9 research outputs found

    Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): an evidence-based multi-level approach

    Get PDF
    Background Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. Method The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. Discussion This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sample, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient concept for suicide prevention for EU-member states

    The European Alliance Against Depression: A Multilevel Approach to the Prevention of Suicidal Behavior

    No full text
    The European Alliance Against Depression (EAAD) was formed in 2004 with funding from the European Commission. The EAAD,which is currently active in 17countries, creates community based networks that use an evidence-based approach to improving care for depressed persons and preventing suicidality. This column describes the creation of EAAD and the cornerstone of the alliance, which is a shared multilevel approach that includes interventions on four levels: education of primary care physicians, a professional public relations campaign, training of community facilitators, and interventions with affected persons and high-risk groups. Several countries have expanded their original model program into other regions or nationwide

    Gender issues in suicide rates, trends and methods among youths aged 15-24 in 15 European countries

    No full text
    Background No recent cross-country examinations for youth suicide trends and methods for Europe were found. Aim The aim of the study is to specify differences in suicide rates, trends and methods used among 15–24 years olds by gender across 15 European countries. Method Data for 14,738 suicide cases in the age group 15–24 in 2000–2004/5 were obtained and analysed. Results Suicide rates ranged 5.5–35.1 for males and 1.3–8.5 for females. Statistically significant decline since 2000 was observed in Germany, Scotland, Spain, and England for males and in Ireland for females. Hanging was most frequently used for both genders, followed by jumping and use of a moving object for males and jumping and poisoning by drugs for females. Male suicides had a higher risk than females of using firearms and hanging and lower risk of poisoning by drugs and jumping. There were large differences between single countries. Limitations The limitations of the study are the small numbers of specific suicide methods in some countries as well as the re-categorisation of ICD-9 codes into ICD-10 in England, Ireland and Portugal. Further, the use of suicides (X60–X84) without events of undetermined deaths (Y10–Y34) continues to be problematic considering the possibility of “hidden suicides”. Conclusions The present study shows that suicide rates among young males are decreasing since 2000 in several European countries. Analysis of suicide methods confirms that there is a very high proportion of hanging in youths, which is extremely difficult to restrict. However, besides hanging there are also high rates of preventable suicide methods and reducing the availability of means should be one of the goals of suicide prevention

    The mouse mutation “thrombocytopenia and cardiomyopathy” (trac) disrupts Abcg5: a spontaneous single gene model for human hereditary phytosterolemia/sitosterolemia

    No full text
    The spontaneous mouse mutation “thrombocytopenia and cardiomyopathy” (trac) causes macrothrombocytopenia, prolonged bleeding times, anemia, leukopenia, infertility, cardiomyopathy, and shortened life span. Homozygotes show a 20-fold decrease in platelet numbers and a 3-fold increase in platelet size with structural alterations and functional impairments in activation and aggregation. Megakaryocytes in trac/trac mice are present in increased numbers, have poorly developed demarcation membrane systems, and have decreased polyploidy. The thrombocytopenia is not intrinsic to defects at the level of hematopoietic progenitor cells but is associated with a microenvironmental abnormality. The trac mutation maps to mouse chromosome 17, syntenic with human chromosome 2p21-22. A G to A mutation in exon 10 of the adenosine triphosphate (ATP)–binding cassette subfamily G, member 5 (Abcg5) gene, alters a tryptophan codon (UGG) to a premature stop codon (UAG). Crosses with mice doubly transgenic for the human ABCG5 and ABCG8 genes rescued platelet counts and volumes. ABCG5 and ABCG8 form a functional complex that limits dietary phytosterol accumulation. Phytosterolemia in trac/trac mice confirmed a functional defect in the ABCG5/ABCG8 transport system. The trac mutation provides a new clinically significant animal model for human phytosterolemia and provides a new means for studying the role of phytosterols in hematologic diseases and testing therapeutic interventions
    corecore