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Improper use of oxytocin may be a major contributor to maternal and newborn morbidity and mortality in Sierra Leone. Initiatives to educate clinicians and to regulate and stop the practice are needed.

There was widespread awareness of PI use among clinicians, and prevalent self-reported prior use among midwives. Risk awareness improved after EmONC training, and the proportion of clinicians reporting likelihood of future use decreased. Improper use of oxytocin may be a major contributor to maternal and newborn morbidity and mortality in Sierra Leone. Initiatives to educate clinicians and to regulate and stop the practice are needed.

Ayahuasca is a psychoactive tea that is rapidly gaining in popularity. Its effects are, however, widely different in various sets and settings, leading to various imaginings.<br/> AIM To distinguish between the recreational, medical and religious use of ayahuasca, and further investigate its religious use.<br/> METHOD Nietzsche's three forms of the Greek God Dionysus are used in order to describe and analyze the three contexts for ayahuasca use.<br/> RESULTS The religious use of ayahuasca, for example in the Santo Daime church, can be understood as a contemporary form of Gnosticism.<br/> CONCLUSION Research needs to take the various sets and settings of ayahuasca use into account. More research into the religious use of ayahuasca is needed.

CONCLUSION Research needs to take the various sets and settings of ayahuasca use into account. More research into the religious use of ayahuasca is needed.

Historical research about the use of psychedelics in specific religious contexts can provide rational explanations for visionary experiences that could otherwise be cause to question the mental health of religious actors. Reversely, if historians ignore or overlook empirical evidence for the use of psychedelics, the result can be that normal and even predictable reactions of healthy subjects to the effects of psychedelic substances are arbitrarily interpreted as 'irrational'.<br/> AIM To describe the meaning of the psychedelic factor in historical visionary experiences.<br/> METHOD Discussion based on three examples of selective use of historical sources on psychedelics.<br/> RESULTS This theme is of broader relevance to cultural history and scientific theory because we are typically dealing with religious practices that have traditionally been categorized as 'magic' and thereby classified in advance as irrational and potentially pathological. The article discusses three historical examples the so-called Mithras Liturgy from Roman Egypt, early modern witches' ointments, and spiritual use of hashish in the nineteenth century.<br/> CONCLUSION Established academics often deny the significance of psychedelics in visionary experiences. Discussion of pre-Enlightenment source material appears to be of considerable importance for the correct interpretation of important religious and cultural traditions. Critical empirical source research without prejudices or implicit agendas is the appropriate method.

CONCLUSION Established academics often deny the significance of psychedelics in visionary experiences. Discussion of pre-Enlightenment source material appears to be of considerable importance for the correct interpretation of important religious and cultural traditions. Critical empirical source research without prejudices or implicit agendas is the appropriate method.

lsd and other hallucinogens or psychedelics have been therapeutically used in psychiatry in the period between the Second World War and the late 1980s. In the past years renewed interest in the medical sciences for research and therapeutic use of these substances has evolved.<br/> AIM A discussion of contemporary lsd research in the context of earlier research.<br/> METHOD A systematic survey of the literature on the psychiatric use of lsd and the reactions towards lsd use in society.<br/> RESULTS Since 1947 lsd has been therapeutically used in the treatment of anxiety, depression, addiction, post traumatic disorders, and other conditions. Since the early 1960s this use has been criticized because of the danger of evoking psychoses in patients, and because of the rise of a widespread non-medical use. However, there is no consolidated evidence-base for either the positive or the negative outcomes of lsd therapy.<br/> CONCLUSION At this moment it is unpredictable whether lsd will make a comeback in psychiatry. Contemporary research attempts to evade all public controversy and to build up a solid evidence-base. Nevertheless it demonstrates a direct continuity with earlier research.

CONCLUSION At this moment it is unpredictable whether lsd will make a comeback in psychiatry. Contemporary research attempts to evade all public controversy and to build up a solid evidence-base. Nevertheless it demonstrates a direct continuity with earlier research.

MDMA is currently a controversial psychedelic in the Netherlands it is banned under the Opium Act, but widely used as a recreational drug. According to the government, the normalization of MDMA must be combated, others argue in favour of legalization. Meanwhile, in recent years psychiatry has become interested in renewed therapeutic use of MDMA.<br/> AIM To place the current discussion of MDMA in the context of recent history. What can we learn from the way MDMA was used in America and Western Europe in the period between the (re)discovery of the drug in the 1970s and its legal prohibition in the 1980s?<br/> METHOD Survey of the literature on the history of MDMA, and additional source research.<br/> CONCLUSION In the period before MDMA became illegal, its use was closely linked to the pursuit of self-actualisation in therapeutic, spiritual and recreational contexts. History shows that the meaning that people attach to a psychoactive substance like MDMA is highly dependent on the context of use. Like all drugs, MDMA also has multiple functionalities and 'framings'. The psychoactive substance cannot be reduced to one valuation or essence.

