Application of Smartphone Technology in the Management and Treatment of Mental Illnesses

Abstract: Background: Mental illness continues to be a significant Public Health problem and the innovative use of technology to improve the treatment of mental illnesses holds great public health relevance. Over the past decade telecommunications technology has been used to increase access to and improve the quality of mental health care. There is current evidence that the use of landline and cellular telephones, computer-assisted therapy, and videoconferencing can be effective in improving treatment outcomes. Smartphones, as the newest development in communications technology, offer a new opportunity to improve mental health care through their versatile nature to perform a variety of functions. Methods: A critical literature review was performed to examine the potential of smartphones to increase access to mental health care, reduce barriers to care, and improve patient treatment outcomes. The review was performed by searching several electronic databases using a combination of keywords related to smartphones and mental health interventions using mobile devices. Literature concerning the use of cell phones, handheld computers, and smartphones to improve access to mental health care and improve treatment outcomes was identified.Results: The majority of studies identified were feasibility and pilot studies on patients with a variety of diagnosed mental illnesses using cell phones and PDAs. Authors report that most study participants, with some exceptions, were capable of using a mobile device and found them acceptable to use. Few studies extensively measured treatment outcomes and instead reported preliminary results and presented case illustrations. Studies which used smartphones successfully used them collect data on patients and deliver multimedia interventions. Discussion: The current literature offers encouraging evidence for the use of smartphones to improve mental health care but also reflects the lack of research conducted using smartphones. Studies which examine care provider use of smartphones to improve care is encouraging but has limited generalizability to mental health care. The feasibility of patient use of smartphones is also encouraging, but questions remain about feasibility in some sub-populations, particularly schizophrenia patients. Pilot testing of mobile devices and applications can greatly increase the feasibility of using smartphones in mental health care. Patients who are unfamiliar with smartphones will likely need initial training and support in their use. Conclusion: The literature identified several ways in which smartphones can increase access to care, reduce barriers, and improve treatment outcomes. Study results were encouraging but scientifically weak. Future studies are needed replicating results of studies using cell phones and PDAs on smartphones. Larger and higher quality studies are needed to examine the feasibility, efficacy, and cost-effectiveness of smartphones to deliver multiple component interventions that improve access to mental health care and improve treatment outcomes

Effect of a 14-Day Mindfulness Intervention on Daily Desire Experiences and Desire Regulation

A growing body of research suggests that mindfulness, a receptive attentiveness to one’s present moment experiences, has the potential to adaptively regulate habitual behaviors. No prior study has tested the effect of mindfulness interventions on people’s daily desire experiences to inform the potential for adaptive desire regulation. The present exploratory randomized controlled trial examined the effect of a 14-day smartphone-based mindfulness intervention (versus a coping control intervention) on the frequency, intensity, duration, and enactment of everyday desires in 19 participants. The desire domains included basic need-based desires (i.e., for food, drink, sleep) and secondary desires (e.g., for sex, media, social interactions, work), assessed for 7 days pre- and post-intervention through ecological momentary assessment (EMA). Emotion data collected alongside, also through EMA, permitted examining the role of the mindfulness intervention in altering a potential link between experienced emotion (positive and negative) and desire. Results showed that intervention condition significantly predicted post-intervention desire frequency; those in the mindfulness condition experienced a higher frequency of desires post-training, and specifically, increased secondary desire frequency, but not basic desire frequency. Intervention condition did not predict the other desire outcomes (enactment, strength, or duration). Results also revealed that intervention significant moderated the association between positive emotion and overall desire frequency; those in the mindfulness condition experienced fewer desires when experiencing increased positive emotion, whereas there was no association between positive emotion and desire after coping training. Intervention condition did not moderate associations between positive emotions and other desire variables, or negative emotions and any desire variables

Consumption of Organic Foods from a Life History Perspective:An Explorative Study among Italian consumers

Taking into consideration individuals’ cognitive reasoning, and assuming that consumption of organic food has involved a change of mind about food experiences and food habits, we have identified the concepts, stories and theories mentioned by respondents in their discourses about organic food. Regular consumers trust organic products because they believe that they are healthier and tastier than any other product. A growing stock of information supports their food choice and confidence in organic food. Occasional consumers have strong beliefs about the better taste and the higher quality of organic food in general. Non organic users sometimes perceive organic food as a new fashion, the last fad. Organic food is still confused with close ‘substitutes’, such as ‘natural’, ‘macrobiotic’ and similar products. Many occasional consumers believe that regular consumers are somewhat obsessed with organic food and that they look and behave strangely. Organic products are generally perceived and experienced as expensive products, when compared to conventional alternatives. To organic consumer the rewards they perceive to gain from organic food is well beyond the resources (in terms of time and money) they employ to search for the higher quality of organic products. Institutional attempts to change consumer behaviour are commonly categorized into consumer information, consumer education and consumer advice (Peter et al., 1999).In order to increase both behavioural and attitudinal loyalty, the level of consumer information and product knowledge should be increased. Besides, consumers will become more committed if their beliefs regarding the intrinsic self-relevance of organic food will increase in the future

