Should we stop saying "epileptic"? A comparison of the effect of the terms "epileptic" and "person with epilepsy"

AbstractObjectiveThe advantages and disadvantages of using “epileptic” as a noun to describe someone with epilepsy have long been debated. Recent high-profile recommendations have stated that the term should not be used, including in English, as it perpetuates stigma. This decision was largely informed by a Brazilian Global Campaign Against Epilepsy study that reported experimental evidence indicating that, with students, the label evokes more negative attitudes than “person with epilepsy”. The generalizability of this effect to different countries/cultures, and thus the justification for the recommendations, has never been tested.MethodsWe replicated the Brazilian study in the UK, in English, while also addressing methodological limitations. It was powered to detect the effects reported by the Brazilian study, with 234 students completing a survey regarding epilepsy attitudes. Half were randomized to Group 1 and half to Group 2. In Group 1, patients were referred to as “people/person with epilepsy” within the attitudinal measures, while in Group 2 they were referred to as “epileptic/s”. Measures included translations of the questions used in the Brazilian study and the Attitudes and Beliefs about Living with Epilepsy scale. Participants' epilepsy familiarity and knowledge were also assessed.ResultsThe two groups were comparable in characteristics. A comparison of their responses to the attitude measures revealed no statistically significant or meaningful differences.ConclusionsIn this English replication, the word “epileptic” did not provoke more negative attitudes. This suggests that the effect reported by the Brazilian study might be culturally dependent. Methodological limitations to that study might also be relevant. Our results have implications for the global debate about how negative attitudes towards epilepsy might be addressed. Simply not saying “epileptic” may not promote the positive attitudes towards epilepsy that had been expected. To know how to best refer to those with epilepsy, evidence on the preferences of those actually living with epilepsy is needed

Tiagabine add‐on for drug‐resistant partial epilepsy

Cochrane Database Syst Rev. 2002;(3):CD001908. Tiagabine add-on for drug-resistant partial epilepsy. Pereira J, Marson AG, Hutton JL. Servico de Neurologia, Hospital de Santo Antonio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal. [email protected] Abstract BACKGROUND: Epilepsy is a common neurological condition, affecting almost 0.5 to 1 per cent of the population. Nearly 30 per cent of people with epilepsy are resistant to currently available drugs. Tiagabine is one of the newer antiepileptic drugs and its effects as an adjunct (add-on) to standard drugs is assessed in this review. OBJECTIVES: To evaluate the effects of add-on treatment with tiagabine upon seizures, side effects, cognition and quality of life for people with drug-resistant localization related seizures. SEARCH STRATEGY: We searched the Cochrane Epilepsy Group trials register (28 March 2002), the Cochrane Controlled Trials Register (Cochrane Library Issue 1, 2002), MEDLINE (1966 to November 2001). In addition, we contacted Sanofi~Synthelabo (makers of tiagabine) and experts in the field to seek any unpublished or ongoing studies. SELECTION CRITERIA: Randomized placebo controlled add-on trials of people of any age with localization related seizures, in which an adequate method of concealment of randomization was used. The studies could be double, single or unblinded and be of parallel or crossover design. They had to have a minimum treatment period of eight weeks. DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials for inclusion and extracted data. Any disagreements were resolved by discussion. Outcomes investigated included 50 per cent or greater reduction in seizure frequency; treatment withdrawal; side effects; effects on cognition and quality of life. The primary analyses were by intention-to-treat. Worst case and best case analyses were also calculated for seizure outcomes. Dose response was evaluated in regression models. MAIN RESULTS: Three parallel group and two crossover group trials were included. The overall relative risk (RR) for a 50 per cent or greater reduction in seizure frequency (tiagabine versus placebo) was 3.16(95% confidence interval 1.97 to 5.07). Due to differences in response rates among trials, regression models were unable to provide reliable estimates of responses to individual doses. The RR for treatment withdrawal was 1.81(95% confidence interval 1.25 to 2.62). The 99% confidence interval for the following side effects: dizziness; fatigue; nervousness and tremor did not include unity, indicating that they are significantly associated with tiagabine. For cognitive and quality of life outcomes the limited data available suggested that there were no significant effects on cognition and mood and adjustment. REVIEWER'S CONCLUSIONS: Tiagabine reduces seizures frequency but is associated with some side effects when used as an add-on for people with drug-resistant localization related seizures. PMID: 12137637 [PubMed - indexed for MEDLINE] Publication Types, MeSH Terms, SubstancesPublication Types: Review MeSH Terms: Anticonvulsants/adverse effects Anticonvulsants/therapeutic use* Drug Resistance Epilepsies, Partial/drug therapy* Humans Nipecotic Acids/adverse effects Nipecotic Acids/therapeutic use* Substances: Anticonvulsants Nipecotic Acids tiagabine LinkOut - more resource

