Emergency department staff experiences of working with people who self‐harm:A qualitative examination of barriers to optimal care

For people who seek help for self‐harm, emergency departments (ED) are often the first point of contact, making them a suitable setting for intervention. In Australia, base rates of self‐harm presentations to ED are increasing, while the quality of care these people receive is often considered sub‐optimal. This study used qualitative interviews to explore potential barriers ED staff face in delivering best possible self‐harm care. Seventeen staff across two EDs in the state of Victoria, Australia, were interviewed regarding their perceptions of barriers to providing optimal self‐harm care and suggestions for improvement. Three themes were identified: (1) system‐related challenges when managing self‐harm in ED, including the shortage of hospital resources, challenges of ED as a physical environment, and insufficient education, training and guidelines about self‐harm care for staff; (2) human‐related challenges regarding management of self‐harm in ED, which encompassed the nature of a person's circumstances and presentation, and staff attitudes towards self‐harm; and (3) staff suggestions for improving self‐harm care in ED. Specific recommendations that were proposed based on these findings included introducing a separate ED area for mental health‐related presentations, provision of specialised education and training about self‐harm care to staff, better implementation of guidelines on treating self‐harm in ED, and employing mental health educators to provide on‐the‐floor mentoring to nurses. The relevance of these barriers and recommendations to the wider healthcare sector is also discussed. Together, these findings may inform improvements to the quality of care provided to those who engage in self‐harm

A systematic review and narrative synthesis of prevalence rates, risk and protective factors for suicidal behavior in international students

International students are a crucial group for suicide prevention efforts. However, no comprehensive review of the prevalence, risk or protective factors for international student suicide has been conducted, complicating prevention efforts. The current systematic review addresses this issue by identifying the prevalence, risk, and protective factors for suicidal thoughts and behavior in international students enrolled in tertiary institutions. We searched CINAHL, EMBASE, ERIC, Medline, and PsycInfo from inception to November 2023, and 24 papers met the study inclusion criteria. Nineteen studies reported on the prevalence or intensity of suicidal ideation, six reported on the prevalence of suicide attempts, and seven on the prevalence of self-harm. No studies provided data on completed suicides. Studies indicated that international students experienced similar or lower levels of suicidal ideation and self-harm, but more frequent suicide attempts than domestic students. A narrative synthesis of risk and protective factors yielded mixed results, although social isolation, comorbid mental health conditions, and experiences of racism or discrimination were commonly linked to suicidal thoughts and behaviors. The mixed evidence quality, numerous measurement issues, and low number of studies in the literature point to a need for further research on suicide among international students.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022307252

Emergency department staff experiences of working with people who self‐harm:A qualitative examination of barriers to optimal care

For people who seek help for self‐harm, emergency departments (ED) are often the first point of contact, making them a suitable setting for intervention. In Australia, base rates of self‐harm presentations to ED are increasing, while the quality of care these people receive is often considered sub‐optimal. This study used qualitative interviews to explore potential barriers ED staff face in delivering best possible self‐harm care. Seventeen staff across two EDs in the state of Victoria, Australia, were interviewed regarding their perceptions of barriers to providing optimal self‐harm care and suggestions for improvement. Three themes were identified: (1) system‐related challenges when managing self‐harm in ED, including the shortage of hospital resources, challenges of ED as a physical environment, and insufficient education, training and guidelines about self‐harm care for staff; (2) human‐related challenges regarding management of self‐harm in ED, which encompassed the nature of a person's circumstances and presentation, and staff attitudes towards self‐harm; and (3) staff suggestions for improving self‐harm care in ED. Specific recommendations that were proposed based on these findings included introducing a separate ED area for mental health‐related presentations, provision of specialised education and training about self‐harm care to staff, better implementation of guidelines on treating self‐harm in ED, and employing mental health educators to provide on‐the‐floor mentoring to nurses. The relevance of these barriers and recommendations to the wider healthcare sector is also discussed. Together, these findings may inform improvements to the quality of care provided to those who engage in self‐harm

Vaginal microbiocenosis and factors affecting its status

The study of vaginal biocenosis and factors affecting its status has for many years been in the spotlight of not only clinical microbiologists, but a wide range of clinical specialists. The search for new methods of correction of dysbiotic states remains relevant; the application of ecoantibiotics is going to occupy a niche in the clinical practice

Young people's disclosure of suicidal thoughts and behavior: A scoping review

Background: Disclosure of suicidal ideation offers a significant opportunity for intervention and pathways to care. Family can be instrumental in young people accessing care. To date there is limited knowledge about the patterns of disclosure of suicidal ideation and behavior in young people, particularly to their family. Methods: A scoping review was conducted to identify studies of disclosure of suicidal ideation and behavior in young people (aged 12–25), to identify the rates of disclosure to informal supports, and the effects of that disclosure. Online databases PsycINFO, CINAHL, Web of Science, Embase, PubMed were searched for eligible articles. Results: Thirty-five studies used a quantitative method, seven reported on qualitative research and two used mixed methods. Studies were examined based on design, setting, sample, reported disclosure, target of disclosure and impact. Rates of suicidal ideation disclosure varied widely amongst community and clinical samples. Few studies reported on the impact of disclosure on either the young person and the target, how the young person perceived the reaction, and how that relates to future disclosure and help-seeking. Limitations: No quality analysis or meta-analyses were done; studies had to be in English, limiting representation. The measurement of suicidal ideation and its disclosure were inconsistent across studies. Conclusions: There is a need to understand how young people choose who they disclose suicidal ideation to and what impact the suicidal disclosure has on both parties. Understanding how disclosures to family members affect help-seeking longitudinally is important and may provide avenues for targeted clinical intervention

