Just a few phone calls could prevent suicide attempts: study

May 8, 2017

Washington, May 8: A few phone calls to people who have suicidal tendencies could significantly reduce future suicide attempts and save many lives, a new study has found. Researchers at the University of Colorado Anschutz Medical Campus and Brown University in the US found that phone calls to suicidal patients following discharge from Emergency Departments led to a 30 per cent reduction in future suicide attempts.

suicideThe year-long trial, which involved 1,376 patients across US, provided suicidal patients with interventions that included specialised screening, safety planning guidance and follow-up telephone calls. "People who are suicidal are often disconnected and socially isolated," said Michael Allen, professor at the CU Anschutz.

"So any positive contact with the world can make them feel better," said Allen. Suicide is the 10th leading cause of death in the US. Over one million people attempt to take their own life every year. Allen said simply handing a suicidal patient a psychiatric referral when discharged is not enough.

"We call them up to seven times to check on them after discharge," said Allen. "If they aren't there we leave a message and call again. For many, this telephone call is all they get," he said. "We don't need more brick and mortar buildings, we can reduce suicide risk by simply calling people on the phone," Allen said.

"Telephone follow-up programs offer a great way to help bridge an ED visit to outpatient mental health care and hopefully save lives," said Emmy Betz, an associate professor at CU Anschutz. The trial took place in three phases to create three comparison groups. In the first phase, 497 patients received each ED's usual treatment as a control group.

In phase two universal screening was implemented and 377 patients received additional attention in the ED. In the third phase, 502 patients received the experimental intervention. Those patients received the same Phase 2 care including additional suicide screening from ED physicians, suicide prevention information from nurses and a personal safety plan they could fill out to prepare for times when they might begin harbouring suicidal thoughts again.

Over the next year, they also received periodic phone calls from trained providers, who would discuss suicide risk factors, personal values and goals, safety and future planning, treatment engagement, and problem solving.

The number of suicide attempts and the proportion of people attempting suicide declined significantly in the intervention group compared to treatment as usual. The middle group, which received only additional screening, did not show a significant drop compared to the treatment as usual group. "This is a remarkably low cost, low tech intervention that has achieved impressive results," Allen said.

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News Network
May 30,2020

May 30: Patients undergoing surgery after contracting the novel coronavirus are at an increased risk of postoperative death, according to a new study published in The Lancet journal which may lead to better treatment guidelines for COVID-19.

In the study, the scientists, including those from the University of Birmingham in the UK, examined data from 1,128 patients from 235 hospitals from a total of 24 countries.

Among COVID-19 patients who underwent surgery, they said the death rates approach those of the sickest patients admitted to intensive care after contracting the virus.

The scientists noted that SARS-CoV-2 infected patients who undergo surgery, experience substantially worse postoperative outcomes than would be expected for similar patients who do not have the infection.

According to the study, the 30-day mortality among these patients was nearly 24 per cent.

The researchers noted that mortality was disproportionately high across all subgroups, including those who underwent elective surgery (18.9 per cent), and emergency surgery (25.6 per cent).

Those who underwent minor surgery, such as appendicectomy or hernia repair (16.3 per cent), and major surgery such as hip surgery or for colon cancer also had higher mortality rates (26.9 per cent), the study said.

According to the study, the mortality rates were higher in men versus women, and in patients aged 70 years or over versus those aged under 70 years.

The scientists said in addition to age and sex, risk factors for postoperative death also included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

"We would normally expect mortality for patients having minor or elective surgery to be under 1 per cent, but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3%) and elective surgery (18.9%)," said study co-author Aneel Bhangu from the University of Birmingham.

Bhangu said these mortality rates are greater than those reported for even the highest-risk patients before the pandemic.

Citing an example from the 2019 UK National Emergency Laparotomy Audit report, he said the 30-day mortality was 16.9 per cent in the highest-risk patients.

Based on an earlier study across 58 countries, Bhangu said the 30-day mortality was 14.9 per cent in patients undergoing high-risk emergency surgery.

"We recommend that thresholds for surgery during the SARS-CoV-2 pandemic should be raised compared to normal practice," he said.

"For example, men aged 70 years and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed," Bhangu added.

The study also noted that patients undergoing surgery are a vulnerable group at risk of SARS-CoV-2 exposure in hospital.

It noted that the patients may also be particularly susceptible to subsequent pulmonary complications, due to inflammatory and immunosuppressive responses to surgery and mechanical ventilation.

The scientists found that overall in the 30 days following surgery 51 per cent of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.

Nearly 82 per cent of the patients who died had experienced pulmonary complications, the researchers said.

"Worldwide an estimated 28.4 million elective operations were cancelled due to disruption caused by COVID-19," said co-author Dmitri Nepogodiev from the University of Birmingham.

"Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital," Nepogodiev said.

According to the researchers, there's now an urgent need for investment by governments and health providers in to measures which ensure that as surgery restarts patient safety is prioritised.

They said this includes the provision of adequate personal protective equipment (PPE), establishment of pathways for rapid preoperative SARS-CoV-2 testing, and consideration of the role of dedicated 'cold' surgical centres.

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News Network
July 28,2020

Bengaluru, Jul 28: Congress leader Siddaramaiah on Monday alleged that BJP is trying to destabilise the Congress government in Rajasthan.

"It is the duty of the Governor to act according to the decision of the state cabinet. But he is acting like a central government puppet," he said at a protest organised here by Karnataka Pradesh Congress Committee (KPCC).

He said the Congress is protesting across the country to save democracy and save the constitution.

"We are not fighting through violence. We are protesting peacefully. The Constitution has given the right to protest in a democratic system," he said.

He accused the BJP of "being disrespectful" to the Constitution.

"Governments must walk within the framework of the Constitution. The Constitution gives everyone rights and duties. BJP destabilises elected governments and buys our legislators by horse-trading by spending crores of money. The same thing happened in Karnataka as well," he alleged.

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Agencies
July 11,2020

Citing the current dismal aviation scenario, Air India is terminating the services of trainee cabin crew and cabin crew by withdrawing the offer of employment of those who were under training.

As per sources, the new crew and trainee pilots might reduce contracts from five years to one year. Sources said Air India is terminating 1,200 crew and employees who are more than 55-yr-old including 190 trainee pilots.

In a letter reviewed by IANS, Air India has informed an applicant who had been selected as cabin crew in August 2019 subject to successful completion of training.

"On behalf of Air India we would like to thank you for the interest shown by you in joining our organization. However, in view of the current aviation scenario, it would not be possible for Air India to impart any further training to you for engaging your services," the company said.

"In view of the above reasons, which are beyond the control of the company, it has been decided to discontinue your training arrangements and dispense with the offer of engagement with immediate effect. The bank guarantee furnished by you at the time of joining is returned herewith," Air India told the cabin crew.

"Once again on behalf of Air India we thank you for your cooperation and trust that you will appreciate the circumstances under which we are constrained to discontinue the training arrangements," the carrier said.

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