Day 1 :
- Mental Health, Psychopharmacology, Psychiatric Disorders, Psychiatry and Psychology, Bipolar and Schizophrenia, Neuropsychiatry, Psychotherepy, Child and Adolescent Psychiatry, Self-Harm and Suicide Prevention, Stress, Anxiety and Depression, Psychosomatic Disorders, Ophthalmology, Paediatric ophthalmology, Ophthalmology surgery
Center for Practical Professional Training, Israel
Time : 09:00-09:30
Anat serves as the chairman of the Israeli Parental Counseling and Family Counseling Association. Over the past three years, together with Ofer Erez, Anat has broadcast a weekly radio show and has daily live broadcasts on social media networks, discussing mental health topics. Anat has published several academic publications in the last year and is involved in ongoing research of her practice. She serves on the editorial board of “Clinical images and case reports journal”.Anat has more than 16 years of practical experience working with children, adolescents and parents. During her undergraduate studies, she worked as a therapist in the Welfare Ministry and served as a group therapist in a Mental health hospital in Ottawa, Canada. Anat is the co-manager of Kelim Shiluvim L.T.D (established in 2006) that specialises in diagnosis and therapy and for individuals and families in both clinical and home settings and has treated hundreds of couples and families.
The Covid - 19 pandemic has brought extreme changes which forced all of us to make adaptations in almost every domain of our daily lives, both at home and in our workplace. World population was forced to adjust too many challenging changes in a very short period of time. One of the critical ones was physical social distancing. Psychotherapy is one of the professional fields which is based upon and anchored in the great impact that open and trusting relationships has on the psychological wellbeing of an individual. In psychotherapy, until the outburst of the pandemic, this relationship was created in a safe space of the clinic. This space was provided by the therapist, to enable growth and development of the therapeutic relationship. The profession which is based on a face to face interaction in a safe space that the clinical setting provided was challenged by the world pandemic. Therapists were forced to decide quickly how to continue to provide psychological help at a time in which it was needed more than ever. They were offered to do this in a different setting which was facilitated by technology, and differed greatly from what traditional psychotherapy was meant to be. 3 years after the pandemic intruded our lives and minds, understandings gathered from the transition of the therapeutic encounter from the face to face to the “zoom” video setting of the therapeutic encounter are offered. Surprisingly, following the remission of the pandemic and the possibility to return to the classical setting, many people still prefer to utilize the online therapy. Understandings related to the advantages and challenges of these transitions are discussed.
Enathe Uwoturikumwe, Bachelor Holder University of Rwanda, School of Medicine and Pharmacy from 2015 to 2019, Licenced Professional Counsellor and Registered Clinical Psychologist. A Clinical Psychologist at Strive Foundation Rwanda a Non-Governmental Organisation that Empower People to Help them-selves in Rwanda from 2020 up to date.
Recently, the research conducted by International journal of mental health system in Rwanda concluded that ‘As a consequence of the genocide, rates of mental disorders are elevated in Rwanda. In community samples rates for PTSD range from 24.8% to 46.4% , for depression rates ranged from 15.5%to46.4%and add rate of up to 58.9% is for anxiety (International journal of mental health system , Article number: 37 (2014)). After the publication of different research findings about mental health problems, the Government of Rwanda noted issue of delinquency. And research made shows that the risk factors related to delinquency were compounded by drugs abuse, poverty, dysfunctional family, violence by most frequently young people are mainly at risk not because they may turn to substance abuse, street living and a petty crimes as a way of dealing with the difficulties they face but also because they are ambitious and are in danger of being exploited. (Rwanda National Rehabilitation service report, on 18th Feb,2018) as response against delinquency the Government of Rwanda established National Rehabilitation centre like I Wawa, mental health settings such as Ndera to address this problem of delinquency. Unfortunately, the establishment of National Rehabilitation centre failed to address problem of delinquency and rehabilitation of social well-being of people because drugs abuse, poverty are not the root cause, but are the symptoms of depression. Rwanda mental heal survey found that Post-Trauma Stress Disorder is more prevalent among genocide survivors compared to the general population (27.9% vs. 3.6%). The research also shows that depression among general population is 11.9% and at least one of five Rwandans have a mental health condition; mental disorders among youth aged 14-18 years old are 10.2%.Rwanda mental health journal published on 06th April 2021.
Imperial College London, UK
Time : 10:30-11:00
In 2020, there were 5,224 deaths due to suicide registered in England and Wales (1). The Mental Health Foundation has reported that ~70% are in patients with depression (2). The number of attempted suicides is much higher – South West London and St George’s mental health trust estimates that at least 140,000 people attempt suicide in England and Wales every year (3).
