Schwartz rounds Health Dictionary

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Schwartz Rounds: From 1 Different Sources

a system of regular meetings in which all health-care and related staff come together to discuss the social and emotional aspects of their work. The aim is to increase mutual support and appreciation, with ultimate benefits for the standard of care provided.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Bulimia

Bulimia means insatiable appetite of psychological origin. This eating-disorder symptom may be of psychological origin or the result of neurological disease – for example, a lesion of the HYPOTHALAMUS. Bulimia nervosa is linked to anorexia nervosa and is sometimes called the binge and purge syndrome. Bulimia nervosa is characterised by overpowering urges to eat large amounts of food, followed by induced vomiting or abuse of laxatives to avoid any gain in weight. Most of the victims are prone to being overweight and all have a morbid fear of obesity. They indulge in bouts of gross overeating, or ‘binge rounds’ as they describe them, to ‘?ll the empty space inside’. By their bizarre behaviour, most of them manage to maintain a normal weight. The condition is most common in women in their 20s; it is accompanied by irregular menstruation, often amounting to amenorrhoea (see MENSTRUATION). Although there are many similarities to anorexia nervosa, bulimia nervosa di?ers in that there is no attempt at deceit; sufferers freely admit to an eating disorder and feel distress about the symptoms that it produces. In spite of this, the response to treatment is, as in anorexia nervosa, far from satisfactory. (See EATING DISORDERS.)... bulimia

Delphi Technique

An iterative group judgment technique in which a central source forwards surveys or questionnaires to isolated, anonymous (to each other) participants whose responses are collated/summarized and recirculated to the participants in multiple rounds for further modification/critique, producing a final group response (sometimes statistical).... delphi technique

Patient-controlled Analgesia

A technique whereby a patient can deliver an analgesic substance (see ANALGESICS) in amounts related to the extent of the PAIN that he or she is suffering. For example, to combat post-operative pain, some hospitals use devices which allow patients to give themselves small intravenous amounts of opiates when they are needed. Pain is more e?ectively controlled if it is not allowed to reach a high level, a situation which tends to happen when patients receive analgesics only on ward drug rounds or when they ask the nursing sta? for them.... patient-controlled analgesia

Vulnerability

n. a position of relative disadvantage, which requires a person to trust and depend upon others. In a medical context, all patients are vulnerable to an extent and some may be particularly so owing to impaired decision-making abilities or social position. Any *exploitation of a vulnerable person is considered contrary to medical ethics. There is increasing interest in the vulnerabilities of health-care professionals themselves and the evidence for *compassion fatigue, *burnout, and *ethical erosion is strong. A number of commentators have argued that the most effective therapeutic relationships occur when both the patient and clinician are aware of their own humanity because they have each experienced being vulnerable. A number of specific services and support groups have been established to help doctors and other health-care professionals in difficulty (see Schwartz rounds). —vulnerable adj.... vulnerability

Rosewood

Aniba rosaeodora

FAMILY: Lauraceae

SYNONYMS: A. rosaeodora var. amazonica, bois de rose, Brazilian rosewood.

GENERAL DESCRIPTION: Medium-sized, tropical, evergreen tree with a reddish bark and heartwood, bearing yellow flowers. Used extensively for timber. NB: This is one of the trees that is being extensively felled in the clearing of the South American rainforests; the continual production of rosewood oil is consequently enviromentally damaging.

DISTRIBUTION: Native to the Amazon region; Brazil and Peru are the main producers.

OTHER SPECIES: There are several species of timber all known as rosewood; however, the essential oil is only distilled from the above species. French Guiana used to produce the cayenne rosewood (Ocotea caudata), which is superior in quality to the Peruvian or Brazilian type.

HERBAL/FOLK TRADITION: Used for building, carving and French cabinet making. Nowadays, most rosewood goes to Japan for the production of chopsticks.

ACTIONS: Mildly analgesic, anticonvulsant, antidepressant, antimicrobial, antiseptic, aphrodisiac, bactericidal, cellular stimulant, cephalic, deodorant, stimulant (immune system), tissue regenerator, tonic.

EXTRACTION: Essential oil by steam distillation of the wood chippings.

CHARACTERISTICS: Colourless to pale yellow liquid with a very sweet, woody-floral fragrance with a spicy hint. Blends well with most oils, especially citrus, woods and florals. It helps give body and rounds off sharp edges.

PRINCIPAL CONSTITUENTS: Linalol (90–97 per cent) in cayenne rosewood; in the Brazilian oil slightly less (80–90 per cent). Also cineol, terpineol, geraniol, citronella!, limonene, pinene, among others.

