777 research outputs found
Variations in the hospital management of self harm in adults in England: observational study
More than 140 000 people present to hospital after an
episode of self harm each year in England and Wales.
Improving the general hospital management of these
people is a key area in preventing suicide. Although
professional consensus has been reached on how self
harm services should be organised and delivered,
wide variations in care delivery have been reported in
two regions in England. Using a nationally
representative sample, we investigated the variation in
services and delivery of care for self harm patients in
hospitals in England
Suicide epidemics: The impact of newly emerging methods on overall suicide rates - A time trends study
Background: The impact of newly emerging, popular suicide methods on overall rates of suicide has not previously been investigated systematically. Understanding these effects may have important implications for public health surveillance. We examine the emergence of three novel methods of suicide by gassing in the 20 th and 21 st centuries and determine the impact of emerging methods on overall suicide rates. Methods. We studied the epidemic rises in domestic coal gas (1919-1935, England and Wales), motor vehicle exhaust gas (1975-1992, England and Wales) and barbecue charcoal gas (1999-2006, Taiwan) suicide using Poisson and joinpoint regression models. Joinpoint regression uses contiguous linear segments and join points (points at which trends change) to describe trends in incidence. Results: Epidemic increases in the use of new methods of suicide were generally associated with rises in overall suicide rates of between 23% and 71%. The recent epidemic of barbecue charcoal suicides in Taiwan was associated with the largest rise in overall rates (40-50% annual rise), whereas the smallest rise was seen for car exhaust gassing in England and Wales (7% annual rise). Joinpoint analyses were only feasible for car exhaust and charcoal burning suicides; these suggested an impact of the emergence of car exhaust suicides on overall suicide rates in both sexes in England and Wales. However there was no statistical evidence of a change in the already increasing overall suicide trends when charcoal burning suicides emerged in Taiwan, possibly due to the concurrent economic recession. Conclusions: Rapid rises in the use of new sources of gas for suicide were generally associated with increases in overall suicide rates. Suicide prevention strategies should include strengthening local and national surveillance for early detection of novel suicide methods and implementation of effective media guidelines and other appropriate interventions to limit the spread of new methods. © 2011 Thomas et al; licensee BioMed Central Ltd.published_or_final_versio
The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems
Background. Brief problem-solving therapy is regarded as a pragmatic treatment for deliberate self-harm (DSH) patients. A recent meta-analysis of randomized controlled trials (RCTs) evaluating this approach indicated a trend towards reduced repetition of DSH but the pooled odds ratio was not statistically significant. We have now examined other important outcomes using this procedure, namely depression, hopelessness and improvement in problems.
Method. Six trials in which problem-solving therapy was compared with control treatment were identified from an extensive literature review of RCTs of treatments for DSH patients. Data concerning depression, hopelessness and improvement in problems were extracted. Where relevant statistical data (e.g. standard deviations) were missing these were imputed using various statistical methods. Results were pooled using meta-analytical procedures.
Results. At follow-up, patients who were offered problem-solving therapy had significantly greater improvement in scores for depression (standardized mean difference =[minus sign]0·36; 95% CI [minus sign]0·61 to [minus sign]0·11) and hopelessness (weighted mean difference =[minus sign]3·2; 95% CI [minus sign]4·0 to [minus sign]2·41), and significantly more reported improvement in their problems (odds ratio = 2·31; 95% CI 1·29 to 4·13), than patients who were in the control treatment groups.
Conclusions. Problem-solving therapy for DSH patients appears to produce better results than control treatment with regard to improvement in depression, hopelessness and problems. It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH
Collective Oscillations of Vortex Lattices in Rotating Bose-Einstein Condensates
The complete low-energy collective-excitation spectrum of vortex lattices is
discussed for rotating Bose-Einstein condensates (BEC) by solving the
Bogoliubov-de Gennes (BdG) equation, yielding, e.g., the Tkachenko mode
recently observed at JILA. The totally symmetric subset of these modes includes
the transverse shear, common longitudinal, and differential longitudinal modes.
