Suicide in Adults Aged 75 and Over in Cornwall: An Epidemiological and Case Study Analysis

Introduction/Background: Suicide in older people is a historically neglected research area. Local audits had suggested that Cornwall had a higher than average suicide rate, and people aged 75 years and over appeared to be at particularly high risk. Heterogeneity between studies and variations in presenting suicide statistics can make comparison of rates difficult. Aims: The study aimed to explore in depth the epidemiology of suicide in elderly people in Cornwall, to develop an understanding of the risk factors (including sources of stress), suicide methods, locations, and warnings, and consequently to identify potential preventive strategies. Methods: A mixed methods approach was taken, combining quantitative epidemiological study of suicide using Office for National Statistics (ONS) Public Health Mortality Files with qualitative retrospective case study analysis using coroner’s records and local audit database. All completed suicides (and some systematically selected open verdicts) in people aged 75 years and over occurring in Cornwall between 2006 and 2010 were included. A questionnaire survey of rural community dwelling people aged 75 years and over (n = 49) in a part of Cornwall was also carried out to identify the main sources of stress associated with ageing in the local area. Results: Some discrepancies in the number of open verdicts reported by the coroner and ONS were noted. Although suicide in the over 75 age group was responsible for only 0.3 % of all-cause mortality in males and 0.1 % in females, the overall suicide rate in this age group in Cornwall was significantly higher than the average for the UK, with a Standardised Mortality Ratio of 172 (95 % CI 123 to 236). Males aged between 75 and 84 years had the highest suicide rate in Cornwall (mean of 25.8 deaths per 100,000 population, 95 % CI 1.1 to 50.5). Jumping from a height and suffocation were the most frequently used methods, accounting for 8 and 7 of the 34 deaths respectively. 28 of the 34 suicides took place at home. Depressive illness, physical illness and bereavement were the most commonly identified risk factors. Concerns revealed in survey responses were closely related to suicide risk factors, including fear of losing independence, bereavement, physical illness, isolation, and fear of becoming a burden. Warnings included previous self-harm or attempted suicide, suicide ideation or plans, behavioural changes and researching euthanasia. Discussion: As persons aged 75 and over are at significantly higher risk of suicide in Cornwall than other regions, there is a need to reduce the number of suicides in this group. Possible preventive measures include reducing access to means (in particular for jumping incidents), earlier detection of depression in the physically ill, bereavement counselling, more social groups and support groups in rural areas, helping people to retain their independence, and a change in societal attitudes towards elderly people. There may also be a need to improve the accuracy of suicide statistics. Conclusion: Health services, councils, voluntary groups and the community as a whole should work together to prevent suicide in older people. Future controlled studies should assess the effectiveness of interventions and focus more on differences between subgroups of elderly people.Funder: Combined Universities in Cornwall European Social Fund. Project carried out in collaboration with Cornwall and Isles of Scilly Primary Care Trust

The Effect of Trigger Point Dry Needling to the Multifidus Muscle on Resting and Contracted Thickness of Transversus Abdominis in Healthy Subjects

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span. Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects. Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated. Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were randomly assigned to receive TPN to the MF or a sham intervention at their initial treatment session. All individuals were instructed on how to perform a concentric contraction of the TrA. Resting and contraction thicknesses of the TrA were obtained through real-time ultrasound (US) measurements before and immediately following intervention. As part of this crossover trial, subjects returned 2-7 days after the initial treatment to receive the alternate intervention, and the US measurements were repeated. Results: Two-way ANOVA revealed a significant interaction for contraction and treatment (p=.002). Simple main effects using paired-samples t-tests and a Bonferroni post-hoc revealed difference in contracted states for needling versus sham (p=.009) and between contracted and resting states for needling (p=.001). There was no significant difference between resting states for needling versus sham. Conclusion: Our results indicate that TPN to the MF causes a decreased thickness of the TrA at rest and an increased thickness of TrA in contracted state. These findings suggest that TPN could allow for a more efficient contraction of the TrA to help increase core stability

The Effect of Size on Ag Nanosphere Toxicity in Macrophage Cell Models and Lung Epithelial Cell Lines Is Dependent on Particle Dissolution

