scholarly journals Repetition of deliberate self-poisoning in rural Sri Lanka

2018 ◽  
Author(s):  
PHGJ Pushpakumara ◽  
SUB Thennakoon ◽  
TN Rajapakse ◽  
Ranil Abeysinghe ◽  
AH Dawson
Keyword(s):  
Sri Lanka ◽  
Time History ◽  
High Sensitivity ◽  
Life Time ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
One Year ◽  
The One ◽  
The Impact ◽  
Lethal Means

AbstractRepetition of deliberate self harm is an important predictor of subsequent suicide. Repetition rates in Asian countries appear to be significantly lower than in western high income countries. The reason for these reported differences is not clear and has been suggested to due methodological differences or the impact of access to more lethal means of self harm. This prospective study determines the rates and demographic pattern of deliberate self-poisoning, suicide and fatal and non fatal repeated deliberate self-poisoning in rural Sri Lanka.Details of deliberate self poisoning admission in all hospitals (n=46) and suicides reported to all the police stations (n=28) of a rural district were collected for 3 years, 2011-2013. Demographic details of the cohort of deliberate self-poisoning patients admitted to all hospitals in 2011 (N=4022), were screened to link with patient records and police reports of successive two years with high sensitivity using a computer program and manual matching was performed with higher specificity. Life time repetition was assessed in a randomly selected subset of DSP patients (n=438).There were 15,914 DSP admissions and 1078 suicides during the study period. Within the study area the deliberate self poisoning and suicide population incidences were, 248.3/100,000 and 20.7/100,000 in 2012. Repetition rate for four weeks, one-year and two-years were 1.9% (95% CI 1.5-2.3%), 5.7% (95% CI 5.0 to 6.4) and 7.9% (95% CI 7.1 to 8.8) respectively. The median interval between two attempts were 92 (IQR 10 - 238) and 191 (IQR 29 - 419.5) days for the one and two-year repetition groups. The majority of patients used the same poison in the repeat attempt. Age and hospital stay of individuals with repetitive events were not significantly different from those who had no repetitive events. The two-year rate for suicide following DSP was 0.7% (95% CI 0.4-0.9%). Reported life time history of deliberate self harm attempts was 9.5% (95% CI 6.7-12.2%).The low comparative repetition rates in rural Sri Lanka was not explained by higher rates of suicide or access to more lethal means or differences in methodology.

Negative Life Events Associated With Deliberate Self-Harm in an African Population in Uganda

Crisis ◽  
2005 ◽  
Vol 26 (1) ◽  
pp. 4-11 ◽  
Author(s):  
E. Kinyanda ◽  
H. Hjelmeland ◽  
S. Musisi
Keyword(s):  
Life Events ◽  
Negative Life Events ◽  
Life Time ◽  
Later Life ◽  
Dose Effect ◽  
Deliberate Self Harm ◽  
Time Period ◽  
Significant Difference ◽  
Self Harm ◽  
Suicide Interventions

Abstract. Negative life events associated with deliberate self-harm (DSH) were investigated in an African context in Uganda. Patients admitted at three general hospitals in Kampala, Uganda were interviewed using a Luganda version (predominant language in the study area) of the European Parasuicide Study Interview Schedule I. The results of the life events and histories module are reported in this paper. The categories of negative life events in childhood that were significantly associated with DSH included those related to parents, significant others, personal events, and the total negative life events load in childhood. For the later-life time period, the negative life events load in the partner category and the total negative life events in this time period were associated with DSH. In the last-year time period, the negative life events load related to personal events and the total number of negative life events in this time period were associated with DSH. A statistically significant difference between the cases and controls for the total number of negative life events reported over the entire lifetime of the respondents was also observed, which suggests a dose effect of negative life events on DSH. Gender differences were also observed among the cases. In conclusion, life events appear to be an important factor in DSH in this cultural environment. The implication of these results for treatment and the future development of suicide interventions in this country are discussed.

scholarly journals Evaluation of Antiviral Therapy Performed after Curative Therapy in Patients with HBV-Related Hepatocellular Carcinoma: An Updated Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian
Keyword(s):  
Hepatocellular Carcinoma ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Curative Therapy ◽  
B Virus ◽  
Effect Of Treatment ◽  
Long Term Prognosis ◽  
One Year ◽  
The One ◽  
The Impact

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.

scholarly journals Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Lars-Gunnar Lundh ◽  
Margit Wångby-Lundh ◽  
My Paaske ◽  
Stina Ingesson ◽  
Jonas Bjärehed
Keyword(s):  
Risk Factor ◽  
Depressive Symptoms ◽  
Longitudinal Design ◽  
Community Sample ◽  
Deliberate Self Harm ◽  
Self Image ◽  
Bidirectional Relationship ◽  
Self Harm ◽  
One Year ◽  
A Prospective Study

The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness.

