Transcranial Direct Current Stimulation Use in Warfighting: Benefits, Risks, and Future Prospects.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique which provides unique potential to directly improve human capability on a temporary, at needs, basis. The purpose of this paper is to consider the utility of tDCS through analysis of the potential risks and benefits in the context of defence service personnel. First, we look at the potential benefits, focusing primarily on warfighter survivability and enriching cognition quality in support of command and control. Second, we look at the potential detriments to tDCS military use, focusing on adverse effects, safety considerations, and risk. Third, we examine how the level of risk can be mitigated through military doctrine development focusing on safety parameters and exclusion criteria. Finally, we explore the future prospects of military tDCS use, particularly in terms of addressing gaps in the literature so that tDCS can be used ethically and efficaciously at the level of individual personnel.

Psychiatric inpatients' perceptions of written no-suicide agreements: an exploratory study.

One hundred thirty-five psychiatric inpatients admitted for suicidal danger were surveyed regarding their views on the benefits/limitations of written no-suicide agreements. A survey instrument developed for this study revealed that these inpatients, for the most part, rated written no-suicide agreements in a positive manner and in ways consistent with clinical opinion expressed in a number of qualitative/expert-opinion articles. Positive views of no-suicide agreements were not materially influenced by social desirability or age, nor were they moderated by gender, presence/absence of Axis II disorders, or admission suicidal danger. However, patient suicide attempt history (no attempts, one attempt, or more than one attempt) exerted a moderating effect on patients' ratings of the helpfulness of these contracts. Multiple attempters viewed written no-suicide agreements as less helpful than those patients with a single or no prior attempts. The methodological problems and generalizability concerns associated with these results are discussed and future research needs are suggested.

Langerhans' cell histiocytosis: current trends and the role of the head and neck surgeon.

Langerhans' cell histiocytosis (LCH)--once called histiocytosis X--is a complex reticuloendothelial disease that often involves the head and neck. We discuss the current nomenclature of this disease and review its pathologic and clinical characteristics, with particular emphasis on the role of the head and neck surgeon. LCH can be challenging to diagnose, and the otolaryngologist must be familiar with its varied presentations. Because LCH usually responds well to medical therapy and extensive resection can easily cause more morbidity than the disease itself, a minimalist approach to treatment usually provides the best outcome. We also discuss the case of a 9-month-old girl with LCH who presented with aggressive head and neck disease.