RESUMO
PURPOSE: Impacting 1 in 1000 women, untreated postpartum psychosis is associated with a 4% infanticide rate. This systematic review aims to identify factors that are associated with infanticide resulting from psychosis in the puerperal period and pinpoint areas of missed opportunity for intervention. METHODS: A systematic literature review was conducted in accordance with PRISMA guidelines to identify and synthesize cases of maternal infanticide among perinatal females with evidence of postpartum psychosis. Four independent reviewers screened 231 articles identified in searches of three databases (PsycInfo, PubMed, and Web of Science) for studies conducted from 2013 to 2023. RESULTS: Twelve studies were included in the final review. Findings indicate that those experiencing puerperal psychosis have increased incidence of infanticide suggesting missed opportunities for intervention and treatment. Common factors in mothers who committed infanticide as a result of delusions and/or hallucinations associated with PMADs were identified, including lack of standardized screening tools, preference for traditional and/or cultural healing practices, and access to care. CONCLUSION: The current body of evidence supports developing and evaluating clinical interventions aimed at improving maternal mental health outcomes and infant outcomes in perinatal women experiencing puerperal psychosis.
RESUMO
Obesity is projected to affect 86% of United States adults by 2030. Recent data show a surge to 41.9%, with the highest proportion in the 40-59 age group (44.3%). Obesity is linked to various health issues and preventable deaths. Telemedicine has emerged as a promising avenue for addressing obesity. This systematic review and meta-analysis examine the effectiveness of telemedicine interventions for managing obesity in US adults aged 40 and above. Through a thorough Preferred Reporting Items for Systematic Reviews and Meta-Analysis-guided search, 16 studies meeting inclusion criteria were identified. These studies employed diverse telemedicine technologies, including video-based and telephone sessions or a mixture of technologies. The analysis reveals a statistically significant mean difference of 0.93 in favor of telemedicine interventions for weight loss. Subgroup analysis suggests that intervention durations of 6-12 months and telephone-based sessions correlate with more substantial mean differences. This study provides valuable insights into the effectiveness of telemedicine in managing obesity, emphasizing the importance of intervention type and duration. Study limitations include variability and potential biases. Customized telemedicine strategies have the potential to combat the obesity epidemic among older adults in the United States, offering guidance to healthcare professionals aiming to reduce health risks and enhance overall well-being.