In suicidal depression, the psychological pain is often unbearable and feels overwhelmingly incompatible with life. One is no longer living, they are merely surviving and eventually, the exhaustion will lead to decompensation. This is marked by suicide. The goal is to end the suffering permanently and this is achieved through death. Depression, like all other physical and mental illnesses, runs a course. This is highly variable between individuals and can be the case even between separate relapse episodes in the same patient. Like many diagnoses, depression is known to lead to death in a significant number of people. Many suicidal depressed patients feel that death will be an inevitable result of the illness. Suicide is often viewed as a symptom of severe depression, but would it be justifiable to consider death as part of the disease process itself? Consequently, would it be justifiable to consider depression in these patients as a form of terminal illness? Since without treatment, the condition would lead to death? Accordingly, could there be a place for palliative care in a small minority of suicidal depressed patients? This would mean that instead of placing the focus on the prevention of deaths and prolonging lifespan, the focus would be on making the patient comfortable as the disease progresses, maintaining their dignity and promoting autonomy.
In this essay, I discuss the ethical and moral implications of suicidal depression from a doctor’s and patient’s perspectives. I also discuss the implications of depression on capacity and decision-making. Lastly, I discuss the ethical dilemmas surrounding assisted suicide and euthanasia for severe suicidal treatment resistant depression. Could there be considered a means of treatment in certain cases?
Nicotine is an alkaloid which isolated from tobacco leaves in 1828 and since then it has been extensively studied. Nicotine in its pure form is a volatile, colorless, and strongly alkaline liquid that turns pale yellow to dark brown on exposure to air producing a properties tobacco smell. From tobacco smoke, nicotine arrives in the blood stream through the lungs, but, nicotine in smokeless tobacco enters the mucosal membrane of the mouth and nose or the skin. After absorption, nicotine transfers rapidly and reaches the brain in seven seconds. It freely crosses in the blood–brain barrier (BBB). Then, nicotine affects numerous physiological processes such as anxiety, nociception, depression, learning and memory. On the other hand, it produces many behavioral processes directly associated with its addictive characteristic including rewarding effect and physical dependence. Nicotine indicates diverse effects on anxiety behavior both in humans and animals. Several studies have revealed that nicotine induces both anxiolytic- and anxiogenic-like behaviors in animals. In fact, nicotine may induce anxiolytic, anxiogenic, and neutral effects on anxiety behavior depending on the doses, route of injection, species, strain, experimental model or number of trials used. The nicotinic acetylcholine receptor (nAChRs) stimulates by acetylcholine (Ach) or nicotine in the brain which are mostly located presynaptically, where they regulate the release of various neurotransmitters (for instance Ach, glutamate, dopamine, norepinephrine, serotonin and GABA which participate in anxiety behavior). These neurotransmitters, binding on diverse post-synaptic receptors, change the anxiety related behaviors in animals. A number of researches indicated that the anxiolytic or anxiogenic responses of nicotine may be due to variation of the brain neurotransmitter release. For example, nicotine application enhanced glutamate release in the prefrontal cortex. This release of glutamate may enhance anxiety-like responses. Also, anxiogenic-like effect of nicotine produced via nicotinic and adrenergic mechanisms. Furthermore, it has been revealed that anxiogenic-like property of nicotine may be due to nicotine-activated dopamine release which both dopamine D1 and D2 receptors are participated in regulation of anxiety-like behavior produced by nicotine. Additionally, there is report displaying the modulatory effects of nicotine on nitric oxide produced anxiogenic-like responses in rodents. In contrast, stimulation of the nAChRs causes the release of GABA neurotransmission, which may mediate nicotineinduced anxiolytic-like behaviors.
Central Middlesex Hospital, UK
Title: Trabecular microbypass stent (istent) implantation in open angle glaucoma patients- Techniques and outcomes
Time : 12:00-12:30
Nadisha Singh is a Consultant Ophthalmologist practising in Central Middlesex hospital, London Northwest NHS trust. Her main areas of interests are Cataract Surgery, Glaucoma, Cornea and Medical retina. She has done four fellowships including at the prestigious Moorfields Eye Hospital. She has a keen interest in teaching and education and has been faculty at various regional, national & international conferences. She has been a tutor at the Undergraduate teaching at Kings College hospital.
Glaucoma is a leading cause of blindness in the world. Intra-ocular pressure (IOP) is a modifiable risk factor in glaucoma which helps to reduce the progression of the disease. Eyedrops and glaucoma filtration surgeries have long known to be effective in lowering the IOP. However, they have their own set of serious complications associated with them.
One of the newer minimally invasive glaucoma device includes istent. This technology can be used alongside cataract surgery in order to reduce the post-operative IOP and help reduce the number of medications that the patient is taking.
In this presentation, I will explain to you regarding the technique of implanting istent and discuss the outcomes of the istent technology.