An Evaluation of the ABEL System

This thesis evaluates and discusses the ABEL system, an interactive theorem prover, developed at the Department of Informatics at the University of Oslo. The ABEL system is ultimately intended to be an environment for program development, including program verification, and is built on the work of Ole-Johan Dahl in the field of formal specification and verification. A review of the necessary background theory is given, including short descriptions of some other theorem provers and verification systems. The review also includes explanations of the most prevalent techniques for mechanised theorem proving. Additionally, the thesis contains a user's guide to the system, meant to help new users of the ABEL system getting started. Some tests of the proof system is performed, wherein its performance with respect to the needs of program verification is investigated. An evaluation is performed, and conclusions drawn on what the system's main weaknesses are. Finally, with this evaluation as background, suggestions are made on how to develop the system further into a true verification system

Changes in mental health services and suicide mortality in Norway: an ecological study

<p>Abstract</p> <p>Background</p> <p>Mental disorders are strongly associated with excess suicide risk, and successful treatment might prevent suicide. Since 1990, and particularly after 1998, there has been a substantial increase in mental health service resources in Norway. This study aimed to investigate whether these changes have had an impact on suicide mortality.</p> <p>Methods</p> <p>We used Poisson regression analyses to assess the effect of changes in five mental health services variables on suicide mortality in five Norwegian health regions during the period 1990-2006. These variables included: number of man-labour years by all personnel, number of discharges, number of outpatient consultations, number of inpatient days, and number of hospital beds. Adjustments were made for sales of alcohol, sales of antidepressants, education, and unemployment.</p> <p>Results</p> <p>In the period 1990-2006, we observed a total of 9480 suicides and the total suicide rate declined by 26%. None of the mental health services variables were significantly associated with female or male suicide mortality in the adjusted analyses (p > 0.05). Sales of antidepressants (adjusted Incidence Rate Ratio = 0.98; 95% CI = 0.97-1.00) and sales of alcohol (adjusted IRR = 1.41; 95% CI = 1.18-1.72) were significantly associated with female suicide mortality; education (adjusted IRR = 0.86; 95% CI = 0.79-0.94) and unemployment (adjusted IRR = 0.91; 95% CI = 0.85-0.97) were significantly associated with male suicide mortality.</p> <p>Conclusions</p> <p>The adjusted analyses in the present study indicate that increased resources in Norwegian mental health services in the period 1990-2006 were statistically unrelated to suicide mortality.</p

Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

<p>Abstract</p> <p>Background</p> <p>Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning.</p> <p>Methods</p> <p>A cohort of patients who self-poisoned (n = 867) over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), and Generalized Self-Efficacy Scale (GSE) were used. The participation rate was 28% (n = 242); mean age, 41 years; 66% females.</p> <p>Results</p> <p>Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe). The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings.</p> <p>Conclusions</p> <p>Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.</p

Onboarding i en bransje med høy turnover

I denne oppgaven har vi tatt for oss temaet onboarding og om denne prosessen har en mulig effekt på turnover i hotellbransjen. Hensikten har vært å danne en forståelse for om det Bauer (2010) betegner som en systematisert onboardingsprosess kan bidra til å redusere turnover i hotellbransjen. Ifølge Bauer (2010) bidrar en systematisert onboardingsprosess til å redusere turnover, og må inneholde nivåene mestringstro, rolleavklaring, sosial integrasjon og kulturbevissthet for å betegnes som vellykket. I tillegg har vi valgt å belyse bruk av rollemodeller og støttende lederskap som forsterkende elementer for å oppnå de fire nivåene i en vellykket onboardingsprosess. På bakgrunn av dette har vi valgt problemstillingen: Hvordan kan en systematisert onboardingsprosess ha betydning for turnover i Thon Hotels og Nordic Choice Hotels? Problemstillingen har vi besvart ved å benytte oss av kvalitative intervjuer av til sammen tre HR-ansvarlige, to mellomledere og seks nyansatte i to hotellkjeder. Videre har vi i analysedelen drøftet hvordan HR-ansvarlige i hver av organisasjonene har utarbeidet sin onboardingsstrategi, i hvilken grad den er implementert ved hvert hotell og hvordan de nyansatte opplever denne prosessen. Våre funn viser at HR-ansvarlige i våre valgte organisasjoner til en viss grad tilrettelegger for elementene Bauer (2010) trekker frem som avgjørende for å oppnå en vellykket onboardingsprosess. Det fremkommer også at implementeringen og bruken av den systematiserte onboardingsprosessen er begrenset. Det konkluderes med at i den grad den nyansatte opplever at onboardingsprosessen inneholder de avgjørende nivåene, har betydning for om vedkommende ønsker å bli værende i organisasjonen. Støttende lederskap viser seg å ha en mulig positiv effekt på Bauers fire nivåer, mens rollemodeller kommer tydelig frem som et forsterkende element for en vellykket onboardingsprosess

Chain of care for patients who have attempted suicide: a follow-up study from Bærum, Norway