Silver (Ag) nanomaterials are increasingly used in a variety of commercial applications. This study examined the effect of size (20 and 110 nm) and surface stabilization (citrate and PVP coatings) on toxicity, particle uptake and NLRP3 inflammasome activation in a variety of macrophage and epithelial cell lines. The results indicated that smaller Ag (20 nm), regardless of coating, were more toxic in both cell types and most active in the THP-1 macrophages. TEM imaging demonstrated that 20 nm Ag nanospheres dissolved more rapidly than 110 nm Ag nanospheres in acidic phagolysosomes consistent with Ag ion mediated toxicity. In addition, there were some significant differences in epithelial cell line in vitro exposure models. The order of the epithelial cell lines’ sensitivity to Ag was LA4 \u3e MLE12 \u3e C10. The macrophage sensitivity to Ag toxicity was C57BL/6 AM \u3e MARCO null AM, which indicated that the MARCO receptor was involved in uptake of the negatively charged Ag particles. These results support the idea that Ag nanosphere toxicity and NLRP3 inflammasome activation are determined by the rate of surface dissolution, which is based on relative surface area. This study highlights the importance of utilizing multiple models for in vitro studies to evaluate nanomaterials

The Effects of Size on Ag Nanosphere Toxicity in Macrophage Cell Models and Lung Epithelial Cell Lines Is Dependent on Particle Dissolution

Silver (Ag) nanomaterials are increasingly used in a variety of commercial applications. This study examined the effect of size (20 and 110 nm) and surface stabilization (citrate and PVP coatings) on toxicity, particle uptake and NLRP3 inflammasome activation in a variety of macrophage and epithelial cell lines. The results indicated that smaller Ag (20 nm), regardless of coating, were more toxic in both cell types and most active in the THP-1 macrophages. TEM imaging demonstrated that 20 nm Ag nanospheres dissolved more rapidly than 110 nm Ag nanospheres in acidic phagolysosomes consistent with Ag ion mediated toxicity. In addition, there were some significant differences in epithelial cell line in vitro exposure models. The order of the epithelial cell lines’ sensitivity to Ag was LA4 \u3e MLE12 \u3e C10. The macrophage sensitivity to Ag toxicity was C57BL/6 AM \u3e MARCO null AM, which indicated that the MARCO receptor was involved in uptake of the negatively charged Ag particles. These results support the idea that Ag nanosphere toxicity and NLRP3 inflammasome activation are determined by the rate of surface dissolution, which is based on relative surface area. This study highlights the importance of utilizing multiple models for in vitro studies to evaluate nanomaterials

Food Retailers’ Perspectives on Pilot Program Strategies to Promote Healthy Eating in SNAP Participants

Food retailers are key stakeholders in the development, implementation, and effectiveness of Supplemental Nutrition Assistance Program (SNAP) nutrition pilot programs. Qualitative interviews were conducted to gather insight from food retailers regarding the feasibility of proposed strategies to improve food choices among SNAP participants. Two corporate and six local-level food retailer managers were identified for interviews based on SNAP participation, rural- urban code, and type of food retail settings in the selected counties. Qualitative thematic analysis was performed by four research team members, and themes were identified via consensus. Marketing, incentive, and disincentive program models were well-received, while restriction and stocking standards models were less well-received. Food retailers viewed simple programs with easy implementation and educational components positively. Driving sales and programs that align with corporate and social responsibility goals were important factors related to willingness to participate in pilot programs. Insights from this present study can inform future pilot programs and promote food retailer buy-in

Inorganic nitrogen and glucose additions alter the short-term formation efficiency of mineral associated organic matter carbon

Carbon within mineral associated organic matter (MAOM) is an important persistent form of soil organic carbon (SOC). However, processes driving the retention of new labile C in MAOM are not fully understood. We investigated the effects of glucose and ammonium nitrate (AN) addition on the short-term (72 h) retention of applied 13C-glucose within MAOM. We found an interactive effect of AN addition with the glucose addition rate. Higher rates of glucose addition resulted in proportionally less glucose-C retained, indicating lower MAOM-C formation efficiency. Addition of AN only altered the proportional retention of glucose where glucose was applied at the lowest rate. In this instance glucose-13C recovery increased with AN addition. However, after 72 h there was no treatment difference in total MAOM-C, indicating that any changes in formation efficiency as a result of AN and glucose additions, did not result in differences in total MAOM-C in the short-term. Whether and how this affects the medium and longer-term dynamics of MAOM-C requires further investigation

