Indigenous Suicide in New Zealand

This article describes patterns of suicide and attempted suicide among the indigenous (Ma ̄ori) population of New Zealand using official data from the New Zealand Health Information Service (NZHIS). The majority of Ma ̄ori suicides (75%) occurr in young people aged \u3c35 years. Rates of suicide are higher among Ma ̄ori males and females aged \u3c25 than in their non-Ma ̄ori peers. Rates of hospitalization for attempted suicides are higher amongst Ma ̄ori males aged 15–24, compared to non-Ma ̄ori. In contrast, suicide is virtually unknown amongst older Ma ̄ori (60 years). This article reviews explanations for the observed rates of suicide in Ma ̄ori, and examines approaches to effective intervention to reduce rates of suicide in young Ma ̄ori

The geographic distribution of Senecio glastifolius in New Zealand: past, current and climatic potential

Senecio glastifolius (Asteraceae) is an invasive species in New Zealand, where it threatens rare and vulnerable coastal floristic communities. It has expanded its range dramatically over recent years and continues to spread. It is subject to control programs in parts of its distribution. Uncertainty over its future distribution and invasive impacts in New Zealand contribute to the difficulty of its management. To address this knowledge gap, the potential distribution of S. glastifolius in New Zealand was predicted, based on its bioclimatic niche. Existing information on its current distribution and historic spread is incomplete, stored in disparate sources, and is often imprecise or inaccurate. In this study, available information on its distribution and spread was synthesised, processed, and augmented with new data collected in the field by the author. This data set was optimised for use in species distribution modelling. The distribution of S. glastifolius is described in its native range of South Africa, plus invaded regions in Australia, the British Isles and New Zealand. The data set describing its distribution is of higher quality than any known previous data set, is more extensive, and more suitable for use in species distribution modelling. The historic spread of S. glastifolius in New Zealand is presented, illustrating its expansion from sites of introduction in Wellington, Gisborne, plus several subsequent sites, to its now considerable range throughout much of central New Zealand. A predictive model of the potential distribution of S. glastifolius was created based on the three main climatic variables observed to limit its distribution: mean annual temperature range, aridity, and minimum temperature of the coldest month. MaxEnt models were trained on data from all regions for which georeferenced records of the species were available; South Africa, Australia, New Zealand and the Isles of Scilly. Predictions were evaluated using methods appropriate to the special case of range-expanding species. Models performed well during validation, suggesting good predictive ability when applied to new areas. Analysis of the realised niche space of S. glastifolius in the two climatic dimensions most influencing its distribution: Annual Temperature Range and Aridity, indicated that it is exploiting almost totally disjunct niche spaces in New Zealand and South Africa. Of the climate space occupied in New Zealand, almost none is available to the species in its native range of South Africa. Predictions of S. glastifolius’s potential distribution in New Zealand reveal significant areas of suitable habitat yet to be invaded. Much of this suitable habitat is contiguous with the current range and active dispersal front of S. glastifolius, suggesting that invasion is highly likely under a scenario of no management intervention. Specifically, it is suggested that control and surveillance in coastal Taranaki are required to prevent invasion of an area covering most of the northern third of the North Island

Refining a Bayesian network using a chain event graph

The search for a useful explanatory model based on a Bayesian Network (BN) now has a long and successful history. However, when the dependence structure between the variables of the problem is asymmetric then this cannot be captured by the BN. The Chain Event Graph (CEG) provides a richer class of models which incorporates these types of dependence structures as well as retaining the property that conclusions can be easily read back to the client. We demonstrate on a real health study how the CEG leads us to promising higher scoring models and further enables us to make more refined conclusions than can be made from the BN. Further we show how these graphs can express causal hypotheses about possible interventions that could be enforced

Serial Monitoring of Lead aVR in Patients with Prolonged Unconsciousness Following Tricyclic Antidepressant Overdose

Severe cardiac and neurologic toxicities of tricyclic antidepressant (TCA) overdose have been reported since the introduction of TCAs in 1950s. Despite the decreased numbers of TCA overdoses, the mortality and morbidity rates of TCA overdose have remained constantly high. Clinical manifestations of TCA overdose are characterized by unconsciousness and specific electrocardiography (ECG) abnormalities such as prolongation of the PR and QTc intervals, widening of the QRS duration, and an increased R wave and R/S ratio in lead aVR. We report a case with unusually prolonged unconsciousness without initial stem reflexes for 7 days and multiple ECG abnormalities following TCA overdose. It is suggested that the serial monitoring of R wave and R/S ratio in lead aVR might be informative in predicting recovery from toxicity following TCA overdose

Psychiatric assessment of suicide attempters in Japan: a pilot study at a critical emergency unit in an urban area

