures at theatres and 12 were cancelled for reasons not related to low temperatures.

Out of the 15 cancelled cases, 3 were for Thoracic, 6 were for Trauma Orthopaedic, 2 were for Paeds Orthopaedic, 1 was for Paeds plastics, and 3 were for Ear, Nose, & Throat.

The problem of temperature control has been a challenge for the facility for years, but it became worse in the last two years due to the copper theft which took place during the period when the facility was evacuated for months after the fire incident. This affected the central heating system of the facility, which regulates the level of acceptable temperatures in the entire hospital, but mostly in the theatres.

To remedy the situation, the process of installing Schedule 40 pipes, which are less susceptible to theft as they do not have an attractive market value as copper does, has started. During the installation process, the theatres and intensive care units (ICU) were prioritised. From the date of appointment, 28 June 2023, to date, the contractor has completed the installation of schedule 40 pipes for Blocks 2, 3 and 4. The installation process at Block 5 has already started and the work is progressing well, ahead of schedule.

The water system is currently running, with close monitoring, at all three blocks where the schedule 40 pipes were installed to check for any possible leaks as the system has not been running for the past two years.

The facility would like to apologise to the public for any inconvenience this might have caused. The installation of the schedule 40 pipes is a necessary project that would address the issue of copper theft and the central heating system.

The facility would further like to assure the public that this matter is getting the urgency it deserves, and cancelled cases are being attended to.

News release issued by the Charlotte Maxeke Johannesburg Academic Hospital

Categories : Immune SystemTags :

Adaptive Immune Memory Resides in the Shape of DNA

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Scanning electron micrograph of a human T lymphocyte (also called a T cell) from the immune system of a healthy donor. Credit: NIAID

One of the adaptive immune system’s most intriguing abilities of the is its memory: upon first contact with antigens, it takes around two weeks to respond, but responses afterwards are much faster, as if the cells ‘remembered’ the antigen. But how is this memory attained? In a recent publication in Science Immunology, a team of researchers examined epigenetic and the structure of DNA for possible clues.

In their research paper, first author Anne Onrust-van Schoonhoven and colleagues compared the response of immune cells that had never been in contact with an antigen (called naïve cells) with cells previously exposed to antigen (memory cells) and sort of knew it. They focused on the differences in the epigenetic control of the cellular machinery and the nuclear architecture of the cells, two mechanisms that could explain the quick activation pattern of memory cells.

While all the cells in an individual have the same genetic information, different cell types access to different parts of the DNA. The term ‘epigenetics’ encompasses the mechanisms that dynamically control this access. The results revealed a particular epigenetic signature in memory T helper (TH)2 cells, resulting in the rapid activation of a crucial set of genes compared to naïve cells. These genes were much more accessible to the cellular machinery, in particular to a family of transcription factors called AP-1. Like athletes before a race, these genes had essentially been ‘warming up’ ever since the cell’s first contact with the antigen.

However, this epigenetic signature was just the tip of the iceberg. It is known that the position of the DNA in the nucleus is not random and reflects the cell’s activation state. The researchers found that, indeed, the 3D distribution of DNA in the nucleus is different between naïve and memory immune cells. Key genes for the early immune response are grouped together and under the influence of the same regulatory regions, called enhancers. Keeping with the racing metaphor, the genes are not only warmed-up, but also gathered together at the starting line.

Although most of the research has focused on healthy cells, the scientific team wondered whether any of the mechanisms found could, when altered, explain actual diseases in which the immune system plays an important role. To address this question, they analysed immune cells from chronic asthma patients and found that the circuits identified as key for an early and strong immune response were overactivated.

The epigenetic control of the immune system is a blossoming field and discoveries like the ones by Dr Stik and colleagues are setting the stage for the next generation of epigenetic drugs and treatments, targeting autoimmune diseases and cancer.

Source: Josep Carreras Leukaemia Research Institute

Categories : HospitalsTags :

Staff at Chatsworth Hospital Picket over Poor Working Conditions

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Staff, including nurses, at RK Khan Hospital in Chatsworth, Durban, picketed on Wednesday over poor working conditions at the facility. Photo: Tsoanelo Sefoloko

By Tsoanelo Sefoloko

Nurses, administration staff and general workers brought parts of RK Khan Hospital in Chatsworth, Durban, to a standstill for about an hour on Wednesday. They protested outside the hospital to highlight what they say are poor working conditions. 