A U-shaped association between depression and vigorous physical activity: A cross-sectional study in a cohort of police officers and staff in England

Policing has become an increasingly sedentary occupation. At the same time, rates of depression are increasing across the police force. Vigorous physical activity (VPA) has been associated with decreasing rates of depression, yet studies of VPA in policing are limited. This study aimed to explore the prevalence of depression and examine its association with VPA in police officers and staff in England, further stratified by gender. A cross-sectional, secondary data analysis of the Airwave dataset was undertaken. The data were analyzed using descriptive statistics and multivariate logistic regression. Of 28,465 police officers and staff in England, 12% reported having doctor-diagnosed depression and 25% were physically inactive. Relative to being physically inactive, undertaking VPA for either four or seven days was significantly associated with having the lowest odds of reporting depression (OR 0.59, 95% CI: 0.51–0.70, p < 0.001) (OR 0.59, 95% CI: 0.45–0.77, p < 0.001), respectively, suggesting a U-shaped/non-linear relationship. This relationship was also observed in the gender-stratification analysis. While the odds of reporting depression were significantly lower for men than women, VPA was significantly associated with reducing the odds of reporting depression slightly more in women (OR 0.43, 95% CI: 0.27–0.67, p < 0.001) than in men (OR 0.50, 95% CI: 0.33–0.75, p < 0.01), indicating women may be more likely to benefit from VPA than men. Vigorous physical activity may provide a protective effect against depression. To prevent the onset of depression in the target population, policy-makers should consider designing physical activity guidelines for police officers to promote VPA in the target population

Activism, affect, identification: trans documentary in France and Spain and its reception

This article explores the documentation of trans activism in France and Spain since the 2000s. The first part addresses questions surrounding the place of affect and narrative in documentary film, particularly in relation to trans issues. The second part o f the article analyses an audience case study from a screening at the International Gay and Lesbian Film Festival in Barcelona of Valérie Mitteaux's Girl or Boy, My Sex is not my Gender (2011), considering how different viewers respond to the representatio n of trans identities. The article builds on qualitative research whilst extending the exploration of sexuality and gender in previous audience studies to a consideration of documentary film, seeking to provide a more nuanced understanding of what audience claims for identification in politicised contexts mean

Right Turn Veteran-Specific Recovery Service: 5 site evaluation pilot: Interim report

The Right Turn project works with the ex-service personnel community in recovery from substance misuse. This report presents the interim findings from a two-year evaluation on the impact on health and wellbeing outcomes on military veterans engaging in this innovative peer-focussed recovery service. The evaluation is designed around a structured quantitative data collection process using an established repeat measure design and utilises qualitative methodologies to explore both the life experiences of this veteran cohort and to take account of their own perceptions of the model of services they feel they require. This report suggests that the military veteran community experience distinct barriers to accessing main stream health and wellbeing services. Alongside comorbidity issues, management of chronic physical conditions and social isolation, this report demonstrates that this cohort's own previous military conditioning forms a further barrier to accessing support services. This report contains recommendations to inform generic support staff when encountering veterans within health and wellbeing settings

Right Turn Veteran-Specific Recovery Service: 5 site evaluation pilot : Interim report

The Right Turn project works with the ex-service personnel community in recovery from substance misuse. This report presents the interim findings from a two-year evaluation on the impact on health and wellbeing outcomes on military veterans engaging in this innovative peer-focussed recovery service. The evaluation is designed around a structured quantitative data collection process using an established repeat measure design and utilises qualitative methodologies to explore both the life experiences of this veteran cohort and to take account of their own perceptions of the model of services they feel they require. This report suggests that the military veteran community experience distinct barriers to accessing main stream health and wellbeing services. Alongside comorbidity issues, management of chronic physical conditions and social isolation, this report demonstrates that this cohort's own previous military conditioning forms a further barrier to accessing support services. This report contains recommendations to inform generic support staff when encountering veterans within health and wellbeing settings