Suicide Prevention for International Students: A Scoping Review

International students are at risk of suicide and suicide prevention activities addressing their unique needs are required. However, no comprehensive review has been undertaken to identify effective suicide prevention approaches for international students. The current scoping review aimed to chart the extent, range, and nature of available evidence on the prevention strategies for international students. We systematically searched Medline, PsycInfo, ERIC, CINAHL, Proquest, and several gray literature databases to identify relevant peer-reviewed articles and gray literature. Eligible publications were those providing data or recommendations related to suicide prevention among international students; 15 peer-reviewed articles and 19 gray literature documents were included in the review. No studies of prevention programs or policies directly targeting suicidal ideation, suicide attempts, or suicide in international students were identified. A narrative synthesis of the suicide prevention recommendations for international students identified four categories: (1) cultural competency training on suicide and provision of culturally sensitive services; (2) improved and increased risk screening for suicide; (3) proactive intervention and engagement strategies; and (4) collaborative approaches to streamline service access and improve available support. These recommendations provide guidance on potential directions for international student suicide prevention. Research assessing the effectiveness of such recommendations will enable the development of novel evidence-based policies and interventions that reduce rates of suicide in international students

DataSheet_1_A systematic review and narrative synthesis of prevalence rates, risk and protective factors for suicidal behavior in international students.pdf

International students are a crucial group for suicide prevention efforts. However, no comprehensive review of the prevalence, risk or protective factors for international student suicide has been conducted, complicating prevention efforts. The current systematic review addresses this issue by identifying the prevalence, risk, and protective factors for suicidal thoughts and behavior in international students enrolled in tertiary institutions. We searched CINAHL, EMBASE, ERIC, Medline, and PsycInfo from inception to November 2023, and 24 papers met the study inclusion criteria. Nineteen studies reported on the prevalence or intensity of suicidal ideation, six reported on the prevalence of suicide attempts, and seven on the prevalence of self-harm. No studies provided data on completed suicides. Studies indicated that international students experienced similar or lower levels of suicidal ideation and self-harm, but more frequent suicide attempts than domestic students. A narrative synthesis of risk and protective factors yielded mixed results, although social isolation, comorbid mental health conditions, and experiences of racism or discrimination were commonly linked to suicidal thoughts and behaviors. The mixed evidence quality, numerous measurement issues, and low number of studies in the literature point to a need for further research on suicide among international students.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022307252.</p

Pelvic inflammatory disease: basic principles of therapy

Inflammatory diseases of the female genitals are an actual problem of obstetrics and gynaecology, as there is no tendency towards decline in the prevalence of these diseases despite improvements in treatment methods. An inadequate assessment of the severity of the infection process and an incorrectly chosen therapy scheme leads to the recurring chronic course

Immunomodulatory drugs in the treatment of postpartum endometritis

Puerperium pyoinflammatory diseases (PID) represent the most crucial problem in obstetrics. Among the PID pathologies, the leading place belongs to postpartum endometritis, most commonly occurring after surgical and pathological childbirth. Given the fact that in the pathogenesis of postpartum PID the significant role belongs to changes in the immunological status characterized either by the combined inhibition of T- and B-systems of immunity or, primarily, by damage to T-lymphocytes, the inclusion of immunomodulatory drugs in the complex therapy of postpartum endometritis contributes to a more rapid achievement of clinical effect and allows to obtain favorable outcomes

DataSheet_2_A systematic review and narrative synthesis of prevalence rates, risk and protective factors for suicidal behavior in international students.docx

International students are a crucial group for suicide prevention efforts. However, no comprehensive review of the prevalence, risk or protective factors for international student suicide has been conducted, complicating prevention efforts. The current systematic review addresses this issue by identifying the prevalence, risk, and protective factors for suicidal thoughts and behavior in international students enrolled in tertiary institutions. We searched CINAHL, EMBASE, ERIC, Medline, and PsycInfo from inception to November 2023, and 24 papers met the study inclusion criteria. Nineteen studies reported on the prevalence or intensity of suicidal ideation, six reported on the prevalence of suicide attempts, and seven on the prevalence of self-harm. No studies provided data on completed suicides. Studies indicated that international students experienced similar or lower levels of suicidal ideation and self-harm, but more frequent suicide attempts than domestic students. A narrative synthesis of risk and protective factors yielded mixed results, although social isolation, comorbid mental health conditions, and experiences of racism or discrimination were commonly linked to suicidal thoughts and behaviors. The mixed evidence quality, numerous measurement issues, and low number of studies in the literature point to a need for further research on suicide among international students.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022307252.</p