scholarly journals Does Lent affect rates of deliberate self-harm?

2020 ◽  
pp. 1-4
Author(s):  
N. Moloney ◽  
K. Glynn ◽  
E. Harding ◽  
V. Murphy ◽  
G. Gulati
Keyword(s):  
Large Scale ◽  
Protective Factor ◽  
Religious Affiliation ◽  
University Hospital ◽  
Age Group ◽  
Deliberate Self Harm ◽  
Significant Difference ◽  
Chi Squared ◽  
Ethical Approval ◽  
Self Harm

Background Research has shown that religious affiliation has a protective effect against deliberate self-harm. This is particularly pronounced in periods of increased religious significance, such as periods of worship, celebration, and fasting. However, no data exist as to whether this effect is present during the Christian period of Lent. Our hypothesis was that Lent would lead to decreased presentations of self-harm emergency department (ED) in a predominantly Catholic area of Ireland. Methods Following ethical approval, we retrospectively analysed data on presentations to the ED of University Hospital Limerick during the period of Lent and the 40 days immediately preceding it. Frequency data were compared using Pearson’s chi-squared tests in SPSS. Results There was no significant difference in the overall number of people presenting to the ED with self-harm during Lent compared to the 40 days preceding it (χ2 = 0.75, df = 1, p > 0.05), and there was no difference in methods of self-harm used. However, there was a significant increase in attendances with self-harm during Lent in the over 50’s age group (χ2 = 7.76, df = 1, p = 0.005). Conclusions Based on our study, Lent is not a protective factor for deliberate self-harm and was associated with increased presentations in the over 50’s age group. Further large-scale studies are warranted to investigate this finding as it has implications for prevention and management of deliberate self-harm.

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.

Suicide and Parasuicide in Childhood and Early Adolescence

1985 ◽  
Vol 146 (5) ◽  
pp. 459-463 ◽  
Author(s):  
Donald J. Brooksbank
Keyword(s):  
Early Adolescence ◽  
Attempted Suicide ◽  
Psychiatric Services ◽  
Age Group ◽  
Deliberate Self Harm ◽  
England And Wales ◽  
The Social ◽  
Self Harm ◽  
Age Range

Suicide is intentional self-killing, and parasuicide an act of deliberate self-harm—either by injury, ingestion or inhalation—not resulting in death (Blacket al,1982). Both are rare under the age of 12 and the rate of suicide in those under 16 remains consistently low. Referrals to psychiatric services reported by Shaffer (1974) indicated that 7–10% were for threatened or attempted suicide, while Hawton (1982) quoted studies giving the incidence as 10–33% for children aged six to 12; in England and Wales (1962–1968), suicide accounted for 0.6% of deaths in the 10–14 age-range. McClure (1984) found that between 1975 and 1980, only ten such deaths were recorded in the 13-and-under range, and 26 deaths in the 14 year-olds, after which the number of suicides rose sharply with each successive year. That study also showed that parasuicide was most common in the 15–24 age-group, but at younger ages there was a higher proportion of undetermined deaths, as against officially recorded suicides. The social taboos associated with suicide may lead to its systematic under-reporting, but even allowing for that, the phenomenon is still a rare one under the age of 16.

Abstract 529: A Modern Large-scale Analysis of Heart Transplantation in Elderly Patients

2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Manish Suryapalam ◽  
Mohammed Kashem ◽  
Val Rakita ◽  
Yoshiya Toyoda
Keyword(s):  
Heart Transplantation ◽  
Large Scale ◽  
Age Groups ◽  
The Elderly ◽  
Survival Outcome ◽  
Outcome Analysis ◽  
Survival Outcomes ◽  
Ischemic Time ◽  
Significant Difference ◽  
Chi Squared

