scholarly journals Australia's National Suicide Prevention Strategy: the next chapter

2006 ◽  
Vol 30 (3) ◽  
pp. 271 ◽  
Author(s):  
Jo Robinson ◽  
Patrick McGorry ◽  
Meredith G Harris ◽  
Jane Pirkis ◽  
Philip Burgess ◽  
...  
Keyword(s):  
Mental Illness ◽  
High Risk ◽  
Suicide Prevention ◽  
Risk Groups ◽  
Evidence Base ◽  
Prevention Strategy ◽  
People With Mental Illness ◽  
Prevention Activities ◽  
The Impact

Australia?s National Suicide Prevention Strategy (NSPS) is about to move into a new funding phase. In this context this paper considers the emphasis of the NSPS since its inception in 1999. Certain high-risk groups (particularly people with mental illness and people who have selfharmed) have been relatively neglected, and some promising approaches (particularly selective and indicated interventions) have been under-emphasised. This balance should be redressed and the opportunity should be taken to build the evidence-base regarding suicide prevention. Such steps have the potential to maximise the impact of suicide prevention activities in Australia.

Prevention of suicide and treatment following self-harm

2020 ◽  
pp. 1303-1314
Author(s):  
Keith Hawton ◽  
Kate E. A. Saunders ◽  
Alexandra Pitman
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Help Seeking ◽  
Population Level ◽  
Risk Groups ◽  
Evidence Base ◽  
Targeted Prevention ◽  
Prevention Interventions ◽  
Physical Health Problems ◽  
Self Harm

Suicide prevention strategies generally combine broad population or universal approaches with complementary high-risk or targeted prevention interventions, with evidence favouring greater impacts of population strategies. This chapter summarizes the evidence supporting a range of approaches to suicide prevention at the population level (restricting access to means of suicide, limiting the effects of suicide suggestion, influencing media portrayals of suicidal behaviour, using psychoeducation to improve help-seeking, primary care training, school interventions, telephone/Internet support services, lay training in gatekeeping) and for high-risk groups (risk management for specific psychiatric disorders, optimizing psychotropic medication, service delivery reform, enhanced support for specific high-risk groups—people with substance misuse and physical health problems, people who self-harm, people in specific occupational groups, prisoners, and people bereaved by suicide). Particular attention is given to evaluating the evidence base for interventions for people who self-harm. The chapter concludes that a comprehensive multi-sectoral approach is required for suicide prevention, tailored to specific local epidemiological patterns.

scholarly journals CanAssist Breast Impacting Clinical Treatment Decisions in Early-Stage HR+ Breast Cancer Patients: Indian Scenario

2019 ◽  
Author(s):  
Satish Sankaran ◽  
Jyoti Bajpai Dikshit ◽  
Chandra Prakash SV ◽  
SE Mallikarjuna ◽  
SP Somashekhar ◽  
...  
Keyword(s):  
High Risk ◽  
Early Stage ◽  
Risk Groups ◽  
Treatment Decisions ◽  
Low Risk ◽  
Not Given ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Risk Of Cancer ◽  
The Impact

AbstractCanAssist Breast (CAB) has thus far been validated on a retrospective cohort of 1123 patients who are mostly Indians. Distant metastasis–free survival (DMFS) of more than 95% was observed with significant separation (P < 0.0001) between low-risk and high-risk groups. In this study, we demonstrate the usefulness of CAB in guiding physicians to assess risk of cancer recurrence and to make informed treatment decisions for patients. Of more than 500 patients who have undergone CAB test, detailed analysis of 455 patients who were treated based on CAB-based risk predictions by more than 140 doctors across India is presented here. Majority of patients tested had node negative, T2, and grade 2 disease. Age and luminal subtypes did not affect the performance of CAB. On comparison with Adjuvant! Online (AOL), CAB categorized twice the number of patients into low risk indicating potential of overtreatment by AOL-based risk categorization. We assessed the impact of CAB testing on treatment decisions for 254 patients and observed that 92% low-risk patients were not given chemotherapy. Overall, we observed that 88% patients were either given or not given chemotherapy based on whether they were stratified as high risk or low risk for distant recurrence respectively. Based on these results, we conclude that CAB has been accepted by physicians to make treatment planning and provides a cost-effective alternative to other similar multigene prognostic tests currently available.

scholarly journals Rates of violence in patients classified as high risk by structured risk assessment instruments

