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da Silva Araújo PS, da Silveira TB, de Moura FR, Dos Santos Maidana M, de Sousa GRD, de Carvalho Dumith S, da Silva Júnior FMR. Epidemiological profile, temporal analysis, and future projections of suicide cases in rural cities in the extreme south of Brazil. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:965-978. [PMID: 37731290 DOI: 10.1080/15287394.2023.2258914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
The present study aimed to verify the time series (2000-2017) of death rates by suicide and its associated factors in 4 municipalities in the extreme south of Brazil. Data were obtained through the analysis of medical reports and police report bulletins at the Instituto Médico Legal, in the city of Rio Grande. The suicide rate in the Rio Grande region varied from 4 to 11 suicides per 100,000 inhabitants and it is estimated that by 2030 this rate could reach 16.5 suicides per 100,000 inhabitants. The rural cities of Santa Vitória do Palmar and Chuí present even higher suicide averages when compared to Rio Grande, the most populous city of the four. The death rate from suicide increased gradually in the period analyzed, with the prevalence rising among the youngest and the elderly population. A more comprehensive understanding of the influences of environmental issues on suicidal decisions constitutes an important action that needs to be taken, both because of regional vulnerabilities and the target population identified. Evidence indicates that knowledge of factors affecting individuals residing in this Brazilian region where increased suicide rates are recorded needs to be recognized as a priority.
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Affiliation(s)
- Paula Santos da Silva Araújo
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Tatiane Britto da Silveira
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Fernando Rafael de Moura
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Merlyn Dos Santos Maidana
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Guaraciaba Ribeiro Duarte de Sousa
- Posto Médico-Legal de Rio Grande, Departamento de Perícias do Interior, Instituto Geral de Perícias, Praça Barão de São José do Norte - Rua Aquidaban - Centro, Rio Grande- RS, Brasil
| | - Samuel de Carvalho Dumith
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
| | - Flavio Manoel Rodrigues da Silva Júnior
- Laboratório de Ensaios Farmacológicos e Toxicológicos - LEFT, Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande (FURG), Rio Grande-RS, Brasil
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Hus Y. Frozen in Time, a Focused Review of Autism Prevalence in Canadian Indigenous Communities. Neuropsychiatr Dis Treat 2023; 19:2451-2468. [PMID: 38029046 PMCID: PMC10658944 DOI: 10.2147/ndt.s439450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
The unprecedented global continuous rise in autism prevalence is often referred to as a Pandemic while its parallel cost increase to society portrays a Tsunami. Autism data originates mostly from industrialized High-Income geopolitical regions in Europe, North America, and Asian regions. Although efforts to determine autism data from regions in Low and Mid-economies are ongoing, prevalence information from geographically remote and economically vulnerable communities within the privileged regions is largely undetermined, as is the case of the Canadian Indigenous communities, the First Nations, Inuit, and Métis highlighted in this focused review. The underlying theoretical approach adopted here is Transcultural Psychiatry with its emphasis on Context including sociopolitical circumstances, considered the gateway to understanding health, illness, and recovery in groups and individuals. Accordingly, the review includes a concise relevant government system description and history of the relations with Indigenous peoples to provide context to present indigenous relations to Canadian government agencies. Scores in these communities face a myriad of survival challenges encompassing meagre health resources and services. Establishing autism prevalence data in these communities are exceedingly difficult due to multiple factors. While prominent among them are their strong ties to traditional approaches to health, illness, and autism conceptualization, the crucial obstacle is Crown and Provincial government authorities' and agencies' historically rooted colonial response to the needs of families with autistic members. It embodies a posture of infantilization, an attitude that is "frozen in time" in the approach, practice, accommodations, and services for these families. The review provides the preferred autism terminology, information sources, article flow, and Future Directions, all found in the Introduction's first paragraphs.
