Communication in Psychiatric Coercive Treatment and Patients’ Decisional Capacity to Consent

An effective communication and the acquisition of a valid consent is central to a good and supporting doctor-patient relationship and a clinician’s ethical obligation in o order to respect patients’ autonomy, as well as their right to be involved in treatment decisions. However, often clinicians face several issues in performing this task, among which the most frequently reported are the fear of hurting the patient by communicating a bad diagnosis or not knowing how to manage the patient’s emotional reactions. In addition, there are vulnerable populations, such as those represented by psychiatric patients, who are at higher risk of decisional incapacity. Especially for those patients it is in fact particularly difficult for clinicians to find the proper balance between respecting the right of capable patients to make choices about their treatment and the right of incapable patients to be protected from the possible harmful consequences of their improper decisions. However, nor the presence of a severe psychiatric disorder nor a status of “involuntary hospitalized patient” have been reported to be a label for incapacity. Several tools have been developed to assist clinicians in patients’ decisional capacity evaluations, together with interventions aimed at enhancing informed consent acquisition in order to achieve a shared decision-making and lead the patient to become actively involved in his/her treatment decisions. Such approach would lead to a decrease in the perceived coercion, often reported in mental health care setting also from patients who are not involuntarily hospitalized, and to an increase in patients’ adherence to treatment

Antioxidants in Diets and Food

none3noNowadays, the society looks with increasing interest in the diet, which is no longer simply a means by which to take the necessary nutrients but has become a means by which it is possible to preserve the health state. German philosopher Ludwig Feuerbach once said: “We are what we eat.” This statement is even truer today because of the hectic life, people often tend to eat frugal, fast, and often very fat and unhealthy meals. Today, there is a very high attention both from the social point of view and by the scientific community to the so-called functional foods. These foods, which contain several bioactive compounds, exert innumerable biological properties and therefore can help to preserve the health state. In addition, the use of nutraceuticals has taken the upper hand, unfortunately, often also to the detriment of functional foods, which unlike the former still remain foods and, as such, with a certainly better efficacy-safety profile. The term nutraceutical, indeed, does not refer to a food but rather to a formulation containing one or more compounds isolated from plant extracts or one or more titrated plant extracts. Moreover, some formulations (capsules, tablets, powders, etc.) are rarely studied before being commercialized, and their effectiveness remains rather doubtful in light of a very lax regulation in many countries worldwide.mixedAntonella Smeriglio, Laura Cornara, Domenico TrombettaSmeriglio, Antonella; Cornara, Laura; Trombetta, Domenic

A cross-species approach to disorders affecting brain and behaviour.

Structural and functional elements of biological systems are highly conserved across vertebrates. Many neurological and psychiatric conditions affect both humans and animals. A cross-species approach to the study of brain and behaviour can advance our understanding of human disorders via the identification of unrecognized natural models of spontaneous disorders, thus revealing novel factors that increase vulnerability or resilience, and via the assessment of potential therapies. Moreover, diagnostic and therapeutic advances in human neurology and psychiatry can often be adapted for veterinary patients. However, clinical and research collaborations between physicians and veterinarians remain limited, leaving this wealth of comparative information largely untapped. Here, we review pain, cognitive decline syndromes, epilepsy, anxiety and compulsions, autoimmune and infectious encephalitides and mismatch disorders across a range of animal species, looking for novel insights with translational potential. This comparative perspective can help generate novel hypotheses, expand and improve clinical trials and identify natural animal models of disease resistance and vulnerability

Low back pain in older adults:risk factors, management options and future directions

Abstract Low back pain (LBP) is one of the major disabling health conditions among older adults aged 60 years or older. While most causes of LBP among older adults are non-specific and self-limiting, seniors are prone to develop certain LBP pathologies and/or chronic LBP given their age-related physical and psychosocial changes. Unfortunately, no review has previously summarized/discussed various factors that may affect the effective LBP management among older adults. Accordingly, the objectives of the current narrative review were to comprehensively summarize common causes and risk factors (modifiable and non-modifiable) of developing severe/chronic LBP in older adults, to highlight specific issues in assessing and treating seniors with LBP, and to discuss future research directions. Existing evidence suggests that prevalence rates of severe and chronic LBP increase with older age. As compared to working-age adults, older adults are more likely to develop certain LBP pathologies (e.g., osteoporotic vertebral fractures, tumors, spinal infection, and lumbar spinal stenosis). Importantly, various age-related physical, psychological, and mental changes (e.g., spinal degeneration, comorbidities, physical inactivity, age-related changes in central pain processing, and dementia), as well as multiple risk factors (e.g., genetic, gender, and ethnicity), may affect the prognosis and management of LBP in older adults. Collectively, by understanding the impacts of various factors on the assessment and treatment of older adults with LBP, both clinicians and researchers can work toward the direction of more cost-effective and personalized LBP management for older people