Smartphone apps for mindfulness interventions with suicidality in Asian youths: literature review

Background: The advent of mobile technology has ushered in an era where smartphone applications can be used for intervention for suicidality. Objective: Review recent research relevant to smartphone application that can be used for mindfulness intervention for suicidality in Asian youths. Methods: The inclusion criteria for this review is papers published in peer reviewed journals from 2007 to 2017 with usage of search terms namely ‘smartphone application’, and ‘mindfulness’, assessed against the inclusion criteria and screened by an experienced Asian clinician to be of clinical utility for mindfulness intervention for suicidality with Asian youths. Results: Initial search on databases yielded 375 results. 14 Full text papers that fit the inclusion criteria were assessed for eligibility and 10 papers were included in the current review. Conclusions: This review highlighted the paucity of evidence-based and empirically validated research into effective smartphone applications that can be used for mindfulness interventions for suicidality with Asian youths

Ethnic influences in suicide risk and prediction of lethality in suicide attempts

Medical records of 666 suicide attempters, who were admitted to a teaching hospital in January 2004 - December 2006, were examined. Of the sample, 69.2% were female, 30.8% were male. 63.8% were Chinese, 15.8% were Indian, 15.0 % were Malay and 5.4% were Eurasian. Significant ethnic differences were seen in suicide risk and protective factors. The Malays reported more protective factors and less risk factors as compared to the Chinese and Indians. Ethnic influences were also seen in the prediction of lethality measures. Compared to the Indians and Chinese, Malays made up the lowest proportion of attempters with high lethality attempts. The Chinese differ from the Indians and Malays in the prediction models for lethality. Cultural influences are discussed with implications for suicide assessments and interventions. Suicide prevention efforts could be targeted at promoting strengths to buffer against the impact of the identified vulnerabilities, and suicide assessment could also be improved by utilising empirical study of the local population

A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study

Background: Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. Objective: This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. Methods: In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. Results: The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. Conclusions: Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary

Health-related quality of life in pediatric patients with leukemia in Singapore: a cross-sectional pilot study

There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore

Smartphone application in postgraduate clinical psychology training: trainees’ perspectives

M-learning refers to the learning that takes advantage of mobile technologies. Although research shows enhanced educational outcomes from m-learning in some Asian countries, the generalizability to postgraduate clinical psychology training in Singapore remains unclear. Current professional standards in clinical psychology training emphasize the importance of attainment of clinical competencies in trainees. Although learning theories indicated potential for m-learning to be incorporated into the local clinical psychology curriculum, trainees’ perspectives have not been adequately explored on m-learning. The study aimed to address this gap by exploring the use of m-learning via a novel smartphone application in clinical psychology training using mixed-methods design. Eight clinical psychology trainees between the ages of 26 to 43 years old (mean age of 31.75, SD = 5.49) enrolled in a relevant coursework subject were recruited. Participants were randomly allocated to the experimental and control groups. The experimental group accessed the novel application weekly, from week 1 to week 6, and participants in the control group accessed the application after week 6. Participants from both groups completed a brief demographic questionnaire, and the following scales New General Self-Efficacy Scale adapted for Education (NGSES-E) and self-reported scale of learning outcomes (SLO). The qualitative study explored how participants perceived and experienced the novel application. Participants from the experimental group were invited to provide open-ended responses about the novel application. Data were analyzed using thematic analysis. Results from the qualitative analysis yielded four themes of: Convenience, preferred learning style, building confidence, and putting theory into practice. Findings from the qualitative study were consistent with previous studies about advantages of m-learning: That the e-platform was convenient, the learning style was engaging, which helped to build confidence, and facilitate practical learning of skills. The qualitative results were helpful in understanding the users’ perspectives and experience of the novel application, indicating that future research in this innovative area is necessary. However, the quantitative outcomes were not significant, limitations would be discussed, and recommendations made for future research

A new oxoaporphine and liriodenine’s anti-neuroblastoma potential from the roots of Polyalthia bullata King

Polyalthia bullata King’s root yielded a new compound named 5-methylliridine (1) in addition to six previously identified compounds. These known compounds include liriodenine (2), 11-methoxyliriodenine (3), lysicamine (4), onychine (5), 5-hydroxy-6-methoxyonychine (6), and 8-methoxyeupolauridine (7). The structures of compounds 1-7 were determined through spectroscopic analysis. Liriodenine (2) exhibited a remarkable ability to decrease the cell viability of cancerous N2A cells to 22% within a 24 h timeframe, indicating its potential as an anti-neuroblastoma agent. Molecular docking results additionally suggested that oxoaporphines (1-4) have the potential to act as inhibitors of protein kinases. These findings highlight the therapeutic potential of P. bullata constituents in cancer treatment, particularly neuroblastoma, and contribute to understanding its medicinal properties

