A systematic literature review of nursing interventions for postpartum depression and their outcomes

Purpose@#This study was conducted to bring together studies on the common nursing interventions for postpartum depression (PPD) and their outcomes. It aims to provide interpretation of relevant findings to help further enhance the nursing care of patients with postpartum depression.@*Design and Methods@#A systematic literature review (SLR) approach was utilized to synthesize studies related to the management of postpartum depression and its outcomes. One hundred five studies (105) were initially retrieved from three online databases. Eventually, fifteen studies were included in this review after the screening process on quality and risk of bias assessments. Codes were identified from the included studies and were clustered into themes. A thematic map was formulated to visualize the interconnections of the nursing interventions for postpartum depression and its outcomes. @*Findings@#Nurses caring for patients with postpartum depression usually practice PPD education, perinatal assessment, PPD counseling, nurse-delivered psychotherapy, providing social support, drug administration, complementary and alternative therapy combined with conventional management, and patient referral. These nursing practices for postpartum depression yielded the following outcomes: (1) symptom alleviation, (2) empowerment, (3) positive feedback, and (4) negative outcomes.@*Conclusions and Recommendations@#There is a range of nursing interventions for postpartum depression. This review highlights the significant roles of PPD education and nursing assessment and emphasizes these interventions to be practiced not only after childbirth but also during the prenatal period to identify at-risk patients and provide early intervention. This review also emphasizes the need for more coordinated care and a multidisciplinary approach, including patient referral, to achieve better outcomes in the care of postpartum depression patients. This relates to the acknowledgment of the various factors contributing to the development of postpartum depression and its lack of clear etiology.

An optimised quadrupole mass spectrometer with a dual filter analyser for in-field chemical sniffing of volatile organic compounds.

We report a novel portable 17 kg system based on a quadrupole mass spectrometer (QMS) with an electronic power consumption of 24 W. The system can be used for the in-field identification of gases and volatile/semivolatile organic compounds (VOCs/SVOCs). The mass analyser is a custom-made quadrupole mass filter with a Brubaker pre-filter that gives a mass range of m/z 1-500. It is an upgrade of the previous m/z 1-200 range triple filter analyser system. Analyser design was optimized using 3D numerical simulations as a performance trade-off between single and triple filter designs while maintaining high sensitivity and ease of integration. This also required enhanced design of the electronic control unit (ECU) compared to the previous triple filter ECU designs with lower power consumption, size, weight and cost of the overall system. Another major ECU improvement includes high stability of DC voltage control and ultra-low RF drift, which is important for in-field applications that require stable mass peaks for reliable quantitative analysis and continuous monitoring. Experimental results are presented for the perfluorotributylamine (PFTBA) calibrant and acetone to assess the functionality of the instrument. Performance comparison between the dual and triple filter quadrupole analysers has also been done. Mass spectra are given for methyl benzoate (cocaine simulant), piperidine (phencyclidine simulant), cyclohexanone (C4 simulant) and 2-nitrotoluene (TNT simulant) to assess potential capability for the identification of threat compounds. All spectral results show good correlation with the NIST library mass spectra with unit resolution obtained for spectral peaks within a m/z 1-400 mass range.

Membrane inlet mass spectrometry for homeland security and forensic applications.

A man-portable membrane inlet mass spectrometer has been built and tested to detect and monitor characteristic odors emitted from the human body and also from threat substances. In each case, a heated membrane sampling probe was used. During human scent monitoring experiments, data were obtained for inorganic gases and volatile organic compounds emitted from human breath and sweat in a confined space. Volatile emissions were detected from the human body at low ppb concentrations. Experiments with compounds associated with narcotics, explosives, and chemical warfare agents were conducted for a range of membrane types. Test compounds included methyl benzoate (odor signature of cocaine), piperidine (precursor in clandestine phencyclidine manufacturing processes), 2-nitrotoluene (breakdown product of TNT), cyclohexanone (volatile signature of plastic explosives), dimethyl methylphosphonate (used in sarin and soman nerve agent production), and 2-chloroethyl ethyl sulfide (simulant compound for sulfur mustard gas). Gas phase calibration experiments were performed allowing sub-ppb LOD to be established. The results showed excellent linearity versus concentration and rapid membrane response times.

Monitoring of human chemical signatures using membrane inlet mass spectrometry.

This work is an attempt to assist border security crackdown on illegal human immigration, by providing essential results on human chemical signatures. Data was obtained using a portable quadrupole mass spectrometer coupled with a membrane probe for volunteers of both genders and under different conditions in a container simulator. During experiments, participants were asked to follow various protocols while volatile organic compounds emitted from their breath, sweat, skin, and other biological excretes were continuously being monitored. Experimental setups using different membrane materials (both hydrophilic and hydrophobic) including heating of the sampling probe and sampling flow rates were examined. From our measurements, significant information was obtained for NH3, CO2, water, and volatile organic compounds levels, illustrating a human chemical profile and indicating human presence in a confined space.

Oil-in-water monitoring using membrane inlet mass spectrometry.

A membrane inlet mass spectrometry (MIMS) system has been used for detection and analysis of two types of North Sea crude oil. The system was installed on-field on the Flotta Oil Terminal (Orkney, UK). It consisted of a quadrupole mass spectrometer (QMS) connected to the capillary probe with a silicone-based membrane. The produced mass spectra and calibration plots from the MIMS instrument showed the capability to measure levels of individual hydrocarbons within crude oil in seawater. The generated mass spectra from the field tests also showed the ability to distinguish between different types of oil and to determine concentrations of toxic hydrocarbons in oil (e.g., benzene, toluene, and xylene (BTX)). The performance of the instrument at different temperatures of seawater and oil droplet sizes was also investigated. The results showed that the QMS-based MIMS system has a potential to complement existing oil-in-water (OiW) monitors by being able to detect different oil types and specific hydrocarbon concentrations with high accuracy, which are currently not supported in commercially available OiW monitors.

Development of quadrupole mass spectrometers using rapid prototyping technology.

In this report, we present a prototype design of a quadrupole mass filter (QMF) with hyperbolic electrodes, fabricated at the University of Liverpool using digital light processing (DLP), a low-cost and lightweight 3D rapid prototyping (RP) technique. Experimental mass spectra are shown for H(2)(+), D(2)(+), and He(+) ions to provide proof of principle that the DLP mass filter is working as a mass analyzer in the low-mass range (1 to 10 amu). The performance of the DLP QMF has also been investigated for individual spectral peaks. Numerical simulations of the instrument were performed by coupling CPO and Liverpool QMS-2 programs to model both the ion source and mass filter, respectively, and the instrument is shown to perform as predicted by theory. DLP thus allows miniaturization of mass spectrometers at low cost, using hyperbolic (or other) geometries of mass analyzer electrodes that provide optimal ion manipulation and resolution for a given application. The potential of using RP fabrication techniques for developing miniature and microscale mass analyzers is also discussed.