Police and Suicide Prevention

Crisis ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 194-204 ◽  
Author(s):  
Lisa Marzano ◽  
Mark Smith ◽  
Matthew Long ◽  
Charlotte Kisby ◽  
Keith Hawton
Keyword(s):  
Suicide Prevention ◽  
Police Officers ◽  
Relative Effectiveness ◽  
Police Attitudes ◽  
Before And After ◽  
Beneficial Impact ◽  
Perceived Impact ◽  
The Uk ◽  
The Impact ◽  
Suicide Awareness

Abstract. Background: Police officers are frequently the first responders to individuals in crisis, but generally receive little training for this role. We developed and evaluated training in suicide awareness and prevention for frontline rail police in the UK. Aims: To investigate the impact of training on officers’ suicide prevention attitudes, confidence, and knowledge. Method: Fifty-three participants completed a brief questionnaire before and after undertaking training. In addition, two focus groups were conducted with 10 officers to explore in greater depth their views and experiences of the training program and the perceived impact on practice. Results: Baseline levels of suicide prevention attitudes, confidence, and knowledge were mixed but mostly positive and improved significantly after training. Such improvements were seemingly maintained over time, but there was insufficient power to test this statistically. Feedback on the course was generally excellent, notwithstanding some criticisms and suggestions for improvement. Conclusion: Training in suicide prevention appears to have been well received and to have had a beneficial impact on officers’ attitudes, confidence, and knowledge. Further research is needed to assess its longer-term effects on police attitudes, skills, and interactions with suicidal individuals, and to establish its relative effectiveness in the context of multilevel interventions.

scholarly journals WHEN SEXUAL INFIDELITY TRIGGERS MURDER: EXAMINING THE IMPACT OF HOMICIDE LAW REFORM ON JUDICIAL ATTITUDES IN SENTENCING

2015 ◽  
Vol 74 (2) ◽  
pp. 307-328 ◽  
Author(s):  
Jeremy Horder ◽  
Kate Fitz-Gibbon
Keyword(s):  
Case Law ◽  
Law Reform ◽  
Loss Of Control ◽  
Sexual Infidelity ◽  
Before And After ◽  
Key Features ◽  
Homicide Law ◽  
The Uk ◽  
Substantive Law ◽  
The Impact

AbstractIn October 2010, the UK Parliament brought into effect law that replaced the partial defence to murder of provocation with a new partial defence of “loss of control”, applicable to England, Wales, and Northern Ireland. Although it retained some key features of its controversial predecessor, the new partial defence was in part designed better to address the gendered contexts within which a large number of homicides are committed. In examining the impact of the reforms, we will focus on long-held concerns about the treatment of sexual infidelity as a trigger for loss of control in murder cases. The article undertakes an analysis of English case law to evaluate the way in which sexual infidelity-related evidence has influenced perceptions of a homicide defendant's culpability, for the purposes of sentencing, both before and after the implementation of reform. The analysis reveals that, in sentencing offenders post reform, the higher courts have failed to follow the spirit of the reforms respecting the substantive law by effecting a corresponding change in sentencing practice.

Suicide by jumping at beachy head in East Sussex – The impact of a suicide prevention patrol scheme

2017 ◽  
Vol 41 (S1) ◽  
pp. s886-s887 ◽  
Author(s):  
S. Durgahee ◽  
M. Isaac ◽  
J. Anderson
Keyword(s):  
Suicide Prevention ◽  
Social Impact ◽  
Phenomenological Approach ◽  
Public Health Issue ◽  
Major Public Health Issue ◽  
Competing Interest ◽  
The Uk ◽  
Qualitative Phenomenological ◽  
The Impact ◽  
Depth Interviews