<p>Abstract</p> <p>Background</p> <p>The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan.</p> <p>Methods</p> <p>Three hundred and twenty consecutive cases of attempted suicide who were admitted to an urban emergency department were interviewed, with the focus on psychosocial background and DSM-IV diagnosis. Moreover, they were divided into two groups according to the method of attempted suicide in terms of lethality, and the two groups were compared.</p> <p>Results</p> <p>Ninety-five percent of patients received a psychiatric diagnosis: 81% of subjects met the criteria for an axis I disorder. The most frequent diagnosis was mood disorder. The mean age was higher and living alone more common in the high-lethality group. Middle-aged men tended to have a higher prevalence of mood disorders.</p> <p>Conclusion</p> <p>This is the first large-scale study of cases of attempted suicide since the dramatic increase in suicides began in Japan. The identification and introduction of treatments for psychiatric disorders at emergency departments has been indicated to be important in suicide prevention.</p

Level of suicidal intent predicts overall mortality and suicide after attempted suicide: a 12-year follow-up study

BACKGROUND: The aim of this study was to comprehensively examine clinical risk factors, including suicide intent and hopelessness, for suicide and risk of death from all causes after attempted suicide over a 12-year follow-up period. METHODS: A systematic sample of 224 patients from consecutive cases of attempted suicide referred to health care in four Finnish cities between 1 January and 31 July 1990 was interviewed. RESULTS: After 12 years of follow-up 22% of these patients had died, 8% by committing suicide. The only statistically significant risk factor for eventual suicide was high scores on Beck's Suicidal Intention Scale. Male gender, older age, physical illness or disability and high scores on Beck's Suicidal Intention Scale predicted death overall. CONCLUSIONS: Following attempted suicide, high intention to kill oneself is a significant risk factor for both death from all causes and suicide

Suicide mortality trends by sex, age and method in Taiwan, 1971–2005

<p>Abstract</p> <p>Background</p> <p>Method-specific suicide trends varied across countries, and studies of the trends in different countries can contribute to the understanding of the epidemiology of suicide. The purpose of this study was to examine the changes in suicide trends by sex, age and method in the years 1971 to 2005 in Taiwan.</p> <p>Methods</p> <p>Mortality data files of suicide and undetermined deaths for the years 1971–2005 were obtained for analyses. Age-, sex- and method-specific suicide rates were calculated by four age groups (15–24, 25–44, 45–64 and 65 and above) and five suicide methods (solids/liquids poisoning, other gases poisoning, hanging, jumping, and others).</p> <p>Results</p> <p>Both sexes experienced downward trends from 1971 to 1993, and then an upward trend since 1993. People aged 65 years and above had the highest suicide rates throughout the study periods. However, males aged 25–64 years experienced the steepest increasing trends. As to suicide methods, an annual increase, since 1991, of people jumping from heights to commit suicide, and a marked increase, since 1998, of people completing suicide by poisoning with other gases (mainly charcoal-burning) were observed.</p> <p>Conclusion</p> <p>Suicide by means of charcoal-burning and jumping from heights has become a serious public health problem in Taiwan. Preventive measures to curb these increasing trends are urgently needed.</p

Who uses firearms as a means of suicide? A population study exploring firearm accessibility and method choice

<p>Abstract</p> <p>Background</p> <p>The 1996 Australian National Firearms Agreement introduced strict access limitations. However, reports on the effectiveness of the new legislation are conflicting. This study, accessing all cases of suicide 1997-2004, explores factors which may impact on the choice of firearms as a suicide method, including current licence possession and previous history of legal access.</p> <p>Methods</p> <p>Detailed information on all Queensland suicides (1997-2004) was obtained from the Queensland Suicide Register, with additional details of firearm licence history accessed from the Firearm Registry (Queensland Police Service). Cases were compared against licence history and method choice (firearms or other method). Odds ratios (OR) assessed the risk of firearms suicide and suicide by any method against licence history. A logistic regression was undertaken identifying factors significant in those most likely to use firearms in suicide.</p> <p>Results</p> <p>The rate of suicide using firearms in those with a current license (10.92 per 100,000) far exceeded the rate in those with no license history (1.03 per 100,000). Those with a license history had a far higher rate of suicide (30.41 per 100,000) compared to that of all suicides (15.39 per 100,000). Additionally, a history of firearms licence (current or present) was found to more than double the risk of suicide by any means (OR = 2.09, <it>P </it>< 0.001). The group with the highest risk of selecting firearms to suicide were older males from rural locations.</p> <p>Conclusion</p> <p>Accessibility and familiarity with firearms represent critical elements in determining the choice of method. Further licensing restrictions and the implementation of more stringent secure storage requirements are likely to reduce the overall familiarity with firearms in the community and contribute to reductions in rates of suicide.</p

Trends in Suicidology: Personality as an Endophenotype for Molecular Genetic Investigations

In studying the genetics of suicide, should personality be used as an endophenotype (an intermediate trait lying somewhere on the developmental pathway from genes to phenotype)