Suicide and self-harm in Britain: researching risk and resilience using UK surveys

Aim The main aim of this study was to raise awareness of surveys that could be used to inform self-harm and suicide prevention work. We asked: What UK survey datasets are available for research? What aspects of people’s lives are associated with self-harm and attempted suicide? How do statistical findings resonate with people’s lived experience? What implications do they see? Findings Survey analyses revealed that risk factors for self-harm are wide ranging and include: Mental health Physical health and health behaviours Social relationships Stressful events Employment and financial circumstances Identity and demographics Many different factors are independently associated with self-harm. There is a dose relationship, with more exposure to a factor linked with increased risk. Risks are cumulative that is, exposure to multiple factors is associated with greater risk. Through facilitated consultation, men with lived experience, bereaved family members, and practitioners identified recommendations for responding to suicidal distress in men. These related to the following three main areas: 1. Recognising need: who is ‘ill enough’? Permission - men said that they often did not know they were entitled to help Ask - people who outwardly appear to be functioning may not be Persistence - ask and offer help more than once. 2. Facilitating access: right words, time and place What is available - support is needed with ongoing stress as well as for crises Find the words - men wanted examples of how to ask for help Allow time - employers expect recovery to be swift, some men felt rushed to come off medications or were discharged from services they still needed. 3. Adjusting delivery: equal engagement Power - some were uncomfortable with service dynamics, preferring peer support Every service contact counts - negative contacts had particular impact Safe spaces - may be different for men and women. Methods There were three strands of work: Secondary analysis of nine survey series, spanning more than twenty years Linkage of 144,000 survey participants to information on whether they were alive in 2013 and whether they had taken their own life Facilitated consultation, through depth interviews with people with lived experience

EXAMINING QUALITY INDICATOR RATES FOR OLDER HOME CARE CLIENTS WITH DUAL SENSORY IMPAIRMENT (DSI) AND EXPLORING THE HETEROGENEITY WITHIN DSI.

Older adults with impairments in both hearing and vision, called dual sensory impairment (DSI), are at an increased risk of negative health outcomes such as impaired communication and difficulties with mobility. It is unknown whether DSI is associated with potential quality of care issues. This study used a set of home care quality indicators (HCQIs) to examine potential quality issues in older clients (65+) with DSI. Further, it looked to explore how HCQI rates differed based on the geographic region of care and whether the client’s level of hearing and vision impairment was related to certain HCQIs. The HCQIs were generated from data collected using the Resident Assessment Instrument for Home Care and capture undesirable outcomes (e.g., falls, cognitive decline). Higher rates indicate a greater frequency of experiencing the issue. In this sample (n=352,656), the average age was 82.8 years (sd=7.9), the majority were female (63.2%), and 20.5% experienced DSI. Compared to those without DSI, clients with DSI had higher rates across 20 of the 22 HCQIs. The HCQI rates differed by geographic region, with specific regions consistently performing worse than others. Finally, the level of hearing and vision impairment was related to certain HCQIs more than others, for example hearing impairment appeared to be more related to the quality indicator measuring communication difficulty. Overall, the hope is that this information can help to identify some of the potential issues around quality and in turn, assist in continually improving the services being provided to these clients

Anticipatory Mobile Computing: A Survey of the State of the Art and Research Challenges

Today's mobile phones are far from mere communication devices they were ten years ago. Equipped with sophisticated sensors and advanced computing hardware, phones can be used to infer users' location, activity, social setting and more. As devices become increasingly intelligent, their capabilities evolve beyond inferring context to predicting it, and then reasoning and acting upon the predicted context. This article provides an overview of the current state of the art in mobile sensing and context prediction paving the way for full-fledged anticipatory mobile computing. We present a survey of phenomena that mobile phones can infer and predict, and offer a description of machine learning techniques used for such predictions. We then discuss proactive decision making and decision delivery via the user-device feedback loop. Finally, we discuss the challenges and opportunities of anticipatory mobile computing.Comment: 29 pages, 5 figure

Food Intake and Dietary Glycaemic Index in Free-Living Adults with and without Type 2 Diabetes Mellitus

A recent Cochrane review concluded that low glycaemic index (GI) diets are beneficial in glycaemic control for patients with type 2 diabetes mellitus (T2DM). There are limited UK data regarding the dietary GI in free-living adults with and without T2DM. We measured the energy and macronutrient intake and the dietary GI in a group (n = 19) of individuals with diet controlled T2DM and a group (n = 19) without diabetes, matched for age, BMI and gender. Subjects completed a three-day weighed dietary record. Patients with T2DM consumed more daily portions of wholegrains (2.3 vs. 1.1, P = 0.003), more dietary fibre (32.1 vs. 20.9 g, P < 0.001) and had a lower diet GI (53.5 vs. 57.7, P = 0.009) than subjects without T2DM. Both groups had elevated fat and salt intake and low fruit and vegetable intake, relative to current UK recommendations. Conclusions: Patients with T2DM may already consume a lower GI diet than the general population but further efforts are needed to reduce dietary GI and achieve other nutrient targets