Introduction: As the prevalence of heart failure increases among older patients, the potential role of heart transplant (HTx) in this demographic demands further investigation. Survival outcome analysis of the elderly has primarily been analyzed in single-center studies, and the few long term studies performed have included a timeframe to the 1980s, introducing substantial variance from much poorer survival outcomes. We investigated the 5 to 10 year survival outcomes of more modern heart transplantation patients by analyzing the UNOS database. Methods: Heart transplantation data for 32,337 patients (2000-2014) was divided into three different age groups- <60, 60-69, and ≥70 years old. Gender, ethnicity, height, weight, BMI, ICU stay, ischemic time, length of stay (LOS), and creatinine level were evaluated for significance using Chi-Squared and H-Tests as appropriate (p<0.05). Survival outcome was assessed using a Kaplan-Meier Curve and log-rank tests. Results: 23,267 were <60, 8,459 were 60-69, and 611 were ≥70, with mean ages of 38±0.1, 64±0.0, and 72±0.1 respectively. The distribution of gender, ethnicity, ischemic time, BMI, height, and weight was significantly different between the cohorts, with p=0.000 for all. Survival analysis indicated complete pairwise significance at 10 years post-HTx, with overall significance of p=0.000. At 5 years post-HTx, only 60-69 vs ≥70 did not have pairwise significance in survival. Conclusion: Contrary to prior studies, results indicate a statistically significant difference in survival the older and younger cohorts. This difference is especially prominent at the 10 th year post-transplant, but can be seen even at the 5 th year.

Children, seen and heard: a descriptive study of all children (aged 12 years and under) referred for acute psychiatric assessment in Tallaght University Hospital over a 10-year period

2020 ◽  
pp. 1-9
Author(s):  
E. Maguire ◽  
K. Glynn ◽  
C. McGrath ◽  
P. Byrne
Keyword(s):  
Female Gender ◽  
University Hospital ◽  
Categorical Variables ◽  
Review Of The Literature ◽  
Suicidal Thoughts ◽  
Chi Squared ◽  
Mental Health Difficulties ◽  
Self Harm ◽  
Worrying Trend ◽  
Over Time

Abstract Objectives: A review of the literature demonstrates that relatively little is known about acute psychiatric presentations in children (0–12 years), compared with adolescents or young adults (12 years+). This study aims to review psychiatric presentations of children to a CAMHS Liaison Service at Children’s Hospital Ireland (CHI) at Tallaght University Hospital over a 10-year period. Methods: A retrospective study was undertaken of case notes of all children aged 12 years and under who were referred to the CAMHS Liaison Service between January 2009 and December 2018 (n = 318). Data were anonymised and inputted into SPSSv25 for analysis. The relationships between presentations and methods of self-harm over time were measured using Pearson’s correlation. Associations between categorical variables were analysed using chi-squared tests. Results: There was a significant increase in presentations of under-12s over the 10-year period (r(8)=0.66, p = 0.02). There was also a significant increase in children presenting with a disturbance of conduct and/or emotions over time (r(8) = 0.79, p < 0.001). There was a significant association between female gender and ingestion (X2 = 12.73, df = 1, p < 0.05) and between male gender and ligature as a method of self-harm (X2 = 5.54, df = 1, p < 0.05). Over half (53%) of children presented with suicidal thoughts and 22% presented with suicidal behaviours. The reported use of ligature as a method of self-harm emerged only from 2012 among cases studied. Conclusions: Children aged 12 years and under are presenting in increasing numbers with acute mental health difficulties, including suicidal thoughts and behaviours. There is a worrying trend in methods of self-harm, particularly in high lethality behaviours such as attempted strangulation.

scholarly journals Comparison of the assessment by doctors and nurses of deliberate self-harm

2003 ◽  
Vol 27 (02) ◽  
pp. 57-60
Author(s):  
Sian Nerys Weston
Keyword(s):  
Mental Illness ◽  
Psychiatric Nurses ◽  
Deliberate Self Harm ◽  
Use Of Resources ◽  
Community Psychiatric ◽  
Significant Difference ◽  
Referral Practices ◽  
Self Harm ◽  
Doctors And Nurses

Aims and Method To compare the assessment by community psychiatric nurses and junior psychiatric doctors of individuals following deliberate self-harm (DSH) and, in particular, to elicit differences in referral practices and perceptions of mental illness. The health professionals involved completed questionnaires after carrying out DSH assessment. Results There was a significant difference in referral patterns between doctors and nurses after DSH assessment. Doctors were significantly more likely to refer individuals for psychiatric follow-up which involved direct contact with other doctors (51 of 72 (71%) compared with 60 of 175 (34%)). Doctors were also significantly more likely than nurses to perceive individuals as having a mental illness (57 of 72 (79%) compared with 86 of 175 (49%)). Clinical Implications Further research is warranted to establish the precise reasons for these differences, and to determine whether the widespread introduction of nurse-led services is an effective and efficient use of resources.