IntroductionSuicide is a major public health issue. It is the leading cause of death among younger adults in the UK. Suicide by jumping is an uncommon method. About 23 people die each year by jumping from the cliffs at beachy head, Sussex. The beachy head chaplaincy established a suicide-prevention patrol at beachy head in August 2004. To date there have been no studies evaluating the impact of a suicide patrol as a prevention strategy. This study aimed to assess the impact of this suicide-prevention patrol.MethodsData from local and national official statistics was gathered to examine the overall suicide numbers and rates of suicide by jumping vs. other methods. This included an in-depth scrutiny of coroners’ data and reports from the beachy head chaplaincy.A qualitative, phenomenological approach using in-depth interviews was used to evaluate the “lived experiences” of members of the suicide-prevention patrol.ResultsThe statistics reveal unexpected and at times, conflicting, results which will be offered for discussion.The thematic analysis of the interviews reveals insights into the motivations for volunteering; how a faith-based patrol works; the physical and psycho-social impact of the work; volunteers’ stories; the centrality of God within their work and motivation.For copyright reasons full details of the analyses cannot be made available before the conference.DiscussionWe welcome an interactive discussion of the results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Reduced fine sediment flux in response to the managed diversion of an upland river channel

2015 ◽  
Vol 3 (4) ◽  
pp. 1179-1220
Author(s):  
M. T. Perks ◽  
J. Warburton
Keyword(s):  
Suspended Sediment ◽  
Fine Sediment ◽  
Sediment Flux ◽  
Analysis Of Covariance ◽  
Before And After ◽  
Suspended Sediment Concentrations ◽  
Sediment Transfer ◽  
The Uk ◽  
The Impact ◽  
B Coefficients

Abstract. This paper describes the implementation of a novel mitigation approach and subsequent adaptive management, designed to reduce the transfer of fine sediment in Glaisdale Beck; a small upland catchment in the UK. Hydro-meteorological and suspended sediment datasets are collected over a two year period spanning pre- and post-diversion periods in order to assess the impact of the channel reconfiguration scheme on the fluvial suspended sediment dynamics. Analysis of the river response demonstrates that the fluvial sediment system has become more restrictive with reduced fine sediment transfer. This is characterised by reductions in flow-weighted mean suspended sediment concentrations from 77.93 mg L−1 prior to mitigation, to 74.36 mg L−1 following the diversion. A Mann–Whitney U test found statistically significant differences (p < 0.001) between the pre- and post-monitoring median SSCs. Whilst application of one-way analysis of covariance (ANCOVA) on the coefficients of sediment rating curves developed before and after the diversion found statistically significant differences (p < 0.001), with both Log a and b coefficients becoming smaller following the diversion. Non-parametric analysis indicates a reduction in residuals through time (p < 0.001), with the developed LOWESS model over-predicting sediment concentrations as the channel stabilises. However, the channel is continuing to adjust to the reconfigured morphology, with evidence of a headward propagating knickpoint which has migrated 120 m at an exponentially decreasing rate over the last 7 years since diversion. The study demonstrates that channel reconfiguration can be effective in mitigating fine sediment flux in upland streams but the full value of this may take many years to achieve whilst the fluvial system, slowly readjusts.

scholarly journals Exploring overcrowding trends in an inner city emergence department in the UK before and during COVID-19 epidemic

2021 ◽  
Author(s):  
J Panovska-Griffiths ◽  
J Ross ◽  
S Elkhodair ◽  
C Baxter-Derrington ◽  
C Laing ◽  
...  
Keyword(s):  
Waiting Time ◽  
Hospital Emergency ◽  
Number Of Patients ◽  
Before And After ◽  
Ed Overcrowding ◽  
University College London ◽  
Flow Through ◽  
Multifaceted Interventions ◽  
The Uk ◽  
The Impact

