Essentials of Informed Consent to Psychedelic Medicine.

Importance: Interest in administering psychedelic agents as mental health treatment is growing rapidly. As drugmakers invest in developing psychedelic medicines for several psychiatric indications, lawmakers are enacting legal reforms to speed access globally, and health agencies are preparing to approve these treatments. Meanwhile, US states, such as Oregon and Colorado, are making psychedelics available for supervised use outside the conventional health care system.

Religion, Spirituality, and Ethics in Psychiatric Practice.

The interface of religion, spirituality, and psychiatric practice has long been of interest to the ethical psychiatrist. Some prominent early psychotherapists had a strained relationship with religion and spirituality. They posited that religion and spirituality were forms of mental illness, which discouraged the discussion of these values during treatment despite the fact that many patients subscribed to a religious or spiritual viewpoint.

General Hospital Agitation Management: Leadership Theory and Health Care Team Best Practices Using TeamSTEPPS.

Background: Acute agitation management is an emergency clinical intervention, often presenting acute danger to patients and medical staff. Unlike many other emergency clinical interventions, acute agitation management lacks a substantial evidence base regarding leadership and teamwork best practices. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) framework is a comprehensive strategy for improving health care outcomes in acute clinical situations.

MIR spectroscopy versus MALDI-ToF-MS for authenticity control of honeys from different botanical origins based on soft independent modelling by class analogy (SIMCA) - A clash of techniques?

In this study, highly reproducible MIR spectroscopy and highly sensitive MALDI-ToF-MS data were directly compared for the metabolomic profiling of monofloral and multifloral honey samples from three different botanical origins canola, acacia, and honeydew. Subsequently, three different classification models were applied to the data of both techniques, PCA-LDA, PCA- kNN, and soft independent modelling by class analogy (SIMCA) as class modelling technique. All monofloral external test set samples were classified correctly by PCA-LDA and SIMCA with both data sets, while multifloral test set samples could only be identified as outliers by the SIMCA technique, which is a crucial aspect in the authenticity control of honey.

Nitrogen monoxide as dopant for enhanced selectivity of isomeric monoterpenes in drift tube ion mobility spectrometry with H ionization.

The ion mobility spectra of the isomeric monoterpenes α-pinene, β-pinene, myrcene, and limonene in drift tube ion mobility spectrometry (IMS) with H radioactive ionization are highly similar and difficult to distinguish. The aim of this work was to enhance the selectivity of IMS by the addition of nitrogen monoxide (NO) as dopant and to investigate the underlying changes in ion formation responsible for the modified ion signals observed in the ion mobility spectra. Even though H-based-IMS systems have been used in hyphenation with gas chromatography (GC) for profiling of volatile organic compounds (VOCs), the investigation of ion formation still remains challenging and was exemplified by the investigated monoterpenes.

Volatilomic Profiling of Juices by Dual-Detection HS-GC-MS-IMS and Machine Learning-An Alternative Authentication Approach.

A prototype dual-detection headspace-gas chromatography-mass spectrometry-ion mobility spectrometry (HS-GC-MS-IMS) system was used for the analysis of the volatile profile of 47 juices including grapefruit, blood orange, and common sweet orange juices without requiring any sample pretreatment. Next to reduced measurement times, substance identification could be improved substantially in case of co-elution by considering the characteristic drift times and / ratios obtained by IMS and MS. To discriminate the volatile profiles of the different juice types, extensive data analysis was performed with both datasets, respectively.

A paper-based colorimetric sensor array for discrimination of monofloral European honeys based on gold nanoparticles and chemometrics data analysis.

A sensitive and simple nanomaterial based colorimetric sensor array (NBCSA) was developed for discrimination of monofloral honey from various European countries based on three botanical origins as Acacia, Canola and Honeydew. The NBCSA was designed by spotting gold (AuNPs) and silver (AgNPs) nanoparticles synthesized using six different reducing and/or capping agents. The colour intensity of AuNPs represented differential changes when interacting with volatile organic compounds appeared in the headspace of the honey samples.

Gas-phase volatilomic approaches for quality control of brewing hops based on simultaneous GC-MS-IMS and machine learning.

For the first time, a prototype HS-GC-MS-IMS dual-detection system is presented for the analysis of volatile organic compounds (VOCs) in fields of quality control of brewing hop. With a soft ionization and drift time-based ion separation in IMS and a hard ionization and m/z-based separation in MS, substance identification in the case of co-elution was improved, substantially. Machine learning tools were used for a non-targeted screening of the complex VOC profiles of 65 different hop samples for similarity search by principal component analysis (PCA) followed by hierarchical cluster analysis (HCA).

Physician-Assisted Death Psychiatric Assessment: A Standardized Protocol to Conform to the California End of Life Option Act.

Background: The California End of Life Option Act (EOLOA), which legalized physician-assisted death (PAD), became effective in 2016. The EOLOA does not require a mental health consultation in all cases nor does it state the standards for the mental health assessment. University of California, San Francisco Medical Center (UCSFMC) policy makers decided to require a mental health assessment of all patients seeking PAD under the EOLOA.

Decisional and Dispositional Capacity Determinations: Neuropsychiatric Illness and an Integrated Clinical Paradigm.

Background: Assessment of decisional capacity requires thorough clinical review of a patient's current psychiatric symptoms and cognitive processes. The assessment to determine the patient's capacity for self-management postdischarge is a different clinical concept from decisional capacity.

Objectives: Standardized guidelines for capacity determinations (both for informed consent and for disposition) would be helpful to clinicians, patients, and their caregivers.

A Systematic Review of Dropout From Psychotherapy for Posttraumatic Stress Disorder Among Iraq and Afghanistan Combat Veterans.

A significant number of veterans of the conflicts in Iraq and Afghanistan have posttraumatic stress disorder (PTSD), yet underutilization of mental health treatment remains a significant problem. The purpose of this review was to summarize rates of dropout from outpatient, psychosocial PTSD interventions provided to U.S.

Strategies for the prescription of psychotropic drugs with black box warnings.

Background: The Black Box Warning (BBW) is the Food and Drug Administration's highest level of drug warning. It signifies that a medication has serious (or potentially life-threatening) side effects and is prominently displayed on a medication's package insert. It literally consists of the medication warning and is surrounded by a bold black border.

Documentation of decision-making capacity, informed consent, and health care proxies: a study of surrogate consent.

Background: Patients in the general hospital are routinely asked to make decisions about their medical care. However, some of them are unable to express a choice, understand the information provided, weigh the options, or make a decision for themselves; when this occurs, the task of making an appropriate medical decision is left to another-a substitute decision-maker (SDM).

Objective: We sought to understand the practice patterns surrounding surrogate consent.

Beyond emergencies: the use of physical restraints in medical and psychiatric settings.

Physical restraints, such as locked-door seclusion and two- or four-point leather restraints, are frequently used in both the medical and psychiatric settings. Efforts are currently under way to reduce the use of physical restraints in psychiatric settings; various institutional, state, and federal policies are place. However, using these same restraints in the context of providing medical care for psychiatric patients is more complicated, as it is uncertain which principles and regulations apply in a particular setting.