Museiljus och teaterljus

Lighting in museums and in theatres The author normally works with a theatre company. Together with a stage designer he has also assisted in the preparation of exhibitions and compares his experiences of lighting in the different settings. The general principles are the same, e.g. that our sense of light and dark is always determined by changes in the intensity of light and by its colouring. The basic difference lies in the fixed position of the audience in the theatre and the moving museum visitor added to which are strict norms governing the amount of light permitted to play on the various materials that make up museum objects with a view to counteracting deterioriation.

Attempted suicide in late life: A prospective study

Background: Elderly have high suicide rates. While attempted suicide is the strongest known predictor of suicide death, there are few controlled studies focusing on elderly attempters and prospective studies are lacking. Aims: To examine social, psychological and psychiatric characteristics in elderly suicide attempters and in a general population comparison group. To investigate one-year outcomes and associated factors. Methods: One-hundred and three suicide attempters (70+) (56 women and 47 men, mean age 80 years) were recruited from five hospitals in western Sweden. A population comparison group with the same sex and age composition was randomly drawn from our ongoing epidemiological studies. Sixty suicide attempters participated in the one-year follow-up study. Instruments included, the Comprehensive Psychopathological Rating Scale (CPRS), the Montgomery-Asberg Depression Rating Scale (MADRS), the Sense of Coherence Scale (SOC) and the Eysenck Personality Inventory (EPI). Medical records were reviewed. Results: Both major and minor depression were associated with suicide attempt. A relationship was observed between perceived loneliness and suicide attempt. This association remained significant after adjustment for depression. A life time history of alcohol use disorder was associated with suicide attempt in both men and women. At one-year follow-up, two thirds of those who had major depression at the index attempt no longer fulfilled criteria for that diagnosis. Predictors for non-remission included higher MADRS- and BSA score, higher suicide intent and lower sense of coherence (SOC) score at index attempt. Two persons died by suicide and six persons repeated a suicide attempt during the one-year observation period. One-year overall mortality was elevated more than two-fold. Suicide attempters scored higher on neuroticism and lower on extroversion than comparison subjects. However, these associations did not remain after adjusting for major depression. Conclusions: Associations observed in this study mirrored those previously shown for death by suicide in late life in the same catchment area. Early detection and adequate treatment of depression and problematic alcohol use, as well as interventions that target loneliness may reduce suicidal behaviour in this vulnerable and growing age group. Key words: Elderly, suicide attempt, depression, loneliness, alcohol use disorder, prospective study, remission, one-year mortality, repeated suicidal behaviour, neuroticism, extroversion

Medically Serious and Non-Serious Suicide Attempts in Persons Aged 70 and Above

High rates of suicide are observed among older adults in many countries worldwide. In clinical settings, those who make a medically serious suicide attempt are generally considered to be at higher risk of subsequent suicide than those who make less serious attempts. Medically serious attempts in older clinical cohorts are, however, relatively understudied. The aim was to compare older adult suicide attempters (70+) who did or did not make medically serious attempts. We hypothesized, in line with the Interpersonal Model of suicide, that social problems and feelings of being a burden would be associated with medical seriousness. Participants (n = 101) were recruited in hospitals in the aftermath of a suicide attempt; they took part in an interview with a research psychologist. Attempters with (n = 28) and without (n = 73) medically serious attempts were compared. Major depression was common in both groups, and scores on the Geriatric Depression Scale did not differ. However, older adults who made medically serious attempts scored higher on the Brief Scale of Anxiety and lower on the Mini Mental State Examination than their peers who made less serious attempts. Medically serious attempters more often attributed the attempt to social problems as well as problems with functioning and autonomy, but perceived burdensomeness was not associated with seriousness. Findings may help to inform clinicians who meet and treat older suicidal persons

Performance measure review practice in heavy automotive industry – a dual perspective case study

Within the field of performance measurement and management (PMM) it is well-established that more research is needed into understanding how change is managed in performance measures (PM) (Eccles, 1991; Ghalayini and Noble, 1996; Neely, 1999; Kennerley and Neely, 2002; Kennerley and Neely, 2003; Melnyk et al., 2004; Neely 2005; Bourne, 2008). Even though academics have risen to the challenge by proposing several performance measurement frameworks (Bititci et al., 2000; Bourne et al., 2000; Najmi et al., 2005; Kennerley et al., 2003) two shortcomings prevail in the contemporary thereotical base. Firstly, little research has focused on the applied practices of organisations in the industry for managing change. Secondly, the research available today takes on a management perspective rather than an organisation-wide equivalent. This has been acknowledged by Bourne (2008) that underlines the need for more collaborative research into understanding how organisations manage change in PM in practice. With these deficiencies in mind, the purpose of this paper is firstly to outline the PM review practice of an organisation within the heavy automotive industry from two perspectives, top-management and operational, and secondly to contrast the practice to theory. In order to do this, two case studies at one case company have been executed, one from each perspective. The heavy automotive industry, defined in this paper as the industry for buses, trucks, and construction equipment, is both interesting and appropriate to study in relation to the outlined phenomenon

Performance measure review practice in heavy automotive industry – a dual perspective case study

