The end of the line for hookworm? An update on vaccine development

Human hookworms are parasitic nematodes infecting about 700 million individuals, largely in tropical regions of the world [1]. In endemic areas, most infected people carry a mixed worm burden, including Ascaris lumbricoides (roundworms), Trichuris trichuria (whipworms), and Ancylostoma duodenale and/or Necator americanus (both hookworms). Of these soil-transmitted helminths, hookworms are the most pathogenic because of their propensity to feed on blood, resulting in anaemia, particularly in those with low iron reserves such as children and women of reproductive age

A study of untimely sudden deaths and people who took their lives while in the care of the Donegal Mental Health Service.

Unexpected, tragic events with adverse outcomes present a huge challenge to individuals, health services, families and communities who are striving to do their best in stressful circumstances. In order to progress towards better mental wellbeing for all, we must question how we can help vulnerable people. This research has examined in depth and in detail those tragic circumstances that no one personally or professionally ever wishes to face. To do this objectively, openly and with a fierce intent to use the findings to improve the identification of people at risk to sudden unexpected deaths in mental health services, examining the factors that contribute to risk and the consequences for families in the aftermath were key objectives of the research team. The findings revealed that no single factor dominated the cases examined. Each case had a complexity which underlined that any recommendations made needed a multifaceted, collaborative approach. It is hoped that the research tools described, the recommendations made and the contributions of all the families who gave their time so unreservedly will help all mental health services in Ireland. This data set of consecutive untimely sudden deaths will contribute to suicide research internationally, but most importantly it helps cast light onto what must be done to provide effective suicide prevention in Ireland. When a series of unexpected deaths occurred in Donegal, local mental health services began to search for answers. P.8 The clinical files of all 34 cases were examined with regard to cause of death. Overdose of medication or drugs accounted for the largest loss of life (n=15, 44%) followed by hanging (n=14, 41%) and drowning (n=5, 14.7%). Almost half of the cases being examined were known to abuse both drugs and alcohol prior to death (n=16, 47%), six had abusive or dependent issues with a single substance while more than one third were reported to abuse neither drugs nor alcohol

Parasuicide and general practice: a pilot study

General Practitioners from Cork City and its environs were sent a questionnaire regarding their experience of parasuicide in the previous twelve months. Replies were received from 133 of the 185 GPs. 189 individuals, accounting for 212 episodes of parasuicide, were seen by 78 doctors, indicating a lower level of repetition than that found in hospital-referred cases. Almost a third of doctors saw no cases, just over one fifth saw one episode and the same proportion dealt with two. A small number of general practitioners saw many cases. Regarding management, 128 (60%) were referred to Casualty, 31 of whom were also referred for psychiatric care. Thirty percent were referred directly for psychiatric care. While only fourteen were retained within general practice without referral, 40% of the GPs felt that, ideally, acts of parasuicide should be retained with more specialised advice being obtained. Furthermore, 88.1% believed that management of parasuicide should form part of an integral part of post-graduate or continued general practitioner medical training. Clearly, GPs are willing to play a more active role in the management of parasuicide

Using a television programme as a tool to increase perceived awareness of mental health and well-being - Findings from ' Our Mental Health ' survey

Background: International research shows that media can increase knowledge, raise public awareness and reduce stigma relating to mental health.Methods: Following the broadcast of a documentary on national television featuring interviews with young people who had experienced mental health difficulties and suicidal behaviour, an anonymous online survey, aimed at examining public perceptions of the impact of a television documentary, was conducted, using a mixed methods approach.Results: 2311 people completed the survey. Of those who watched the documentary and answered the closed questions (n = 854), 94% stated that the documentary will positively impact young people's mental health and well-being. The majority (91%) stated that the documentary will encourage young people to talk to someone if experiencing difficulties and 87% indicated it will help to reduce stigma associated with mental health. Viewers had a 5% higher level of intention to seek help than non-viewers. Participants indicated that the identifiable personal stories and discourse around stigma and shame, and the increased understanding and awareness gained, had the most profound impact on them.Conclusions: These findings indicate that a documentary addressing mental health and suicidal behaviour, which incorporates real life identifiable stories of resilience and recovery, has the potential to impact positively on emotional well-being and general mood, to reduce stigma related to mental health and to encourage help-seeking behaviour. Documentaries including these concepts, with a public mental health focus and a consistent message, incorporating pre- and post-evaluations, and customisation for target audiences in compliance with current media recommendations, should be considered

National Self-Harm Registry Ireland annual report 2017.

