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| == '''[[Electroconvulsive therapy]]''' ==
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| ''by [[User:Gareth Leng|Gareth Leng]]
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| '''Electroconvulsive therapy''' ('''ECT''') is a [[psychiatry|psychiatric]] treatment that involves inducing a seizure in a patient by passing electricity through the brain. ECT was introduced for treating [[schizophrenia]] by the Italian neurologist [[Ugo Cerletti]] in the 1930s, and became a common treatment for mood disorders. While many psychiatrists believe that properly administered ECT is a safe and effective treatment for some conditions, some psychiatrists, former patients, [[antipsychiatry]] activists, and others warn that ECT might harm the patients' subsequent mental state.
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| ECT was a common treatment until the late 20th century, when better drug therapies became available for more conditions. It is now reserved for severe cases of clinical [[depression]] and [[bipolar disorder]] that do not respond to other treatments. When still in common use, ECT was sometimes abused by mental health professionals to punish or control uncooperative patients. Many people came to view ECT unfavorably after negative depictions of it in several books and films, and the treatment is still controversial.
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| In its early days, ECT was given without anaesthesia or muscle relaxants, and patients were often injured as a side effect of the seizure. Now, ECT is given under anaesthesia and with muscle relaxants. ECT without anaesthesia is known as "unmodified ECT", or "direct ECT", and is illegal in most countries.
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| ===Current use===
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| ECT is mainly used to treat severe depression, particularly if complicated by psychosis<ref>{{cite journal | author=Potter WZ, Rudorfer MV | title=Electroconvulsive therapy--a modern medical procedure | journal=N Engl J Med | volume=328 | issue=12 | pages=839–46 | year=1993 | id=PMID 8441434}}; see also [http://consensus.nih.gov/1985/1985ElectroconvulsiveTherapy051html.htm]</ref>. It is also used in cases of severe depression when antidepressant medication, psychotherapy, or both, have been ineffective, when medication cannot be taken, or when other treatments would be too slow (e.g. in a person with delusional depression and intense, unremitting suicidal tendencies). Specific indications include depression accompanied by a physical illness or pregnancy, which makes the usually preferred antidepressants dangerous to the patient or to a developing fetus. It is also sometimes used to treat the manic phase of bipolar disorder and the rare condition of catatonia. In the USA, modern use of ECT is generally limited to evidence-based indications. <ref>{{cite journal | author=Hermann R ''et al.'' | title=Diagnoses of patients treated with ECT: a comparison of evidence-based standards with reported use. | journal=Psychiatr Serv | volume=50 | pages=1059-65 | year=1999 | id=PMID 10445655}}</ref> Accurate statistics about the frequency, context and circumstances of ECT in the USA are hard to obtain, as few states have laws that require this information to be given to state authorities. <ref>{{cite news | first = Dennis | last = Cauchon | title = Controversy and Questions Shock Therapy: Patients often aren't informed of full danger | publisher = USA Today | date = 1995-12-06 }}</ref>
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| ''[[Electroconvulsive therapy|.... (read more)]]''
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Latest revision as of 09:19, 11 September 2020
The Mathare Valley slum near Nairobi, Kenya, in 2009.
Poverty is deprivation based on lack of material resources. The concept is value-based and political. Hence its definition, causes and remedies (and the possibility of remedies) are highly contentious.[1] The word poverty may also be used figuratively to indicate a lack, instead of material goods or money, of any kind of quality, as in a poverty of imagination.
Definitions
Primary and secondary poverty
The use of the terms primary and secondary poverty dates back to Seebohm Rowntree, who conducted the second British survey to calculate the extent of poverty. This was carried out in York and was published in 1899. He defined primary poverty as having insufficient income to “obtain the minimum necessaries for the maintenance of merely physical efficiency”. In secondary poverty, the income “would be sufficient for the maintenance of merely physical efficiency were it not that some portion of it is absorbed by some other expenditure.” Even with these rigorous criteria he found that 9.9% of the population was in primary poverty and a further 17.9% in secondary.[2]
Absolute and comparative poverty
More recent definitions tend to use the terms absolute and comparative poverty. Absolute is in line with Rowntree's primary poverty, but comparative poverty is usually expressed in terms of ability to play a part in the society in which a person lives. Comparative poverty will thus vary from one country to another.[3] The difficulty of definition is illustrated by the fact that a recession can actually reduce "poverty".
Causes of poverty
The causes of poverty most often considered are:
- Character defects
- An established “culture of poverty”, with low expectations handed down from one generation to another
- Unemployment
- Irregular employment, and/or low pay
- Position in the life cycle (see below) and household size
- Disability
- Structural inequality, both within countries and between countries. (R H Tawney: “What thoughtful rich people call the problem of poverty, thoughtful poor people call with equal justice a problem of riches”)[4]
As noted above, most of these, or the extent to which they can be, or should be changed, are matters of heated controversy.
- ↑ Alcock, P. Understanding poverty. Macmillan. 1997. ch 1.
- ↑ Harris, B. The origins of the British welfare state. Palgrave Macmillan. 2004. Also, Oxford Dictionary of National Biography.
- ↑ Alcock, Pt II
- ↑ Alcock, Preface to 1st edition and pt III.