Within the field of performance measurement and management (PMM) it is well-established that more research is needed into understanding how change is managed in performance measures (PM) (Eccles, 1991; Ghalayini and Noble, 1996; Neely, 1999; Kennerley and Neely, 2002; Kennerley and Neely, 2003; Melnyk et al., 2004; Neely 2005; Bourne, 2008). Even though academics have risen to the challenge by proposing several performance measurement frameworks (Bititci et al., 2000; Bourne et al., 2000; Najmi et al., 2005; Kennerley et al., 2003) two shortcomings prevail in the contemporary thereotical base. Firstly, little research has focused on the applied practices of organisations in the industry for managing change. Secondly, the research available today takes on a management perspective rather than an organisation-wide equivalent. This has been acknowledged by Bourne (2008) that underlines the need for more collaborative research into understanding how organisations manage change in PM in practice. With these deficiencies in mind, the purpose of this paper is firstly to outline the PM review practice of an organisation within the heavy automotive industry from two perspectives, top-management and operational, and secondly to contrast the practice to theory. In order to do this, two case studies at one case company have been executed, one from each perspective. The heavy automotive industry, defined in this paper as the industry for buses, trucks, and construction equipment, is both interesting and appropriate to study in relation to the outlined phenomenon

Overlapping patterns of suicide attempts and non-suicidal self-injuries in adults : a prospective clinical cohort study

Objective: An overlap of non-suicidal self-injuries (NSSIs) and suicide attempts (SAs) is observed in young cohorts, but there are few robust prospective studies for adults. We compared 1-year outcomes in adults with different self-harm patterns: NSSI only, NSSI + SA, and SA only. Methods: 793 patients (67% women) consecutively presenting with NSSI (17%) or SA (83%) at 3 Swedish hospitals took part in face-to-face interviews. Past and current self-harm was characterized by the Columbia-Suicide Severity Rating Scale. Clinical records and national register data were employed to determine 1-year outcomes. Results: At inclusion, over half of the participants had engaged in both NSSI and SA; 41% had SA only and 5%, NSSI only. During follow-up, non-fatal SAs were observed in approximately one-third of the total group (n = 269). Suicides occurred in 2% of those with NSSI + SA; the same proportion was seen in the SA only group. No suicides were observed in those with NSSI only. In a multiple logistic regression analysis, the NSSI + SA pattern was associated with a more than 3-fold risk of subsequent fatal/non-fatal suicidal behavior compared to "pure" NSSI; risk was not elevated in those with "pure" SA. Neither sex nor age group predicted subsequent suicidal behavior. Conclusions: Switching between behaviors with and without suicidal intent was common in this adult clinical cohort. Risk of subsequent suicidal behavior was tripled in the combined group. Clinicians who assess adults with NSSI must evaluate not only current but also previous episodes when assessing future risk of suicidal behavior

Clinical Characteristics in Older, Middle-Aged and Young Adults Who Present With Suicide Attempts at Psychiatric Emergency Departments : A Multisite Study

Objectives: To study age group differences in clinical characteristics in older, middle-aged and younger adults with actual suicide attempts (SA). Design: Cross-sectional cohort study. Setting: 3 Swedish university hospitals. Participants: 821 persons who presented with self-harm at psychiatric emergency departments participated. Those with non-suicidal self-injury according to the Columbia Suicide Severity Rating Scale (C-SSRS) were excluded, leaving a total of 683 with an actual SA (18–44 years, n = 423; 45-64 years, n = 164; 65+, n = 96). Measurements: Suicidal behavior was characterized with the C-SSRS and the Suicide Intent Scale (SIS); symptoms associated with suicide were rated with the Suicide Assessment Scale (SUAS). Diagnoses were set using the Mini-International Neuropsychiatric Interview. Patients self-rated their symptoms with the Karolinska Affective and Borderline Symptoms Scale (KABOSS). Results: Older adults scored higher than the younger group on SIS total score and on the subjective subscale, but no age group differences were detected for the objective subscale. Half of the 65+ group fulfilled criteria for major depression, compared to 3-quarters in both the middle-aged and young groups. Anxiety disorders, as well as alcohol and substance use disorders were also less prevalent in the 65+ group, while serious physical illness was more common. Older adults scored lower on all symptom scales; effect sizes were large. Conclusions: While older adults with an SA showed higher suicide intent than young adults, they had lower scores on all ratings of psychiatric symptomatology. Low ratings might interfere with clinicians’ assessments of the needs of older adults with intentional self-harm

Attention deficit hyperactivity disorder in adults who present with self-harm : a comparative 6-month follow-up study

Background: ADHD is common in psychiatric populations. This study aimed to compare clinical characteristics in adults with and without ADHD who presented with self-harm, and to compare later risk of suicidal behaviour within 6 months. Methods: Eight hundred four adults presented with self-harm (with and without suicidal intent) at psychiatric emergency services at three Swedish hospitals. Persons with a discharge ICD-10 diagnosis F90.0-F90.9 or a prescription for ADHD medication were considered to have ADHD (n = 93). Medical records were reviewed for evidence of subsequent suicide attempts (SA) within 6 months; suicides were identified by national register. Results: Recent relationship problems were more prevalent in the ADHD group. While the index episodes of those with ADHD were more often non-suicidal, and actual SAs more often rated as impulsive, medical lethality at presentation did not differ in attempters with and without ADHD. Subsequent SAs (fatal or non-fatal) were observed in 29% of the ADHD group and 20% in all others (P = .005). A logistic regression model showed elevated risk of suicidal behaviour during follow-up in the ADHD group (OR = 1.70, CI 1.05–2.76), although a final regression model suggested that this association was partly explained by age and comorbid emotionally unstable personality disorder. Conclusions: Findings highlight the need for clinicians to take self-harm seriously in adults with ADHD