Protesting nurses say they are forced to perform cleaning duties in addition to patient care because the hospital has not employed enough cleaners. Other workers complained of staff shortages in the administration and general units.

Workers say they met with the management in February. Union leaders had asked the facility to commit to resolving their complaints.

Nurse Zizakele Ndlovu said they were told by the union leaders that working conditions would improve. But nothing changed, she said.

“The conditions we work under at the hospital are not good. We end up having to work more hours, and we don’t get paid for overtime. Sometimes I even work as a clerk,” she said.

“The department treats us as if we don’t know our job, and we don’t deserve what we are asking for. We lost many workers to Covid; some retired and others resigned. Those vacancies have not been filled. Even at top management there are lots of vacancies and this leads to poor service.”

Chairperson at the hospital of the National Education, Health and Allied and Workers’ Union (NEHAWU) David Mpongose said they had engaged management and had been promised that the situation would improve.

“Our bosses are arrogant. They really don’t take us seriously. Each time they make empty promises, so we decided to protest for the provincial government to assist us,” said Mpongose.

Xolani Mnguni, a cleaner, said he earned R7800 per month under the hospital’s previous contractor, but now only earns R3000 under the current contractor. He also said he has to do jobs other than cleaning.

Hospital CEO Linda Sobekwa accepted the workers’ memorandum and signed it on behalf of the provincial health department. She promised to ensure that the department responded within ten days as requested.

Agiza Hlongwane, spokesperson for the KwaZulu-Natal Department of Health, said officials would consider the workers’ demands and respond to them.

Republished under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : Ophthalmology PaediatricsTags :

Atropine Eyedrops Fail to Slow Myopia Progression in US Children

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Photo by Jeffrey Riley on Unsplash

Use of low-dose atropine eyedrops (concentration 0.01%) was no better than placebo at slowing myopia progression and elongation of the eye among children treated for two years, according to a randomised controlled trial conducted in the US. The trial aimed to identify an effective way to manage this leading and increasingly common cause of refractive error, which can cause serious uncorrectable vision loss later in life. Results from the trial, published in JAMA Ophthalmology, contradict those from recent trials in East Asia.

The study was conducted by the Pediatric Eye Disease Investigator Group (PEDIG) and funded by the National Eye Institute (NEI).

“The overall mixed results on low-dose atropine show us we need more research. Would a different dose be more effective in a US population? Would combining atropine with other strategies have a synergistic effect? Could we develop other approaches to treatment or prevention based on a better understanding of what causes myopia progression?” said Michael F. Chiang, MD, director of the NEI, which is part of the National Institutes of Health.

Identifying an optimal approach for preventing high (advanced) myopia is urgently needed given the escalating prevalence of myopia overall and the risk of it progressing to high myopia. By 2030, it’s predicted that 39 million people in the U.S. will have myopia. By 2050, that number is expected to grow to 44 million in the U.S. and to 50% of the global population.

Much stronger concentrations of atropine eyedrops (0.5-1.0%) have long been used by pediatric eye doctors to slow myopia progression. While effective, such doses cause light sensitivity and blurry near vision while on the nightly eyedrops. Thus, there is interest in clinical studies assessing lower concentrations that have been shown to have fewer side effects.

“The absence of a treatment benefit in our US-based study, compared with East Asian studies, may reflect racial differences in atropine response. The study enrolled fewer Asian children, whose myopia progresses more quickly, and included Black children, whose myopia progresses less quickly compared with other races,” noted the study’s lead co-author, Michael X. Repka, M.D., professor of ophthalmology, Johns Hopkins University.

For the study, 187 children ages 5 to 12 years with low-to-moderate bilateral myopia were randomly assigned to use nightly atropine (0.01%) (125 children) or placebo (62 children) eyedrops for two years. Study participants, their parents, and the eye care providers were masked to the group assignments.

After the treatment period, and 6 months after treatment stopped, there were no significant differences between the groups in terms of changes in degree of myopia compared with baseline. Nor were there significant differences in axial length within the two groups when compared with baseline measurements.

“It’s possible that a different concentration of atropine is needed for US children to experience a benefit,” noted the study’s other lead co-author, Katherine K. Weise, OD, professor, University of Alabama at Birmingham. “Clinical researchers could evaluate new pharmaceuticals and special wavelengths of light in combination with optical strategies, like special glasses or contact lenses, to see what works in reducing the progression of myopia.”