This is the sixteenth annual report from the National Self-Harm Registry Ireland. It is based on data collected on persons presenting to hospital emergency departments following self-harm in 2017 in the Republic of Ireland. The Registry had near complete coverage of the country’s hospitals for the period 2002-2005 and, since 2006, all general hospital and paediatric hospital emergency departments in the Republic of Ireland have contributed data to the Registry. Role of alcohol in self-harm: Alcohol was involved in 31% of all cases. Alcohol was significantly more often involved in male episodes of self-harm than female episodes (33% and 29%, respectively). In line with previous years, misuse or abuse of alcohol is one of the factors associated with the higher rate of self-harm presentations on Sundays, Mondays and public holidays, around the hours of midnight. Recent publications from the Registry data have highlighted the role of alcohol in selfharm. Such complex presentations indicate the need for active consultation and collaboration between the mental health services and addiction treatment services for patients who present with dual diagnoses. In addition, alcohol involvement has been shown to be strongly associated with self-harm presentations out-of-hours, at weekends and on public holidays. The Registry findings related to alcohol provide further support for the full implementation of the Public Health (Alcohol) Bill, which would introduce evidence-based policies to reduce the burden of alcohol harm on our society by improving health, safety and wellbeing. Restricting access to means: …In line with previous years, drug overdose was the most common method of self-harm recorded. Over the years, the Registry has identified the drug types most frequently involved in intentional overdoses. New research has classified the range of drugs recorded by the Registry according to the World Health Organisation’s (WHO) Anatomical Therapeutic Chemical (ATC) classification system. This work has systematically classified the wide range of drugs involved in intentional overdoses, and will be instrumental in facilitating comparative work in this area. This system has allowed for examination of trends in specific drug types, with a recent publication highlighting the increasing involvement of gabapentinoids (prescription-only neuropathic pain medication). Despite a decrease in their involvement in intentional overdose in 2017, minor tranquillisers have been the most frequently used type of drug involved in intentional overdoses. Reducing access to frequently used drugs should be an ongoing priority

The Iowa Homemaker vol.22, no.1

Keeping Up With Today, page 2 Meat – to the Front, Dorothy Ann Roost, page 3 When Defense Workers Eat, Marjorie Beneke, page 4 “Martha Duncan Says to You”, Julie Wendel, page 5 Design for Spring, Trymby Calhoun, page 6 Homemaking on the Test, Katherine Kaufman, page 8 A Textiles Journalist Talks Shop, Ida Halpin, page 9 What’s New in Home Economics, Ruth Vogel, page 10 Dress for Action, Betty Roth, page 12 Army Health Marches On, Marabeth Porter, page 13 Departmental Highlights, Lila Williamson, page 14 Across Alumnae Desks, Mary Ellen Sullivan, page 15 A Book for Home Managers, Helen Pundt, page 16 Alums in the News, Harriet Zook, page 18 Bookmarks, Eileen Dudgeon, page 19 Victory Shipments Advance, Bernadine Nelson, page 2

The Impact of Infectious Disease-Related Public Health Emergencies on Suicide, Suicidal Behavior, and Suicidal Thoughts:A Systematic Review

Background: Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims: We investigated the potential impacts of epidemics on suicide-related outcomes. Method: We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13–16, 2020. Inclusion criteria: primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria: not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration: #CRD42020187013. Results: Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations: Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion: Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes

Efficiency and safety of varying the frequency of whole blood donation (INTERVAL): a randomised trial of 45 000 donors