Secondary Prevention of Non-fatal Deliberate Self-harm

1993 ◽  
Vol 163 (1) ◽  
pp. 111-112 ◽  
Author(s):  
H. G. Morgan ◽  
E. M. Jones ◽  
J. H. Owen
Keyword(s):  
British Journal ◽  
Early Stage ◽  
Psychiatric Services ◽  
Easy Access ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
One Year ◽  
First Time ◽  
Experimental Group

In an attempt to address the low compliance with offers of treatment shown by patients after episodes of non-fatal deliberate self-harm (DSH), patients who had harmed themselves for the first time were offered rapid, easy access to on-call trainee psychiatrists in the event of further difficulties, and they were encouraged to seek help at an early stage should such problems arise. The follow-up data obtained after one year showed a significant reduction of actual or seriously threatened DSH in the experimental group, who also made considerably less demands on medical and psychiatric services, when compared with controls.British Journal of Psychiatry (1993), 163, 111–112

scholarly journals Parents´ Knowledge about the Effects of Oral Hygiene, Proper Nutrition and Fluoride Prophylaxis on Oral Health in Early Childhood

2018 ◽  
Vol 22 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Aleksandrija Djordjevic
Keyword(s):  
Early Childhood ◽  
Oral Health ◽  
Oral Hygiene ◽  
Rural Areas ◽  
Urban Areas ◽  
Education Institution ◽  
Preventive Dentistry ◽  
One Year ◽  
The One ◽  
The Impact

SummaryBackground/Aim: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting and achieving good oral health. The aim of this study was to determine the influence of parents´ knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Material andMethods: Parents were asked to fill a questionnaire which consisted of three sections, oral hygiene, fluoride prophylaxis and nutrition. The study included 136 parents of children, aged between 3-6 years. The survey was conducted in pedagogical-education institution - PE “Our happiness” - Leposavic, Kosovo and Metohia, Serbia. Results: More than 58% parents from urban areas and 63% parents from rural areas were informed that the teeth should be brushed at least twice a day (p=0.007). Only 31.11% of parents from urban and 15.22% of parents from rural areas were informed that a child should visit dentists for the first time, at the one year of age (p=0.083). The analysis of the questionnaire section regarding the nutrition and oral health, showed that parents from rural areas were better informed than parents from urban areas. Awareness about fluoride and their role in preventive dentistry was poor, as only 3% of children from urban and 1% of children from rural areas were using tablets based on fluoride while only 1% of children from urban and none from rural areas were using fluoride mouth rinses. Conclusions: The study showed that parents have the knowledge about the impact of oral hygiene, food and fluoride prophylaxis on the oral health but unfortunately they do not apply their knowledge in practice.

scholarly journals The impact of the COVID-19 pandemic on referrals to liaison psychiatry services at University Hospital Hairmyres, NHS Lanarkshire

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S46-S47
Author(s):  
Cristina Paton ◽  
James Hills ◽  
Rekha Hegde
Keyword(s):  
Community Services ◽  
University Hospital ◽  
Direct Result ◽  
Secondary Effects ◽  
Liaison Psychiatry ◽  
Nursing Service ◽  
Self Harm ◽  
Local Emergency Department ◽  
One Year ◽  
The Impact