Among children, myopia will stabilise in about half of children around age 16 years, and among an increasingly larger percentage as they get older. By their early twenties, about 10% of individuals with myopia will continue to grow more nearsighted, and by age 24 years that percentage is 4%.

“Vision scientists may help us figure out what’s different about the myopic eye, even among different races and ethnicities, to help create new treatment strategies,” she said. It will take a real convergence of eye research to solve the environmental, genetic, and structural mystery of myopia.”

Source: NIH/National Eye Institute

Categories : Ethics and Law Surgeries & ProceduresTags :

Plastic Surgeon Loses Medical Licence for Streaming Surgeries on TikTok

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Photo by Piron Guillaume on Unspalsh

A plastic surgeon in the US has had her medical licence permanently revoked for livestreaming parts of her surgeries and causing harm to her patients while doing so, according to the Washington Post.

Dr Katherine Grawe, who was also fined US$4500, streamed her operations with between 100 000 and 500 000 viewers at a time, speaking to the camera and on occasion answering viewers’ questions.

Three of her patients whose surgeries she had streamed experienced complications – infections, a perforated intestine and a loss of brain function – that required further medical care. She told the Washington Post that she did not believe that her livestreaming her surgeries had resulted in harm to her patients.

“Nobody wants a complication, and we never want things to go poorly, but any complications that happened with me were not because I was not paying attention,” Grawe said. “My whole goal in life is to give these people confidence and make them more beautiful. And, unfortunately, they suffered these complications, and I feel very sad for them. I would never want anything bad to happen to them.”

She specialised in cosmetic surgery for women’s breasts, as well as tummy tucks and other procedures, Grawe said. She is also being sued by the three patients who had complications. Since she started practising in 2010 with her Dr Roxy practice, she built up a social media following and eventually began livestreaming on TikTok in an effort to break down “this scary wall” between patients and doctors. Her patients all signed consent forms for their procedures to be livestreamed.

Grawe’s licence was suspended in November, and she pleaded with the board, saying that she would never livestream her surgeries again. The board was not moved by her appeal. “Dr Grawe’s social media was more important to her than the lives of the patients she treated,” the board stated.

The board had warned her in 2018 over patient confidentiality concerns in her livestreaming, and again in 2021.

Surgeries conducted in front of an audience are nothing new in medicine; medical students and clinicians alike observe procedures to learn and share knowledge. Some operating theatres are specially designed to host audiences behind windows overlooking the operating table. In the 21st century, it has become commonplace for educational livestreaming of surgeries, with considerable benefits for surgeons and increased anatomy knowledge scores.

There is also some evidence of risks to patients: one review found no increased risk of harm in urology, but this was not true for other surgical fields. Thirteen

Unlike in-person viewing of surgeries, data protection considerations must be employed as operating on a patient often may reveal identifiable information even if not livestreaming to a wide audience. Certain video conferencing platforms may not be secure, and recordings of the procedure may inadvertently be accessible to others, eg being stored on network drives, on the cloud without password protection and so on. There are secure communication apps that can be used to confidentially view and share patient data, such as TigerConnect, Medic Bleep, Forward Health and Siilo.

Categories : NeurologyTags :

Simple Oxygen Therapy can Boost Motor Skills Rehabilitation

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Photo by Samuel Ramos on Unsplash

Scientists studying the impact of oxygen supplementation on motor learning have found a promising treatment that could help patients who have experienced neurological trauma recover lost motor skills.

“A simple and easy to administer treatment with 100% oxygen can drastically improve human motor learning processes,” said Dr Marc Dalecki, now at the German University of Health and Sports in Berlin, senior author of the study in Frontiers in Neuroscience.

Repurposing a frontline treatment

Brains have a high oxygen demand, and hypoxia causes cognitive function to decrease, while in high-oxygen contexts it recovers, and the delivery of 100% oxygen is already used to help preserve as much of the brain as possible in patients with neurological injuries.

Motor learning is particularly dependent on oxygen-reliant information processing and memory functions: humans learn by trial and error, so the ability to remember and integrate information from previous trials is critical to efficient and effective motor learning. So could supplementing oxygen while learning a motor task help people learn faster and more effectively, offering hope for neurorehabilitation patients?

