New guidelines for management of schizophrenia
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has published new clinical practice guidelines for the management of schizophrenia and related disorders. According to a press release from the College, the guidelines reflect “an increased emphasis on early intervention, physical health, psychosocial treatments, cultural considerations, improved vocational outcomes and recovery”. RANZCP Working Group Chair, Professor Cherrie Galletly said the guidelines use “a clinical staging model as a framework for recommendations regarding assessment, treatment, and ongoing care”. “The guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. At all stages, the therapeutic relationship is the foundation of clinical care. Time must be spent building trust and good communication. It is essential to take a respectful approach, provide accurate information, and address the person’s questions and concerns.” The new guideline is available, open access, in the May edition of the Australian and New Zealand Journal of Psychiatry.
Global sleep crisis brewing
Social pressures are forcing people to cut back on the number of hours they sleep, according to a report in the South China Morning Post. Using a smartphone app called Entrain, which was launched in 2014 to help users fight jet lag, scientists from the University of Michigan have tracked sleep data from 6000 people around the world, “gathering data about how age, gender and the amount of natural light to which people are exposed affect sleep patterns in 100 countries”. “We find that social pressures weaken and/or conceal biological drives in the evening, leading individuals to delay their bedtime and shorten their sleep,” the authors were quoted as saying. Lack of sleep is mostly affected by the time people go to bed, the study found. Middle-aged men get the least amount of sleep, less than the recommended 7 to 8 hours, and age is the main factor determining amount of sleep. The average amount of sleep in the world varies from a minimum of 7 hours, 24 minutes in Singapore and Japan to a maximum of 8 hours, 12 minutes in the Netherlands, the study found. The researchers also found that women sleep 30 minutes longer than men on average by going to bed earlier and rising later, and that people exposed longer to natural light every day often go to bed earlier.
Food processing link to T2D
Researchers from Monash University and the University of Queensland have linked the widespread heat processing of foods to a worsening in insulin sensitivity and the development of type 2 diabetes (T2D). An estimated 25% of Australians aged over 25 years have prediabetes or diabetes, and the associated financial burden on the country is expected to double to more than $2 billion by 2025. Associate Professor Barbora de Courten from Monash said long-term dietary intake of advanced glycation end products (AGEs) worsens insulin sensitivity and increases the likelihood of the development of T2D. “Our study demonstrated that consumption of a low AGE diet results in lower urinary AGE concentrations and improved insulin sensitivity when compared to a diet high in AGEs,” Professor de Courten said. “T2D is not only a major threat to public health, but also an increasing burden on the economy. These findings have important public health implications. Important studies are needed to confirm that lower dietary AGE consumption can reduce the incidence of T2D diagnoses, and help relieve pressure on the healthcare budget.”
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