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Suicide rates in Scotland have increased markedly relative to those in England in recent decades.
To compare changing patterns of suicide risk in Scotland with those in England & Wales, 1960–2008.
For Scotland and for England & Wales separately, we obtained national data on suicide counts and population estimates. Gender-specific, directly age-standardised rates were calculated.
We identified three distinct temporal phases: 1960–1967, when suicide rates in England & Wales were initially higher than in Scotland, but then converged; 1968–1991, when male suicide rates in Scotland rose slightly faster than in England & Wales; and 1992–2008, when there was a marked divergence in national trends. Much of the recent divergence in rates is attributable to the rise in suicide among young men and deaths by hanging in Scotland. Introduction of the ‘undetermined intent’ category in 1968 had a significant impact on suicide statistics across Great Britain, but especially so in Scotland.
Differences in temporal patterns in suicide risk between the countries are complex. Reversal of the divergent trends may require a change in the perception of hanging as a ‘painless' method of suicide.
Anaesthetic and Perioperative Complications dissects the nature of complications and helps anaesthetists and anaesthetic practitioners understand, avoid and manage them efficiently. Leading experts combine the detailed clinical management of common and important anaesthetic and perioperative complications with discussion of the key philosophical, ethical and medico-legal issues that arise with assessing a medical complication. Initial chapters discuss how and why complications occur, the prevention of complications and risk management. The main body of the text reviews the clinical management of airway, respiratory, cardiovascular, neurological, psychological, endocrine, hepatic, renal and transfusion-related complications, as well as injury during anaesthesia, complications related to regional and obstetric anaesthesia, drug reactions, equipment malfunction and post-operative management of complications. Each chapter contains sample cases of complications and medical errors, giving clinical scenario, outcomes and recommendations for improved management. This is an important practical and clinical text for all anaesthetists and anaesthetic practitioners, both trained and trainees.