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To investigate cases of suicide in which there was no healthcare contact, by looking at history of help-seeking and evidence of previous mental health vulnerability. To identify any life events associated with suicide for which individuals did not seek help.
Previous research has suggested that non-consultation is the main barrier to suicide prevention among men. Estimates suggest approximately 22% of men who die by suicide have not consulted their GP in the year before their death. Little is known about the lifetime pattern of engagement with services among these individuals and whether or not this may influence their help-seeking behaviour before death.
Coroner records of suicide deaths in Northern Ireland over 2 years were linked to general practice (GP) records. This identified 63 individuals who had not attended health services in the 12 months before death. Coroner’s data were used to categorise life events associated with the male deaths. Lifetime mental health help-seeking at the GP was assessed.
The vast majority of individuals who did not seek help were males (n=60, 15% of all suicide deaths). Lack of consultation in the year before suicide was consistent with behaviour over the lifespan; over two-thirds had no previous consultations for mental health. In Coroner’s records, suicides with no prior consultation were primarily linked to relationship breakdown and job loss. These findings highlight the limitations of primary care in suicide prevention as most had never attended GP for mental health issues and there was a high rate of supported consultation among those who had previously sought help. Public health campaigns that promote service use among vulnerable groups at times of crisis might usefully be targeted at those likely to be experiencing financial and relationship issues.
This article examines the mid-nineteenth-century Scottish education debates in the context of intra-Presbyterian relations in the aftermath of the 1843 ‘Disruption’ of the Church of Scotland. The debates of this period have been characterized as an attempt to wrest control of Scottish education from the Church of Scotland, with most opponents of the existing scheme critical of the established kirk's monopoly over the supervision of parish schools. However, the debate was not simply between those within and outside the religious establishment. Those advocating change, particularly within non-established Presbyterian denominations, were not unified in their proposals for a solution to Scotland's education problem. Disputes between Scotland's largest non-established churches, the Free Church and the United Presbyterian Church, and within the Free Church itself over the type of national education scheme that should replace the parish schools severely hampered their ability to express common opposition to the existing system. These divisions also placed increasing strain on the developing cooperation in Scottish Dissent on ecclesiastical, political and social matters after the Disruption. This article places the issue of education in this period within this distinctly Dissenting context of cooperation, and examines the extent of the impact these debates had on Dissenting Presbyterian relations.
Subjective cognitive decline (SCD), the potentially earliest notable manifestation of preclinical Alzheimer's disease and other dementias, was consistently associated with lower quality of life in cross-sectional studies. The aim of this study was to investigate whether such an association persists longitudinally – particularly with health-related quality of life (HRQoL) in older individuals without cognitive impairment.
Data were derived from follow-up 2–6 of the prospective Germany Study on Ageing, Cognition and Dementia in Primary Care (AgeCoDe) covering a total six-year observation period. We used linear mixed effects models to estimate the effect of SCD on HRQoL measured by the EQ-5D visual analogue scale (EQ VAS).
Of 1,387 cognitively unimpaired individuals aged 82.2 years (SD = 3.2) on average, 702 (50.6%) reported SCD and 230 (16.6%) with SCD-related concerns. Effect estimates of the linear mixed effects models revealed lower HRQoL in individuals with SCD (unadjusted: –3.7 points on the EQ VAS, 95%CI = –5.3 to –2.1; SE = 0.8; p < 0.001; adjusted: –2.9 points, 95%CI = –3.9 to –1.9; SE = 0.5; p < 0.001) than in individuals without SCD. The effect was most pronounced in SCD with related concerns (unadjusted: –5.4, 95%CI = –7.6 to –3.2; SE = 1.1; p < 0.001; adjusted: –4.3, 95%CI = –5.8 to –2.9, SE = 0.7; p < 0.001).
SCD constitutes a serious issue to older cognitively unimpaired individuals that is depicted in persisting lower levels of HRQoL beyond depressive symptoms and functional impairment. Therefore, SCD should be taken seriously in clinical practice.
Assessments of biodiversity status are needed to track trends, and the IUCN Red List has become the accepted global standard for documenting the extinction risk of species. Obtaining robust data on population size is an essential component of any assessment of a species’ status, including assessments for the IUCN Red List. Obtaining such estimates is complicated by methodological and logistical issues, which are more pronounced in the case of cryptic species, such as the snow leopard Panthera uncia. Estimates of the total population size of this species have, to date, been based on little more than guesstimates, but a comprehensive summary of recent field research indicates that the conservation status of the snow leopard may be less dire than previously thought. A revised categorization, from Endangered to Vulnerable, on the IUCN Red List was proposed but met some opposition, as did a recent, similar recategorization of the giant panda Ailuropoda melanoleuca. Possible factors motivating such attitudes are discussed. Downlisting on the IUCN Red List indicates that the species concerned is further from extinction, and is always to be welcomed, whether resulting from successful conservation intervention or improved knowledge of status and trends. Celebrating success is important to reinforce the message that conservation works, and to incentivize donors.
The demonstration of sexual dimorphism in the fossil record can provide vital information about the role that sexual selection has played in the evolution of life. However, statistically robust inferences of sexual dimorphism in fossil organisms are exceedingly difficult to establish, owing to issues of sample size, experimental control, and methodology. This is particularly so in the case of dinosaurs, for which sexual dimorphism has been posited in many species, yet quantifiable data are often lacking. This study presents the first statistical investigation of sexual dimorphism across Dinosauria. It revisits prior analyses that purport to find quantitative evidence for sexual dimorphism in nine dinosaur species. After the available morphological data were subjected to a suite of statistical tests (normality and unimodality tests and mixture modeling), no evidence for sexual dimorphism was found in any of the examined taxa, contrary to conventional wisdom. This is not to say that dinosaurs were not sexually dimorphic (phylogenetic inference suggests they may well have been), only that the available evidence precludes its detection. A priori knowledge of the sexes would greatly facilitate the assessment of sexual dimorphism in the fossil record, and it is suggested that unambiguous indicators of sex (e.g., presence of eggs, embryos, medullary bone) be used to this end.
Although substance misuse is a key risk factor in suicide, relatively
little is known about the relationship between lifetime misuse and misuse
at the time of suicide.
To examine the relationship between substance misuse and subsequent
Linkage of coroners' reports to primary care records for 403 suicides
occurring over 2 years.
With alcohol misuse, 67% of the cohort had previously sought help for
alcohol problems and 39% were intoxicated at the time of suicide.
Regarding misuse of other substances, 54% of the cohort was tested.
Almost one in four (38%) tested positive, defined as an excess of drugs
over the prescribed therapeutic dosage and/or detection of illicit
substances. Those tested were more likely to be young and have a history
of drug misuse.
A deeper understanding of the relationship between substance misuse and
suicide could contribute to prevention initiatives. Furthermore,
standardised toxicology screening processes would avoid diminishing the
importance of psychosocial factors involved in suicide as a ‘cause of
Trade records show that since the 1990s China has changed from a net exporting to a net importing country with respect to some species of snakes. Imports of snakes to China increased up to 2002, when the National Wildlife Management Authority imposed a suspension of international trade in snakes. We investigated the impact of the ban using the same methods as an earlier study of this trade for the period 1990–2001. We found that both imports and exports of snakes recorded in the CITES Trade Database and the Wild Animal and Plant International Trade Database of China have decreased markedly since 2004. The combination of national-level control measures and CITES regulations appear to have controlled the previously unsustainable utilization of snakes in China.