A comparison of the prevalence and risk factors of suicidal ideation and suicide attempts in two American Indian population samples and in a general population sample

BackgroundPeople living with HIV/AIDS (PLWHA) must contend with a significant burden of disease. However, current studies of this demographic have yielded wide variations in the incidence of suicidality (defined as suicidal ideation, suicide attempt and suicide deaths).AimsThis systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.MethodsPublications were identified from PubMed (MEDLINE), SCOPUS, OVID (MEDLINE), Joanna Briggs Institute EBP and Cochrane Library databases (from inception to before 1 February 2020). The search strategy included a combination of Medical Subject Headings associated with suicide and HIV. Researchers independently screened records, extracted outcome measures and assessed study quality. Data were pooled using a random-effects model. Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity. Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.ResultsA total of 185 199 PLWHA were identified from 40 studies (12 cohorts, 27 cross-sectional and 1 nested case-control). The overall incidence of suicide completion in PLWHA was 10.2/1000 persons (95%CI: 4.5 to 23.1), translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons. The lifetime prevalence of suicide attempts was 158.3/1000 persons (95%CI: 106.9 to 228.2) and of suicidal ideation was 228.3/1000 persons (95%CI: 150.8 to 330.1). Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease (AIDS), the risk of suicide completion increased by 34 per 1000 persons. The quality of evidence by Grading of Recommendations, Assessment, Development and Evaluations for the suicide deaths was graded as ‘moderate’ quality.ConclusionsThe risk of suicide death is 100-fold higher in people living with HIV than in the general population. Lifetime incidence of suicidal ideation and attempts are substantially high. Suicide risk assessments should be a priority in PLWHA, especially for those with more advanced disease.

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Molluscum Contagiosum in a Pediatric American Indian Population: Incidence and Risk Factors

PLoS ONE ◽

10.1371/journal.pone.0103419 ◽

2014 ◽

Vol 9 (7) ◽

pp. e103419 ◽

Cited By ~ 11

Author(s):

Andrea M. McCollum ◽

Robert C. Holman ◽

Christine M. Hughes ◽

Jason M. Mehal ◽

Arianne M. Folkema ◽

...

Keyword(s):

Risk Factors ◽

American Indian ◽

Indian Population ◽

Molluscum Contagiosum ◽

American Indian Population ◽

Population Incidence

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Euthanasia Distress and Fearlessness About Death in German Veterinarians

Crisis ◽

10.1027/0227-5910/a000689 ◽

2020 ◽

pp. 1-7

Author(s):

Heide Glaesmer ◽

Mahtab Bahramsoltani ◽

Kathrin Schwerdtfeger ◽

Lena Spangenberg

Keyword(s):

Risk Factors ◽

Veterinary Medicine ◽

General Population ◽

Population Sample ◽

Elevated Risk ◽

Risk Of Bias ◽

Self Report ◽

General Population Sample ◽

Specific Risk ◽

Related Risk

Abstract. Background: The elevated risk of suicide in veterinarians is still not well understood, but euthanasia distress and increased fearlessness about death (FAD) have been discussed as specific risk factors. Aims: We investigated German veterinarians to test whether FAD is increased compared with the general population, whether FAD is associated with euthanasia distress, and whether there are differences between different fields in veterinary medicine. Methods: German veterinarians were assessed via self-report instruments and compared with a representative general population sample. There was no difference in FAD. Lower euthanasia distress was significantly associated with higher FAD. Limitations: Although we were able to recruit a large sample of veterinarians, the generalizability is limited by the voluntary nature of participation and the related risk of bias. Results: There was no difference in FAD. Lower euthanasia distress was significantly associated with higher FAD. Conclusion: Although lower euthanasia distress as an indicator of habituation to euthanasia is associated with higher FAD, one cannot assume that increased FAD in veterinarians is a specific risk factor for suicidality in veterinarians.

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Nasal Carriage of Methicillin-ResistantStaphylococcus aureusin an American Indian Population

Infection Control and Hospital Epidemiology ◽

10.1086/502361 ◽

2004 ◽

Vol 25 (2) ◽

pp. 121-125 ◽

Cited By ~ 23

Author(s):

Richard Leman ◽

Francisco Alvarado-Ramy ◽

Sean Pocock ◽

Neil Barg ◽

Molly Kellum ◽

...

Keyword(s):

Risk Factors ◽

American Indian ◽

Indian Population ◽

Nasal Carriage ◽

Population Based ◽

Antimicrobial Use ◽

Carriage Rate ◽

Cross Sectional ◽

American Indian Population ◽

Mrsa Colonization

AbstractBackground and Objective:Although reports of methicillin-resistantStaphylococcus aureus(MRSA) infections without healthcare exposure are increasing, population-based data regarding nasal colonization are lacking. We assessed the prevalence of and risk factors for community-associated MRSA nasal carriage in patients of a rural outpatient clinic.Design:A cross-sectional population survey was conducted through random sample and stratification by community of residence. Recent healthcare exposure (ie, hospitalization, dialysis, or healthcare occupation) and other risk factors for MRSA carriage were assessed. Cultures of the nares were performed. Community-associated MRSA was defined as MRSA carriage without healthcare exposure.Setting:A predominantly American Indian community in Washington.Patients:Those receiving healthcare from an Indian Health Service clinic.Results:Of 1,311 individuals identified for study, 475 (36%) participated. Unsatisfactory culture specimens resulted in exclusion of 6 participants. In all, 128 (27.3%) of 469 participants hadS. aureus.Nine (1.9%) of 469 had MRSA carriage; of these, 5 had community-associated MRSA (5 of 469; overall community-associated MRSA carriage rate, 1.1%). MRSA carriage was associated with antimicrobial use in the previous year (risk ratio [RR], 7.2;P= .04) and residence in a household of more than 7 individuals (RR, 4.5;P= .03). Pulsed-field gel electrophoresis indicated that 5 (55%) of 9 MRSA carriage isolates were closely related, including 3 (60%) of 5 that were community associated.Conclusions:Prevalence of community-associated MRSA colonization was approximately 1% in this rural, American Indian population. Community-associated MRSA colonization was associated with recent antimicrobial use and larger household.

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