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Affiliation(s)
- Yvette Hus
- Department of Rehabilitation Sciences Theralab Research Director Prof. Kakia Petinou, Cyprus University of Technology, Limassol, Cyprus
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Flórez G, Espandian A, Llorens N, Seoane-Pillado T, Saiz P. Suicide deaths and substance use in the Galician provinces between 2006 and 2020. Front Psychiatry 2023; 14:1242069. [PMID: 37645637 PMCID: PMC10461002 DOI: 10.3389/fpsyt.2023.1242069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Background Suicide is a serious public health problem that affects our entire country, including the Galician provinces. The aim of this research was to study the variation in completed suicide rates, between 2006 and 2020, in the different Galician provinces and their relationship with the consumption of addictive substances. Methods Completed suicide data from the Spanish Office for National Statistics and the Institute of Legal Medicine of Galicia were analyzed with a Joinpoint regression model to determine time trends. The relationship between the variation in completed suicide rates with sociodemographic variables obtained from the Spanish Office for National Statistics and variables related to the consumption of substances obtained from the survey on alcohol and other drugs in Spain (EDADES) of the Government Delegation for the National Plan on Drugs was also analyzed. Results The Joinpoint regression model did not reveal any point of significant change in the period studied for any Galician province. The following variables correlated positively with the variation in completed suicide rates in the Galician provinces: masculinity ratio, average age, daily alcohol consumption and daily illegal substance consumption. Conclusion Applying preventive strategies on the daily consumption of alcohol and illegal substances would help reduce the rates of completed suicide in the Galician provinces.
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Affiliation(s)
- Gerardo Flórez
- Addictive Treatment Unit, Ourense University Hospital, Ourense, Spain
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
| | | | - Noelia Llorens
- Spanish Observatory of Drugs and Addictions, Government Delegation for the National Plan on Drugs, Spanish Ministry of Health, Madrid, Spain
| | - Teresa Seoane-Pillado
- Area of Preventive Medicine and Public Health, Department of Health Sciences, University of A Coruña – INIBIC, A Coruña, Spain
| | - Pilar Saiz
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Health Research Institute of the Principality of Asturias (ISPA), Asturias, Spain
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Mahinpey N, Pollock NJ, Liu L, Contreras G, Thompson W. Self-harm and rurality in Canada: an analysis of hospitalization data from 2015 to 2019. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1161-1170. [PMID: 37029322 PMCID: PMC10081931 DOI: 10.1007/s00127-023-02463-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/08/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE The incidence of self-harm is an important indicator in suicide surveillance and a target outcome for suicide prevention. Self-harm rates vary by geographic location and rurality appears to be a risk factor. The objectives of this study were to estimate rates of self-harm hospitalization in Canada over a 5-year period by sex and age group, and examine relationships between self-harm and rurality. METHODS Hospitalizations related to self-harm were identified in a national dataset (the Discharge Abstract Database) for all patients aged 10 years or older who were discharged from hospital between 2015 and 2019. Self-harm hospitalization rates were calculated and stratified by year, sex, age group, and level of rurality, as measured using the Index of Remoteness. A Poisson regression was fit to estimate rate ratios for the levels of rurality. RESULTS Rates of self-harm hospitalization were higher for females than males across all levels of rurality and increased with each level for both sexes, except for among young males. The widest rural-to-urban disparities were observed for the 10-19 and 20-34-year old age groups. Females aged 10-19 in very remote areas had the highest self-harm hospitalization rate. CONCLUSION The rate of self-harm hospitalization in Canada varied by sex, age group, and level of rurality. Clinical and community-based interventions for self-harm, such as safety planning and increased access to mental health services, should be tailored to the differential risks across geographic contexts.