“I had this idea in my mind for almost a decade and promised myself to investigate it once I got my own research lab,” said Dalecki, who led the experimental research at the School of Kinesiology at Louisiana State University. “And with Zheng Wang, now Dr Zheng Wang, I had the perfect doctoral student to run it – a keen physiotherapist with a clinical background and stroke patient experience.”

Hand-eye coordination

Dalecki and Wang recruited 40 participants, 20 of whom received 100% oxygen at normobaric pressure and 20 of whom received medical air (21% oxygen) through a nasal cannula during the “adaptation” or learning phase of a task.

Dalecki and Wang selected a simple visuomotor task which involved drawing lines between different targets on a digital tablet with a stylus. The task was designed to test how quickly the participants were able to integrate information from the eye and hand, a crucial part of motor learning. After the task had been learned, the alignment of the cursor and the stylus was altered to see how effectively the participants adapted to the inconsistency, and then realigned for a final session to see how they adapted to the realignment.

“The oxygen treatment led to substantially faster and about 30% better learning in a typical visuomotor adaptation task,” said Wang, first author of the study and now at the Mayo Clinic in Rochester. “We also demonstrate that the participants were able to consolidate these improvements after the termination of the oxygen treatment.”

Oxygen improved learning by 30%

The scientists found that the participants who had received oxygen learned faster and performed better, improvements which extended into later sessions of the task when oxygen was not administered.

The oxygen group moved the pen more smoothly and more accurately, and when the cursor was adjusted in a deliberate attempt to throw them off, they adapted more quickly. They also made bigger mistakes when the alignment of the stylus was corrected, suggesting they had integrated the previous alignment more thoroughly than the other group.

Dalecki and Wang plan to investigate the long-term effects of this supplementation on learning and test the intervention with other motor learning tasks: it is possible that the relevant brain functions for this task in particular benefit from high ambient oxygen levels, leading to the observed advantages in performance. They also hope to bring the oxygen treatment to elderly and injured people, in the hope that it will help them re-learn motor skills.

“Our future plan is to investigate whether this treatment can also improve motor recovery processes following brain trauma,” said Dalecki. “Since it worked in the young healthy brain, we expect that the effects may even be larger in the neurologically impaired, more vulnerable brain.”

Source: Medical Xpress

Categories : Lab Tests and Imaging Medical Research & TechnologyTags :

Gravity-powered Biomedical Devices Pull Droplets Through a Maze

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Source: Unsplash CC0

Biomedical engineers at Duke University have developed an entirely new approach to building point-of-care diagnostic devices that only use gravity to transport, mix and otherwise manipulate the liquid droplets involved. The demonstration, in the journal Device, requires only commercially available materials and very little power to read results, making it a potentially attractive option for applications in low-resource settings.

“The elegance in this approach is all in its simplicity – you can use whatever tools you happen to have to make it work,” said Hamed Vahabi, a former postdoctoral researcher at Duke. “You could theoretically even just use a handsaw and cut the channels needed for the test into a piece of wood.”

The study was conducted in the laboratory of Ashutosh Chilkoti, the Alan L. Kaganov Distinguished Professor of Biomedical Engineering at Duke.

There is no shortage of need for simple, easy-to-use, point-of-care devices. Many demonstrations and commercial devices seek to make diagnoses or measure important biomarkers using only a few drops of liquid with as little power and expertise required as possible. Their goal is to improve health care for the billions of people living in low-resource settings far from traditional hospitals and trained clinicians.

All of these tests have the same basic requirements; they must move, mix and measure small droplets containing biological samples and the active ingredients that make measuring specific biomarkers possible. More expensive examples use tiny electrical pumps to drive these reactions. Others use the physics of liquids within microchannels (microfluidics) that create a sort of suction effect.

This is the first demonstration that only uses gravity. Each approach offers uniquely useful abilities as well as drawbacks.

“Most microfluidic devices need more than just capillary forces to operate,” Chilkoti said. “This approach is much simpler and also allows very complex fluid paths to be deigned and operated, which is not easy or cheap to do with microfluidics.”

The new gravity-driven approach relies on a set of nine commercially available surface coatings that can tweak the wettability and slipperiness at any given point on the device. That is, they can adjust how much droplets flatten down into pancakes or remain spherical while making it easier or harder for them to slide down an incline.

Used together in clever combinations, these surface coatings can create all the microfluidic elements needed in a point-of-care test. For example, if a given location is extremely slippery and a droplet is placed at an intersection where one side pulls liquid flat and the other pushes it into a ball, it will act like a pump and accelerate the droplet toward the former.

