Forgot to add that the SMART test has been found to be more accurate in recent research than other methods: http://taylorandfrancis.metapress.com/app/home/contribution.asp?wasp=573da12d6ae74cb58abf690f9e40a544&referrer=parent&backto=issue,3,10;journal,89,110;linkingpublicationresults,1:100653,1
The Sensory Modality Assessment Rehabilitation Technique A tool for assessment and treatment of patients with severe brain injury in a vegetative state Brain Injury, Volume 11, Number 10 / October 1, 1997 H. Gill Thwaites Abstract: An analysis of data from 30 subjects diagnosed as being in vegetative state VS on admission to a specialized Brain Injury Unit was carried out. Rancho Level ratings given by the referring physician were compared with those of the units occupational therapists OT . Scores were obtained from the Sensory Modality Assessment Technique SMART and the Western Neuro Sensory Stimulation Profile WNSSP on admission and at 2 monthly intervals and converted to Rancho Level ratings to allow comparison. The comparison of the assessments within one week of admission showed agreement between Rancho Level scores derived from the WNSSP and those from the referring physicians. The Rancho scores derived from the SMART were significantly different from the physicians and the WNSSP (P<0.01) , with the SMART rating the patient at a higher level of cognitive functioning. Although all 30 subjects were diagnosed as VS on admission, the SMART assessed six subjects not to be in VS within 2 to 4 months from admission and this was established at least 6 weeks earlier than the comparable conclusion from the WNSSP in four subjects. This initial validation study shows that the SMART is a useful tool in discriminating awareness and more sensitive at detecting the higher cognitive functions than both the WNSPP and referring physician, thus indicating the need to conduct a specifically designed prospective study to validate and further evaluate the SMART. On Mon, 21 Mar 2005 13:38:17 -0500, Larry C. Lyons <[EMAIL PROTECTED]> wrote: > If you look at those studies that reported up to a 43% misdiagnosis, > those occured within the first few months after the diagnosis, NOT > after 15 years. > > Moreover the studies that reported suchy a high rate were from the > early 90's and late 80's. Since then the definitions have been > tightened up considerably. Additionally there are new diagnostic tools > such as SMART, > (http://www.ingentaconnect.com/search/expand?pub=infobike://tandf/tbin/2000/00000014/00000004/art00002), > that have vastly improved diagnosis. > > larry > > > On Mon, 21 Mar 2005 11:11:27 -0700, Dana <[EMAIL PROTECTED]> wrote: > > do you have a link to anything about this -- > > > > Moreover the imaging that has been done has shown irretrievable damage > > to areas such as the cerebral cortex and the corpus callosum to such > > an extent that only the lower maintenance functions within the brain > > are left. In other words the higher levels of the brain (the cerebral > > cortext and the mammalian brain) are atrophied or destroyed, leaving > > the reptilian brain that controls breathing and other functions. In > > other words what is left is a breathing corpse. Nothing of what made > > Terri Shiavo is left. > > > > I am quite willing to believe that there is such a thing as PVS and it > > is irreversible. What I am concerned about is that 43% rate of > > misdiagnosis. > > > > Dana > > > > On Mon, 21 Mar 2005 13:04:50 -0500, Larry C. Lyons > > <[EMAIL PROTECTED]> wrote: > > > Are these people trained neurologists? What I read is impressionistic > > > non-medical reports. CNA's are not trained in diagnosis. Moreover > > > every diagnostic criteria I've read cautions the clinician not to > > > interpret, but rather report on the actual behaviors. The propaganda > > > you've reported on is pure interpretation > > > -- > > > http://bmj.bmjjournals.com/cgi/content/full/319/7213/841 > > > > > > Observation versus interpretation > > > When obtaining evidence from other observers or from written material, > > > it is vital that the examiner distinguishes clearly between observed > > > behaviour and interpretation of the behaviour. Thus, family or staff > > > should be asked directly what behaviour was actually observed. The > > > examiner may then ask for their interpretations, which may show > > > further observational evidence. However, interpretations made by > > > observers may well be biased and the assessor should make her or his > > > own interpretation. > > > -- > > > > > > I've found in working in neuro rehab, that the CNA's are nothing more > > > than glorified cleaners and feeders. The training they receive in > > > medical diagnosis, and neuological assessment is nill. In other words > > > their testimony is worthless from a medical diagnostic point of view. > > > > > > Moreover the imaging that has been done has shown irretrievable damage > > > to areas such as the cerebral cortex and the corpus callosum to such > > > an extent that only the lower maintenance functions within the brain > > > are left. In other words the higher levels of the brain (the cerebral > > > cortext and the mammalian brain) are atrophied or destroyed, leaving > > > the reptilian brain that controls breathing and other functions. In > > > other words what is left is a breathing corpse. Nothing of what made > > > Terri Shiavo is left. > > > > > > here are relevant articles from various journals I've found that discuss > > > PVS: > > > http://jnnp.bmjjournals.com/cgi/content/full/73/4/355 > > > http://bmj.bmjjournals.com/cgi/content/full/319/7213/841 > > > http://bmj.bmjjournals.com/cgi/content/full/321/7255/196 > > > http://bmj.bmjjournals.com/cgi/content/full/321/7255/196 > > > http://pmj.bmjjournals.com/cgi/content/full/75/884/321 > > > http://neurology.org/cgi/content/abstract/58/3/349 > > > http://archinte.ama-assn.org/cgi/content/abstract/151/5/930 > > > > > > http://scholar.google.com/scholar?as_q=&num=100&btnG=Search+Scholar&as_epq=Persistent+Vegetative+State&as_oq=&as_eq=&as_occt=any&as_sauthors=&as_publication=&as_ylo=1995&as_yhi=2006&hl=en&lr=&safe=off > > > > > > larry > > > > > > On Mon, 21 Mar 2005 09:38:52 -0800, Sam <[EMAIL PROTECTED]> wrote: > > > > Does this help at all? It's an affidavit from last year. > > > > > > > > http://www.hospicepatients.org/heidi-law-09-03-affidavit-re-terri-schiavo-michael.html > > > > > > > > At least three times during any shift where I took care of Terri, I > > > > made sure to give Terri a wet washcloth filled with ice chips, to keep > > > > her mouth moistened. I personally saw her swallow the ice water and > > > > never saw her gag. > > > > "[Another CNA] and I frequently put orange juice or apple juice in her > > > > washcloth to give her something nice to taste, which made her happy. > > > > On three or four occasions I personally fed Terri small mouthfuls of > > > > Jello, which she was able to swallow and enjoyed immensely." > > > > > > > > 15. During the time I cared for Terri, she formed words. I have heard > > > > her say "mommy" from time to time, and "momma," and she also said > > > > "help me" a number of times. She would frequently make noises like > > > > she was trying to talk. Other staff members talked about her > > > > verbalizations. > > > > > > > > > > > > On Mon, 21 Mar 2005 11:44:59 -0500, Bill Wheatley wrote: > > > > > Nah none of what he called her matters. Dana points out he has not > > > > > acted as her husband for a long time and that somehow equates that to > > > > > being a reason for him lose his rights as her guardian. > > > > > > > > > > 1) It does not matter, the piece of paper is still the piece of paper > > > > > and no matter how you behave until you're divorced it is still the way > > > > > it is. If i died today my wife would still be able to decide what > > > > > happens to my body even though we haven't seen each other in 3 years. > > > > > 2) If i was in his position i don't think i could sit by her bed alone > > > > > the whole time i was going through it. I would probably find someone > > > > > else too. And i can see how i might get resentful over time at all the > > > > > stuff thats going on and say something out of anger. > > > > > > > > > > And I don't know if a feeding tube falls under HEROIC EFFORT either. > > > > > But it should go along with a DNR if you don't want to be hooked up to > > > > > any machines then you shouldn't be hooked up. I can't imagine how > > > > > horrible a way to die starving is but until our country allows > > > > > physican assisted suicide its the only way possible (Being removed > > > > > from machines keeping you alive). And myself personally i would not > > > > > want to be like that. I would want to given a lethal dose of morphine > > > > > or precluding that i would want to be disconnected from the machines. > > > > > Be it a feeding machine or a ventilator. I mean people including my gf > > > > > have said its a horrible way to die and I would say dieing itself is > > > > > horrible and i have come close to drowning before so i know how sucky > > > > > it must be to have your ventilator pulled and not be able to breath. > > > > > Sure you die faster but is it a less painful death? Nobody can say. > > > > > > > > > > Just because they are her parents does not make them right. And just > > > > > because the hubby has made some mistakes doesn't mean he did not know > > > > > her wishes. > > > > > > > > > > But what shouldn't be happening is the federal government jumping into > > > > > a case that has been upheld all the way to the FL supreme court. The > > > > > US Supreme court would not hear the case maybe because it is such a > > > > > firestorm but maybe because they think there was no need and that the > > > > > merits spoke for themselves. > > > > > > > > > > I think this is the point bluntly: > > > > > We as humans should be able to do whatever we want with our bodies. > > > > > It's not the f'ing govt's business. It is certainly not these > > > > > buttheads business who keep jumping in and protesting because somehow > > > > > in their heads they draw a parallel to abortion. It really should be > > > > > private. So it is really the case of 2 parents who can't accept the > > > > > fact that their little girl is gone. And even above that they can't > > > > > respect her ADULT wishes of never wanting that to happen to her. > > > > > > > > > > BTW guys if i ever die and for some reason my living will was not > > > > > executed (because the govt started second guessing us to if we really > > > > > meant it) please point them to this thread so they can see i want to > > > > > have my plug pulled if i can't speak for myself. *shrugs* > > > > > > > > > > Sucky case and its sucky that the republicans are taking this on > > > > > because they think the democrats have a weak case. And also because > > > > > they want to screw with bill nelson. Anyone who plays politics with > > > > > this shit should be shot. Any republican any democrat whoever tries to > > > > > use this crap as a political goldmine needs to be drug out on their > > > > > ass. > > > > > > > > > > But that's not what will happen people who believe its murder etc etc > > > > > will rally around the republicans and say YES they are fighting for > > > > > this poor innocent woman. That is horsecrap, they don't give a flying > > > > > feather about her, especially since she can't vote :>. > > > > > > > > > > I have a prediction where this will go. The us govt tries to step its > > > > > nose into peoples lives too far the supreme court will get involved > > > > > and overrule the law for whatever reason and she will die. EVENTUALLY > > > > > but she will die. Maybe the republicans will even go for a > > > > > consitutional amendment if it gets overruled. > > > > > > > > > > > > > > > > > > > > > > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Purchase RoboHelp from House of Fusion, a Macromedia Authorized Affiliate and support the CF community. http://www.houseoffusion.com/banners/view.cfm?bannerid=59 Message: http://www.houseoffusion.com/lists.cfm/link=i:5:151088 Archives: http://www.houseoffusion.com/cf_lists/threads.cfm/5 Subscription: http://www.houseoffusion.com/lists.cfm/link=s:5 Unsubscribe: http://www.houseoffusion.com/cf_lists/unsubscribe.cfm?user=11502.10531.5 Donations & Support: http://www.houseoffusion.com/tiny.cfm/54
