Mental health of ethnic minorities: the role of racism.

Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated.

Virtual reality as a means to explore assistive technologies for the visually impaired.

Visual impairment represents a significant health and economic burden affecting 596 million globally. The incidence of visual impairment is expected to double by 2050 as our population ages. Independent navigation is challenging for persons with visual impairment, as they often rely on non-visual sensory signals to find the optimal route. In this context, electronic travel aids are promising solutions that can be used for obstacle detection and/or route guidance. However, electronic travel aids have limitations such as low uptake and limited training that restrict their widespread use. Here, we present a virtual reality platform for testing, refining, and training with electronic travel aids. We demonstrate the viability on an electronic travel aid developed in-house, consist of a wearable haptic feedback device. We designed an experiment in which participants donned the electronic travel aid and performed a virtual task while experiencing a simulation of three different visual impairments: age-related macular degeneration, diabetic retinopathy, and glaucoma. Our experiments indicate that our electronic travel aid significantly improves the completion time for all the three visual impairments and reduces the number of collisions for diabetic retinopathy and glaucoma. Overall, the combination of virtual reality and electronic travel aid may have a beneficial role on mobility rehabilitation of persons with visual impairment, by allowing early-phase testing of electronic travel aid prototypes in safe, realistic, and controllable settings.

New Pharmacological Targets for the Treatment of Schizophrenia: A Literature Review.

BACKGROUND: The pharmacological treatment of schizophrenia is currently based on the employment of antipsychotic medications showing an antagonism of dopaminergic and serotoninergic inhibitors. 20-40% of patients are drug-resistant or residually symptomatic in the long-term antipsychotic treatment, and new strategies are needed for improving their functional and cognitive impairment. METHODS: This systematic review has summarized evidences from the literature regarding the newer pharmacological targets proposed for the treatment of psychosis. We included 128 peer-reviewed articles and 5 other relevant sources published from 2002 to 2020 on PubMed EMBASE, The Cochrane Library, and Google Scholar. RESULTS: The possible role of glutamate and its receptors as targets of the antipsychotic mechanism of action has been described. Glutamatergic neurotransmission and NMDA receptors hypofunction are involved in the neurobiological explanatory model of psychosis and possibly targeted for the successful treatment of cognitive and residual symptoms. Results show an efficacy of D-cycloserine (antagonist at the Glycine site of the NMDA-R) in the treatment of negative symptoms of schizophrenia as well as Memantine (NMDA- Receptor antagonist) for cognition and psychopathology. The putative antipsychotic effect of cannabidiol on positive symptoms and cognition will also be discussed. The action on serotoninergic and GABAergic receptors will be considered as a new pharmacological target, with a possible efficacy of Vabicaserin on symptoms of psychosis. Mynocicline has shown to induce improvements in cognitive symptoms in schizophrenia, as well as Erythropoietin. Oxytocin has been reported to have an antipsychotic-like effect; moreover, COX-2 inhibitors lead to a reduction in positive symptoms of psychosis, specifically in the first episode of illness. CONCLUSION: This narrative report suggests a promising role of new agents in the treatment of Schizophrenia; however, more research is needed to approve their clinical employment.

Psychosocial interventions in schizophrenia: Focus on guidelines.

BACKGROUND: Schizophrenia is a lifelong condition with acute exacerbations and varying degrees of functional disability. Acute and long-term treatments are based on antipsychotic drugs, even if some domains of personal and social functioning are not addressed by psychopharmacotherapy. In fact, psychosocial interventions show a positive impact on patient's functioning and clinical outcome. In addition, psychosocial interventions are significantly associated with a lower number of relapses and hospitalizations in schizophrenia. METHODS: An analytical review of the International Guidelines on Psychosocial Interventions in Schizophrenia has been performed; we included the National Institute for Health and Care Excellence (NICE) guidelines, the Scottish Intercollegiate Guidelines Network (SIGN) guidelines, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) guidelines, the Schizophrenia Patient Outcomes Research Team (PORT) guidelines and the American Psychiatric Association (APA) guidelines. RESULTS: The international guidelines recommend psychosocial interventions as supportive treatments alongside pharmaceutical or psychotherapeutic ones. CONCLUSION: More research studies need to be conducted and included in the updated version of the international guidelines to confirm the effectiveness of psychosocial interventions in the long-term outcome of schizophrenia.

Delusion, possession and religion†.

BACKGROUND: Religion and psychiatry may be both considered to be two different ways of explaining the unknown, of responding to questions about the meaning of life, and of bringing healing. AIMS: To discuss the border between religion and psychiatry. METHOD: This lecture explores the interface between religion and psychiatry and discusses the border between soul and mind. RESULTS: Religious beliefs may affect behaviours and may been seen on a psychopathological continuum with overvalued ideas and delusions. There is an overlap between psychiatric and religious categories, in possession states described in research literature and by many cultural groups. Several studies suggest possible factors for differentiating schizophrenia from demonic influence and report on the efficacy of exorcism among possessed/psychotic subjects. Diagnostic criteria have been proposed for dissociative trance disorder or possession disorder. CONCLUSIONS: Both mental health professionals and religious believers may require criteria to distinguish adaptive and maladaptive expressions of religious experience.

Diagnóstico de enfermagem de idosas carentes de um programa de saúde da família (PSF) / Nursing diagnoses of pauper elderly women of a family health program (FHP) / Diagnósticos de Enfermería de Ancianas Carentes de un Programa de Salud de la Familia (PSF)

Considerando que as mulheres idosas e pobres são propensas à maior vulnerabilidade nas condições de saúde, no presente estudo propôs-se a identificar os diagnósticos de enfermagem, segundo a taxonomia II de NANDA, sobre um grupo de idosas consideradas muito pobres. Foram selecionadas 69 idosas, a partir da aplicação do instrumento de Classificação Econômica Brasil (CCEB) em 301 idosos residentes na área de abrangência de um PSF. O estado de saúde das idosas foi avaliado utilizando-se a Avaliação Geriátrica Ampla (AGA), que envolve os aspectos funcionais, emocionais, sociais e ambientais. Foram identificadas 23 categorias diagnósticas nas idosas do estudo e uma média de 7,4 diagnósticos/ idosa. Entre os diagnósticos mais freqüentes destacam-se “ Mobilidade física prejudicada”,”Dor crônica”,”Manutenção do lar prejudicada”. Os diagnósticos revelaram-se impor tantes na caracterização das complexas necessidades apresentadas pelas idosas e no grande avanço no direcionamento da assistência.

A utilização da videoendoscopia da deglutição para a avaliação quantitativa da duração das fases oral e faríngea da deglutição na população geriátrica / The role of videoendoscopic swallowing study in the quantitative evaluation of the oral and pharyngeal phases of deglutition in the elderly

A disfagia orofaríngea caracteriza-se por um problema de transferência do bolo alimentar da cavidade oral até o esôfago. Avanços relacionados ao entendimento fisiopatológico da disfagia e aos métodos de avaliação existentes têm proporcionado seu diagnóstico precoce e a escolha de melhores opções terapêuticas, com redução de potenciais complicações. A videofluoroscopia é considerada o "padrão-ouro" para avaliação da deglutição. A videoendoscopia da deglutição pode representar uma boa alternativa diagnóstica, sendo que seu papel na avaliação quantitativa da deglutição já está bem estabelecido na prática clínica.