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Previous studies analysing blood alcohol concentration (BAC) at the time of suicide have primarily focused on sociodemographic factors. Limited research has focused on psychosocial factors and co-ingestion of other substances to understand the mechanisms of how alcohol contributes to death by suicide. The aim was to examine time trends, psychosocial factors related to acute alcohol use and co-ingestion of alcohol and other substances before suicide.
The Queensland Suicide Register in 2004–2015 was utilised and analysed in 2019. The cut-off point for positive BAC was set at ⩾0.05 g/dl. Substances were categorised as medicines, illegal drugs and other. Medicines were coded by the Anatomical Therapeutic Chemical (ATC) classification system. Joinpoint regression, univariate odds ratios, age and sex-adjusted odds ratios and Forward Stepwise logistic regression were performed.
BAC information was available for 6744 suicides, 92% of all cases in 2004–2015. The final model showed that independent factors distinguishing BAC+ from BAC− were: age group 25–44 years, Australian Indigenous background, being separated or divorced, hanging, diagnosis of substance use, lifetime suicidal ideation, relationship and interpersonal conflict, not having psychotic and other psychiatric disorder, and no nervous system drugs or any other substances in blood at the time of suicide.
Our findings suggest that people who die by suicide while under the influence of alcohol are more likely to be under acute stress (e.g. separation) and not have earlier psychiatric conditions, except substance use. This highlights the importance of more strict alcohol policies, but also the need to improve substance use treatment.
Suicide rates differ when comparing older adults by specific age groups (e.g. Shah et al., 2016) and they have different socio-demographic and clinical characteristics (Koo et al., 2017). In order to prevent suicide in older adults, these should not be treated as a homogenous group.
In the limited research into suicides in older adults, they have been treated as a homogenous group without distinguishing between different age groups. This study aimed to compare differences in sociodemographic variables, recent life events, and mental and physical illnesses between three age groups within older adults who died by suicide: young-old (65–74 years), middle-old (75–84 years), and oldest old (85 years and over) in Queensland, Australia, during the years 2000–2012 (N = 978).
The Queensland Suicide Register was utilized for the analysis. Annual suicide rates were calculated. Odds ratios with 95% confidence intervals and χ2 tests for trend were calculated to examine differences between the three groups.
Suicide rates were increasing with age for males, but not for females. Hanging and firearms were the predominant methods of suicides. However, suffocation by plastic bag and drowning as suicide methods increased with age, in contrast firearms and explosives decreased with age. Overall, psychiatric problems, suicidal behavior, legal and financial stressors, and relationship problems decreased significantly with age, meanwhile physical conditions and bereavement increased with age.
Suicide across older adulthood is not a homogenous phenomenon. Our findings showed significant differences in the prevalence of potential risk factors within the three different age groups considered. To prevent suicide in older adults would require targeting specific factors for each subgroup while using holistic and comprehensive approaches.
Globally, suicide rates increase with age, being highest in older adults. This study analyzed differences in suicides in older adults (65 years and over) compared to middle-aged adults (35–64 years) in Queensland, Australia, during the years 2000–2012.
The Queensland Suicide Register was utilized for the analysis. Annual suicide rates were calculated by gender and age group, and odds ratios with 95% confidence intervals were examined.
In Queensland, the average annual rate of suicides for older adults was 15.27 per 100,000 persons compared to 18.77 in middle-aged adults in 2000–2012. There were no significant changes in time trends for older adults in 2002–2012. Suicide methods differed between gender and age groups. Older adults who died by suicide were more likely to be male, widowed, living alone or in a nursing home, and out of the work force. The prevalence of untreated psychiatric conditions, diagnosed psychiatric disorders, and consultations with a mental health professional three months prior to death was lower in older adults than middle-aged adults. Somatic illness, bereavement, and attention to suicide in the media were more common among older adults than middle-age adults. Older females were particularly more likely to pay attention to suicide in the media.
Our findings show older adults who died by suicide were more likely to experience somatic illnesses, bereavement, and pay attention to suicide in the media compared to middle aged. Preventing suicide in older adults would therefore require holistic and comprehensive approaches.
