Using Telemedicine to Reduce Suicide Ideation and Behavior: A Systematic Literature Review

Objective: To review the published research for reported effectiveness of telemedicine in reducing suicide ideation and behavior in patients already diagnosed with a psychiatric disorder. Design: A thorough literature search on the PubMed, Web of Science, PsycInfo, Cochrane Library, and TRIP (Turning Research Into Practice) Medical Database was conducted. Phrases such as “telemedicine,” “telehealth,” “remote consultation,” “mobile health,” “psychiatric disorders,” “suicide,” “suicide, attempted or ideation,” and “telepsychiatry” were employed in a variety of combinations. The primary inclusion criteria encompassed peer-reviewed articles published in the past 5 years. Secondary inclusion criteria comprised: (1) the diagnosis of any psychiatric disorder for all patients included in the study, (2) the absence or presence of use of telepsychiatry to offer consultation and communication, and (3) reported outcomes involving suicide rates or attempted suicide rates. The research publications passing inclusion criteria were assessed, and all their corresponding outcome measures were included in a meta-analysis. Results: A total of 705 studies were identified by applying the initial search strategy to the electronic databases described. Of these, 205 passed the primary inclusion criteria. After excluding duplicates and non-English articles, 105 articles were screened using the secondary inclusion criteria. Nine articles remained, including three systematic reviews that were excluded. Finally, a total of six independent, non-overlapping studies were included in this meta-analysis, encompassing data for 576 participants. The 18 outcome measures in this meta-analysis included five “positive” measures: perceived ability to cope with suicidal ideation, optimism, gratitude, positive affect, and the Mini Mental State Exam. The “negative” measures included: suicidal ideation intensity, hopelessness, depression, suicidality, HAMD (Hamilton Depression Rating Scale) score, HAMD score without suicide item, medical admissions, number of days of medical hospitalizations, number of psychiatric hospitalizations, number of emergency room visits, suicide ideation questionnaire (SIQ) from baseline to posttreatment, and SIQ from baseline to follow-up. Overall, this review found support for the hypothesis that telemedicine can reduce suicide ideation and behavior. There was a moderate effect size for the 18 measures analyzed. Based on the four different forest plots presented in this analysis, all average effect sizes calculated showed that the intervention of telemedicine has a small-to-moderate effect on the measures studied, which translates loosely to a small-to-moderate effect on the patient’s suicide ideation and behavior. Conclusions: Telemedicine appears to be a promising way to reduce suicidal ideation, although how this translates into reductions in self-harm and/or suicide attempts is unclear from this review alone.

Well-being in high-risk pregnancy: an integrative review

Background A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in HRP, there is no clear definition for it. This study aimed to explore the concept of well-being in HRP. Methods This integrative review was conducted using the Whittemore and Knafl’s approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance to well-being in HRP. The full-texts of all these articles were assessed using the checklists of the Joanna Briggs Institute. Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in HRP. Results Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. The four unique dimensions of well-being in HRP are physical, mental-emotional, social, and spiritual well-being. These dimensions differentiate well-being in HRP from well-being in low-risk pregnancy and in non-pregnancy conditions. Conclusion As a complex and multidimensional concept, well-being in HRP refers to the pregnant woman’s evaluation of her life during HRP. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components.

Well-being in high-risk pregnancy: an integrative review

Background: A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in HRP, there is no clear definition for it. This study aimed to explore the concept of well-being in HRP. Methods: This integrative review was conducted using the Whittemore and Knafl’s approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance to well-being in HRP. The full-texts of all these articles were assessed using the checklists of the Joanna Briggs Institute. Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in HRP. Results: Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. The four unique dimensions of well-being in HRP are physical, mental-emotional, social, and spiritual well-being. These dimensions differentiate well-being in HRP from well-being in low-risk pregnancy and in non-pregnancy conditions. Conclusion: As a complex and multidimensional concept, well-being in HRP refers to the pregnant woman’s evaluation of her life during HRP. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components.