2014 ◽  
Vol 204 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Jay P. Singh ◽  
Seena Fazel ◽  
Ralitza Gueorguieva ◽  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
Evidence Base ◽  
Assessment Tools ◽  
Current Evidence ◽  
Assessment Instruments ◽  
Individual Liberty ◽  
Current Evidence Base ◽  
Study Heterogeneity

BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995–2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

scholarly journals Attitudes towards disclosing a mental illness: impact on quality of life and recovery

2021 ◽  
Author(s):  
Lea Mayer ◽  
Patrick W. Corrigan ◽  
Daniela Eisheuer ◽  
Nathalie Oexle ◽  
Nicolas Rüsch
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Help Seeking ◽  
Social Withdrawal ◽  
Social Consequences ◽  
People With Mental Illness ◽  
High Internal Consistency ◽  
Initial Support ◽  
The Impact

Abstract Purpose The decision whether to disclose a mental illness has individual and social consequences. Secrecy may protect from stigma and discrimination while disclosure can increase social support and facilitate help-seeking. Therefore, disclosure decisions are a key reaction to stigma. The first aim of this study was to test a newly developed scale to measure disclosure attitudes, the Attitudes to Disclosure Questionnaire (AtDQ). The second aim was to examine the impact of attitudes towards disclosing a mental illness on quality of life and recovery. Methods Among 100 participants with mental illness, disclosure attitudes, quality of life, recovery, benefits of disclosure, secrecy, social withdrawal, self-stigma, and depressive symptoms were assessed at weeks 0, 3 and 6. Psychometric properties of the AtDQ were analysed. Longitudinal associations between disclosure attitudes at baseline and quality of life and recovery after 6 weeks were examined in linear regressions. Results The analyses of the AtDQ indicated one-factor solutions, high acceptability, high internal consistency, and good retest reliability for the total scale and the subscales as well as high construct validity of the total scale. Results provided initial support for sensitivity to change. More positive disclosure attitudes in general and in particular regarding to family at baseline predicted better quality of life and recovery after 6 weeks. Conclusion The current study provides initial support for the AtDQ as a useful measure of disclosure attitudes. Disclosing a mental illness, especially with respect to family, may improve quality of life and recovery of people with mental illness.

After Teen Suicide: Issues for Pediatricians Who Are Asked to Consult to Schools

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 982-987 ◽  
Author(s):  
Richard S. Adler ◽  
Michael S. Jellinek
Keyword(s):  
High Risk ◽  
Suicide Prevention ◽  
Risk Groups ◽  
School Community ◽  
Ongoing Task ◽  
It Impacts

Every suicide is a unique tragedy. This article has attempted to provide a framework for understanding suicide as it impacts on the scmunity.ool community. Given this background, we have listed 10 frequent dilemmas faced by pediatricians (and others) who consult to schools. The central themes of the approach offered are to avoid inadvertently glorifying suicide, target high-risk groups for interventions, and consider suicide prevention as part of the broad, ongoing task of providing a caning environment for adolescents in which the collaboration of the school community is essential.

The national impact of the COVID-19 pandemic on U.S. prostate cancer community care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5061-5061
Author(s):  
Matthew R. Cooperberg ◽  
Paul Brendel ◽  
Daniel J. Lee ◽  
Rahul Doraiswami ◽  
Hariesh Rajasekar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Language Processing ◽  
Care Delivery ◽  
Specific Antigen ◽  
Risk Groups ◽  
Low Risk ◽  
T Stage ◽  
Risk Stratum ◽  
The Impact

5061 Background: We used data from a specialty-wide, community-based urology registry to determine trends in outpatient prostate cancer (PCa) care during the COVID-19 pandemic. Methods: 3,165 (̃ 25%) of US urology providers, representing 48 states and territories, participate in the American Urological Association Quality (AQUA) Registry, which collects data via automated extraction from electronic health record systems. We analyzed trends in PCa care delivery from 156 practices contributing data in 2019 and 2020. Risk stratification was based on prostate-specific antigen (PSA) at diagnosis, biopsy Gleason, and clinical T-stage, and we used a natural language processing algorithm to determine Gleason and T-stage from unstructured clinical notes. The primary outcome was mean weekly visit volume by PCa patients per practice (visits defined as all MD and mid-level visits, telehealth and face-to-face), and we compared each week in 2020 through week 44 (November 1) to the corresponding week in 2019. Results: There were 267,691 PCa patients in AQUA who received care between 2019 and 2020. From mid-March to early November, 2020 (week 10 – week 44) the magnitude of the decline and recovery varied by risk stratum, with the steepest drops for low-risk PCa (Table). For 2020, overall mean visits per day (averaged weekly) were similar to 2019 for the first 9 weeks (̃25). Visits declined to week 14 (18.19; a 31% drop from 2019), recovered to 2019 levels by week 23, and declined steadily to 11.89 (a 58% drop from 2019) as of week 44, the cut off of this analysis. Conclusions: Access to care for men with PCa was sharply curtailed by the COVID-19 pandemic, and while the impact was less for men with high-risk disease compared to those with low-risk disease, visits even for high-risk individuals were down nearly one-third and continued to fall through November. This study provides real-world evidence on the magnitude of decline in PCa care across risk groups. The impact of this decline on cancer outcomes should be followed closely.[Table: see text]

