Psychedelic Therapy for Serious Illness and End of Life Care

Webinar: September 28, 2023, 4-6 pm. Articles about psychedelic treatments for serious illness and end of life care seem to be everywhere. Rarely a week goes by without a newly published study appearing in a peer-reviewed medical journal, usually followed by reports of the study in prominent news outlets. In this webinar, we will present recent research on this topic, provide an update on the current legislation efforts to legalize these treatments in Washington State, and reflect on proposed treatment guidelines how legalization may impact treatment plans. Panelists include: Dr. David Gruenwald, Medical Director of the Palliative Care and Hospice Service at VA Puget Sound Health Care System Lisa Yeager, MSW, LICSW, CPTR Licensed Independent Clinical Social Worker Jesse Salomon, J.D. Democratic State Senator representing the 32nd Legislative District in Washington Moderated by Devyani Chandran, Director, Palliative Care Institute, Western Washington University, Bellingham, Washingto

Mushrooms Red Book of Ukraine in Culture. 1. Patterns of Growth Hericium coralloides

На території НПП «Гуцульщина» виявлено лише три локалітети Hericium coralloides – гриба, занесеного до Червоної книги України. У результаті проведених досліджень виділено в чисту культуру аборигенний штам К01. Як для виділення, так і для підтримки та забезпечення життєздатності гриба в культурі картопельно-глюкозний агар виявився оптимальним серед апробованих середовищ. Індивідуальні особливості росту H. coralloides К01 вказують на вузькі трофічні можливості цього штаму при поверхневому культивуванні, оскільки з п’яти апробованих середовищ придатними для росту виявилися лише два. Цей штам гриба вважаємо перспективним для використання як інокулянта відповідних субстратів у природному середовищі, оскільки для нього характерні високі показники радіального росту, короткий період log-фази та утворення в чистій культурі стадії телеоморфи. The national park «Hutsulshchyna» found only three localities of Hericium coralloides − mushroom Red Book of Ukraine. The result of the research was to obtain in a pure culture of the native strain K01. As for the release, and to support and ensure the viability of the fungus in culture potato - glucose agar was the best among the tested environments. Individual features of the growth of H. coralloides K01 indicate the narrow trophic features of this strain at cultivation because from five tested media suitable for growth were only two. This strain K01 H. coralloides may be considered promising for use as an inoculant respective substrates in the environment , because it is characterized by high rates of radial growth , a short period of log- phase and ability to form stage teleomorfy in pure culture.Роботу виконано у НПП «Гуцульщина», ННЦ «Інститут біології» КНУ ім. Т. Шевченк

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

BACKGROUND: Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients' views about continuing or discontinuing antipsychotic treatment. AIMS: To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support. METHODS: We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken. RESULTS: We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction. CONCLUSIONS: This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued

An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders

Background Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients’ views about continuing or discontinuing antipsychotic treatment. Aims To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support. Methods We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken. Results We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction. Conclusions This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued

Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses

PURPOSE: The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. METHODS: We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. RESULTS: We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. CONCLUSION: Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research

Towards long-term standardised carbon and greenhouse gas observations for monitoring Europe's terrestrial ecosystems : a review

Research infrastructures play a key role in launching a new generation of integrated long-term, geographically distributed observation programmes designed to monitor climate change, better understand its impacts on global ecosystems, and evaluate possible mitigation and adaptation strategies. The pan-European Integrated Carbon Observation System combines carbon and greenhouse gas (GHG; CO2, CH4, N2O, H2O) observations within the atmosphere, terrestrial ecosystems and oceans. High-precision measurements are obtained using standardised methodologies, are centrally processed and openly available in a traceable and verifiable fashion in combination with detailed metadata. The Integrated Carbon Observation System ecosystem station network aims to sample climate and land-cover variability across Europe. In addition to GHG flux measurements, a large set of complementary data (including management practices, vegetation and soil characteristics) is collected to support the interpretation, spatial upscaling and modelling of observed ecosystem carbon and GHG dynamics. The applied sampling design was developed and formulated in protocols by the scientific community, representing a trade-off between an ideal dataset and practical feasibility. The use of open-access, high-quality and multi-level data products by different user communities is crucial for the Integrated Carbon Observation System in order to achieve its scientific potential and societal value.Peer reviewe

Antipsychotic Medication Management In Primary Care - Using Realist informed synthesis To Develop Recommendations For Policy And Practice

Introduction: Increasing numbers of service users with a severe mental health (SMI) diagnosis are discharged from secondary care services back to their General Practitioner (GP). Recent estimates suggest that this affects between 30-50% of people with a SMI diagnosis, most of whom are prescribed long term antipsychotic medication. Given the wide range of associated adverse effects, and lack of efficacy of antipsychotic medication in some people, this medication needs to be reviewed, and potentially adjusted, regularly. It is unclear to which extent antipsychotic medication reviews are completed in primary care and what potential barriers and facilitators may be, and what GPs and service users’ views and experiences of primary care reviews are. It is also unclear if service users in primary care have particular needs in comparison to those service users still under specialist secondary care services, which may have treatment implications. Method: A realist informed synthesis was conducted: An initial programme theory was developed as part of a realist review (Chapter 2). This was further refined through an analysis of Service User interviews (Chapter 3) and a GP survey (Chapter 4). Chapter 3 analyses quantitative and qualitative data from semi-structured interviews of N=269 service users from a range of secondary and primary care services. This allowed a between groups comparison on a range of demographic and clinical variables. It also explores service user views on long term antipsychotic medication, reducing and stopping antipsychotics. The data were analysed using univariate statistical tests and thematic analysis. The GP survey was developed based on the initial programme theory and included GPs (N=103) views on long term antipsychotics, primary care only medication reviews, and explores barriers and facilitators of medication reviews, with the GP – Service User relationship at its core. Results: The realist review identified 5 CMOCs, indicating why meaningful antipsychotic medication reviews may not occur for people with a SMI diagnosis in primary care. The literature suggests a lack of hope and trust between GPs and service users. This manifests in low expectations of recovery for service users with a diagnosis of SMI, for which the GP survey also provided some evidence. The review also suggested that Service Users are perceived as lacking capacity to understand and participate in medication reviews, linked with a lack of mutual information sharing regarding mental wellbeing and rationale for medication. Research also suggests that GPs may feel at risk in consultations, for which the GP survey also provided some evidence. The most pervasive evidence was collated on the topic of uncertainty. Uncertainty regarding antipsychotic dose and illness trajectory meant that reviews may not occur. Little published data was identified, however the service user interviews highlighted that primary care service users are more reluctant to reduce their medication, despite increased age, than secondary care service users. Primary Care service users were most concerned with fears of relapse. Key considerations included effects on employment if medication is changed, older age as a barrier to reduction, and it being part of their role to take medication lifelong. Similarly, GPs listed uncertainty regarding relapses, a lack of knowledge and confidence, paired with lack of secondary care support as their reason for not reviewing or reducing medication. GPs highlighted the lack of “exit plans” upon discharge, detailing the proposed strategy for antipsychotic medication dose adjustment in the long term. Conclusions: Meaningful antipsychotic medication reviews may not occur in primary care. This PhD identifies key considerations to help explain why this might be the case and summarises these in a list of recommendations, which carry important implications for policy and practice. Further research is required to identify evidence-based means of addressing these issues