scholarly journals Prevalence Survey of Sexual Dysfunction among Women in the Reproductive Age Group Referred to the Islamic Azad University Hospital During 2011-2012

2014 ◽  
Vol 3 (1) ◽  
pp. 14-19
Author(s):  
Zhila Amirkhani ◽  
Ehsan Jangholi ◽  
Pariroukh Ramezi ◽  
Mahsa Shafiei ◽  
Mahsa Saberi ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Educational Level ◽  
Pearson Correlation ◽  
Reproductive Age ◽  
Self Report ◽  
University Hospital ◽  
Sexual Dysfunctions ◽  
Age Group ◽  
Significant Difference ◽  
Reproductive Age Group

Background: Sexual dysfunctions are common and are regarded as important health problems for women of all ages with related quality of life issues. The purpose of this cross-sectional study was to explore the frequency of sexual dysfunction among women in reproductive age group referred to the Islamic Azad University hospitals.Materials and Methods: This study was performed on married women selected by simple random sampling, aged 15-45 years who referred to Boo–Ali, Amir-Al-Momenin and Javaheri hospitals in Tehran, Iran from August 2011 to August 2012. Data were collected by face-to-face interview and completion of self-report questionnaires that assessed sexual functions among women in six separate dimensions. Analysis was done using Pearson correlation coefficient by SPSS 14.0; significant difference was set at 0.05.Results: A total of 384 women with mean age of 28.6±7.1 years were enrolled. The mean Body Mass Index (BMI) was 27.4±2.6 kg/m2. Ninety-seven subjects (25.2%) had never attained an orgasm, 31 (8%) had a low level satisfactory relationship with their husband, 55(14.3%) had painful intercourse, 42(10.9%) had arousal disorder, all of which increased significantly with age (P=0.003). Female Sexual dysfunctions had a significant negative correlation with BMI (P=0.004). The emotional relationship (P=0.003) and educational level (P=0.08) were significantly associated with the Female Sexual Function (FSF) score. No significant difference was detected in marriage duration (P=0.081) and used contraception methods (P=0.081).Conclusion: The prevalence of female sexual dysfunction including desire, arousal, lubrication, orgasm, satisfaction and pain problems increased with age and BMI. In addition, lower educational level is an associated factor that may cause sexual dysfunction. Also, emotional relationship had positive association with FSF score, while it was not associated with the use of contraceptive methods.

scholarly journals Budesonide Prophylaxis Reduces Engraftment Syndrome (ES) after Autologous Hematopoietic Cell Transplantation (autoHCT) in Multiple Myeloma (MM)

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 35-36
Author(s):  
Bicky Thapa ◽  
Huaying Dong ◽  
Sergey Tarima ◽  
Binod Dhakal
Keyword(s):  
Research Funding ◽  
Large Scale ◽  
Hematopoietic Cell Transplantation ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Advisory Board ◽  
Prophylaxis Group ◽  
Significant Difference ◽  
Chi Squared ◽  
Engraftment Syndrome