scholarly journals RISK ASSESSMENT OF HEALTH DISORDERS IN EMPLOYEES AT THE MACHINERY ENTERPRISE

2020 ◽  
Vol 99 (1) ◽  
pp. 76-79
Author(s):  
Lyubov A. Balabanova ◽  
S. K. Kamaev ◽  
A. A. Imamov ◽  
O. R. Radchenko
Keyword(s):  
High Risk ◽  
Working Conditions ◽  
Preventive Measures ◽  
Risk Groups ◽  
Machine Building ◽  
Occupational Factors ◽  
Building Enterprise ◽  
The Impact ◽  
Occupational Contact ◽  
Male Workers

Introduction. Adverse effects of environmental factors can cause dysfunction of organs and systems, hormonal dysfunction, genetic disorders, which can adversely affect the health of future generations. The aim is to study occupational risk factors and assess their impact on the health of male workers of machine-building enterprises, to develop preventive measures. Material and methods. The working conditions of 318 male workers of the main professions of the machine-building enterprise (miller, locksmith, electric and gas welder, turner, caster, etc.), having occupational contact with harmful occupational factors, were studied in comparison with 148 employees of the control group. Epidemiological, socio-hygienic, statistical and risk calculation methods were used. Results. 68.2% of respondents were found to have occupational contact with cutting fluid, 24.3% contact with chemicals, 14.4% - with heavy metals, 66.2% of respondents work in conditions of noise exposure, 40.1% - local vibration, 22.3% - in conditions of hypothermia, 14.4% - in conditions of overheating. Excess of maximum permissible concentrations of benzo(a)pyrene, aerosols of mineral oils, epichlorohydrin was detected in the air of the working zone. At workplaces, there were excess levels of noise, general vibration, thermal radiation. The impact of harmful occupational factors in the workplace was established to create a high risk to the health of workers. Conclusion. Working conditions of workers of the machine-building enterprise are mainly estimated as harmful. Critical organs and systems for the development of occupational pathology were identified, the high carcinogenic risk from exposure to benzo(a)pyrene was revealed. Employees of the machine-building enterprise were shown to have a high risk of oncology, respiratory diseases, central nervous system diseases, pathology in offspring. As a result, risk groups were formed and targeted preventive measures were proposed, including monitoring of the health status of high-risk groups, occupational selection, and medical examinations.

The History of the Treatment of Mental Illness

2016 ◽  
pp. 1-16
Author(s):  
Lauren Mizock ◽  
Zlatka Russinova
Keyword(s):  
Mental Illness ◽  
Middle Ages ◽  
Western Europe ◽  
Psychiatric Treatment ◽  
Shock Therapy ◽  
The United States ◽  
Models Of Care ◽  
People With Mental Illness ◽  
History Of ◽  
The Impact

Chapter 1 reviews the history of psychiatric treatment of people with mental illness in the United States and Western Europe, highlighting past perspectives in care, such as ancient trephination and exorcism during the demonology era, humorism in early Greek and Roman thought, a return to demonological perspectives in the Middle Ages, as well as mesmerism and psychoanalysis in the 19th and 20th centuries. The 20th-century biological perspective is described, including the use of insulin shock therapy, electroconvulsive therapy, and lobotomy. Next, the development of more humane treatment approaches is discussed, such as the moral treatment movement of the 1800s. The ex-patient’s movement of the 1970s is reviewed, leading up to the contemporary recovery-oriented and psychosocial rehabilitation models of care. The impact of stigma on the acceptance of serious mental illness is explored throughout this history. Discussion questions, activities, and diagrams are also included.

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