Assessing the Efficacy of Restricting Access to Barbecue Charcoal for Suicide Prevention in Taiwan: A Community-Based Intervention Trial

Objective Charcoal-burning suicide has recently been spreading to many Asian countries. There have also been several cases involving this new method of suicide in Western countries. Restricting access to suicide means is one of the few suicide-prevention measures that have been supported by empirical evidence. The current study aims to assess the effectiveness of a community intervention program that restricts access to charcoal to prevent suicide in Taiwan. Methods and Findings A quasi-experimental design is used to compare method-specific (charcoal-burning suicide, non-charcoal-burning suicide) and overall suicide rates in New Taipei City (the intervention site, with a population of 3.9 million) with two other cities (Taipei City and Kaohsiung City, the control sites, each with 2.7 million residents) before (Jan 1st 2009- April 30th 2012) and after (May 1st 2012-Dec. 31st 2013) the initiation of a charcoal-restriction program on May 1st 2012. The program mandates the removal of barbecue charcoal from open shelves to locked storage in major retail stores in New Taipei City. No such restriction measure was implemented in the two control sites. Generalized linear regression models incorporating secular trends were used to compare the changes in method-specific and overall suicide rates before and after the initiation of the restriction measure. A simulation approach was used to estimate the number of lives saved by the intervention. Compared with the pre-intervention period, the estimated rate reduction of charcoal-burning suicide in New Taipei City was 37% (95% CI: 17%, 50%) after the intervention. Taking secular trends into account, the reduction was 30% (95% CI: 14%, 44%). No compensatory rise in non-charcoal-burning suicide was observed in New Taipei City. No significant reduction in charcoal-burning suicide was observed in the other two control sites. The simulation approach estimated that 91 (95%CI [55, 128]) lives in New Taipei City were saved during the 20 months of the intervention. Conclusion Our results demonstrate that the charcoal-restriction program reduced method-specific and overall suicides. This study provides strong empirical evidence that restricting the accessibility of common lethal methods of suicide can effectively reduce suicide rates.published_or_final_versio

The Impact of Improving Suicide Death Classification in South Korea: A Comparison with Japan and Hong Kong

Introduction The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. Method We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. Results We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. Conclusion Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.published_or_final_versio

Eight Challenges of Servitization for the Configuration, Measurement and Management of Organisations

Purpose – There is an extensive research literature on servitisation and the related field of product-service systems that has emerged independently from different fields including engineering, management, design and environmental studies. The purpose of this paper is to conduct a structured literature review to explore, identify and synthesise the multi-disciplinary research challenges in the journey towards servitisation. Design/methodology/approach – The research approach is a systematic literature review using key word searches and citation tracking for research reported between 1990 and 2013 in research databases that cover the fields which have generated the body of knowledge. Findings – One of the key findings from the extant literature on servitisation is that it suffers from three fundamental weaknesses. First, numerous studies are conceptual in nature with limited practicality. Second, there are relatively few empirical studies, and often the findings relate to a single case study based on the insights of a limited number of senior managers. Third, often the dynamics are insufficiently studied in these organisations because data for most cases are collected post-event. Research limitations/implications – Based on the literature review and its shortfalls, this paper proposes a holistic framework of eight themes that require further attention from academic researchers in order that a more complete conceptual understanding of servitisation is developed to support practice. Practical implications – Each theme in the framework has an associated list of questions that can be addressed through research and presented to managers as a challenge agenda to improve their servitisation efforts. That servitisation is associated with differentiation and competitive advantage makes this a valuable approach for managing corporate performance. Originality/value – Research from multi-disciplinary sources is synergised in order to develop an overarching servitisation agenda that transcends domain-based boundaries. This paves the way for an approach to servitisation that is coherent and harmonious

Mental wellbeing amongst younger and older migrant workers in comparison to their urban counterparts in Guangzhou city, China: a cross-sectional study

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Human papillomavirus status in southern Chinese women

1. The overall and type-specific human papillomavirus (HPV) prevalence differed between Hong Kong and Guangzhou healthy women. The prevalence of HPV was significantly higher in Guangzhou than Hong Kong women. Younger women had significantly higher risk of HPV infection. 2. HPV16 remained the most common type detected in both regions; the frequency increased with increasing disease severity. The prevalence of HPV58 and HPV52 was relatively high in women with normal cervix and precancerous lesions.published_or_final_versio

Hedgehog/notch-induced premature gliogenesis represents a new disease mechanism for Hirschsprung disease in mice and humans

Hirschsprung (HSCR) disease is a complex genetic disorder attributed to a failure of the enteric neural crest cells (ENCCs) to form ganglia in the hindgut. Hedgehog and Notch are implicated in mediating proliferation and differentiation of ENCCs. Nevertheless, how these signaling molecules may interact to mediate gut colonization by ENCCs and contribute to a primary etiology for HSCR are not known. Here, we report our pathway- based epistasis analysis of data generated by a genome-wide association study on HSCR disease, which indicates that specific genotype constellations of Patched (PTCH1) (which encodes a receptor for Hedgehog) and delta-like 3 (DLL3) (which encodes a receptor for Notch) SNPs confer higher risk to HSCR. Importantly, deletion of Ptch1 in mouse ENCCs induced robust Dll1 expression and activation of the Notch pathway, leading to premature gliogenesis and reduction of ENCC progenitors in mutant bowels. Dll1 integrated Hedgehog and Notch pathways to coordinate neuronal and glial cell differentiation during enteric nervous system development. In addition, Hedgehog-mediated gliogenesis was found to be highly conserved, such that Hedgehog was consistently able to promote gliogenesis of human neural crest-related precursors. Collectively, we defined PTCH1 and DLL3 as HSCR susceptibility genes and suggest that Hedgehog/Notch-induced premature gliogenesis may represent a new disease mechanism for HSCR.published_or_final_versio

High Diversity of Genogroup I Picobirnaviruses in Mammals

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The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

<p>Abstract</p> <p>Background</p> <p>Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell.</p> <p>Methods</p> <p>We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell.</p> <p>Results</p> <p>Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement).</p> <p>Conclusions</p> <p>Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT.</p

Josephson Junctions and AdS/CFT Networks

We propose a new holographic model of Josephson junctions (and networks thereof) based on designer multi-gravity, namely multi-(super)gravity theories on products of distinct asymptotically AdS spacetimes coupled by mixed boundary conditions. We present a simple model of a Josephson junction (JJ) that exhibits the well-known current-phase sine relation of JJs. In one-dimensional chains of holographic superconductors we find that the Cooper-pair condensates are described by a discretized Schrodinger-type equation. Such non-integrable equations, which have been studied extensively in the past in condensed matter and optics applications, are known to exhibit complex behavior that includes periodic and quasiperiodic solutions, chaotic dynamics, soliton and kink solutions. In our setup these solutions translate to holographic configurations of strongly-coupled superconductors in networks with weak site-to-site interactions that exhibit interesting patterns of modulated superconductivity. In a continuum limit our equations reduce to generalizations of the Gross-Pitaevskii equation. We comment on the many possible extensions and applications of this new approach.Comment: 39 pages, 11 figures; v2 clarified the nature and computation of the Josephson current in subsec. 3.2 and specific properties of the two-site system, analogous minor modifications in subsec. 4.4 and added a new subsec. 4.5 with a new fig.

The Evolution of the Epidemic of Charcoal-Burning Suicide in Taiwan: A Spatial and Temporal Analysis

Shu-Sen Chang and colleagues describe the epidemiology of an epidemic of suicide by charcoal burning in Taiwan and discuss possible reasons for its spread