Background: Limits on the frequency of whole blood donation exist primarily to safeguard donor health. However, there is substantial variation across blood services in the maximum frequency of donations allowed. We compared standard practice in the UK with shorter inter-donation intervals used in other countries. Methods: In this parallel group, pragmatic, randomised trial, we recruited whole blood donors aged 18 years or older from 25 centres across England, UK. By use of a computer-based algorithm, men were randomly assigned (1:1:1) to 12-week (standard) versus 10-week versus 8-week inter-donation intervals, and women were randomly assigned (1:1:1) to 16-week (standard) versus 14-week versus 12-week intervals. Participants were not masked to their allocated intervention group. The primary outcome was the number of donations over 2 years. Secondary outcomes related to safety were quality of life, symptoms potentially related to donation, physical activity, cognitive function, haemoglobin and ferritin concentrations, and deferrals because of low haemoglobin. This trial is registered with ISRCTN, number ISRCTN24760606, and is ongoing but no longer recruiting participants. Findings: 45 263 whole blood donors (22 466 men, 22 797 women) were recruited between June 11, 2012, and June 15, 2014. Data were analysed for 45 042 (99·5%) participants. Men were randomly assigned to the 12-week (n=7452) versus 10-week (n=7449) versus 8-week (n=7456) groups; and women to the 16-week (n=7550) versus 14-week (n=7567) versus 12-week (n=7568) groups. In men, compared with the 12-week group, the mean amount of blood collected per donor over 2 years increased by 1·69 units (95% CI 1·59–1·80; approximately 795 mL) in the 8-week group and by 0·79 units (0·69–0·88; approximately 370 mL) in the 10-week group (p<0·0001 for both). In women, compared with the 16-week group, it increased by 0·84 units (95% CI 0·76–0·91; approximately 395 mL) in the 12-week group and by 0·46 units (0·39–0·53; approximately 215 mL) in the 14-week group (p<0·0001 for both). No significant differences were observed in quality of life, physical activity, or cognitive function across randomised groups. However, more frequent donation resulted in more donation-related symptoms (eg, tiredness, breathlessness, feeling faint, dizziness, and restless legs, especially among men [for all listed symptoms]), lower mean haemoglobin and ferritin concentrations, and more deferrals for low haemoglobin (p<0·0001 for each) than those observed in the standard frequency groups. Interpretation: Over 2 years, more frequent donation than is standard practice in the UK collected substantially more blood without having a major effect on donors' quality of life, physical activity, or cognitive function, but resulted in more donation-related symptoms, deferrals, and iron deficiency. Funding: NHS Blood and Transplant, National Institute for Health Research, UK Medical Research Council, and British Heart Foundation

Study protocol for the implementation and evaluation of the Self-harm Assessment and Management for General Hospitals programme in Ireland (SAMAGH)

Background: Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm for mental health professionals is limited. Within this context, we aim to develop, implement and evaluate a training programme, SAMAGH, Self-harm Assessment and Management Programme for General Hospitals in Ireland. SAMAGH aims to (a) reduce hospital-based self-harm repetition rates and (b) increase rates of mental health assessments being conducted with self-harm patients. We also aim to evaluate the training on self-harm knowledge, attitudes, and skills related outcomes of healthcare professionals involved in the training. Methods/design: The study will be conducted in three phases. First, the SAMAGH Training Programme has been developed, which comprises two parts: 1) E-learning Programme and 2) Simulation Training. Second, SAMAGH will be delivered to healthcare professionals from general hospitals in Ireland. Third, an outcome and process evaluation will be conducted using a pre-post design. The outcome evaluation will be conducted using aggregated data from the National Self-Harm Registry Ireland (NSHRI) on self-harm repetition rates from all 27 public hospitals in Ireland. Aggregated data based on the 3-year average (2016, 2017, 2018) self-harm repetition rates prior to the implementation of the SAMAGH will be used as baseline data, and NSHRI data from 6 and 12 months after the implementation of SAMAGH will be used as follow-up. For the process evaluation, questionnaires and focus groups will be administered and conducted with healthcare professionals who completed the training. Discussion: This study will contribute to the evidence base regarding the effectiveness of an evidence informed training programme that aims to reduce repeated hospital self-harm presentations and to improve compliance with self-harm assessment and management. This study is also expected to contribute to self-harm and suicide training with the possibility of being translated to other settings. Its feasibility will be evaluated through a process evaluation