CONCLUSION In the period before MDMA became illegal, its use was closely linked to the pursuit of self-actualisation in therapeutic, spiritual and recreational contexts. History shows that the meaning that people attach to a psychoactive substance like MDMA is highly dependent on the context of use. Like all drugs, MDMA also has multiple functionalities and 'framings'. The psychoactive substance cannot be reduced to one valuation or essence.

Ecstasy (MDMA) is used by approximately 370,000 Dutch people yearly, mainly young adults with a good education.<br/> AIM To describe ecstasy-related negative health effects, health risks, use profiles and crime based on data from scientific literature and other publicly available sources.<br/> RESULTS Ecstasy appears to cause little health damage during recreational use. Adverse health incidents, particularly hyperthermia, are observed, but are probably partly due to the use of ecstasy under (a combination of) unfavourable circumstances, such as a warm environment, too little drinking, and considerable physical exertion (dancing). The estimated risk of serious ecstasy-related non-fatal accidents was 1 in 3,400 pills and 1 per 700 users. The number of fatal ecstasy-related incidents is estimated to be a maximum of 35 per year. Crime associated with the production and trade of ecstasy is worrying and, according to some authors, disruptive to society.<br/> CONCLUSION On the basis of these results, we conclude that the use of ecstasy does involve health risks, but given the widespread use of ecstasy, the number of (fatal) incidents is relatively low. Better information about the conditions under which ecstasy can be used more safely will contribute to fewer incidents.

CONCLUSION On the basis of these results, we conclude that the use of ecstasy does involve health risks, but given the widespread use of ecstasy, the number of (fatal) incidents is relatively low. Better information about the conditions under which ecstasy can be used more safely will contribute to fewer incidents.

In recent years there was a renewed interest in psychedelic substances.<br/> AIM To present an overview of what is known about the use of classic psychedelic drugs and 'atypical' psychedelic drugs (i.e. entactogen/empathogenic drugs like mdma and dissociative drugs such as ketamine) in the Netherlands.<br/> METHOD Data from a Dutch adult general population survey from 2016 and 2018 and other surveys - mainly among nightlife attendees - were used to provide prevalence estimates and user characteristics. In addition to that, data from several Dutch monitoring systems were included for information on problematic psychedelic drug use, health emergencies and psychedelic drug markets.<br/> RESULTS The last year prevalence of ecstasy among Dutch adults was 2.9%, making it the most used psychedelic in the general population. For hallucinogenic mushrooms/truffles, lsd, 2C-B and ketamine, the last year prevalence estimate ranged between 0.2 and 0.6%. For all psychedelic substances, higher use rates were found among men, young adults between 20-29 years old, adults with higher education, and inhabitants of urban areas. In different groups of nightlife attendees, psychedelic substance use prevalence was greater than that of the general population. Data from various sources suggested an increase in the number of ketamine users.<br/> CONCLUSION Apart from ecstasy, the use of psychedelic substances is relatively low in the general population. In subgroups of the Dutch population, ketamine use increased in recent years. Further research is needed to gain a better understanding of the use of psychedelics in the Netherlands, particularly in subpopulations.

CONCLUSION Apart from ecstasy, the use of psychedelic substances is relatively low in the general population. In subgroups of the Dutch population, ketamine use increased in recent years. Further research is needed to gain a better understanding of the use of psychedelics in the Netherlands, particularly in subpopulations.

Psychedelics have a strong therapeutic potential for the treatment of biomedical disorders, but the working mechanisms underlying psychedelics are only poorly understood.<br/> AIM To discuss different mechanisms underlying the therapeutic effects of classic psychedelics.<br/> METHOD To make a distinction between different levels of explanation the pharmacological, the neurocognitive and the psychological level.<br/> RESULTS At the pharmacological level, classic psychedelics affect via the serotonin-receptor, the production of glutamate and brain-derived neurotrophic factor (bdnf), which stimulate neurogenesis. CD38inhibitor1 Psychedelics also have anti-flammatory properties and thereby have a protective effect on the brain. At the neurocognitive level, psychedelics have been associated with a reduced activation of the default mode network, which has been implicated in self-referential processing and rumination. At the same time, the brain's entropy increases, reflected in an increased connectivity between different brain areas.

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