Introduction: ES after autoHCT encompasses a continuum of peri-engraftment complications characterized by non-infectious fever, rash, diarrhea, and capillary leak features. ES is an increasingly recognized complication after autoHCT in MM, with the varying incidence reported, based on the diagnostic criteria used. ES is typically mild and self-limited in most patients, while a subset can develop severe complications. In this study, we explored whether the use of budesonide prophylaxis reduces ES rates in MM patients undergoing autoHCT. Methods: All patients who underwent autoHCT for MM from 12/2017 to 11/2019 were included after IRB approval at our institution. Beginning on 12/15/2018, as a quality improvement institutional initiative to reduce ES, budesonide 3 mg orally three times a day was initiated at day +5 post autoHCT and continued until the time of discharge. In patients developing ES, systemic steroids were started, and budesonide was discontinued. The efficacy of the intervention was compared with patients who did not receive prophylaxis prior to the study period. ES was defined according to the previously published criteria [T R Spitzer BMT 50, 469-475(2015)]. Patient demographics, disease, and treatment outcomes between the 2 groups were compared using Mann-Whitney and Chi-squared tests when appropriate. The primary outcome was the ES rates between the 2 groups. Multiple logistic regression was used to model ES rates with other predictors, including budesonide prophylaxis as the main effect. Length of stay (LOS) and 30-day readmission were the secondary endpoints. Results: Table 1 shows the patient-, disease- and treatment characteristics between no prophylaxis (N=148) and prophylaxis (N=109) groups. The two groups were well matched overall except for induction therapy and Karnofsky performance status (KPS). The rates of ES were significantly higher in the no prophylaxis group vs. prophylaxis group [69 (75%) vs. 23 (25%); p&lt;0.001]. All patients in both groups were able to achieve neutrophil and platelet engraftment at day 28 and day 100, respectively. There was no significant difference in LOS [mean 15 (±3.2) vs. 16 (±2.8); p=0.27] and 30-day readmission [9 (6%) vs. 8 (7%); p=0.81] between the no prophylaxis and prophylaxis groups, respectively. On adjusted analysis, budesonide prophylaxis was associated with a significantly lower risk of developing ES compared to no prophylaxis groups [Odds ratio, OR 0.30 (95%CI: 0.17-0.53); p&lt;0.0001]. No other significant predictors were identified for the development of ES. There was no difference in the 30-day readmission rates [OR 1.12 (95%CI: 0.41-3.03); p= 0.75], but a trend for shorter LOS in the prophylaxis group [7.3% reduction in LOS (95%CI: 14.4%- 0%); p=0.052] (Table 2). Conclusion: Our study concludes that the use of budesonide prophylaxis significantly reduces the risk of ES in MM patients undergoing autoHCT. Future large-scale randomized studies are needed to confirm these findings in patients undergoing autoHCT for MM and other diseases. Disclosures Dhakal: Celgene: Consultancy, Honoraria; Takeda: Consultancy, Other: Advisory Board; Sanofi: Research Funding; Amgen: Consultancy, Other: AdvIsory Board, Research Funding; Janssen: Consultancy, Other: Advisory Board, Research Funding; GSK: Consultancy, Research Funding, Speakers Bureau.

Safety and feasibility of laparoscopic surgery for colorectal cancer in elderly patients (YSURG1401 study).

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 725-725
Author(s):  
Yosuke Atsumi ◽  
Masakatsu Numata ◽  
Toru Aoyama ◽  
Tsutomu Hayashi ◽  
Naoto Yamamoto ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Elderly Patients ◽  
Surgical Outcomes ◽  
Operation Time ◽  
University Hospital ◽  
Age Group ◽  
Significant Difference ◽  
Group A ◽  
Group B

725 Background: The safety and feasibility of laparoscopic surgery (LAP) for colorectal cancer has not yet been fully evaluated in elderly patients. The aim of this study was to compare the short term surgical outcomes of LAP and evaluate the safety and feasibility of LAP in colorectal cancer patients aged > 75 years. Methods: This retrospective study enrolled consecutive patients who underwent laparoscopic surgery for colorectal cancer between April 2013 and March 2014 at Yokohama City University Hospital and its related general hospitals. The patients were categorized into two groups: elderly patients (≧75 years of age: group A) and non-elderly patients ( < 75 years of age: group B). Surgical outcomes and postoperative complications were compared between the two groups. The severity of complications was evaluated using the Clavien–Dindo classification. Results: A total of 237 patients were evaluated in the present study. Eighty-four patients were classified into group A, and 153 into group B. Preoperative clinicopathological outcomes demonstrated no significant differences except for the ASA score. When comparing the surgical outcomes between group A and group B, the rate of conversion to open procedure (3.6 % vs 5.2 %, P = 0.751), median operation time (232 min vs 232 min, P = 0.318), median blood loss (20 ml vs 12 ml, P = 0.353). There was no significant difference in the surgical outcomes. Although the incidence of Japanese D3 dissection was significantly lower in Group A (56 % vs 69.3 %, P = 0.047), the incidences of postoperative surgical complications of grade ≧ Ⅱ were similar between two groups (15.5 % vs 11.8 %, p = 0.427). The length of postoperative hospital stay was also similar (10days vs 10days, p = 0.347). Conclusions: The present study suggested that laparoscopic surgery for colorectal cancer is safe and feasible, regardless of the age of the patient, especially for elderly patients who may be candidates for colorectal cancer surgery.

scholarly journals Comprehensive study of ovarian tumours in Kathmandu University Hospital