“We came up with many different elements to control the motion, interaction, timing and sequence of multiple droplets in the device,” Vahabi said. “All of these phenomena are well-known in the field, but nobody thought of using them to control the motion of droplets in a systematic way before.”

By combining these elements, the researchers created a prototype test to measure the levels of lactate dehydrogenase (LDH) in a sample of human serum. They carved channels within the test platform to create specific pathways for droplets to travel, each coated with a substance that stops the droplets from sticking along their journey. They also primed specific locations with dried reagents needed for the test, which are soaked up by droplets of simple buffer solution as they travel through.

The whole maze-like test is then capped with a lid containing a couple of holes where the sample and buffer solution are dripped in. Once loaded, the test is placed inside a box-like device with a handle that turns the test 90° to allow gravity to do its work. This device is also equipped with a simple LED and light detector that can quickly and easily detect the amount of blue, red, or green in the test results. This means that the researchers can tag three different biomarkers with different colours for various tests to measure.

In the case of this prototype LDH test, the biomarker is tagged with a blue molecule. A simple microcontroller measures how deep of a blue hue the test results become and how quickly it changes colour, which indicates the amount and concentration of LDH in the sample, to generate results.

“We could eventually also use a smart phone down the line to measure results, but that’s not something we explored in this specific paper,” said Jason Liu, a PhD candidate in the Chilkoti lab.

The demonstration provides a new approach for consideration when engineering inexpensive, low-power, point-of-care diagnostic devices. While the group plans to continue developing their idea, they also hope others will take notice and work on similar tests.

“While a well-designed microfluidic system can be fully automated and easy-to-use by passive means, the timing of discrete steps is usually programmed into the design of the device itself, making modifications to protocol more difficult,” added David Kinnamon, a PhD candidate in the Chilkoti group. “In this work, the user retains more control of the timing of steps while only modestly sacrificing ease-of-operation. Again, this is an advantage for more complex protocols.”

Source: Duke University

Categories : Mental HealthTags :

You’re Not Getting Sleepy: Six Myths and Misconceptions about Hypnosis

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Photo by Bruce Christianson on Unsplash

A strange mystic swings a pocket watch back and forth, repeating the phrase “You’re getting sleepy, very sleepy,” giving them absolute command over their subject. That’s not how hypnotism really works, but it’s the way it’s often depicted in pop culture. Even some clinicians and hypnosis educators propagate harmful myths about hypnosis.

Steven Jay Lynn, a professor of psychology at Binghamton University, State University of New York, is an expert on hypnosis who has made major contributions to the judicial system for his insight on the practice. Lynn believes that hypnosis has many useful clinical applications, but that myths keep it from being utilised to its full potential.

In a recent paper published in BJPsych Advances, he and his colleagues, Madeline Stein and Devin Terhune from the Institute of Psychiatry, Psychology & Neuroscience at King’s College, addressed a number of errors and misconceptions regarding the characteristics and practice of hypnosis. These are a few of the common myths that are widely believed and commonly circulated in popular culture.

Hypnotised people can’t resist suggestions

A deeply hypnotised person is believed to display “blind obedience,” going along automatically with whatever the hypnotist suggests. Yet individuals do not lose control over their actions during hypnosis – contrary to the notion the media reinforces that hypnosis is something done to you and that hypnosis can be used to control someone. In fact, people can resist and even oppose hypnotic suggestions. Their experience of control during hypnosis depends on their intentions and expectations regarding whether or not they retain voluntary control.

Hypnosis is a “special state”

Hypnosis is often mischaracterised as a “special state” where defence mechanisms are reduced and a “unique state of physical relaxation and conscious unconsciousness’ allows us to ‘enter our subconscious depths through hypnosis. However, people can respond to hypnotic suggestions even while they are alert and on an exercise bicycle. Aside from being a contradiction in terms, ‘conscious unconsciousness’ is an inaccurate depiction, because during hypnosis even the most highly suggestible individuals remain fully conscious and cognisant of their surroundings. It is more accurate to consider hypnosis as a set of procedures in which verbal suggestions are used to modulate awareness, perception and cognition, rather than to unnecessarily invoke ‘special states.’