Transmission electron backscatter diffraction (t-EBSD) was used to investigate the effect of dealloying on the microstructure of 140-nm thin gold foils. Statistical and local comparisons of the microstructure between the nonetched and nanoporous gold foils were made. Analyses of crystallographic texture, misorientation distribution, and grain structure clearly prove that during the dealloying manufacturing process of nanoporous materials the crystallographic texture is enhanced significantly with a clear decrease of internal strain, whereas maintaining the grain structure.
Limited research is focused on suicides in children aged below 15 years.
To analyse worldwide suicide rates in children aged 10–14 years in two decades: 1990–1999 and 2000–2009.
Suicide data for 81 countries or territories were retrieved from the World Health Organization Mortality Database, and population data from the World Bank data-set.
In the past two decades the suicide rate per 100 000 in boys aged 10–14 years in 81 countries has shown a minor decline (from 1.61 to 1.52) whereas in girls it has shown a slight increase (from 0.85 to 0.94). Although the average rate has not changed significantly, rates have decreased in Europe and increased in South America. The suicide rates remain critical for boys in some former USSR republics.
The changes may be related to economic recession and its impact on children from diverse cultural backgrounds, but may also be due to improvements in mortality registration in South America.
Background. The elderly population size is growing worldwide due increased life expectancy and decreased mortality in the elderly. This has lead to an increase in the number of centenarians, and their numbers are predicted to increase further. Little is known about suicide rates in centenarians.
Methods. Data on the number of suicides (ICD-10 codes, X60–84) in centenarians of both gender for as many years as possible from 2000 were ascertained from three sources: colleagues, national statisics office websites and e-mail contact with the national statistics offices of as many countries as possible. The number of centernarians for the corresponding years was estimated for each country using data provided by the United Nations website.
Results. Data were available from 17 countries. The suicide rate was 57 (95% confidence interval 45–69) per 100, 000 person years in men and 6.8 (95% confidence interval 5.1–8.5) per 100,000 person years in women.
Conclusions. Suicide rates were sufficiently large amongst centenarians for there to constitute a public health concern given the anticipated rise in the centenarian population and the paucity of data on risk and protective factors for suicide in this age group.
Violence against women is recognized as a significant global problem, a major public health concern, and widespread violations of human rights. Unicef focused on domestic violence (DV) as one of the most prevalent and yet hidden and ignored forms of violence against women and girls globally, and defined this as comprising violence by an intimate partner or other family members, including violence occurring beyond the confines of the home, and across all ages from pregnancy to old age. The World Health Organization (WHO) distinguished intimate-partner violence (IPV) and sexual violence (SV), while recognizing significant overlap between these. This chapter shows that higher rates tend to occur in lower-income countries. A higher risk of violence is found in societies with traditional gender norms and roles, unequal distribution of power and resources between men and women, a normative use of violence to resolve conflicts, and cultural approval of violence against women.
Australia is one of the world's foremost mining nations. While the economic and employment benefits of the mining industry are well documented, potentially negative aspects of mining industry employment are less understood. It has been suggested that mining industry workers may be more likely than workers in other occupations to experience relationship problems and work-family stress, but there is very little empirical study examining this proposal. Data from the nationally representative Household, Income, and Labour Dynamics in Australia (HILDA) survey were used to compare males employed in the Australian mining industry with males working in other occupations, on indices of relationship quality and work-family balance, as well as mental and emotional health. Employment in the resources sector was not associated with poorer outcomes on these measures, relative to other occupations. These results suggest that hypothesised connections between mining industry employment and relationship/family stress require careful examination.
This paper is concerned with the internal distributed control problem for the 1D
iut(x,t) = −uxx+α(x) u+m(u) u,
that arises in quantum semiconductor models. Here m(u)
is a non local Hartree–type nonlinearity stemming from the coupling with the 1D Poisson
equation, and α(x) is a regular function with linear
growth at infinity, including constant electric fields. By means of both the Hilbert
Uniqueness Method and the contraction mapping theorem it is shown that for initial and
target states belonging to a suitable small neighborhood of the origin, and for
distributed controls supported outside of a fixed compact interval, the model equation is
controllable. Moreover, it is shown that, for distributed controls with compact support,
the exact controllability problem is not possible.