AbstractBackgroundWe compared impact of three pre-COVID-19 interventions and of the COVID-19 UK-epidemic and the first UK national lockdown on overcrowding within University College London Hospital Emergency Department (UCLH ED). The three interventions: target the influx of patients at ED (A), reduce the pressure on in-patients’ beds (B) and improve ED processes to improve the flow of patents out from ED (C).MethodsWe analysed the change in overcrowding metrics (daily attendances, the proportion of people leaving within four hours of arrival (four-hours target) and the reduction in overall waiting time) across three analysis. The first analysis used data 01/04/2017-31/12-2019 to calculate changes over a period of six months before and after the start of interventions A-C. The second and third analyses focused on evaluating the impact of the COVID-19 epidemic, comparing the first 10 months in 2020 and 2019, and of the first national lockdown (23/03/2020-31/05/2020).ResultsPre-COVID-19 all interventions led to small reductions in waiting time (17%, p<0.001 for A and C;9%, p=0.322 for B) but also to a small decrease in the number of patients leaving within four hours of arrival (6.6%,7.4%,6.2% respectively A-C,p<0.001).In presence of the COVID-19 pandemic, attendance and waiting time were reduced (40% and 8%;p<0.001), and the number of people leaving within four hours of arrival was increased (6%,p<0.001). During the first lockdown, there was 65% reduction in attendance, 22% reduction in waiting time and 8% increase in number of people leaving within 4 hours of arrival (p<0.001). Crucially, when the lockdown was lifted, there was an increase (6.5%,p<0.001) in the percentage of people leaving within four hours, together with a larger (12.5%,p<0.001) decrease in waiting time. This occurred despite the increase of 49.6%(p<0.001) in attendance after lockdown ended.ConclusionsThe mixed results pre-COVID-19 (significant improvements in waiting time with some interventions but not improvement in the four-hours target), may be due to a ‘spill-over effect’ where clogging up one part of the ED system affects other parts. Hence multifaceted interventions and a system-wide approach to improve the pathway of flow through the ED system is necessary.During 2020 and in presence of the COVID-19 epidemic, a shift in public behaviour with anxiety over attending hospitals and higher use of virtual consultations, led to notable drop in UCLH ED attendance and consequential curbing of overcrowding.Importantly, once the lockdown was lifted, although there was an increase in arrivals at UCLH ED, overcrowding metrics were reduced. Thus, the combination of shifted public behaviour and the restructuring changes during COVID-19 epidemic, maybe be able to curb future ED overcrowding, but longer timeframe analysis is required to confirm this.

scholarly journals The Impact of the November 2020 English National Lockdown on COVID-19 case counts

2021 ◽  
Author(s):  
Paul R Hunter ◽  
Julii Brainard ◽  
Alastair Grant
Keyword(s):  
Reproductive Rate ◽  
Tier 2 ◽  
New Variant ◽  
Tier System ◽  
Obvious Benefit ◽  
Beneficial Impact ◽  
R Value ◽  
The Uk ◽  
Tier 3 ◽  
The Impact

In the UK the epidemic of COVID-19 continues to pose a significant threat to public health. On the 14th October the English government introduced a tier system for control of the epidemic but just 3 weeks later a National lockdown across all areas of England was implemented. When English areas emerged from Lockdown many were placed in different tiers (most typically moved up at least one tier). However, the effectiveness of the tier system has been challenged by the emergence of a new variant of SARS-CoV-2 which appears to be much more infectious. In addition, from early November a trial mass testing service was being run in Liverpool. We used publicly available data of daily cases by local authority (local government areas) and estimated the reproductive rate (R value) of the epidemic based on 7-day case numbers compared with the previous 7-day period. There was a clear surge in infections from a few days before to several days after the lockdown was implemented. But this surge was almost exclusively associated with Tier 1 and Tier 2 authorities. In Tier 3 authorities where hospitality venues were only allowed to operate as restaurants there was no such surge. After this initial surge, cases declined in all three tiers with the R value dropping to a mean of about 0.7 independent of tier. London, The South East and East of England Regions saw rising infection rates in the last week or so of lockdown primarily in children of secondary school age. We could find no obvious benefit of the trial mass screening programme in Liverpool city. We conclude that in Tiers 1 and 2 much of the beneficial impact of the national lockdown was lost probably because of the leak of its likely implementation five days early leading to increased socialising in these areas before the start of lockdown. We further conclude that given that the new variant is estimated to have an R value of between 0.39 and 0.93 greater than previous variants, any lockdown as strict as the November one would be insufficient to reverse the increase in infections by itself. The value of city-wide mass testing to control the epidemic remains uncertain.