People are either hypnotisable or they are not

People’s responsiveness to hypnosis can be relatively stable over time. Yet it is inaccurate to assume that people are either hypnotisable or not. People vary greatly in their responsiveness and often respond to some suggestions but not others. Still, most people are sufficiently hypnotisable to reap substantial benefits from therapeutic suggestions.

Responsiveness to suggestions reflects nothing more than compliance or faking

Suggested behaviours during hypnosis can seem so much a departure from the mundane that questions inevitably arise regarding whether hypnotic responses are genuine. However, neuroimaging studies reveal that the effects of hypnotic suggestions activate brain regions (eg, visual processing) consistent with suggested events (eg, hallucinating an object).These findings provide convincing evidence that hypnotic effects are represented at the neurophysiological level consistent with what people report.

Hypnotic methods require great skill to administer

One popular misconception is that of the mesmerist, or magician-like hypnotist with special powers of influence who can “hypnotise” anyone. This widespread idea is pure myth; in actuality, administering a hypnotic induction and specific suggestions do not require any special skills or abilities beyond those required for basic social interactions and administration of experimental or clinical procedures, such as the ability to establish rapport. However, hypnosis should be practiced only by professionals trained in the use of hypnosis.

Hypnotic age regression can retrieve accurate memories from the distant past

TV shows and movies often feature people being able to recall extremely accurate memories from a distant past life under hypnosis. But research suggests a contrary view. When researchers check the accuracy of memories of people who are “age regressed” to an earlier time (e.g., 10th century) against factual information from the suggested period, they find that the information is almost invariably incorrect. What people report is mostly consistent with information experimenters provide regarding their supposed past life experiences and identities (eg, different race, culture, sex). These findings imply that “recall” reflects participants’ expectancies, fantasies, and beliefs regarding personal characteristics and events during a given historical period.

Source: Binghamton University

Categories : Healthcare Politics and RegulationsTags :

High Court Ruling Paves the Way for Affordable Medical Scheme Benefits in South Africa

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Photo by Bill Oxford on Unsplash

The recent judgement by the Pretoria High Court in favour of the Board of Health Funders (BHF) carries substantial implications for medical schemes in South Africa. This follows BHF’s court application, which sought to compel the Council for Medical Schemes (CMS) to give a complete record, providing light on the LCBO’s decision-making process thus far.

The Court ordered the Minister of Health and the CMS to provide all of the papers listed in Rule 30A within 10 days of receiving the applicant’s notice of motion. The completion of this crucial milestone hinges on the provision of several documents, which we eagerly await.

This significant victory brings us closer to the ultimate goal of granting Medical Schemes exemptions to offer Low-Cost Benefit Options (LCBOs), which aim to provide greater access to affordable medical scheme benefits for low-income earners. The BHF’s success aligns with the mission of improving
healthcare accessibility and advancing progress towards universal healthcare coverage (UHC) in the country.

In the main application lodged on 8 August, the BHF requested the High Court to:

  • Lift the moratorium that prevents medical schemes from offering LCBOs when the Council for Medical Schemes (CMS) refuses to grant applications for exemptions to medical schemes, pending the finalisation of LCBO guidelines.
  • Declare the failure by the respondents to develop and implement LCBO guidelines as irrational, unreasonable, and unlawful, as per Section 6 of the Promotion of Administrative Justice Act and Section 1(c) of the Constitution.

The BHF represents the majority of the country’s medical schemes and healthcare funders, encompassing schemes and administrators serving nearly 4.5 million individuals.

According to Charlton Murove, the protracted process of crafting a framework for Low-Cost Benefit Options has taken over seven years and is yet to be finalised. Many policymakers have criticised medical schemes for their lack of affordability. The proposed solution aims to address these concerns and move closer to the principles of UHC, ensuring that the healthcare system grants everyone access to quality and affordable healthcare.

Murove stated, “This application seeks to drive a progressive agenda for the public and private healthcare sectors, fostering collaboration to alleviate the current challenges in our healthcare system. The Council for Medical Schemes and the Minister have pivotal roles in implementing policies that enhance access to healthcare. However, progress with LCBOs has been hindered by the CMS’s failure to take the necessary steps for reform, despite the publication of demarcation regulations in 2016.”

The BHF’s victory in the High Court represents a significant step forward in the pursuit of affordable and accessible medical scheme benefits. By addressing the current burdens faced by the state and ensuring that medical scheme premiums remain affordable, we can strive towards a healthcare system that benefits all South Africans.