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Affiliation(s)
- Newsha Mahinpey
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Nathaniel J Pollock
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
- School of Arctic and Subarctic Studies, Labrador Campus, Memorial University, Happy Valley-Goose Bay, NL, Canada.
| | - Li Liu
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Gisèle Contreras
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Wendy Thompson
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
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Kim J, Gwak D, Kim S, Gang M. Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods. J Adv Nurs 2023; 79:641-651. [PMID: 36534434 DOI: 10.1111/jan.15549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/10/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN This study applied an exploratory, descriptive and cross-sectional design. METHODS The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - DongHyeon Gwak
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Seonhee Kim
- Nursing Department, Songwon University, Gwangju, South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Kaggwa MM, Rukundo GZ, Wakida EK, Maling S, Sserumaga BM, Atim LM, Obua C. Suicide and Suicide Attempts Among Patients Attending Primary Health Care Facilities in Uganda: A Medical Records Review. Healthc Policy 2022; 15:703-711. [PMID: 35469181 PMCID: PMC9034861 DOI: 10.2147/rmhp.s358187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background Suicide is one of the leading causes of death globally, accounting for about 800,000 deaths annually. The suicide burden drastically increased since the beginning of the COVID-19 pandemic. In Uganda, no known study has determined the suicide rate since the beginning of the COVID-19 pandemic. Objective To determine the suicide mortality rate and describe the characteristics of victims of suicide attempts from January to December 2020 in south western Uganda. Methods This study was based on the health management information systems (HMIS) of patients’ registered data for the year 2020 at 15 selected primary health care facilities in four districts in south-western Uganda. We used a data extraction tool to capture demographic and clinical characteristics of the individuals who had attempted or completed suicide. We estimated yearly incidence rates of fatal and non-fatal suicide attempts, and used chi-square and t-test to determine the statistical difference between suicide attempt outcomes. Results A total of 130 non-fatal suicide attempts and 26 suicides were identified. Majority were male 69.87% (n = 109/156) and the mean age was 27.16 (SD = 14.71) years. The overall incidence of suicide attempts was about 60 attempts per 100,000 people, while that of completed suicide was about three deaths per 100,000 people. The suicide attempts increased following the first month of COVID-19 lockdown in the country (March 2020) and most individuals attempted suicide by poisoning (n = 144). Conclusion Suicide is a common occurrence in primary health care settings of Uganda and there has been a rapid increase in suicide attempts since the onset of the COVID-19 pandemic. With suicide by poisoning being common, there is need for proactive interventions, such as the control of pesticides and herbicides, to prevent suicide among members of this community, especially during pandemic conditions.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Correspondence: Mark Mohan Kaggwa, Email
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Edith K Wakida
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medical Education, California University of Science and Medicine, San Barnardino, CA, United States of America
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Baker Makaya Sserumaga
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Letizia Maria Atim
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | - Celestino Obua
- Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, Uganda
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Komar D, Denic N, Marsh B, Rumbolt N. Hangings in Newfoundland and Labrador: A 40-year retrospective analysis of medical examiner data. J Forensic Sci 2022; 67:1557-1564. [PMID: 35122244 DOI: 10.1111/1556-4029.15008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
A comprehensive review of medical examiner data was undertaken of all hanging deaths in the Canadian Maritime province of Newfoundland and Labrador from 1982 to 2021. A total of 811 cases were identified representing suicidal, accidental, and undetermined manners of death. Variables examined included age; sex; seasonality; ligature type; location; time since death; prior attempts/suicidal ideation; presence/absence of a suicide note; and presence/absence of alcohol and drugs. Data subsets were generated, and additional analysis was conducted for hangings involving females; suicidal hangings occurring in the region of Labrador; and those who hanged themselves outdoors. Results indicate that females are choosing to kill themselves by hanging in rapidly increasing numbers. Outdoor suicides by hanging were more common in Newfoundland and Labrador (22.1%) than previously reported in Alberta (11.5%), Texas (5%), and Turkey (12-13%). Unique trends in seasonality were revealed, as were repeated incidents of suicidal clusters. The age distribution was skewed strongly toward youths (10 to 22 years of age), particularly in Labrador. Although Labrador represents only 5% of the total provincial population, it produced 20.1% of the total suicidal hangings in the study. The suicide rate in Canada has decreased by 24% over the past 40 years, yet the rates of suicidal hangings nationally and in Newfoundland and Labrador have increased during the same time period. With a better understanding of the circumstances under which people commit suicide by hanging within the province, it may be possible to target at-risk groups to prevent future cases.
