Discrepancies Between Nomenclature and Indications of Psychotropics.

Introduction: While the current nomenclature of psychotropic drugs is disease-based, their approved indications do not always match their classifications.

Methods: Information on approved indications of "second-generation antipsychotics" and "newer antidepressants" that are available in the United States (US), the United Kingdom (UK), France, Germany, and Japan were extracted from their packet inserts.

Results: A significant proportion of "atypical antipsychotics" were approved for psychiatric conditions other than psychotic disorders (i.

Physician characteristics influence the trends in resuscitation decisions at different ages.

Aim: We examined how physicians in different medical specialties would evaluate treatment decisions for vulnerable patients in need of resuscitation.

Methods: A survey depicting six acutely ill patients from newborn infant to aged, all in need of resuscitation with similar prognoses, was distributed (in 2009) to a representative sample of 1650 members of the Norwegian Medical Association and 676 members of the Norwegian Pediatric Association.

Results: There were 1335 respondents (57% participation rate).

Association between alcoholism and the gene encoding the endocannabinoid synthesizing enzyme diacylglycerol lipase alpha in the Japanese population.

The endocannabinoid system has been recognized to be involved in neuropsychiatric diseases. 2-arachidonoyl glycerol (2-AG) is one of the two main endocannabinoids, and their regulation could play roles in disorders under environmental influence. This study investigated the involvement of the 2-AG biosynthesizing enzyme diacylglycerol lipase alpha (DAGLA) in the pathogenesis of alcoholism.

Subtyping Schizophrenia by Social Functioning - a Pragmatic Proposal for Clinics and Research.

Schizophrenia has been claimed to be a "heterogeneous" disorder despite the fact that a diagnosis is made without reliable biomarkers but sorely with a constellation of "common" observable symptoms that however may be overlooked. Alternatively functional impairments are the prerequisite to make a diagnosis and may be simpler and more pragmatic to express objectively. It would then be reasonable to categorize patients according to the magnitude of psychosocial impairments, as has been done in terms of the severity of "classical" symptoms.

Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study.

Objective: The impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross-sectional study.

Method: Three-hundred sixty-nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM-IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25-item Resilience Scale.

Counseling parents at risk of delivery of an extremely premature infant: Differing strategies.

Background: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents.

Methods: Semistructured interviews asked internationally recognized experts to share their perspectives on perinatal consultations.

Personalized Decision Making: Practical Recommendations for Antenatal Counseling for Fragile Neonates.

Emphasis has been placed on engaging parents in processes of shared decision making for delivery room management decisions of critically ill neonates whose outcomes are uncertain and unpredictable. The goal of antenatal consultation should rather be to adapt to parental needs and empower them through a personalized decision-making process. This can be done by acknowledging individuality and diversity while respecting the best interests of neonates.

Managing Ethical Dilemmas in End-Stage Neurodegenerative Diseases.

Neurodegenerative diseases are chronic, progressive and incurable illnesses that ultimately lead to death. The patient deteriorates inexorably towards the terminal phase of the disease when he becomes mentally and physically incapacitated. This article discusses the many ethical and moral dilemmas faced by the clinician and family members as they care for patients with neurodegenerative illnesses approaching the end of life.

Definition of compassion in healthcare: a systematic literature review.

Aim: To reflect on the definition of compassion and analyse the concepts encompassed by the term.

Background: A large number of authors have defined compassion, with certain nuances that differ from case to case. This raises the need for specificity in the definition of the term.

Moral distress within neonatal and paediatric intensive care units: a systematic review.

Objective: To review the literature on moral distress experienced by nursing and medical professionals within neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs).

Design: Pubmed, EBSCO (Academic Search Complete, CINAHL and Medline) and Scopus were searched using the terms neonat*, infant*, pediatric*, prematur* or preterm AND (moral distress OR moral responsibility OR moral dilemma OR conscience OR ethical confrontation) AND intensive care.

Results: 13 studies on moral distress published between January 1985 and March 2015 met our inclusion criteria.

The ethics of neonatal research: An ethicist's and a parents' perspective.

The ethics of neonatal research are complex because vulnerable new parents are asked to provide consent on behalf of their fragile baby. Whereas clinical neonatal care has evolved to value personalized and shared decision-making, the goal of research ethics is still to standardize the informed consent process and make it as complete and thorough as possible. Ethicists, lawyers and physicians have shaped the field of research ethics and consent for research.

Trainee Perspectives on Manikin Death During Mock Codes.

Background: The acceptability of simulated death has been debated by experts, but there is scarce information regarding trainees' perspective.

Methods: Trainees in a large pediatric program were invited to perform mock codes, including pre and post questionnaires. Participants were exposed to 2 mock codes of neonates born pulseless.

Dutch neonatologists have adopted a more interventionist approach to neonatal care.

Aim: This study investigated whether continuous improvements to neonatal care and the legalisation of newborn euthanasia in 2005 had changed end-of-life decisions by Dutch neonatologists.

Methods: We carried out a retrospective study of foetuses and neonates of more than 22 weeks' gestation that died in the delivery room or in the neonatal intensive care unit (NICU) of a tertiary referral hospital in the Netherlands, comparing end-of-life decisions and mortality in 2001-2003 and 2008-2010, before and after euthanasia legislation was introduced.

Results: In 2008-2010, there were more deaths in the delivery room due to termination of pregnancy than in 2001-2003 (17% versus 29%, p = 0.

Attitudes of Australian neonatologists to resuscitation of extremely preterm infants.

Aim: We aimed to investigate how Australian neonatologists made decisions when incompetent patients of different ages needed resuscitation.

Methods: A survey including vignettes of eight incompetent patients requiring resuscitation was sent to 140 neonatologists. Patients ranged from a very preterm infant to 80 years old.

Implementation of palliative care as a mandatory cross-disciplinary subject (QB13) at the Medical Faculty of the Heinrich-Heine-University Düsseldorf, Germany.

Background: By means of the revision of the Medical Licensure Act for Physicians (ÄAppO) in 2009, undergraduate palliative care education (UPCE) was incorporated as a mandatory cross sectional examination subject (QB13) in medical education in Germany. Its implementation still constitutes a major challenge for German medical faculties. There is a discrepancy between limited university resources and limited patient availabilities and high numbers of medical students.

Ethics and etiquette in neonatal intensive care.

When parents voice their dissatisfaction with the neonatal intensive care unit (NICU), it is often not because they think their baby has not received good medical care. Instead, it is often because their needs have not been addressed. Policy statements and pedagogy alike urge professionals to be empathetic, compassionate, honest, and caring.