Objective – To test the psychometric properties of the Italian version of the WHOQOL-BRIEF (e.g., construct and internal validity, concorrent validity with the MOS SF-36 and test-retest reliability). The WHOQOL-BRIEF is a 26-items self-report instrument which assesses four domains assumed to represent the Quality Of Life (QOL) construct: physical domain, psychological domain, social relationships domain and environment domain, plus two facets for assessing overall QOL and general health. Methods – Data have been collected in three sites (Bologna, Modena and Padua), located in the North of Italy, in the framework of the international WHOQOL project. According to the study design, the sample had to include about 50% males and 50% females, 50% of subjects below and 50% above the age of 45, all in contact with various health services. A subsample has been re-interviewed after 2-3 weeks in order to study test-retest reliability. After the WHOQOL-BRIEF, most subjects have also been administered the MOS-SF36 in order to test the concurrent validity between these two instruments. Results – The instrument was administered to 379 subjects (1/6 healthy and 1/6 sick), chosen to be representative of a variety of different medical conditions. Seventy patients, wTio displayed stable health conditions, have been reassessed after 2-3 weeks to study test-retest reliability. The WHOQOL-BRIEF domains has shown good internal consistency, ranging from 0.65 for the social relationships domain to 0.80 for the physical domain; it has been able to discriminate between in- and out-patients and between the two age groups considered in the present study (<45, ≥45 years). Only physical and psychological domains were found to discriminate between healthy and ill subjects. No gender differences in the mean scores for the four domains were found. Concurrent validity between the WHOQOL-Brief and the MOS-SF-36 was satisfactory, and specific for the physical and psychological health domains. Test-retest reliability values were also good, ranging from 0.76 for the environment domain to 0.93 for the psychological domain. Conclusions – This study shows that the WHOQOL-BRIEF is psychometrically valid and reliable, and that it is also potentially useful in discriminating between subjects with different health conditions in clinical settings.
Given the uncontested role of psychiatric illnesses in both fatal and non-fatal suicidal behaviours, efforts are continuously made in improving mental health care provision. In cases of severe mental disorder, when intensified treatment protocols and continuous supervision are required due to individual's impaired emotional, cognitive and social functioning (including danger to self and others), psychiatric hospitalisation is warranted. However, to date there is no convincing evidence that in-patient care prevents suicide. In fact, quite paradoxically, both admissions to a psychiatric ward and recent discharge from it have been found to increase risk for suicidal behaviours. What elements in the chain of well-intentioned approaches to treating psychiatric illness and suicidality fail to protect this vulnerable population is still unclear. The same holds true for the identifications of factors that may increase the risk for suicide. This editorial discusses current knowledge on this subject, proposing strategies that might improve prevention.
Background. While recent studies have found problem-solving impairments in individuals who engage in deliberate self-harm (DSH), few studies have examined repeaters and non-repeaters separately. The aim of the present study was to investigate whether specific types of problem-solving are associated with repeated DSH.
Method. As part of the WHO/EURO Multicentre Study on Suicidal Behaviour, 836 medically treated DSH patients (59% repeaters) from 12 European regions were interviewed using the European Parasuicide Study Interview Schedule (EPSIS II) approximately 1 year after their index episode. The Utrecht Coping List (UCL) assessed habitual responses to problems.
Results. Factor analysis identified five dimensions – Active Handling, Passive-Avoidance, Problem Sharing, Palliative Reactions and Negative Expression. Passive-Avoidance – characterized by a pre-occupation with problems, feeling unable to do anything, worrying about the past and taking a gloomy view of the situation, a greater likelihood of giving in so as to avoid difficult situations, the tendency to resign oneself to the situation, and to try to avoid problems – was the problem-solving dimension most strongly associated with repetition, although this association was attenuated by self-esteem.
Conclusions. The outcomes of the study indicate that treatments for DSH patients with repeated episodes should include problem-solving interventions. The observed passivity and avoidance of problems (coupled with low self-esteem) associated with repetition suggests that intensive therapeutic input and follow-up are required for those with repeated DSH.