Recent Posts

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The Lounge / Re: Members birthdays
« Last post by Amanda_George on March 20, 2024, 07:18:12 AM »
Happy birthday, Weburndaylight and also Michibelle!
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The Lounge / Re: Members birthdays
« Last post by Pip on March 19, 2024, 07:16:34 PM »
:bday1: roadrunner and desposy anim_65
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Fun Stuff / The crab
« Last post by Pip on March 19, 2024, 06:55:57 PM »
A female crab was walking down the beach one evening when she noticed a male crab coming toward her, but he was walking straight and not sideways.  Impressed by his talent, she decided to marry him immediately. The next morning she noticed him walking sideways like any ordinary crab. She asked, "What happened? Yesterday you were able to walk straight!"

He answered, "What?! I can't get that drunk every day!"
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The Lounge / Re: Members birthdays
« Last post by Amanda_George on March 19, 2024, 07:39:13 AM »
roadrunner and desposy are both celebrating their birthdays today!   :singes15: anim_32
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Pagan/Heathen / Crystals
« Last post by Amanda_George on March 18, 2024, 06:06:17 PM »
Merry Meet.

I posted this on Facebook 5 hours ago but I'm putting it here too 'cos this is the Pagany part of the forum, so might get more interest/knowledge here:

Quick question for crystal-loving Pagans, especially Heathens:  I know that in Wicca the compass points are really important to placement of crystals etc, but is it also important for Heathenry or can I put my crystals wherever "feels" right please? 

Also do the crystals prefer to be out on display or is it OK to keep them stored in a box and just cleanse and programme them occasionally please? 

Should I invest in a compass or is it OK to just go with whatever "feels" right please?  I've got my eye on a display cabinet but if it's better to leave the crystals on display then that's OK too.

I've got a small collection of crystals in a wooden box upstairs and I've got a new quartz point that I wanna put out after I've cleansed and programmed them all, but I dunno if certain crystals prefer different positions/rooms/compass points or if I should just ask for Gaia or the Green Man for guidance.

So come on, all you Pagany crystal-lovers, what do I do please?

TIA!
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The Lounge / Re: Members birthdays
« Last post by Pip on March 15, 2024, 12:39:38 PM »
 :bdayballoons:  rorycald216  :hug:
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The Lounge / Re: Members birthdays
« Last post by Amanda_George on March 15, 2024, 11:20:29 AM »
Happy birthday, rorycald216! anim_65
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Christian / Re: Devotions
« Last post by Pip on March 13, 2024, 12:37:12 PM »
https://proverbs31.org/read/devotions/full-post/2023/05/15/the-one-voice-im-learning-to-listen-to-as-a-mom?utm_campaign=Daily%20Devotions&utm_medium=email&_hsmi=257061334&_hsenc=p2ANqtz-_0NRvpCLYOy4zm3iDPZvyRvUNApY80l8NUkNuHCXQD6aEcQ7OjRWWqAkrv_fZvab8fTGP7a8S0sMNrro7DMC8dJQ5MXQ&utm_content=257061334&utm_source=hs_email#disqus_thread


Devotions
The One Voice I’m Learning To Listen to as a Mom
May 15, 2023
Ruth Schwenk
by Ruth Schwenk

"The Spirit himself testifies with our spirit that we are God’s children." Romans 8:16 (NIV)

Long gone are the diapers and sippy cups. No more onesies. Or high chairs. And as my children have outgrown one season and grown into another, becoming teens and young adults, I’ve been experiencing some “proud mom” moments coupled with sighs of relief as I see the fruit of my labor as a mom becoming a reality.  No, this relief isn’t because my children are perfect or because I feel like I have “made it.” The relief is that through 20 years of being a mom, I am learning who to listen to.  We all have those voices in our lives, often speaking with sincerity, that try to help us by telling us what we should or shouldn’t do or be. Those voices can seem especially loud for us moms. Maybe it is even our own voice speaking words of insecurity, shame or inadequacy. Whatever voices seem the loudest, this new season of mine is marked not by becoming deaf to those voices but instead by becoming far more discerning. I still want to listen and learn. But when it comes to who I listen to and am shaped by, I'm more selective.  It’s no surprise that as we turn to the pages of the Bible, we are often told to listen to voices of wisdom and truth. A good example is Romans 8:16: “The [Holy] Spirit himself,” Paul writes, “testifies with our spirit that we are God’s children.”

