Suicide Prevention and Follow-Up Services: A Narrative Review

Previous suicide attempt is the most important predictor of death by suicide. Thus preventive interventions after attempting to suicide is essential to prevent reattempts. This paper attempts to determine whether phone preventive interventions or other vehicles (postal cards, email and case management) are effective in reattempt prevention and health promotion after discharge by providing an overview of studies on suicide reattempts. The research investigated in this review conducted from 1995 to 2014. A total of 26 cases related to the aim of this research were derived from 36 English articles with the aforementioned keywords Research shows that providing comprehensive aids, social support, and follow-up after discharge can significantly prevent suicide reattempts. Several studies showed that follow-up support (phone calls, crisis cards, mails, postal cards.) after discharge can significantly decrease the risk of suicide. More randomized controlled trials (RCT) are required to determine what factors of follow-up are more effective than other methods

Review narrative: Nursing in research action towards moving

Action research is a learning-by-practice method wherein a group of people recognize a problem in a situation and take actions to resolve it. If nurses themselves find a solution and resolve the problems, executive problems will be reduced and become more acceptable. This study reviews Action Research-based studies released on nursing to better understand and further apply them in nursing. This is a review study. Data collection procedure was done via searching in scientific data bases. The keywords �Action Research� and �Nursing Care� in the title and abstract of articles were applied. Articles were accurately reviewed. Finally, data analysis was conducted and results were discussed. Reviewed studies were carried out between 2007 and 2014. Amongst them, 12 full text English accessible paperswere reviewed. Additionally, in domestic databasesan English article as well as a Persian study on the subject were discussed and reviewed. Through Action Research, nurses are able to understand clinical situation and make decisions based on their authorities and responsibilities. This increases their confidence as well as their personal, occupational and social growth. It can also enhance their satisfaction and inner motivation. This, in turn can lead to the provision of better services and enhance the quality of cares. It is suggested that opportunities be provided for enhancing clinical and academic nurses� participation by setting the scene for implementing action research for nurses. © Medwell Journals, 2016

New visiting policy: A step toward nursing ethics

Background: Patients� rights arise from their expectations of the healthcare system, which are rooted in their needs. Visitation is seen as a necessary need for patients and families in intensive care units. Objectives: The authors attempted to design, implement, and evaluate a new visiting policy in the intensive care units. Research design: This study was an action research, including two qualitative and quantitative approaches. Participants and research context: The viewpoints of 51 participants (patients, families, doctors, nurses, and guards) on how to change the limited visiting policy were explained through semi-structured interviews and focus groups. The new visiting policy (contractual visitation) was designed, implemented, and evaluated with the involvement of participants. Ethical considerations: The hospital ethics committee approval was gained and the informed consent was obtained from all the participants. Findings: The content of interviews was analyzed and classified into four categories: advantages and disadvantages of visiting policies, and barriers and facilitators of changing the limited visiting policy. After implementation of the new policy (contractual visitation), a significant difference observed in satisfaction status before and after the changes (p value < 0.001). Discussion: Nowadays, many countries� clinical guidelines recommend flexible visiting policy, which is consistent with the results of this study. Conclusion: Changing the limited visiting policy was a necessary need for patients and families that established with the involvement of them and staff. © The Author(s) 2017

Aftercare and Suicide Reattempt Prevention in Tehran, Iran: Outcome of 12-Month Randomized Controlled Study

Background: A previous suicide attempt is one of the strongest risk factors for subsequent suicide. Effective care following a suicide attempt may reduce the risk of suicide reattempts. Aims: We aimed to investigate the effect of a brief educational intervention and contact program on suicide reattempts. Method: This study was performed as a randomized clinical trial (RCT) recruiting 305 individuals who had attempted suicide (brief intervention and contact = 153 individuals, BIC; treatment as usual = 152 individuals, TAU) who were referred to Baharlu Hospital in Tehran. The SUPRE-MISS questionnaire and a discharge follow-up questionnaire were used for data collection. Cox proportional hazard models and log-rank tests were used to assess the association of the variable with the event (reattempt). Kaplan-Meier curves were used to depict the time to the event of reattempt. Results: In the BIC group, 11 of the individuals had attempted suicide once, and 25 of the TAU group had attempted suicide once (12.4), twice (9.3), and three times (3.8), respectively. The results of Kaplan-Meier analysis indicated the mean time of reattempt in the BIC (0.76) and TAU groups (0.25) as the fourth and second months of follow-up, respectively (log rank, �2 = 12.48, p <.001). The hazard ratio for the TAU group was 2.57 (95 CI 1.4, 5.9). Limitations: Loss to follow-up due to stigma is one of the serious problems of follow-up services. Conclusion: Implementing a brief educational intervention and contact program on suicide reattempts is feasible and effective in reducing the rate of reattempt; however, it should be accommodated within the mental health services of the county. © 2021 Hogrefe Publishing

