Should compulsory admission to hospital be part of suicide prevention strategies?

The World Health Organization report Preventing Suicide: A Global Imperative provides governments with guidance for comprehensive suicide prevention strategies. However, it does not mention the role that compulsory admission to hospital of psychiatric patients should have in policies for suicide prevention. This was a missed opportunity for international discussion and guidance about a measure that, although widely used, is becoming increasingly controversial in light of the existing evidence and human rights norms

Forgiveness in PTSD after man-made traumatic events: a systematic review

Forgiveness has proven to be beneficial for the physical and mental health of individuals. In sufferers of posttraumatic stress disorder (PTSD) after man-made traumatic events, it is often believed to have a positive effect to forgive the transgressor. This systematic review identifies and presents a summary ofthe literature into the association of symptoms of PTSD with forgiveness after man-made traumatic events. The bibliography databases EMBASE, PubMed/Medline, PsycInfo, PsycExtra, Scopus, and Web of Science were searched. Thirteen studies met the inclusion criteria. The review shows significant differences between individual studies regarding the type of trauma, the setting, the forgiveness concept, and the measurement instruments used for PTSD and forgiveness. Only 1 study could not establish a significant correlation between forgiveness and PTSD symptoms. The other studies found that higher forgiveness levels were associated with lower PTSD-related symptoms scores, but other factors have to be taken into account, as demographic variables, the relationship between transgressor and survivor of trauma, the type and severity of trauma, and other variables were also shown to be relevant

A cross-cultural study of attitudes toward suicide among young people in India, Italy and Australia

Background: An understanding of the cultural aspects of suicidal behavior is essential for the development of culturally appropriate suicide prevention and intervention strategies. Aims: This study explored the attitudes toward youth suicide in 686 Italian, Indian and Australian undergraduate students (18-24 years old). Method: A 21-item suicide attitude inventory titled Attitude towards Youth Suicide (AtYS) Scale was used in the three samples. Results: Four factors were extracted, labelled negative attitudes toward suicide, belief that suicide was not preventable, suicide as acceptable and normal, and the existence of risk signs for suicide. Country differences were found for all four subscales, with Indian students having the most negative attitudes toward suicide. Sex differences were found in all three countries with women, on the whole, having less negative attitudes toward suicide, more belief in the preventability of suicide in India and more belief in risk signs for suicide in Italy. Conclusions: Attitudes are linked to suicide in a complex manner. More quantitative and qualitative studies, including in lower-income and non-English speaking Western societies, are needed

Priests, a grandmother and schizophrenia

The observations reported in this article have been recorded as part of the research project ‘Using collaborative visual research methods to understand experiences of mental illness, coercion and restraint in Ghana and Indonesia’, an Economic and Social Research Council (UK) GCRF-funded project

On-line monitoring of the freeze-drying process: A new image-based PAT.

In this work a Process Analytical Technology (PAT) for the on-line monitoring of a Vacuum Freeze-Drying (VFD) based on the information extracted from the infrared images of the process is presented and validated. An infrared camera, placed inside the drying chamber, provided information about the thermal evolution of the process over time; after images pretreatment and segmentation, temperature profiles were extracted and processed to obtain the variables of interest. Experiments were carried out according to factorial design on a set of different operating conditions, namely fluid temperature and chamber pressure, type of vials and solid percentage in the solution. Both sucrose and mannitol solutions, were studied. Together with the temperature in several positions along the product height, we were able to correctly estimate the ending time of the primary drying phase together with the sublimating interface position and the heat and mass transfer coefficients, Kv and Rp. Those two parameters have a dramatic importance since they can be used in a mathematical model of the process for on-line or off-line optimization of the process. Being based on a contactless technology, the PAT studied in this work does not present any issue regarding the sterility requirement of the process or the possible interference of the sensing element with the product dynamics

Indonesian stakeholders' perspectives on warning signs and beliefs about suicide

The suicide rate in Indonesia is considered low among Asian countries, but the underreporting rate is at a staggering 303%, and the latest reports suggest an increase in suicidal behaviour, particularly among young people. As a multicultural country, Indonesia has a complex system of beliefs about suicide. Thus, various aspects specific to Indonesia must be considered in understanding and preventing suicide. This paper explores Indonesian stakeholders’ perspectives through semi-structured interviews and focus group discussions. A total of 9 participants were individually interviewed, and 42 were involved in focus group discussions. They were mainly people with lived experiences of suicide. The other stakeholders were Indonesian experts who have experience in dealing with suicidal behaviour, helping people with a lived experience of suicide, or were involved in suicide prevention. Indonesian stakeholders highlighted various general and contextualised aspects concerning suicide. These aspects included a wide range of cultural beliefs and culturally specific warning signs, which included “bingung” (confusion) and longing for deceased persons. Other cultural beliefs such as viewing suicide as infectious, unpreventable, and guided by ancient spirits, and as an honourable act in some circumstances, also emerged. These findings can inform suicide prevention programs, including suicide prevention guidelines for Indonesia

Monitoring of a vial freeze-drying process with IR thermography.