scholarly journals The Reception Process in Ireland and the United Kingdom

2008 ◽  
Author(s):  
Samantha Besson
Keyword(s):  
United Kingdom ◽  
Legal Order ◽  
The United Kingdom ◽  
Before And After ◽  
The Uk ◽  
The Impact

This chapter examines the reception of the ECHR in the UK and Ireland both before and after incorporation. Both countries incorporated the ECHR using roughly the same model. One might have assumed that the mode of incorporation into a dualist legal order would largely determine outcomes. In Ireland and the UK, however, the impact of acts of incorporation was heavily mediated by pre-existing constitutional structure and practice.

scholarly journals P047 Evaluating the impact of pre-prepared neonatal intubation premedication kits on a level 3 neonatal unit (Project NIK)

2019 ◽  
Vol 104 (7) ◽  
pp. e2.52-e2
Author(s):  
Suzannah Hibberd ◽  
Alok Sharma ◽  
Marhamat Chavoshzadeh
Keyword(s):  
Nursing Staff ◽  
Response Rate ◽  
Electronic Prescribing ◽  
Drug Preparation ◽  
Prescribing Errors ◽  
Before And After ◽  
Level 3 ◽  
Perceived Impact ◽  
Set Up ◽  
The Impact

BackgroundIn January 2018, neonatal intubation premedication kits containing atropine, suxamethonium and fentanyl were introduced alongside the implementation of dose- banding for these medicines according to patient’s weight and regardless of the patient’s gestation. A prescribing bundle on the electronic prescribing system was also created to automatically populate the doses based on the patient’s weight. Seven kits are produced each week by the Pharmacy Technical Services Unit.AimTo assess the staff perceived impact of pre-prepared intubation drug kits with associated dose-banding of the medication.MethodsThree months after the kits were implemented, a survey was sent to all nursing and medical staff to establish their thoughts on the intubation process before and after the introduction of pre-made intubation drug kits.Results78 staff responded, 45.5% were doctors and 54.5% were nursing staff. The response rate was 53.8%. 78% of respondents reported being part of a difficult intubation over the last 5 years. The main problems identified, prior to the implementation of the neonatal intubation drug kits, included the intubation process (51.5%), preparation and communication prior to intubation, (13.6%), time drawing up intubation drugs (10.6%) and the patient having a difficult airway (9%). 87.2% found the premade intubation kits very useful, none of the respondents thought the kits were not useful. Four themes were found irrespective of whether the respondent was a doctor or member of nursing staff. The themes were: they made the process easier; quicker; reduced risk of error and helped provide better patient care. When asked if any complications had arisen, 4% reported that they had run out of kits and 2.7% said there was confusion when signing the kits out of the controlled drug (CD) register.Three weeks out of 25 saw all the kits being used, average usage is 4 intubation kits per week. 97.4% reported the doses used were effective in sedating and paralysing the baby prior to intubation, 2.6% commented that they were somewhat effective but that in one occasion the paralysis had not been optimal, however they questioned whether the cannula had been functioning properly.ConclusionThe implementation of ready to use intubation drug kits has made the process of preparing for an intubation easier and quicker for all involved in the process. Having the dose banding set up on the electronic prescribing system has reduced the chance of prescribing errors and the pre- filled kits have reduced the chances of calculation errors during drug preparation. When the kits run out there are instructions in the guideline detailing how to make the required concentrations. As a result of this study standardised teaching videos were introduced from the beginning of July 18. Further simulations have been completed to ensure that all staff follow a standardised process. Next steps are to ensure that the documentation in the CD register includes all necessary information without any need for amendments. To overcome this, a stamp is being designed to use in the book each time a patient requires a kit, thereby providing a prompt for the nurses.