2018 ◽  
Vol 7 (4) ◽  
pp. 173-179
Author(s):  
Suman Raj Tamrakar ◽  
Ramesh Makaju ◽  
Abha Shrestha ◽  
Suresh Kayastha
Keyword(s):  
Cystic Teratoma ◽  
Malignant Tumour ◽  
University Hospital ◽  
P Value ◽  
Age Group ◽  
Primary Malignancy ◽  
Benign Ovarian Tumours ◽  
Significant Difference ◽  
Ovarian Tumours ◽  
The Mean

Background: Ovarian tumours account for 15% to 25% of all primary malignancy and the leading cause of death from gynaecolgical malignancies. There are limited publications related to ovarian tumours from Nepal. Ovarian related surgeries are the common surgeries in Kathmandu University Hospital. This study aims to provide basic information related to ovarian tumours from this geographical region of Nepal. Objectives: To review the nature of ovarian problems and certain socio-demographic information namely: caste, age, address and co-morbid condition of the patients presenting with ovarian problems. Methodology: This is a retrospective study of patients seeking surgical treatment of ovarian lesions in Kathmandu University Hospital from January 1, 2011 to June 30, 2018. This study was undertaken by reviewing the inpatient, outpatients and OT records in the Department of Obstetrics and Gynaecology and the records from Department of Pathology. All the files and computer records were reviewed and analyzed for nature of ovarian problems and certain demographic variables. Results: Out of the 860 cases, about 61% were non-neoplastic while benign ovarian tumours and malignant ovarian tumours were 35% and 3.7 % respectively. Almost one third of the cases were of Brahmin/Chhetri (37.3%) and 58.3% of the patients were from Kavre district. Mean age of the patients with ovarian problems was 34.89±11.15 years (range 12-72 years). There was no statistically significant difference between the mean age of patients with non-neoplastic ovarian lesions and neoplastic ovarian lesions (p value = 0.3371). There was statistically significant difference between the mean age of patients with benign ovarian tumours and malignant ovarian tumours (p value = 0.0001). And malignant ovarian tumours were significantly high among patients above 41 years in comparison to benign ovarian tumours of same age group (p value = 0.0008). Out of 32, ten malignant ovarian tumours occurred in relatively young age group. Of the 860 ovarian lesions, 438 and 422 ovarian lesions were removed through open technique and laparoscopic techniques respectively. Mature cystic teratoma (64.1%) was the commonest benign tumor and serous cyst adenocarcinoma (43.8%) was the commonest malignant tumour in this study. Conclusion: Ovarian tumours are one of the gynaecological diagnoses in Kathmandu University Hospital. If only ovarian neoplasms are considered, most of the ovarian tumours are benign and few are malignant. Minimal invasive surgeries are possible, except that for malignant ovarian tumours.

scholarly journals Deliberate Self-Harm: Clinical and Socio-Economic Characteristics of 368 Patients

1975 ◽  
Vol 127 (6) ◽  
pp. 564-574 ◽  
Author(s):  
H. Gethin Morgan ◽  
Christopher J. Burns-Cox ◽  
Helen Pocock ◽  
Susan Pottle
Keyword(s):  
Antisocial Behaviour ◽  
Alcohol Addiction ◽  
Royal Infirmary ◽  
Age Group ◽  
Deliberate Self Harm ◽  
Functional Psychosis ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
Previous Occasion

SummaryIn this study 368 patients were interviewed after they had attended the Bristol Royal Infirmary Accident and Emergency Department following a non-fatal act of deliberate self-harm. There were twice as many women (247) as men (121), and two thirds of the patients were in the 15–35 age group. Ninety-five per cent had taken a drug overdose, most commonly one or more of the tranquillizers, antidepressants, hypnotics or analgesics. Seventy-eight per cent had taken drugs prescribed by a doctor. Half the patients mentioned interpersonal conflict as a major precipitating factor in the episode. A psychiatric diagnosis was completed for all admitted patients, of whom 52 per cent were considered to be suffering from neurotic depression, 29 per cent from personality disorder, 12 per cent from functional psychosis and 10 per cent from alcohol addiction. Almost half had deliberately harmed themselves on a previous occasion. The series showed a greater than average incidence of unemployment, overcrowded living conditions, divorce and antisocial behaviour. The implications of these findings for the clinical management and prevention of non-fatal deliberate self-harm are discussed.

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