AimsThe COVID-19 pandemic has led to sweeping public health restrictions with predictable impact on mental health. In Scotland, lockdown measures during the first wave of the pandemic commenced on 23rd March 2020 and only began to ease after 29th May 2020. The aim of this study was to evaluate the impact of the first wave of the COVID-19 pandemic on the number and type of referrals made to the adult psychiatric liaison nursing service (PLNS) at University Hospital Hairmyres, NHS Lanarkshire.MethodWe collated all of the archived referrals made by our local emergency department to the PLNS at University Hospital Hairmyres for adults (aged 18–65 years) during the period of the first COVID-19 national lockdown (April-July 2020) and the corresponding period one-year prior (April-July 2019) to analyse differences in referral numbers and demographics. Additionally, for referrals made during 2020, we conducted a qualitative review of electronic records to determine the reason for referral, contributory stressors to presentation, and in particular any effect from COVID-19.ResultA total of 549 referrals were made over the study period, with 320 in 2019 and 229 in 2020, a decrease of almost 30%. In 2019, referrals fell each month from April (n = 89) to July (n = 74), while this trend was reversed in 2020, rising from April (n = 45) to near-usual levels by July (n = 68). Compared to baseline, referrals in April 2020 were for a higher proportion of men (62.2%). On qualitative analysis, 26 records (11.3%) could not be found. Otherwise, the most common reasons for referral were suicidal ideation (43.3%) and/or deliberate self-harm (39.9%). Many patients presented with comorbid substance misuse (54.2%) and the majority were not known to community services (64.5%). COVID-19 was implicated in 48 referrals (23.6%), but only 2 of these arose as a direct result of infection.ConclusionWe have observed clear differences in the pattern of referrals made to the adult PLNS during the first COVID-19 national lockdown. COVID-19 was implicated in a minority of referrals, but most were related to secondary effects of lockdown restrictions rather than COVID-19 infection. Possible reasons for fewer referrals during this time could be non-presentation through fears of contracting COVID-19 or altruistic avoidance of putting “pressure on the NHS”. Further studies would be insightful; in particular, equivalent analysis of contacts with community services; and qualitative patient perspectives regarding reasons for non-presentation during this time.

scholarly journals Recurring infection with ecologically distinct human papillomavirus (HPV) types explains high prevalence and diversity

2017 ◽  
Author(s):  
Sylvia Ranjeva ◽  
Edward B. Baskerville ◽  
Vanja Dukic ◽  
Luisa Villa ◽  
Eduardo Lazcano-Ponce ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hpv Prevalence ◽  
Increased Risk ◽  
High Prevalence ◽  
Hpv Types ◽  
One Year ◽  
The One ◽  
The Impact

AbstractThe high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or “homologous” immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterwards. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the one-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher two years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from auto-inoculation, episodic reactivation of latent virus, or both. Overall our results show that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Due to the high risk of reinfection, vaccinating boys that have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits from vaccinating previously infected individuals.

scholarly journals Sinus heart rate post pulmonary vein ablation and long-term risk of recurrences

2020 ◽  
Author(s):  
Gesa von Olshausen ◽  
Ott Saluveer ◽  
Jonas Schwieler ◽  
Nikola Drca ◽  
Hamid Bastani ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pulmonary Vein ◽  
Heart Rate Change ◽  
Rate Change ◽  
Study Cohort ◽  
The Mean ◽  
One Year ◽  
The One ◽  
The Impact

Abstract Purpose Cather ablation is known to influence the autonomic nervous system. This study sought to investigate the association of sinus heart rate pre-/post-ablation and recurrences in patients with atrial fibrillation undergoing pulmonary vein isolation (PVI). Methods Between January 2012 and December 2017, data of 482 patients undergoing their first PVI were included. Sinus heart rate was recorded before (PRE), directly post-ablation (POST) and 3 months post-ablation (3 M). All patients were screened for atrial tachyarrhythmia recurrences during the one-year follow-up. Results In the total study cohort, the mean resting sinus heart rate at PRE [mean 57.9 bpm (95% CI 57.1–58.7 bpm)] increased by over 10 bpm to POST [mean 69.4 bpm (95% CI 68.5–70.3 bpm); p < 0.001] followed by a slight decrease at 3 M [mean 67.3 bpm (95% CI 66.4–68.2 bpm)] but still remaining higher compared to PRE (p < 0.001). This pattern was observed in patients with and without recurrences at POST and 3 M (both p < 0.001 compared to PRE). However, at 3 M the mean sinus heart rate was significantly lower in patients with compared to patients without recurrences (p = 0.031). In this regard, patients with a heart rate change < 11 bpm (PRE to 3 M) or, as an alternative parameter, patients with a heart rate < 60 bpm at 3 M had a significantly higher risk of recurrences compared to the remaining patients (Hazard ratio (HR) 1.82 (95% CI 1.32–2.49), p < 0.001 and HR 1.64 (95% CI 1.20–2.25), p = 0.002, respectively). Conclusion Our study confirms the impact of PVI on cardiac autonomic function with a significant sinus heart rate increase post-ablation. Patients with a sinus heart rate change < 11 bpm (PRE to 3 M) are at higher risk for recurrences during one-year post-PVI.

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