Suicide Interventions in Spain and Japan: A Comparative Systematic Review

(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components.

Use of i.m. ranitidine for the prophylaxis of aspiration pneumonitis in obstetrics

Twenty patients who underwent elective Caesarean section received ranitidine 150 mg by mouth 8-14 h, and 50 mg i.m. 90 min, before surgery. Intraoperative gastric aspiration resulted in contents with a pH greater than 2.5 and volume less than 25 ml in all patients (mean pH 6.5 (SD 0.8); mean volume 9.0 (SD 7.2) ml). Sixty patients in labour, who received ranitidine 50 mg i.m. 6-hourly, underwent emergency surgery. Half of this group received, in addition, a single preinduction dose of either 15 or 30 ml of sodium citrate 0.3 mol litre-1. A further 30 patients who remained unmedicated during labour and required emergency surgery received a preinduction dose of 15 or 30 ml of sodium citrate 0.3 mol litre-1 alone. Ranitidine medication resulted in a mean aspirated gastric volume of 31.4 (26.6) ml and pH of 5.3 (2.1); five of 30 patients had a pH less than 2.5. The addition of sodium citrate 0.3 mol litre-1 resulted in gastric pH greater than 2.5 in all patients and a mean gastric volume of 43.2 (38.3) ml. The group who received only sodium citrate 0.3 mol litre-1 had a mean pH of 5.3 (1.1) and a mean volume 122.7 (98.2) ml.