Durkheim’s Greatest Blunder

In describing fatalism in Suicide, Durkheim executes two blunders. The first can be categorized in errors of commission while the second should be included in errors of omission. In the error of commission area, he hypothesizes two platforms for existence of fatalistic suicide. Without employing theory-embedded data, he contends that infertility is a catalyst for fatalistic suicidal. Later, he asserts that slavery is fertile soil for fatalistic suicide. Although there is suicidal data in these two arenas, a closer inspection demonstrates that these are not characteristics of fatalistic suicide. For errors of omission, he failed to systematically observe two social factors for which data was available during his time of study. Poverty and poor health existed in a social environment which is best described by Durkheim’s vision of fatalistic suicide. He missed observing and collecting the available data to lend support for the empirical existence of fatalistic suicide. These four social factors are discussed

A Vineyard in a Law Clinic: The Practical Application of a Therapeutic Jurisprudence Philosophy in a UK Law Clinic

In late 2015, the British Red Cross approached the lead author. It was increasingly evident that given the austerity-driven political agenda of the UK government in cutting public funding to advisory services, coupled with the developing refugee crisis and its impact on countries and regions, refugees in many parts of the UK were in need of legal and non-legal assistance. University law clinics were an obvious source of support given their objectives of developing students’ understanding and engagement with community groups. As our law clinic, based in the Helena Kennedy Centre for International Justice (HKC), was developed specifically to address the needs of groups such as refugees, and given the ground-breaking work of Wexler and Winick (in Therapeutic Jurisprudence) and Gould and Perlin (on its application to clinical legal education) on providing a therapeutically positive experience for users, we sought to base our clinic aligned with Therapeutic Jurisprudence (TJ) principles. This paper examines the development and practical operation of a law clinic from a TJ perspective

Multi-wavelength visibility measurements of the red giant R Doradus

We present visibility measurements of the nearby Mira-like star R Doradus taken over a wide range of wavelengths (650--990 nm). The observations were made using MAPPIT (Masked APerture-Plane Interference Telescope), an interferometer operating at the 3.9-m Anglo-Australian Telescope. We used a slit to mask the telescope aperture and prism to disperse the interference pattern in wavelength. We observed in R Dor strong decreases in visibility within the TiO absorption bands. The results are in general agreement with theory but differ in detail, suggesting that further work is needed to refine the theoretical models.Comment: 8 pages; SPIE Conf. 4006 "Interferometry in Optical Astronomy

Domino Michael-aldol annulations for the stereocontrolled synthesis of bicyclo[3.3.1]nonane and bicyclo[3.2.1]octane derivatives

Domino Michael-aldol annulation of cycloalkane-1,3-diones with enals affords a general route to 6-hydroxybicyclo[3.3.1]nonane-2,9-diones and 2-hydroxybicyclo[3.2.1]octane-6,8-diones, notably in one-pot procedures under convenient conditions. The annulation is shown to be compatible with one or more substituents at six positions of the bicyclo[3.3.1]nonane-2,9-dione scaffold. In some cases, the relative configuration of the product can be controlled by the appropriate choice of solvent, base and temperature for the annulation. In contrast to the chair–chair conformations usually adopted, the bicyclo compounds derived from 2,4,4-trimethylcyclohexane-1,3-dione possessed boat-chair conformations. Oxidation of the annulation products gave the corresponding bicyclo triketones

Model-based sensitivity analysis for outcome reporting bias in the meta analysis of benefit and harm outcomes

Outcome reporting bias occurs when outcomes in research studies are selectively reported, the selection being influenced by the study results. For benefit outcomes, we have shown how risk assessments using the Outcome Reporting Bias in Trials risk classification scale can be used to calculate bias-adjusted treatment effect estimates. This paper presents a new and simpler version of the benefits method, and shows how it can be extended to cover the partial reporting and non-reporting of harm outcomes. Our motivating example is a Cochrane systematic review of 12 studies of Topiramate add-on therapy for drug-resistant partial epilepsy. Bias adjustments for partially reported or unreported outcomes suggest that the review has overestimated the benefits and underestimated the harms of the test treatment