Quartz fluid inclusions characteristics of fluvial deposit in Changjiang River and their implications

<p><strong>The morphological characteristics of quartz inclusions in sediments from five locations in the upper, middle and lower reaches of the Changjiang River are analyzed. The source indication of sediments is discussed through the differences in shape, size, quantity, gas percentage and genetic type. From upstream to downstream, the</strong> <strong>characteristics of quartz inclusions in sediments are different. The inclusion types appearing in the samples from upstream to estuary are gradually enriched. The sediment influx from the tributaries of the Changjiang River makes new types of quartz inclusions appearing in the downstream and estuary. In terms of quantity and size, most quartz inclusions are concentrated in the range of 2-4 </strong><strong>μ</strong><strong>m in size and 10-150/mm<sup>3</sup> in number. The number and size range of different positions are also different. In SGJS-01 collected from Shigu, is 2-18 </strong><strong>μ</strong><strong>m, the number is 2-166 per volume. In YBCJ-01, YZD-63 and YZD-10 samples collected from Yibin, Yichang and Wuhan, the size is 2-15</strong><strong>μ</strong><strong>m, 2-10</strong><strong>μ</strong><strong>m</strong><strong>, 2-12</strong><strong>μ</strong><strong>m and the number is 1-270, 2-220 and 1-308 per volume. The primary inclusions of SGJS-01 in Shigu is 14%, higher than that of primary inclusions in the middle and lower reaches, and that of YBCJ-01 in Yibin decreases to 6%, and for YZD-63, YZD-10 and HK-01 they were 8%, 6% and 5% respectively. The change of the primary inclusion proportion reflects the difference of source rock types of sediments. The difference of source rocks of sediments can be reflected in the type, size, quantity and</strong> <strong>proportion of primary inclusions. The characteristics of quartz inclusions could be a new way to explore the source of sediments. </strong></p>

Raman spectroscopic identification of cookeite in the crystal-rich inclusions in spodumene from the Jiajika lithium pegmatite deposit, China, and its geological implications

Cookeite usually occurs as a late alteration product in lithium–cesium–tantalum-type granitic pegmatite. Consequently, cookeite-bearing crystal-rich inclusions (CIs) in pegmatite are considered to be of secondary origin, which constrains our understanding of pegmatite formation. Thus far, no reported cookeite has produced a distinct Raman spectrum. However, the CIs hosted in spodumene in the Jiajika pegmatite deposit, China, contain a cookeite-like hydrous lithium–aluminum–silicate phase, yielding a distinct Raman spectrum. In electron microprobe analysis, focused ion beam scanning electron microscopy, and time-of-flight secondary ion mass spectrometry (ToF-SIMS), the average composition of this hydrous phase was determined as Li1.005(Al3.997Fe0.018)(Si3.086Al0.914)O10.076OH7.902F0.098, close to the International Mineralogical Association (IMA) formula of cookeite, (Al, Li)3Al2(Si, Al)4O10(OH)8. The distinct Raman peaks at 98, 167, 219, 266, 342, 382, 457, 592, 710, and 3640 cm−1 were consistent with those of natural cookeite recrystallized in a hydrothermal diamond-anvil cell. The peaks were ascribed to the crystallization of cookeite from the liquid trapped in the closed space during the spodumene crystallization, which occurred at relatively high temperature and pressure without incorporating the minor elements commonly present during alteration processes. These minor elements often obscure the Raman signals, primarily by fluorescence effects. This type of cookeite in CIs with distinct Raman signals is unusual and can indicate whether the cookeite crystallized from fluid trapped within the closed space of a primary inclusion. In such a case, the fluid can be considered a flux-rich hydrous melt in pegmatite formation models.