We also solve the time-dependent Gross-Pitaevskii (TDGP) equation to simulate
the actual JILA experiment, obtaining the Tkachenko mode and identifying a pair
of breathing modes. Combining both the BdG and TDGP approaches allows one to
unambiguously identify every observed mode.Comment: 5 pages, 4 figure
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Suicide and self-harm in Britain: researching risk and resilience using UK surveys
Aim The main aim of this study was to raise awareness of surveys that could be used to inform self-harm and suicide prevention work. We asked:
What UK survey datasets are available for research?
What aspects of people’s lives are associated with self-harm and attempted suicide?
How do statistical findings resonate with people’s lived experience? What implications do they see?
Findings Survey analyses revealed that risk factors for self-harm are wide ranging and include:
Mental health
Physical health and health behaviours
Social relationships
Stressful events
Employment and financial circumstances
Identity and demographics
Many different factors are independently associated with self-harm. There is a dose relationship, with more exposure to a factor linked with increased risk. Risks are cumulative that is, exposure to multiple factors is associated with greater risk.
Through facilitated consultation, men with lived experience, bereaved family members, and practitioners identified recommendations for responding to suicidal distress in men. These related to the following three main areas:
1. Recognising need: who is ‘ill enough’?
Permission - men said that they often did not know they were entitled to help
Ask - people who outwardly appear to be functioning may not be
Persistence - ask and offer help more than once.
2. Facilitating access: right words, time and place
What is available - support is needed with ongoing stress as well as for crises
Find the words - men wanted examples of how to ask for help
Allow time - employers expect recovery to be swift, some men felt rushed to come off medications or were discharged from services they still needed.
3. Adjusting delivery: equal engagement
Power - some were uncomfortable with service dynamics, preferring peer support
Every service contact counts - negative contacts had particular impact
Safe spaces - may be different for men and women.
Methods
There were three strands of work:
Secondary analysis of nine survey series, spanning more than twenty years
Linkage of 144,000 survey participants to information on whether they were alive in 2013 and whether they had taken their own life
Facilitated consultation, through depth interviews with people with lived experience
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Double jeopardy: the potential for problems when bats interact with breathable roofing membranes in the United Kingdom
In order to reduce environmental impacts and achieve sustainability, it is important to balance the interactions
between the built and natural environment. The construction industry is becoming more aware of ecological concerns and the importance that biodiversity and maintenance ecosystem services has for sustainability. Bats constitute an important component of urban biodiversity and several species in the UK are highly dependent on buildings, making them particularly vulnerable to anthropogenic and environmental changes. Many buildings suitable for use as bat roosts often require re-roofing as they age and traditional bituminous roofing felts are frequently being replaced with breathable roofing membranes (BRMs). In the UK new building regulations and modern materials may substantially reduce the viability of existing roosts, yet at thesame time building regulations require that materials be fit for purpose. Reports suggest that both bats and BRMs may experience problems when the two interact. Such information makes it important to understand how house dwelling bats and BRMs may be affected. This paper considers the possible ways in which bats and BRMs may interact, how this could affect existing bat roosts within buildings and the implications for BRM service life predictions and warranties.
