Distant mood monitoring for depressive and bipolar disorders: a systematic review.

BACKGROUND: Broadening our knowledge of the longitudinal course of mood symptoms is cardinal to providing effective long-term treatments. Research indicates that patients with mental illness are willing to engage in the use of telemonitoring and mobile technology to assess and monitor their mood states. However, without the provision of distant support, adverse outcomes and events may be difficult to prevent and manage through self-monitoring. Understanding patient perspectives is important to achieving the best balance of self-monitoring, patient empowerment, and distant supporter involvement. METHODS: This systematic review synthesises quantitative and qualitative evidence of the effectiveness and feasibility of daily/weekly/monthly remote mood monitoring that includes distant support in participants with mood disorders. Inclusion criteria comprised mood monitoring of mood disorder patients as main intervention, study design, method of monitoring, and presence of psychotherapy and psychoeducation. Effectiveness was defined by the change in depression and/or mania scores. Feasibility was determined on participant feedback and completion/attrition rates. Studies were assessed for quality using the Mixed Methods Appraisal Tool version 2018. RESULTS: Nine studies of acceptable quality met the inclusion criteria. Distant mood monitoring was effective in improving depression scores but not mania scores. Feasibility, as measured through compliance and completion rates and participant feedback, varied. CONCLUSION: Distant mood monitoring with support may be a useful, acceptable, and feasible intervention for diverse groups of patients in terms of age and ethnicity. Further, it may be effective in improving symptoms of depression, increasing treatment adherence, and facilitating the prevention and management of adverse outcomes. As a task-shifting intervention, distant mood monitoring may help to alleviate the burden on mental health providers in developing countries.

The association between biopsychosocial factors and disability in a national health survey in South Africa.

The association between psychosocial factors and disability is less clear. This study investigated the biological and psychosocial (employment and psychological distress) factors associated with level of disability in an adult sample in South Africa. Data were analysed from a cross-sectional survey among adults aged 18-64 (n = 4974). Multiple linear regression was used to investigate the associations of the selected variables with disability. The mean percentage score on the WHODAS scale of disability was 5.31% (95% CI: 4.74-5.88). Age (p < 0.001) and race (p = 0.0002) were significantly associated with disability, and history of stroke (ß = 7.19, 95% CI: 3.19-11.20) and heart-related conditions (ß = 2.08, 95% CI: [0.23-3.93) showed positive associations. Of the psychosocial variables, psychological distress (ß = 10.49 [8.63-12.35]) showed a strong positive association while employment (-1.62 [-2.36 to -0.88]) showed a negative association with disability. The association between demographic factors, medical conditions and increased disability confirms the findings in the literature. The finding that psychological distress is associated with increased disability has not been frequently reported. This study highlights specific psychosocial targets that may be usefully addressed by health policies and interventions in order to improve disability management.

van der Waals interaction energies for ferric ion sensors using prismatic and cylindrical pore approximations for a MOF pore.

Using the Lennard-Jones potential, we determine analytical expressions for van der Waals interaction energies between a point and a rectangular prism-shaped pore, writing them in terms of standard elementary functions. The parameter values for a new ferric ion sensor are used to compare these calculations with the cylindrical pore approximation for the interactions between an ion and a metal organic framework (MOF) pore. The results using the prismatic pore approximation predict the same qualitative outcomes as a cylindrical pore approximation. However, the prismatic approximation predicts lower magnitudes for both the interaction potential energy minimum and the force maximum, since the average distance from the centre-line to the surface of the prism is greater. We suggest that in some circumstances it is sufficient to use the simpler cylindrical approximation, provided that the cylinder radius is chosen so that the cross-sectional area is equal to the area of the prism pore opening. However, atoms at the nodes should remain approximated by semi-infinite lines. We also determine the interaction between a second ferric ion and a blocked MOF pore; as expected, the second ferric ion experiences a force away from the pore, implying that approaching ferric ions can only occupy vacant MOF pores.

A collaborative and evolving response to the needs of frontline workers, patients and families during the COVID-19 pandemic at Tygerberg Hospital, Western Cape Province, South Africa.

The global devastation caused by the COVID-19 pandemic and its mental health impact is undeniable. The physical and psychological consequences are wide-ranging - affecting patients fighting the disease, frontline workers in the trenches with them, healthcare staff deployed in high-care settings, and families disconnected from their loved ones in their darkest hours. Within 6 weeks of the COVID-19 outbreak in South Africa, the Department of Psychiatry at Stellenbosch University established the TBH/SU COVID Resiliency Clinic to provide psychological support to frontline workers at Tygerberg Hospital. Identified barriers in healthcare workers accessing mental healthcare resulted in moving towards an on-site visibility to try to remove some of these barriers. This greater on-site presence enabled networking and building of relationships with frontline staff that over time highlighted other frontline needs, such as providing psychosocial and spiritual support to patients and their families. We share challenges, lessons learned and recommendations from two initiatives: the TBH/SU COVID-19 Resiliency Clinic, and an embedded COVID Care Team (CCT). We describe the establishment, roll-out and progress of the Clinic and the subsequent CCT.

Mechanics of cranial sutures using the finite element method.

To investigate how cranial suture morphology and the arrangement of sutural collagen fibres respond to compressive and tensile loads, an idealised bone-suture-bone complex was analysed using a two-dimensional finite element model. Three suture morphologies were simulated with an increasing interdigitation index (I.I.): butt-ended, moderate interdigitated, and complex interdigitated. The collagen matrix within all sutures was modelled as an isotropic material, and as an orthotropic material in the interdigitated sutures with fibre alignment as reported in studies of miniature pigs. Static uniform compressive or tensile loading was applied to the complex. In interdigitated sutures with isotropic material properties, the orientation of the maximum (tensile) principal stresses within the suture matched the collagen fibre orientation observed in compressed and tensed sutures of miniature pigs. This suggests that randomly arranged sutural collagen fibres could optimise to an orientation most appropriate to withstand the predominant type of loading. A compression-resistant fibre arrangement imparted the highest suture strain energy relative to the isotropic and tension-resistant arrangements, indicating that this configuration maximises energy storage. A comparison across the different suture morphologies indicated that bone strain energy generally decreased with a decrease in I.I., irrespective of the sutural fibre arrangement. However, high bone stress at the interdigitation apices shifted to the limbs of the suture with an increase in I.I. These combined findings highlight the importance of suture morphology and anisotropy as properties having a significant influence on sutural mechanics.