Shear strength properties of cable bolts using a new double shear instrument, experimental study, and numerical simulation

A newly developed double shear apparatus without contact between concrete blocks was developed to conduct a series of double shear tests. This new double shear apparatus is capable of determining the pure shear strength of pre-tensioned fully grouted cable bolt without friction between sheared concrete blocks. Five different types of cable bolt, with various pretension loads, were tested to investigate the influence of surface profile type and pretension load on the shear strength of cable bolt. Concrete blocks of 40 MPa strength and the Stratabinder HS grout were used for consistency across the entire tests. The results showed that the plain cable bolts had higher peak shear load compared with the indented and spiral strand cable bolts. The shear displacement and peak shear load decreased by increasing the pretension load. A numerical analysis was carried out, based on the Fast Lagrangian Analysis of Continua (FLAC 2D) and the result was compared with the experimental data. It was observed that FLAC 2D is capable of simulating the performance of cable bolt satisfactorily

An Experimental Study on the Shear Performance of Fully Encapsulated Cable Bolts in Single Shear Test

A set of single shear tests on fully encapsulated cable bolts was carried out using a newly developed and integrated Megabolt single shear apparatus. The instrument is designed to determine the pure shear strength of cable bolts where there is no contact between the host body faces during the shearing process. Eight different types of cable bolt were encapsulated in 40 MPa concrete cylinders, using Stratabinder HS grout. Prior to encapsulation, cable bolts were pretensioned at the desired value using a manual pretensioner. Effects of surface profile, pretension value and debonding on shear strength of cable bolts were investigated. It was found that the shear strength of spiral/indented cable bolts was lower than that of plain cable bolts. Increasing the pretension load decreased the peak shear load of cable bolts. In general, no debonding was observed for spiral/indented cable bolts during shear testing; however, all tested plain cable bolts were debonded

Hospital facilities at home for heart failure patients

Background: Heart failure is a complex syndrome and also one of the common reasons for readmission following discharge. This condition imposes an enormous economic burden on healthcare sectors. The present research aimed to study the establishment of a home care system for patients with heart failure in order to evaluate the cost-effectiveness of this system and patient satisfaction. Methods: The present health system research selected 40 patients as the sample with eligible criteria. Care was provided by nurses based on physicians� instructions. In the first visit at home, a questionnaire on the quality of life was filled out by the patients or the nurses. The financial data of the medical records of the patients constituted the reference for the analysis of cost. After the intervention, the questionnaire on the quality of life was filled out by the patients once again and their satisfaction was measured. The data were statistically analyzed using the Python programming language and SPSS-16 at the 0.05 level of significance. Results: The length of stay in the hospital for each patient decreased from 2.1 days to 0.9 days per month. The number of annual hospitalizations also decreased from 5 to 3, and the number of annual outpatient visits showed a reduction from 46 to 38 for each patient. The results of the patient satisfaction assessment also indicated that most of the patients were satisfied with the services provided to them. Conclusions: The results showed that our study was cost-effective. We suggest that interventions be performed on larger scales so that the results can be used in the future as services available to patients with heart failure. © 2020, Iranian Heart Association. All rights reserved

Warning signals of elevated prediabetes prevalence in the modern Iranian urban population

Background: We sought to estimate the prevalence of diabetes mellitus (DM) and pre-DM and their associated factors among a sample of the Iranian urban population between 2017 and 2019. Methods: The present investigation is a sub-study on the HAMRAH cohort study, a longitudinal population-based cohort study to assess the 10-year risk of cardiovascular diseases and their related risk factors in the adult population of the Iranian capital, Tehran. Via a multistage cluster randomized sampling method, 2123 adults aged between 30 and 75 years who had no history of cardiovascular diseases were selected for the study. With the aid of the 2010 American Diabetes Association criteria for the definition of DM and pre-DM, age and sex-specific prevalence rates were estimated. Results: The estimated overall prevalence of DM was 14.3 (95 CI: 13.1�15.8): 10.4 known DM (95 CI: 9.1�11.8) and 4 newly diagnosed DM (95 CI: 3.1�5.1). Pre-DM was detected in about 29.2 of the study participants (95 CI: 22.9�36.3). Our logistic regression analysis revealed that increasing age, higher systolic blood pressure, higher levels of triglycerides, and lower levels of high-density lipoprotein were significantly associated with DM. Conclusions: DM and pre-DM follow a notable incremental pattern among the Iranian urban population. This finding underscores the significance of the need to improve prevention and screening strategies in the Iranian urban population. © 2021 Primary Care Diabetes Europ