Keywords –Breathable Roofing Membranes, Bats in Buildings, Material Deterioration, Sustainability, Conservation, Biodiversi
Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka
<p>Abstract</p> <p>Background</p> <p>Deliberate self-poisoning with agricultural pesticides is the commonest means of suicide in rural Asia. It is mostly impulsive and facilitated by easy access to pesticides. The aim of this large observational study was to investigate the immediate source of pesticides used for self-harm to help inform suicide prevention strategies such as reducing domestic access to pesticides.</p> <p>Methods</p> <p>The study was conducted in a district hospital serving an agricultural region of Sri Lanka. Patients who had self-poisoned with pesticides and were admitted to the adult medical wards were interviewed by study doctors following initial resuscitation to identify the source of pesticides they have ingested.</p> <p>Results</p> <p>Of the 669 patients included in the analysis, 425 (63.5%) were male; the median age was 26 (IQR 20-36). In 511 (76%) cases, the pesticides had been stored either inside or immediately outside the house; among this group only eight patients obtained pesticides that were kept in a locked container. Ten percent (n = 67) of the patients used pesticides stored in the field while 14% (n = 91) purchased pesticides from shops within a few hours of the episode. The most common reasons for choosing the particular pesticide for self-harm were its easy accessibility (n = 311, 46%) or its popularity as a suicide agent in their village (n = 290, 43%).</p> <p>Conclusion</p> <p>Three quarters of people who ingested pesticides in acts of self-harm used products that were available within the home or in close proximity; relatively few patients purchased the pesticide for the act. The study highlights the importance of reducing the accessibility of toxic pesticides in the domestic environment.</p
Sedimentation record in the Konkan-Kerala Basin: implications for the evolution of the Western Ghats and the Western Indian passive margin
The Konkan and Kerala Basins constitute a major depocentre for sediment from the onshore hinterland of Western India and as such provide a valuable record of the timing and magnitude of Cenozoic denudation along the continental margin. This paper presents an analysis of sedimentation in the Konkan-Kerala Basin, coupledwith a mass balance study, and numerical modelling of flexural responses to onshore denudational unloading and o¡shore sediment loading in order to test competing conceptual models for the development of high-elevation passive margins. The Konkan-Kerala Basin contains an estimated 109,000 km<sup>3</sup>; of Cenozoic clastic sediment, a volume difficult to reconcile with the denudation of a downwarped rift flank onshore, and more consistent with denudation of an elevated rift flank. We infer from modelling of the isostatic response of the lithosphere to sediment loading offshore and denudation onshore that flexure is an important component in the development of the Western Indian Margin.There is evidence for two major pulses in sedimentation: an early phase in the Palaeocene, and a second beginning in the Pliocene. The Palaeocene increase in sedimentation can be interpreted in terms of a denudational response to the rifting between India and the Seychelles, whereas the mechanism responsible for the Pliocene pulse is more enigmatic
Investigating whether adverse prenatal and perinatal events are associated with non-clinical psychotic symptoms at age 12 years in the ALSPAC birth cohort
Background. Non-clinical psychosis-like symptoms (PLIKS) occur in about 15% of the population. It is not clear
whether adverse events during early development alter the risk of developing PLIKS. We aimed to examine whether
maternal infection, diabetes or pre-eclampsia during pregnancy, gestational age, perinatal cardiopulmonary resuscitation
or 5-min Apgar score were associated with development of psychotic symptoms during early adolescence.
Method. A longitudinal study of 6356 12-year-old adolescents who completed a semi-structured interview for
psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Prenatal and
perinatal data were obtained from obstetric records and maternal questionnaires completed during pregnancy.
Results. The presence of definite psychotic symptoms was associated with maternal infection during pregnancy
[adjusted odds ratio (OR) 1.44, 95% confidence interval (CI) 1.11–1.86, p=0.006], maternal diabetes (adjusted OR 3.43,
95% CI 1.14–10.36, p=0.029), need for resuscitation (adjusted OR 1.50, 95% CI 0.97–2.31, p=0.065) and 5-min Apgar
score (adjusted OR per unit decrease 1.30, 95% CI 1.12–1.50, p<0.001). None of these associations were mediated by
childhood IQ score. Most associations persisted, but were less strong, when including suspected symptoms as part of
the outcome. There was no association between PLIKS and gestational age or pre-eclampsia.
Conclusions. Adverse events during early development may lead to an increased risk of developing PLIKS.
Although the status of PLIKS in relation to clinical disorders such as schizophrenia is not clear, the similarity
between these results and findings reported for schizophrenia indicates that future studies of PLIKS may help us to
understand how psychotic experiences and clinical disorders develop throughout the life-course
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