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Affiliation(s)
- Debra Komar
- Newfoundland and Labrador Office of the Chief Medical Examiner, Health Sciences Centre, St. John, Canada
| | - Nebojsa Denic
- Newfoundland and Labrador Office of the Chief Medical Examiner, Health Sciences Centre, St. John, Canada
| | - Bryan Marsh
- Newfoundland and Labrador Office of the Chief Medical Examiner, Health Sciences Centre, St. John, Canada
| | - Niki Rumbolt
- Newfoundland and Labrador Office of the Chief Medical Examiner, Health Sciences Centre, St. John, Canada
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Pollock NJ, Liu L, Wilson MM, Reccord C, Power ND, Mulay S, Karaivanov Y, Tonmyr L. Suicide in Newfoundland and Labrador, Canada: a time trend analysis from 1981 to 2018. BMC Public Health 2021; 21:1291. [PMID: 34215242 PMCID: PMC8252247 DOI: 10.1186/s12889-021-11293-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The suicide rate in Canada decreased by 24% during the past four decades. However, rates vary between provinces and territories, and not all jurisdictions experienced the same changes. This study examined suicide rates over time in the province of Newfoundland and Labrador. METHODS We used cross-sectional surveillance data from the Canadian Vital Statistics Death Database to examine suicide rates in Newfoundland and Labrador from 1981 to 2018. We calculated annual age-standardized suicide mortality rates and used joinpoint regression to estimate the average annual percent change (AAPC) in suicide rates overall and by sex, age group, and means of suicide. RESULTS From 1981 to 2018, 1759 deaths by suicide were recorded among people in Newfoundland and Labrador. The age-standardized suicide mortality rate increased more than threefold over the study period, from 4.6 to 15.4 deaths per 100,000. The suicide rate was higher among males than females, and accounted for 83.1% of suicide deaths (n = 1462); the male-to-female ratio of suicide deaths was 4.9 to 1. The average annual percent change in suicide rates was higher among females than males (6.3% versus 2.0%). Age-specific suicide rates increased significantly for all age groups, except seniors (aged 65 or older); the largest increase was among youth aged 10 to 24 years old (AAPC 3.5; 95% CI, 1.6 to 5.5). The predominant means of suicide was hanging/strangulation/suffocation, which accounted for 43.8% of all deaths by suicide. CONCLUSIONS The suicide rate in Newfoundland and Labrador increased steadily between 1981 and 2018, which was in contrast to the national rate decline. The disparity between the provincial and national suicide rates and the variations by sex and age underscore the need for a public health approach to prevention that accounts for geographic and demographic differences in the epidemiology of suicide.
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Affiliation(s)
- Nathaniel J Pollock
- School of Arctic and Subarctic Studies, Labrador Institute, Memorial University, Happy Valley-Goose Bay, Newfoundland and Labrador, Canada. .,Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada. .,Discipline of Emergency Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada.
| | - Li Liu
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margo M Wilson
- Discipline of Emergency Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Charlene Reccord
- Department of Research and Innovation, Eastern Health, St. John's, Newfoundland and Labrador, Canada
| | - Nicole D Power
- Department of Research and Innovation, Eastern Health, St. John's, Newfoundland and Labrador, Canada
| | - Shree Mulay
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Yordan Karaivanov
- Medical Services, Labrador Health Centre, Labrador-Grenfell Health, Happy Valley-Goose Bay, Newfoundland and Labrador, Canada.,Northern Family Medicine, Discipline of Family Medicine, Faculty of Medicine, Memorial University, Happy Valley-Goose Bay, Newfoundland and Labrador, Canada
| | - Lil Tonmyr
- Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
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