One of the primary jobs of the Holy Spirit is to speak to us. He reminds us who we are. His job is to testify to what is true. So the voice I am learning to listen to the most is God’s voice.  Yes, we listen to the voices of others to learn and grow, but ultimately God’s voice guides us and grounds us in this journey. Here are three reasons we listen to God’s voice above all the rest:

1. God’s voice reminds us that we are loved.

What really grounds us is not seeing the fruit of our labor, getting thanked for it, or feeling respected and fulfilled because of it. What steadies our souls is that our Father deeply loves us, and we are in Christ through faith. We are God’s children, fully accepted and cherished, not because of our works as moms but because of the work of Christ.

2. God’s voice leads us without driving us.

People’s voices try to drive us as moms, telling us what we should be and do. Too often, we get caught up in the chorus and become driven by fear, pride or insecurity. In contrast, the voice of God is one that “will guide you into all the truth” (John 16:13a, NIV, emphasis added). He reminds us that motherhood is not a race or a competition. Just as He is leading us, He is leading our children. We don’t have to be anxious, fearful or envious.

3. God’s voice makes us more like Jesus.

Many times, the voices around us tell us what we’re not. God's good and gracious voice reminds us of the hope of who we are becoming. Motherhood is not about perfection; motherhood is about God making us more like our perfect Savior, Jesus, every day. This process of being perfected is a lifelong journey of the Holy Spirit’s work inside us that will one day be complete when Christ returns. We are to tune our ears to Him the Author and Perfecter of our faith (Hebrews 12:1-2). He alone can truly help us when we are weak, and He humbles us when we rely too much on our own strength.

So today when you hear all those outside voices, or maybe even the ones inside, stop and listen. But listen first to the voice of love and truth the voice that matters the most. The voice of a good and perfect Father who saves all who trust in His Son, Jesus. The voice of the One who calls you His own.
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https://www.psychiatrictimes.com/view/depressed-suicidal-and-likely-less-able-to-consent-to-treatment?utm_medium=email&utm_campaign=11102023_Editorial%20eNewsletter_MJH-23-MEL0126%20-%20INTL&eKey=cGhpbGlwcGExOTYxQGdtYWlsLmNvbQ==

Depressed, Suicidal, and Likely Less Able to Consent to Treatment
November 7, 2023
Kenneth J. Bender, PharmD, MA

Among individuals with depression, those who have attempted suicide were found to have less capacity to provide informed consent for treatment, according to the results of a study1 relating history of suicide attempts with impaired decision-making.

“The suicide attempt history has never been considered in studies on the capacity to consent to treatment, although it is associated with depression severity and cognitive impairment that may affect decision-making capacity,” indicated Emilie Olié PhD, MD, of the Department of Emergency Psychiatry and Acute Care at Lapeyronie Hospital, Centre Hospitalier Universitaire (CHU) Montpellier, Montpellier, France, and colleagues.

“Indeed, suicide attempters display impaired decision-making abilities; lower problem-solving, leading to feelings of entrapment; and lack of future positive thinking,” Olié and colleagues noted, citing several previous studies.

To isolate the relation of suicide attempts to decision-making in individuals with depression, the investigators administered the MacArthur Competence Assessment Tool for Treatment (MacCAT-T)2 to 60 adult patients in a current depressive episode, with (n=33) and without (n=27) history of attempted suicide. The median Beck Depression Inventory (BDI) score of depression severity was 21 (10 to 36).

The MacCAT-T measures 4 dimensions relevant to the patient's capacity to make decisions from information disclosures about their illness to the nature of treatment options and their risks and benefits:

    Understanding the disclosed information
    Appreciation, or appreciating the significance of the information to one's condition and situation
    Reasoning about the potential risks and benefits of one's choices
    Expressing choice, or communicating choices regarding proposed treatment

“If 1 of these 4 areas is impaired, a patient may be considered unable to exercise their autonomy relative to treatment decision-making,” Olié and colleagues explained. “Appreciation, which requires comparing several alternatives, seems to be the most altered decision-making capacity component in individuals with depression.”

In addition to the MacCAT-T and the BDI, the investigators administered the Beck Cognitive Insight Scale (BCIS) and quantified insight using the BCIS composite index (subtracting the self-certainty subscale score from the self-reflection subscale score).