Well-being in high-risk pregnancy: an integrative review

Background: A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in high-risk pregnancy, there is no clear definition for it. This study aimed to explore the concept of well-being in high-risk pregnancy. Methods: This integrative review was conducted using the Whittemore and Knafl’s approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance well-being in high-risk pregnancy. The full-texts of all articles were assessed using the checklists of the Joanna Briggs Institute (JBI). Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in high-risk pregnancy. Results: Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. Findings showed that the four dimensions of well-being in high-risk pregnancy concept were physical, mental-emotional, social, and spiritual well-being. Conclusion: As a complex and multidimensional concept, well-being in high-risk pregnancy refers to the pregnant woman’s evaluation of her life during high-risk pregnancy. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components. Keywords: Well-being, Pregnancy, High-risk pregnancy

Well-being in high-risk pregnancy: an integrative review

Abstract Background: A prerequisite to the interventions for well-being improvement in high-risk pregnancy is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in high-risk pregnancy, there is no clear definition for it. This study aimed to explore the concept of well-being in high-risk pregnancy. Methods: This integrative review was conducted using the Whittemore and Knafl’s approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance well-being in high-risk pregnancy. The full-texts of all articles were assessed using the checklists of the Joanna Briggs Institute (JBI). Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in high-risk pregnancy. Results: Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. Findings showed that the four dimensions of well-being in high-risk pregnancy concept were physical, mental-emotional, social, and spiritual well-being. Conclusion: As a complex and multidimensional concept, well-being in high-risk pregnancy refers to the pregnant woman’s evaluation of her life during high-risk pregnancy. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components. Keywords: Well-being, Pregnancy, High-risk pregnancy

The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study

IntroductionUnderstanding the natural course of neuropsychiatric symptoms (NPS) in dementia is important for planning patient care and trial design, but few studies have described the long-term course of NPS in individuals.MethodPrimary inclusion of 223 patients with suspected mild dementia from general practice were followed by annual assessment, including the Neuropsychiatric Inventory (NPI), for up to 12 years. Total and item NPI scores were classified as stable, relapsing, single episodic or not present based on 4.96 (s.d. 2.3) observations (98% completeness of longitudinal data) for 113 patients with Alzheimer's disease and 84 patients with LBD (68 dementia with Lewy bodies and 16 Parkinson's disease dementia).ResultsWe found that 80% had stable NPI total ≥1, 50% had stable modest NPI total ≥12 and 25% had stable NPI total ≥24 scores. Very severe NPS (≥48) were mostly single episodes, but 8% of patients with Alzheimer's disease had stable severe NPS. Patients with Alzheimer's disease and the highest 20% NPI total scores had a more stable or relapsing course of four key symptoms: aberrant motor behaviour, aggression/agitation, delusions and irritability (odds ratio 55, P < 0.001). This was not seen in LBD. Finally, 57% of patients with Alzheimer's disease and 84% of patients with LBD had reoccurring psychotic symptoms.ConclusionsWe observed a highly individual course of NPS, with most presenting as a single episode or relapsing; a stable course was less common, especially in LBD. These findings demonstrate the importance of an individualised approach (i.e. personalised medicine) in dementia care.

Problems Faced by Agricultural Landless Laborers in Cuddalore District, Tamil Nadu: A Status Analysis

India is the second the largest part populous country of the world and has changing socio-economic condition and political demographic and morbidity patterns that have been illustration global thought in current years. Though in recent times enacted MGNREGA, 2005 provides 100 days guarantee of employment in a year, there is great deal of fraud in issuing job cards. Moreover, gather rolls are not maintained accurately and work is not provided to job seekers who really are in need of such support. The problem of agricultural landless laborers is part of the wider problem of unemployment and under-employment in rural areas. Research is primarily a study of how the problems of agricultural workers face. The study is conducted among the farmers in the Parangipettai block in Cuddalore district. Multi-stage purposive sampling method was adopted for selection of the respondents. In this, contexts were selected from 3 select villages of Parangipettai block, Cuddalore district. Size of the primary inclusion is 120. Hence the agricultural landless labourers play an important to role in agriculture sector where the production depends on both the agricultural landless labourers and landowning farmers.