With no cure available for Alzheimer's disease and other dementias, the Hebrew Home in New York has started an innovative pilot program to improve the quality of life of their residents with dementia using video technology. To see the effect that this project is having check out the video from the Associated Press below. Police in Hamilton, Ontario have a new approach to dealing with calls involving a possible mental health issue: they're bringing mental health workers along with them. In the past, police officers called to a scene would typically remove a person with a possible mental health issue to a secured location, such as a police facility or a hospital, and a mental health worker would be called to evaluate the person's mental health status. That process can take hours and require confinement, during which time suspects are isolated from other people, their support structure, and the environment they are familiar with. It is a recipe for misbehaviour. Hamilton's approach now involves initial appraisal of a scene and, assuming there is an acceptable level of risk, has the mental health worker step in to de-escalate the situation and build rapport with the suspect. The full story is available here. An interesting critique of how the discussion surrounding mental health and #depression has shifted from unspoken and discounted to manifestations that through social media such as #tumblr has created a platform for exhibitionism and romanticism of their condition.
http://www.theatlantic.com/…/social-media-is-redefi…/280818/ With an aging population, it isn't surprising that the prevalence of mild cognitive impairment (MCI) and dementia is also increasing. There has been a significant amount of research in recent years looking at ways to prevent the onset of MCI and dementia. A recent study published in Neurology has found that engagement in creative activities can prevent memory impairment. "People who engaged in artistic activities, such as painting, drawing and sculpting, in both middle and old age were 73% less likely to have memory and thinking problems, such as mild cognitive Impairment, that lead to dementia.The study also revealed that craft-based activities such as sewing, woodworking and ceramics in midlife and old age, were 45% less likely to encounter cognitive issues." To read more about the study's findings, check out this article recently published by CNN. A new clinical trial using a novel, ultra-sensitive test allows scientists to measure the mutant protein in the cerebrospinal fluid of Huntington’s disease patients. Researchers found that the level of mutant protein is higher in patients with more advanced disease. The concentration of mutant protein also predicts the severity of movement and cognitive problem in patients. Dr. Blair Leavitt, a professor in UBC’s department of medical genetics heading up the city’s part of the international clinical trial, said the drug has the potential to directly treat the underlying cause of Huntington’s disease. The drug, which was developed by California-based Isis Pharmaceuticals, will be administered into the patients’ cerebrospinal fluid to “turn off” the mutant gene in the brain, said Leavitt. http://metronews.ca/news/vancouver/1333888/new-drug-for-huntingtons-disease-to-be-tested-in-vancouver/ Put your knowledge and skills to the test with a case of a 76 year old man, who was admitted to hospital after a fall and reports feeling depressed and tired, and wants all life sustaining therapies withdrawn and tells his family and healthcare team that he "has had enough, i'm done" and to "just let me go". The patient's medical history includes hypertension, diabetes and CAD. While in hospital for the fall he developed pneumonia that led to respiratory failure and the need for a tracheostomy. He then developed c difficile colitis and ARF that required temporary renal replacement therapy. During his hospital stay he was transferred to the ICU multiple times, once for management of ileus where he required an NG tube, a second time for management of a pneumothorax, and the third time for bronchoscopy and ventilation. In terms of mental health history, he reports a 30 year history of depression managed with trials of medications, psychotherapy and even ECT. How would you assess this patient's capacity to make treatment decisions? How would you manage this patient? "Depressed and sick with ‘nothing to live for’" by Alyson Kepple, Priya Gopalan, and Pierre N. Azzam (Current Psychiatry) While the use of technology has been largely beneficial, including in the medical profession, there are some drawbacks to society's increasing reliance on things like the internet as many physicians will point out often mentioning their frustrations over how frequently patients are now self-diagnosing by using Dr. Google. From the psychiatry stand point, as psychiatrist Anna Fels from Weill Cornell Medical College points out in the article "Do You Google Your Shrink?", the internet has led the field to change and evolve as we never would have predicted. In her article, she examines the ways in which technology has been both a help and a hindrance within the world of psychiatric medicine. "I knew my psychiatric practice was forever changed the day a patient arrived with a manila folder stuffed with printouts and announced that it contained the contents of a Google search that he had done on me. He pulled out a photo of my mother and me, age 7, that had been published in my hometown newspaper; architectural plans for an addition to my house that was never built but apparently was registered locally by the architect; an announcement about my great-grandfather’s becoming editor of Amazing Stories magazine in his old age; and my brother’s history as a college activist... IN some ways, the relentless electronic interconnectivity of our lives serves to highlight therapy’s singular virtues. We are more appreciative of the strange, private dialogue that is the heart of #therapy. There are precious few times and spaces left in our society in which people quietly speak to one another in a sustained, intimate conversation. The therapist’s office is one of the last safe places. Secrets, reflections, fears or confusion never leave the room." New study finds that a novel approach to treating #depression, involves manipulation of the NMDA pathway, which is commonly associated with the party drug #ketamine. This new method has shown promising results in roughly 3/4 of participants, and patients show improvements in the span of a day.
http://www.nature.com/news/rave-drug-holds-promise-for-treating-depression-fast-1.16664 |
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Supporting and enhancing students' and health professionals' knowledge and understanding of mental health and psychiatry
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