Quality of Life in Patients With a Major Mental Disorder in Singapore

Background: There has been a paradigm shift in mental health service delivery, from a focus on reducing symptoms to a more holistic approach, which considers Quality of Life (QoL).Method: This study aimed to explore prediction of Quality of Life (QoL) in Asian patients with a major mental disorder i.e., depression or schizophrenia in Singapore. In the current study, there were 43 patients (65.1% females) with depression. Their ages ranged from 18 to 65 (M = 44.63, SD = 12.22). The data were combined with the data on patients with schizophrenia, where there were 43 patients (65.1% females) with schizophrenia, their ages ranging from 18 to 65 (M = 44.60, SD = 12.19).Results: The components of QoL were examined i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS). For all patients, social support and age accounted for 17.3% of the variance in PCS, F(2, 83) = 8.66, p &lt; 0.001. For patients with depression, disorder severity, age, and duration of treatment accounted for 48.3% of the variance in PCS, F(3, 39) = 12.15, p &lt; 0.001. For patients with schizophrenia, education (Primary or Lower vs. Post-Secondary or Higher) and emotional coping accounted for 21.3% of the variance in PCS, F(2, 40) = 5.40, p &lt; 0.01. For all patients, self-efficacy and age accounted for 27.0% of the variance in MCS, F(2, 83) = 15.37, p &lt; 0.001. For patients with depression, disorder severity accounted for 45.6% of the variance in MCS, F(1, 41) = 34.33, p &lt; 0.001. For patients with schizophrenia, number of hospitalizations accounted for 18.5% of the variance in MCS, F(1, 41) = 9.29, p &lt; 0.01.Conclusion: The findings were discussed in regards to implications in interventions to enhance QoL of patients with schizophrenia and depression in Singapore

Examining the validity of the Mini-Mental State Examination (MMSE) and its domains using network analysis

Background: The Mini-Mental State Examination (MMSE) is the most widely used standardised screener for impairments across a range of cognitive domains. However, the degree to which its domains (orientation, registration, attention, recall, language, and visuospatial) capture cognitive functioning measured using standardised neuropsychological tests is unclear. Method: A longitudinal research design with four biannual assessments over a 6-year period was used with an initial sample of 1037 older adults (aged above 70 years). Participants completed MMSE and neuropsychological tests at each assessment. Network analysis was utilised to investigate unique associations among the MMSE and its domains and neuropsychological test performance at each time point. Results: The total MMSE and two of its domains, language and recall, were associated with neuropsychological memory performance. The MMSE orientation, registration and visuospatial domains did not have any unique associations with neuropsychological performance. No stable internal interconnections between MMSE domains were found over time. The association of total MMSE as well as its recall domain with neuropsychological memory performance remained very similar over the 6-year period. Conclusions: The present study adds evidence to the validity of the MMSE and supports the clinical usage of the MMSE, whereby the total score is used for screening patients with or without cognitive impairments, with repeated administration to monitor cognitive changes over time, to inform intervention. However, the tool is not able to diagnose the cases for changes in specific cognitive domains and as such, should not replace a complete neuropsychological assessment

Applying generalizability theory to examine assessments of subjective cognitive complaints: whose reports should we rely on - participant versus informant?

OBJECTIVES: This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools. DESIGN: G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up. SETTING: Community-dwelling older adults aged 70-90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study. PARTICIPANTS: The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38). MEASUREMENTS: The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS: The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77-0.80) was optimized by removing one item resulting in G = 0.80-0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions. CONCLUSIONS: While both informants' (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual

Prevalence of internet addiction and gaming disorders in Southeast Asia: A meta-analysis.

This meta-analytic review aimed to examine the pooled prevalence rates of Internet addiction and gaming disorders in Southeast Asia. Several databases including PubMed, MEDLINE, PsycINFO, Web of Science, Embase, and Cochrane Central were searched and a total of 24 studies were included in this study. The selection of studies was conducted in accordance to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two meta-analyses were conducted to examine data on Internet addiction and gaming disorders separately. A random-effects model was employed to derive the pooled prevalence rate. Mixed-effects meta-regression and subgroup analyses were performed to examine the moderators of the between-study heterogeneity. Publication bias was tested using the Egger's regression test and funnel plot. Only seven out of the 11 Southeast Asian countries were represented in the literature. All except for two of the included studies were cross-sectional in nature. The findings revealed a pooled prevalence rate of 20.0% (95% confidence interval: 14.5%-27.0%) and 10.1% (95% confidence interval: 7.3%-13.8%) for Internet addiction and gaming disorders respectively. Mean age and study population were significant moderators of the between-study heterogeneity in the prevalence rates of gaming disorders such that samples involving older participants showed higher prevalence rate than those involving younger individuals. Country of study was found to be significant moderator of the between-heterogeneity for both Internet addiction and gaming disorders, however the findings should be interpreted with caution due to the small and unbalanced sample sizes. There was no significant publication bias. Such epidemiology research should be extended to the Southeast Asian countries that have not been studied or are under-studied. Given that the prevalence rates appear to be higher in Southeast Asia than in other world regions, future research should also explore the factors behind these inter-regional differences. Further longitudinal studies should also be conducted to examine the trajectories of such disorders