This work presents a new device constituted by an IR camera placed inside the drying chamber to monitor the temperature of the vials without interferences. It is possible to estimate the ending point of the primary drying, the heat transfer coefficient to the product and the resistance of the dried product to vapor flux. Experiments were performed in a freeze-dryer using thermocouples and the IR camera. The measurements validate the IR camera as an effective technology for the process

Vitamin D

BACKGROUND: Vitamin D status may influence heart failure (HF) patient outcomes by affecting b-type natriuretic peptide (BNP), parathyroid hormone (PTH), and enhancing cardiac contractility. Vitamin D deficiency is associated with morbidity and mortality in HF patients. The objective of this study was to determine if vitamin D3 at a comparatively high dose would replete 25-hydroxyvitamin D (25(OH)D) stores, improve BNP, PTH, cardiopulmonary function, reduce inflammatory markers, and improve quality of life (QOL) in HF patients. METHODS: This was a 6 month, parallel group, double-blind, placebo-controlled, single clinic center, randomized trial of supplemental vitamin D3 using a dose of 10,000 IU daily or placebo in 40 vitamin D deficient or insufficient (25(OH)D level ≤ 32 ng/ml) patients with stable New York Heart Association Class II-III HF in a specialty cardiology clinic. All variables were measured at baseline and 6 months. Values between the two treatment groups were assessed using Student\u27s t-test or Mann-Whitney Test. Univariate analysis of covariance was conducted to adjust for variance in baseline 25(OH)D. RESULTS: All results were adjusted for baseline 25(OH)D. The change in BNP from baseline was ∆ +30 ± 950 pg/ml for treatment vs. placebo ∆ +400 ± 1900 pg/ml, p = 0.003. 25(OH)D serum levels rose by 49 ± 32 ng/ml in the treatment group vs 4 ± 10 ng/ml in the placebo group, p \u3c 0.001. PTH and exercise chronotropic response index improved in the treatment group vs placebo group, respectively, but both were attenuated by adjustment ((∆-20 ± 20 pg/ml vs ∆ + 7 ± 53 pg/ml respectively (p = 0.01, adjusted p = 0.07)) and (∆ + 0.13 ± 0.26 vs. ∆-0.03 ± 02.9 respectively, p \u3c 0.01, adjusted p = 0.17)). Other measured cardiopulmonary parameters remained unchanged. High sensitivity C-reactive protein (hsCRP) remained unchanged for women, but improved for men (∆-2 ± 4 treatment versus ∆2 ± 5 mg/L placebo, p = 0.05). QOL scores, including composite overall and clinical summary scores significantly improved in treatment compared to placebo (∆ + 10 ± 15 versus -6 ± 15, p \u3c 0.01 and ∆ + 8 ± 14 versus -8 ± 18, p = 0.01, respectively). CONCLUSIONS: Repletion of 25(OH)D may improve QOL in HF patients and may help to normalize BNP, PTH, and hsCRP. TRIAL REGISTRATION: Clinicaltrials.gov, Trial Registration Number: NCT01636570 , First registered 3 July 2012

Suicide first aid guidelines for Indonesia: a Delphi consensus study

Background: The concept that "suicide is preventable" is fairly recent in Indonesia. Suicide prevention training is also new for community leaders and laypeople. On the other side, in a collectivistic society like Indonesia, community leaders, neighbours, and friends are essential parts of someone's life. Therefore, guidelines to assist first aiders in preventing suicide is urgently needed. Aim: This study aimed to develop guidelines to recognise key warning signs and provide first aid support to Indonesians at potential immediate risk for suicide. Methods: The guidelines was developed through three steps: (i) systematic literature review; (ii) focus group discussions and interviews; and (iii) expert consensus using the Delphi approach. These steps were taken to ensure that the final guidelines reflected the cultural beliefs and norms of the Indonesian context. Results: Three rounds of Delphi resulted in 460 accepted items out of 539 items generated from the literature search and group and individual interviews. Some key differences with other countries where similar studies were carried out were highlighted. Conclusions: This study emphasised the need for gatekeeper training as the ideal way of educating community members on the guidelines