Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial

BACKGROUND: Suicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed \u27aftercare\u27 interventions). METHODS: A controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019. DISCUSSION: The study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers

An Optimal driving force for converting excitons into free carriers in excitonic solar cells

A general but limiting characteristic in excitonic photovoltaics is that a portion of the incident photon energy appears necessary for converting excitons into electrical charges, resulting in a loss of efficiency. Currently, the mechanism underlying this process is unclear. Here, we describe the development of an experimental method for measuring charge creation yields in organic solar cell materials. We use this method to examine a series of conjugated polymer:fullerene blend films and observe two unexpected features: the existence of an optimal driving force and a loss in conversion efficiency if this force is exceeded. These observations have implications for the design of excitonic photovoltaic devices and can be explained by a simple Marcus formulation that introduces the importance of reorganization energy.8 page(s

An Optimal Driving Force for Converting Excitons into Free Carriers in Excitonic Solar Cells

A general but limiting characteristic in excitonic photovoltaics is that a portion of the incident photon energy appears necessary for converting excitons into electrical charges, resulting in a loss of efficiency. Currently, the mechanism underlying this process is unclear. Here, we describe the development of an experimental method for measuring charge creation yields in organic solar cell materials. We use this method to examine a series of conjugated polymer:fullerene blend films and observe two unexpected features: the existence of an optimal driving force and a loss in conversion efficiency if this force is exceeded. These observations have implications for the design of excitonic photovoltaic devices and can be explained by a simple Marcus formulation that introduces the importance of reorganization energy