scholarly journals Understanding the Barriers and Pathways to Male Help-Seeking and Help-Offering: A Mixed Methods Study of the Impact of the Mates in Construction Program

2019 ◽  
Vol 16 (16) ◽  
pp. 2979 ◽  
Author(s):  
Victoria Ross ◽  
Neil Caton ◽  
Jorgen Gullestrup ◽  
Kairi Kõlves
Keyword(s):  
Mixed Methods ◽  
Help Seeking ◽  
Mixed Methods Study ◽  
Individual Interviews ◽  
Making A Difference ◽  
Before And After ◽  
Effectiveness Of Training ◽  
Training And Support ◽  
The Impact ◽  
Suicide Awareness

The Mates in Construction (MATES) program was developed to address the issue of high suicide rates among males in the Australian construction industry. The program delivers early intervention training and support to construction workers. This mixed-methods study aimed to (1) examine the effectiveness of training for MATES connectors and (2) examine the barriers, motivations and pathways to help-seeking and help-offering for both MATES connectors and clients. A total of 104 volunteers completed a short survey before and after connector training sessions. Quantitative data analysis showed significant increases in connectors’ self-reported suicide awareness, and willingness to offer help to workmates and seek help themselves. For the qualitative component, 27 connectors and clients participated in focus groups and individual interviews. Thematic analysis identified six themes from the connectors’ data: awareness, skills and confidence; removing stigma; making a difference; simplicity of the model; understanding the industry; and visibility, camaraderie and passion. For clients, three key themes emerged: barriers and pathways to help-seeking; speaking the same language; and flow-on effects. The results provide evidence for the effectiveness of connector training and indicate that MATES’s peer support model is enabling workers to overcome traditional barriers and attitudes to seeking and offering help.

Consensus treatment guidelines for urgent symptoms in cholangiocarcinoma (CC) patients (pts) with biliary stents or catheters using the modified RAND/UCLA Delphi process.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 452-452 ◽  
Author(s):  
Renuka V. Iyer ◽  
Susan G. Acquisto ◽  
John A. Bridgewater ◽  
Michael A. Choti ◽  
Theodore S. Hong ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Unmet Need ◽  
Cost Of Care ◽  
Delphi Process ◽  
Biliary Stents ◽  
Clinical Scenarios ◽  
Consensus Statements ◽  
Before And After ◽  
The Uk ◽  
The Impact

452 Background: CC pts with biliary stents or catheters often present with fever and/or jaundice requiring urgent treatment for which there is no uniform guideline. We aimed to develop an expert panel consensus on this topic using the modified RAND/UCLA Delphi process to rate treatment appropriateness. Methods: We recruited 13 physician experts from relevant specialty, geography, and practice settings. Patient scenarios were developed based on a literature review, and therapies were rated by the experts before and after a face-to-face discussion. The appropriateness of various therapies was rated on a 1-9 scale and classified as appropriate, inappropriate, or uncertain. Scenarios with > 2 ratings of 1-3 (inappropriate) and > 2 ratings of 7-9 (appropriate) were considered to have disagreement and were not assigned an appropriateness rating. Results: Panelists were from all US regions (92%) and the UK (8%); had practiced for a mean 16.5 years (4-33 years) and reported seeing an average of 120 unique CC patients a year (0-900 pts). Panelists rated 288 clinical scenarios. Experts decided that ongoing treatment with chemotherapy did not influence decision-making. Disagreement decreased from 37.5% before the meeting to 10.4% after. Consensus statements are summarized in table 1. Conclusions: The Delphi process produced consensus guidelines to fill an unmet need in urgent management of ascending cholangitis in pts with CC. Studies of the impact of these guidelines on cost of care and pt outcomes are warranted. (Support: The Cholangiocarcinoma Foundation)[Table: see text]

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