“In general, the capacity to consent is a dimension that is often overlooked because it is challenging to evaluate for clinicians,” Olié told Psychiatric Times®. “Nevertheless, collective reflection on this dimension is crucial in our patient care.”

Across both groups, the median MacCAT-T sub-scores were 4.62 (2.35 to 6) for Understanding, 3 (1 to 4) for Appreciation, 5.5 (1 to 8) for Reasoning, and 2 (0 to 2) for Expressing Choice. The investigators determined that capacity to consent was impaired in 36 patients (60%) with low scores for Understanding, in 18 (30%) scoring low in Appreciation, and in 32 (53%) scoring low in Reasoning. They found no association of insight with decision-making, however, with a median BCIS composite index of 2 (-15 to 22).

In their comparison of those with and without a lifetime history of suicide attempt, those who had attempted suicide had a higher number of past depressive episodes and greater severity of symptoms, but a lower BCIS composite index. Suicide attempt was associated with lower MacCAT-T sub-scores than those with no history of suicide attempt: Understanding was 4.4 (2.35 to 8) versus 5.3 (3 to 13.6), Appreciation was 3 (1 to 4) versus 4 (2 to 4), Reasoning was 4 (1 to 7) versus 7 (3 to 8), and Expressing Choice was 1 (0 to 2) versus 2 (0 to 2).

In addition to supporting the hypothesis that some patients with greater depressive symptomatology have impaired decision-making capacity, the investigators emphasized that their results “add that history of suicide attempt is associated (with) impaired decision-making capacity in depressed patients.”

Impaired Decision-Making and Assist-To-Die

“We have been concerned with the capacity to consent of depressed patients, particularly those at risk of suicide, following a review of data regarding euthanasia in psychiatric patients,” Olié recounted when discussing the study with Psychiatric Times. “These data indicate that the capacity to consent is rarely assessed in these patients, making this issue central.”

Assist-to-die services for the terminally ill, and in some jurisdictions for incapacitation, commonly exclude individuals with mental illness that would impair the capacity to grant informed consent. Olié and colleagues cited a Dutch study,3 however, that found that the capacity to consent is commonly based on a global judgment of the patient's capacity and was determined in only 55% of a national assist-to-die cohort; most of these patients had depression, and many had a history of suicide attempts.

“Importantly, many patients had refused potential effective treatments before requesting and receiving assisted suicide,” observed Olié and colleagues, who suggested that using the MacCAT-T to better assess the capacity to consent might have averted resorting to an assist-to-die service.

“Through our findings, we aim to emphasize the need for clinicians to be vigilant in this regard and to be more proactive in promoting understanding and acceptance of treatment tailored to depressed patients at risk of suicide,” Olié said. “This represents a potential avenue for improving suicide prevention.”

Dr Bender reports on medical innovations and advances in practice and edits presentations for news and professional education publications. He previously taught and mentored pharmacy and medical students, and provided and managed pharmacy care and drug information services.

References

1. Olié E, Catanzaro T, Malestroit M, et al. The capacity to consent to treatment is altered in suicidal patients. Ann Gen Psychiatry. 2023;22(1):35.

2. Grisso T, Appelbaum PS. The MacArthur Treatment Competence Study. III: Abilities of patients to consent to psychiatric and medical treatments. Law Hum Behav. 1995;19(2):149-174.

3. Doernberg SN, Peteet JR, Kim SY. Capacity evaluations of psychiatric patients requesting assisted death in the Netherlands. Psychosomatics. 2016;57(6):556-565.
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Fun Stuff / A proposal
« Last post by Pip on March 13, 2024, 12:25:42 PM »
Once there was a millionaire who collected live alligators.  He kept them in the pool in back of his mansion.  The millionaire also had a beautiful single daughter.  So one day he decides to throw a huge party, and during the party he announces: "My dear guests, I have a proposition to every man here.  I will give one million dollars or my daughter to the man that can swim across this pool full of alligators and emerge unharmed!"

As soon as he finished his last word there was the sound of a large SPLASH!  One guy was in the pool, swimming as fast as he could, with the crowd was cheering him on.  Finally he made it to the other side, miraculously unharmed.  The millionaire was impressed. "My boy that was incredible!  Fantastic!  I didn't think it could be done!  Well I must keep my end of the bargain. Which do you want: my daughter or the one million dollars?"
 
The guy says, "Listen, I don't want your money!  And I don't want your daughter!  I just want the name of the guy who pushed me into that pool!"
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