<p>Abstract</p> <p>Background</p> <p>Individuals who have attempted suicide are at increased risk of subsequent suicidal behavior. Since 1983, a community-based suicide prevention team has been operating in the municipality of Bærum, Norway. This study aimed to test the effectiveness of the team's interventions in preventing repeated suicide attempts and suicide deaths, as part of a chain of care model for all general hospital treated suicide attempters.</p> <p>Methods</p> <p>Data has been collected consecutively since 1984 and a follow-up was conducted on all individuals admitted to the general hospital after a suicide attempt. The risk of repeated suicide attempt and suicide were comparatively examined in subjects who received assistance from the suicide prevention team in addition to treatment as usual versus those who received treatment as usual only. Logistic regression and Cox regression were used to analyze the data.</p> <p>Results</p> <p>Between January 1984 and December 2007, 1,616 subjects were registered as having attempted suicide; 197 of them (12%) made another attempt within 12 months. Compared to subjects who did not receive assistance from the suicide prevention team, individuals involved in the prevention program did not have a significantly different risk of repeated attempt within 6 months (adjusted <it>OR </it>= 1.08; 95% CI = 0.66-1.74), 12 months (adjusted <it>OR </it>= 0.86; 95% CI = 0.57-1.30), or 5 years (adjusted <it>RR </it>= 0.90; 95% CI = 0.67-1.22) after their first recorded attempt. There was also no difference in risk of suicide (adjusted <it>RR </it>= 0.85; 95% CI = 0.46-1.57). Previous suicide attempts, marital status, and employment status were significantly associated with a repeated suicide attempt within 6 and 12 months (p < 0.05). Alcohol misuse, employment status, and previous suicide attempts were significantly associated with a repeated attempt within 5 years (p < 0.05) while marital status became non-significant (p > 0.05). With each year of age, the risk of suicide increased by 3% (p < 0.05).</p> <p>Conclusions</p> <p>The present study did not find any differences in the risk of fatal and non-fatal suicidal behavior between subjects who received treatment as usual combined with community assistance versus subjects who received only treatment as usual. However, assistance from the community team was mainly offered to attempters who were not receiving sufficient support from treatment as usual and was accepted by 50-60% of those deemed eligible. Thus, obtaining similar outcomes for individuals, all of whom were clinically judged to have different needs, could in itself be considered a desirable result.</p

Can We Really Prevent Suicide?

Every year, suicide is among the top 20 leading causes of death globally for all ages. Unfortunately, suicide is difficult to prevent, in large part because the prevalence of risk factors is high among the general population. In this review, clinical and psychological risk factors are examined and methods for suicide prevention are discussed. Prevention strategies found to be effective in suicide prevention include means restriction, responsible media coverage, and general public education, as well identification methods such as screening, gatekeeper training, and primary care physician education. Although the treatment for preventing suicide is difficult, follow-up that includes pharmacotherapy, psychotherapy, or both may be useful. However, prevention methods cannot be restricted to the individual. Community, social, and policy interventions will also be essentia

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries

<p>Abstract</p> <p>Background</p> <p>In the period 1990-2006, strong and almost equivalent increases in sales figures of selective serotonin re-uptake inhibitors (SSRIs) were observed in all Nordic countries. The sales figures of tricyclic antidepressants (TCAs) dropped in Norway and Sweden in the nineties. After 2000, sales figures of TCAs have been almost constant in all Nordic countries. The potentially toxic effect of TCAs in overdose was an important reason for replacing TCAs with SSRIs when treating depression. We studied whether the rapid increase in sales of SSRIs and the corresponding decline in TCAs in the period 1990-98 were associated with a decline in suicide rates.</p> <p>Methods</p> <p>Aggregated suicide rates for the period 1975-2006 in four Nordic countries (Denmark, Finland, Norway and Sweden) were obtained from the national causes-of-death registries. The sales figures of antidepressants were provided from the wholesale registers in each of the Nordic countries. Data were analysed using Fisher's exact test and Pearson's correlation coefficient.</p> <p>Results</p> <p>There was no statistical association (P = 1.0) between the increase of sales figures of SSRIs and the decline in suicide rates. There was no statistical association (P = 1.0) between the decrease in the sale figures of TCAs and change in suicide rates either.</p> <p>Conclusions</p> <p>We found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990-98. We did not find any inverse relationship between the increase in sales of SSRIs and declining suicide rates in four Nordic countries.</p

Secondary Prevention of Suicide

Leo Sher and colleagues discuss recent research on interventions to prevent secondary suicide and discuss the additional research that is needed

Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007)

[Abstract] Background: Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General Hospital. Methods: An observational-descriptive study of patients admitted to the A Coruña University Hospital (Spain) during the period 1997-2007, assessed by the Consultation and Liaison Psychiatric Unit. We include n = 5,234 admissions from 4,509 patients. Among these admissions, n = 361 (6.9%) were subsequent to a suicide attempt. Admissions arising from a suicide attempt were compared with admissions occurring due to other reasons.Multivariate generalised estimating equation logistic regression models were used to examine factors associated with suicide attempts. Results: Adjusting by age, gender, educational level, cohabitation status, being employed or unemployed, the psychiatric diagnosis at the time of the interview and the information on previous suicide attempts, we found that the variables associated with the risk of a suicide attempt were: age, psychiatric diagnosis and previous suicide attempts. The risk of suicide attempts decreases with age (OR = 0.969). Psychiatric diagnosis was associated with a higher risk of suicide attempts, with the highest risk being found for Mood or Affective Disorders (OR = 7.49), followed by Personality Disorders (OR = 7.31), and Schizophrenia and Other Psychotic Disorders (OR = 5.03).The strongest single predictive factor for suicide attempts was a prior history of attempts (OR = 23.63). Conclusions: Age, psychopathological diagnosis and previous suicide attempts are determinants of suicide attempts