SAFETY DATA: Non-toxic, non-irritant, nonsensitizing.

AROMATHERAPY/HOME: USE

Skin care: Acne, dermatitis, scars, wounds, wrinkles and general skin care: sensitive, dry, dull, combination oily/dry, etc. ‘Although it does not have any dramatic curative power ... I find it very useful especially for skin care. It is very mild and safe to use.’.

Immune system: Colds, coughs, fever, infections, stimulates the immune system.

Nervous system: Frigidity, headaches, nausea, nervous tension and stress-related conditions.

OTHER USES: Once extensively used as a source of naturallinalol, now increasingly replaced by the synthetic form. Acetylated rosewood oil is used extensively in perfumery work – soaps, toiletries, cosmetics and perfumes. The oil is employed in most major food categories, alcoholic and soft drinks.... rosewood

Multiple Sclerosis

Or disseminated sclerosis. A brain and spinal cord disorder with damage to nerve sheaths. Nerve fibres are protected by a sheath known as myelin. Like an electrical flex, it insulates nerve structures. When damaged in different places, demyelination shows in the form of ‘plaques’ which interfere with transmission of nerve impulses and tissue nutrients. Symptoms depend upon the particular nerves affected. Not all cases present a consistent symptom picture but generally include: pins and needles in arms or legs, muscle cramps, weakness of legs, walking difficulties, “always tired”, urinary bladder problems, blurring of vision, clumsy movements, vertigo.

As described by the French physician, Charcot, over 100 years ago, it is not infectious. Symptom-free periods may extend for months, even years, though relapses may be triggered by emotional crises, physical injury, the contraceptive pill, influenza and other infections.

While the cause is unknown, some studies have revealed a link between the disorder and the distemper virus in dogs. Others have linked the disease with mercury toxicity from amalgam dental fillings shown to generate electromotive forces which propel ionised mercury particles into the body from teeth. A further link is persistent infective sinusitis.

MS is high in families that eat excessive meat fat, butter and dairy products but with too little vegetable fat (corn, Soya, sunflower oil, etc). Linoleic acid levels in the blood of MS patients are abnormally low, especially during relapse. (Schwartz JH, Bennett B. Int Arch Allergy Appl Immunol 45; 899-904, 1973) Evening Primrose oil is claimed to make up the deficiency. Ethnic peoples with a diet wholly of fish (Eskimos) seldom develop this disease.

While cure is not possible, herbal medicine may in some cases arrest deterioration. Treatment of severe nerve conditions should be supervised by neurologists and practitioners whose training prepares them to recognise serious illness and to integrate herbal and supplementary intervention safely into the treatment plan.

Nerve sheaths require calcium; herbs to increase its levels: Oats, Lobelia, Horsetail.

Evening Primrose oil makes good a deficiency of linoleic acid (Vitamin F) for efficient function of the brain.

Alternatives:– Tablets/capsules. Black Cohosh, Cramp bark, Prickly Ash, Skullcap, Ginseng.

Formula. Ginkgo 2; Prickly Ash 1; Black Cohosh; Ginger quarter. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Formula, for pain. Lobelia 1; Ladyslipper 1; Ginger quarter. Dose: Liquid Extracts: 30-60 drops. Tinctures: one 5ml teaspoon. Powders: 250-500mg.

Rue tea. Traditional remedy for MS.

Evening Primrose: 4 × 500mg capsules, daily.

Aromatherapy. Spinal massage. 10 drops oils of Rosemary and Lavender in egg-cup Almond oil (or other vegetable oil).

Purslane herb. A rich source of non-fish EPA – suitable for a vegetarian approach.

Diet. A diet rich in essential fatty acids appears to arrest deterioration. (MS Unit, Central Middlesex Hospital, London)

High protein, low fat with oily fish. Lecithin. Sugar-free. Gluten-free (see Gluten diet). Cholesterol- free (avoid milk and dairy products). Grape juice. Dandelion coffee. One tablespoon Cod Liver oil daily. Red beet. Vegetable oils (safflower, sunflower, etc). Avoid coffee and caffeine stimulants.

Vitamins. Dismutase enzymes (see entry). B-complex, B3, B6. Vitamin C, 500-1000mg. Vitamin E, 200iu. Daily. Some authorities advise maximum dosage of Vitamin B12.

Minerals. Dolomite. Manganese. Zinc.

Information. Multiple Sclerosis Society, 25 Effie Road, London SW6 1EE, UK. Send SAE. ... multiple sclerosis


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